Geriatrics

20 pages, 480 KiB

Open AccessArticle

An Optimal Beneficiary Profile to Ensure Focused Interventions for Older Adults

by Dorina-Claudia Bălan, Rozeta Drăghici, Ioana Găiculescu, Alexandra Rusu, Andrada-Elena Stan and Polixenia Stan

Geriatrics 2025, 10(2), 59; https://doi.org/10.3390/geriatrics10020059 - 14 Apr 2025

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Abstract

Background: Aging is a lifelong process, and many chronic diseases and geriatric syndromes are influenced by lifestyle factors. For active aging and maintaining functional capacity facilitate health, there are essential aspects in geriatric care. Our objective was to create a specific profile focusing [...] Read more.

Background: Aging is a lifelong process, and many chronic diseases and geriatric syndromes are influenced by lifestyle factors. For active aging and maintaining functional capacity facilitate health, there are essential aspects in geriatric care. Our objective was to create a specific profile focusing on the characteristics of a possible optimal beneficiary of a newly developed program that is meant to increase the social inclusion and participation in social life of older adults. Methods: The profile was built based on a mixed design, a quantitative and qualitative analysis that identified the typology of an optimal beneficiary of a newly developed yoga program. The quantitative analysis (50 subjects from NIGG “Ana Aslan” Bucharest) identified the main predictors impacting subjects’ willingness to participate in a yoga program based on their pathologies at a mental and/or physical level. The main materials used for this were the Clinical Assessment Scales for the Elderly (CASE-SF) and the Quality-of-Life Assessment Questionnaire (WHOQOL-BREF). The qualitative analysis consisted of four focus groups (10 subjects from NIGG “Ana Aslan” and 7 subjects from GNSPY), aiming to provide the in-depth reasons for participating in a yoga program. Results: The results showed that a diagnosed physical impairment was correlated with an increased willingness to participate in yoga classes, while a mental pathology was associated with a decreased willingness to participate in such a program. Five main themes emerged from the qualitative analysis. Conclusions: The profile provides answers related to the specifics of the beneficiary based on their motivation, limits, and personality traits. Full article

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18 pages, 474 KiB

Open AccessArticle

Culturally Tailored Community Brain Health Education for Chinese Americans Aged 50 or Above: A Mixed-Methods Open Pilot Study

by Kaipeng Wang, Fei Sun, Peiyuan Zhang, Carson M. De Fries, Xiaoyouxiang Li, Jie Zhu and My Ngoc To

Geriatrics 2025, 10(2), 58; https://doi.org/10.3390/geriatrics10020058 - 14 Apr 2025

Viewed by 158

Abstract

Background: Chinese Americans, the largest Asian American subgroup in the U.S., face linguistic, cultural, and socio-economic barriers to dementia prevention. To promote brain health in this population, a culturally tailored community approach is essential. This study evaluates a culturally tailored community brain health [...] Read more.

Background: Chinese Americans, the largest Asian American subgroup in the U.S., face linguistic, cultural, and socio-economic barriers to dementia prevention. To promote brain health in this population, a culturally tailored community approach is essential. This study evaluates a culturally tailored community brain health education program to enhance brain health knowledge and motivate lifestyle changes to prevent the risk of dementia among Chinese Americans aged 50 or older. Methods: The program was developed and evaluated in four phases. First, we assessed participants’ interests in brain health topics, availability, and preferred delivery modes. Next, experts on the identified topics developed educational content and outcome assessments. The third phase focused on implementing a six-session program covering general knowledge about Alzheimer’s disease and related dementias, diet, sleep, physical exercise, health checks, and mindfulness. Finally, we evaluated the program’s feasibility and effectiveness using pre–post surveys, feedback questionnaires, and focus groups. Results: Seventy-seven participants registered for the program, and sixty-nine (90%) attended at least four sessions. The quantitative results, based on paired t-tests, showed significant increases in brain health knowledge, sleep quality, and behavioral motivation for lifestyle changes, and a decrease in depressive symptoms, with two-tailed p-values lower than 0.05. The qualitative results further revealed promising feasibility and acceptability, as well as the perceived benefits of the program. Conclusions: The findings highlight the feasibility, acceptability, and potential effectiveness of a culturally tailored community education approach for promoting brain health and lifestyle changes. Sustained community outreach and education efforts among Chinese Americans are needed. Full article

(This article belongs to the Section Healthy Aging)

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11 pages, 365 KiB

Open AccessArticle

The Influence of Frailty on Pharmacotherapy Adherence and Adverse Drug Reactions in Older Psychiatric Patients

by Tuan Anh Phan and Rob Kok

Geriatrics 2025, 10(2), 57; https://doi.org/10.3390/geriatrics10020057 - 7 Apr 2025

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Abstract

Aim/Objectives: To investigate whether frailty predicts adherence to psychotropic drug treatment or adverse drug reactions, within 6 months after treatment initiation. Methods: A prospective cohort study including 77 patients over the age of 65, treated in one large psychiatric institute in [...] Read more.

Aim/Objectives: To investigate whether frailty predicts adherence to psychotropic drug treatment or adverse drug reactions, within 6 months after treatment initiation. Methods: A prospective cohort study including 77 patients over the age of 65, treated in one large psychiatric institute in the Netherlands. Patients were assessed at baseline for their frailty status, using different operationalizations of the Fried frailty criteria. Data on duration of psychotropic drug treatment and number of reported adverse drug reactions were retrieved from electronic patient files. Regression analyses were adjusted for age, sex, patient setting, and polypharmacy as potential confounders. Results: Frail patients were not significantly more likely to discontinue psychotropic treatment than non-frail patients (OR = 1.4; 95% CI 0.6–3.7, p = 0.468). Time to treatment discontinuation was also not statistically different between both study groups (HR = 0.8; 95% CI 0.4–1.6, p = 0.498), and neither was the number of adverse drug reactions (OR = 1.6, 95% CI 0.6–4.1, p = 0.345). Conclusions: We could not demonstrate a statistically significant effect of frailty as predictor of discontinuing psychotropic treatment or adverse drug reactions, but a lack of power may also explain our results. A more comprehensive frailty assessment may be needed to predict treatment adherence or adverse drug reactions in psychiatric patients. Full article

(This article belongs to the Section Geriatric Psychiatry and Psychology)

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16 pages, 1377 KiB

Open AccessArticle

Impact of Rehabilitation Intervention for Cancer Patients with Spinal Bone Metastasis: Psychosocial and Clinical Outcomes

by Noémi Németh, Lavinia Davidescu, Liviu Lazăr, Florica Voiță-Mekeres, Mariana Racoviță and Călin Tudor Hozan

Geriatrics 2025, 10(2), 56; https://doi.org/10.3390/geriatrics10020056 - 7 Apr 2025

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Abstract

Background/Objectives: Cancer remains a significant global health issue in the 21st century, accounting for 16.8% of all deaths and 22.8% of noncommunicable disease (NCD) deaths globally. This study investigated the impact of a novel integrated rehabilitation intervention on clinical and psychosocial outcomes in [...] Read more.

Background/Objectives: Cancer remains a significant global health issue in the 21st century, accounting for 16.8% of all deaths and 22.8% of noncommunicable disease (NCD) deaths globally. This study investigated the impact of a novel integrated rehabilitation intervention on clinical and psychosocial outcomes in cancer patients with vertebral metastasis. Methods: The three-year study included newly diagnosed oncological patients or those undergoing treatment, aged 18 years or older, with vertebral metastasis and spinal pain. The intervention was tailored to each patient based on mental and functional reserves, risk of vertebral fractures, physical reserves, fatigue, and ongoing oncological therapy. Results: The control and experimental groups were compared in terms of baseline characteristics, physical activity, tumor characteristics, pain, sphincter disorders, complications, survival, functional scores, and coping mechanisms. The experimental group demonstrated significantly better outcomes, including longer mean survival time (3.5 vs. 2.8 years, p < 0.001), higher Barthel Total Score (60.7 vs. 40.8, p = 0.002), and lower prevalence of fractures (20.0% vs. 55.4%, p < 0.001), osteoporosis (17.0% vs. 37.0%, p = 0.001), anemia (22.2% vs. 57.4%, p < 0.001), and vomiting (6.1% vs. 54.5%, p < 0.001). The experimental group also exhibited a lower reliance on avoidant coping strategies (29.0 vs. 31.3, p < 0.001). Conclusions: The study provides robust evidence that a personalized rehabilitation intervention significantly improves survival, functional independence, and coping strategies in cancer patients with spinal bone metastasis. Full article

(This article belongs to the Section Geriatric Oncology)

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25 pages, 1432 KiB

Open AccessArticle

Development of an Adult Daycare Center Service Model for the Elderly Through Community Participation: An Action Research Approach

by Benjayamas Pilayon, Kanin Chueaduangpui, Juthaluck Saentho, Ruchakron Kongmant and Niruwan Turnbull

Geriatrics 2025, 10(2), 55; https://doi.org/10.3390/geriatrics10020055 - 4 Apr 2025

Viewed by 470

Abstract

Introduction: This study aimed to develop a service model for daycare centers for the elderly through community participation using participatory action research methods. The objectives were threefold: (1) to investigate the current situation of the elderly in the community and their needs [...] Read more.

Introduction: This study aimed to develop a service model for daycare centers for the elderly through community participation using participatory action research methods. The objectives were threefold: (1) to investigate the current situation of the elderly in the community and their needs for daycare center services, (2) to develop a daycare center for the elderly with active community involvement, and (3) to evaluate the effectiveness of the service delivery at the daycare center for the elderly. Methods: The study was conducted in Ban Kho Subdistrict, Phon Sawan District, Nakhon Phanom Province. Research participants included 210 elderly individuals surveyed to assess their situation, and 15 key informants, including elderly club leaders, subdistrict health promotion hospital staff, volunteers, subdistrict administrative organization officers, and village health volunteers, were specifically selected for in-depth insights. The research process was structured into three phases: Phase 1 focused on studying the situation of the elderly in the community and their service needs; Phase 2 was dedicated to developing the daycare center with community participation; and Phase 3 involved evaluating the service delivery of the daycare center. Results: The results indicated that the development process of the daycare center service model for the elderly, through community participation, involved four key mechanisms: elderly clubs, subdistrict health promotion hospitals, volunteer teachers or technicians, and village volunteers. Additionally, the supporting mechanisms included academic institutions, hospitals, temples, village heads, the Non-Formal Education Center, foundations, and the subdistrict administrative organization. The comprehensive service model encompassed five components: health, social, psychological, economic, and environmental aspects. Conclusions: The study successfully developed a daycare center service model for the elderly through community participation, which can be expanded and adapted to other semi-urban and semi-rural contexts. This model demonstrates the importance of community involvement in providing holistic care for the elderly, addressing various aspects of their well-being. Full article

(This article belongs to the Special Issue Healthy Ageing and Lifestyle Medicine: Current Knowledge and Future Direction)

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14 pages, 439 KiB

Open AccessArticle

Factors Associated with Mortality and Short-Term Patient Outcomes for Hip Fracture Repair in the Elderly Based on Preoperative Anticoagulation Status

by Vimal Desai, Priscilla H. Chan, Kathryn E. Royse, Ronald A. Navarro, Glenn R. Diekmann, Kent T. Yamaguchi, Elizabeth W. Paxton and Chunyuan Qiu

Geriatrics 2025, 10(2), 54; https://doi.org/10.3390/geriatrics10020054 - 4 Apr 2025

Viewed by 228

Abstract

Background: The one-year mortality risk for elderly patients undergoing proximal femur fracture repair surgery is three to four times higher compared to the general population. Other than time to surgery, risk factors for postoperative morbidity and mortality following surgery are poorly understood in [...] Read more.

Background: The one-year mortality risk for elderly patients undergoing proximal femur fracture repair surgery is three to four times higher compared to the general population. Other than time to surgery, risk factors for postoperative morbidity and mortality following surgery are poorly understood in the elderly. We sought to identify risk factors associated with morbidity and mortality in geriatric patients by anticoagulation status undergoing hip fracture repair. Methods: Patients aged ≥65 years undergoing surgery for hip fracture repair were included (2009–2019) from a US-based hip fracture registry. Factors associated with 90-day mortality were determined using multivariable logistic regression and stratified by antithrombotic agent medication use prior to surgery. Direct oral anticoagulation (DOAC) medications were the largest group, and all antithrombotic agents were included in the delineation. Results: A total of 35,463 patients were identified, and 87.1% (N = 30,902) were DOAC-naïve. Risk factors for 90-day mortality in DOAC-naïve patients were an American Society of Anesthesiologist’s (ASA) classification ≥3 (odds ratio [OR] = 2.56, 95% confidence interval [CI] = 2.24–2.93), preoperative myocardial infarction (OR = 1.87, 95% CI = 1.33–2.64), male gender (OR = 1.73, 95% CI = 1.59–1.88), congestive heart failure (CHF) (OR = 1.64, 95% CI = 1.50–1.80), psychoses (OR = 1.27, 95% CI = 1.15–1.42), renal failure (OR = 1.29, 95% CI = 1.19–1.40), smoking history (OR = 1.19, 95% CI = 1.09–1.29), chronic pulmonary disease (OR = 1.14, 95% CI = 1.05–1.25), increasing age (OR = 1.07, 95% CI = 1.06–1.07), and decreasing body mass index (BMI) (OR = 1.06, 95% CI = 1.05–1.08). Identified factors for mortality in the DOAC group also included ASA classification ≥3 (OR = 2.15, 95% CI = 1.44–3.20), male gender (OR = 1.68, 95% CI = 1.41–2.01), CHF (OR = 1.45, 95% CI = 1.22–1.73), chronic pulmonary disease (OR = 1.34, 95% CI = 1.12–1.61), decreasing BMI (OR = 1.04, 95% CI = 1.02–1.06), and increasing age (OR = 1.02, 95% CI = 1.01–1.03). Conclusions: Regardless of preoperative DOAC status, ASA classification, gender, CHF, chronic pulmonary disease, lower BMI, and higher age are associated with an increased risk of mortality. Some of these comorbidities can be utilized for risk stratification prior to surgery. Full article

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15 pages, 470 KiB

Open AccessReview

Implementation of Instrumental Assessment to Assess Dysphagia in Older Adults Receiving Long-Term Care Services: A Scoping Review

by Alvis Ki-Fung Kan, Elaine Kwong, Michael Siu-Wai Chan and Phoebe Tsz-Ching Shek

Geriatrics 2025, 10(2), 53; https://doi.org/10.3390/geriatrics10020053 - 3 Apr 2025

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Abstract

Background/Objectives: Dysphagia, a prevalent condition among older adults, poses significant health risks if not accurately assessed and managed. Instrumental assessments (IAs) like videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES) allow detailed examinations of swallowing physiology but are underutilized in [...] Read more.

Background/Objectives: Dysphagia, a prevalent condition among older adults, poses significant health risks if not accurately assessed and managed. Instrumental assessments (IAs) like videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES) allow detailed examinations of swallowing physiology but are underutilized in long-term care settings due to logistical challenges. This study aims to explore the current practice patterns, stakeholder perspectives, and barriers to and facilitators of IA implementation in these settings. Methods: A scoping review was conducted following the PRISMA-ScR guidelines, analyzing the literature from databases including CINAHL Complete, EMBASE, MEDLINE, and SCOPUS. A total of 1339 articles were identified. After the removal of 332 duplications, 1007 articles were screened, with four meeting the inclusion criteria for describing IA implementation or stakeholder perspectives in community-based long-term care settings for older adults. Results: This review identified significant underutilization of IA in long-term care settings, primarily due to logistical barriers and transportation issues. Stakeholders, particularly speech–language pathologists (SLPs), acknowledged the benefits of IA in improving dysphagia management but encountered challenges in accessing these assessments. Mobile FEES (mFEES) emerged as a promising solution, offering on-site assessments that could enhance the accuracy and timeliness of dysphagia care. Conclusions: While IA is crucial for effective dysphagia management in older adults, its implementation in long-term care settings is hindered by various barriers. mFEES presents a viable solution to improve IA accessibility and representativeness. Further research is warranted to develop context-specific implementation strategies and to explore the perspectives of all stakeholders involved in dysphagia care. Full article

(This article belongs to the Section Dysphagia)

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16 pages, 262 KiB

Open AccessArticle

The Role of Inflammatory Sarcopenia in Increasing Fall Risk in Older Adults: Exploring the Impact on Mobility-Impaired and Immunocompromised Patients

by Marc-Dan Blajovan, Simona-Alina Abu-Awwad, Mirela-Cleopatra Tomescu, Cristina Tudoran, Daniela Gurgus, Anca Dinu and Ahmed Abu-Awwad

Geriatrics 2025, 10(2), 52; https://doi.org/10.3390/geriatrics10020052 - 1 Apr 2025

Cited by 1 | Viewed by 231

Abstract

Background/Objectives: Inflammatory sarcopenia, characterized by muscle weakness exacerbated by chronic systemic inflammation, has emerged as a critical factor in fall risk among older adults. While previous studies have examined sarcopenia and inflammation independently, few have investigated their combined impact on mobility impairments [...] Read more.

Background/Objectives: Inflammatory sarcopenia, characterized by muscle weakness exacerbated by chronic systemic inflammation, has emerged as a critical factor in fall risk among older adults. While previous studies have examined sarcopenia and inflammation independently, few have investigated their combined impact on mobility impairments and fall susceptibility, particularly in immunocompromised individuals. This study aimed to assess the role of inflammatory sarcopenia in increasing fall risk by comparing functional performance, muscle strength, and inflammatory biomarkers across three groups: healthy older adults, individuals with non-inflammatory sarcopenia, and those with inflammatory sarcopenia. A secondary objective was to evaluate fall incidence in immunocompromised versus non-immunocompromised individuals. Methods: A prospective observational study was conducted on 250 adults aged ≥65 years, categorized based on inflammatory status and muscle health. Functional assessments included handgrip strength, the Timed Up and Go (TUG) test, and fall frequency analysis. Inflammatory status was determined by measuring C-reactive protein (CRP) and interleukin-6 (IL-6) levels. Multivariate regression models were used to identify predictors of fall risk. Results: Participants with inflammatory sarcopenia exhibited significantly higher CRP and IL-6 levels, greater muscle weakness, poorer mobility performance, and a fourfold increase in fall incidence compared to controls (p < 0.001). Immunocompromised individuals had nearly double the fall risk of their non-immunocompromised counterparts (p < 0.001). TUG test performance was the strongest fall predictor. Conclusions: Our findings highlight the importance of integrating fall prevention strategies that not only focus on muscle-strengthening programs but also include regular screening for inflammatory markers. Given the strong association between systemic inflammation, muscle weakness, and fall risk, identifying and managing chronic inflammation may play a crucial role in reducing mobility impairments and improving outcomes in older adults. Full article

16 pages, 1322 KiB

Open AccessArticle

Implications of Intra-Individual Variability in Motor Performance on Functional Mobility in Stroke Survivors

by Neha Lodha, Prakruti Patel, Evangelos A. Christou, Anjali Tiwari and Manfred Diehl

Geriatrics 2025, 10(2), 51; https://doi.org/10.3390/geriatrics10020051 - 24 Mar 2025

Viewed by 285

Abstract

Background: Motor impairments following stroke contribute to deficits in functional mobility. Traditionally, these impairments are quantified by mean-level motor performance. However, this mean-level approach neglects the well-established fact that motor performance becomes highly variable in aging and disease. Increased intra-individual variability (IIV) in [...] Read more.

Background: Motor impairments following stroke contribute to deficits in functional mobility. Traditionally, these impairments are quantified by mean-level motor performance. However, this mean-level approach neglects the well-established fact that motor performance becomes highly variable in aging and disease. Increased intra-individual variability (IIV) in behavior predicts functional decline in neurological disorders. Despite this, the impact of stroke on IIV in motor performance and its influence on functional mobility has not been investigated. This study aimed to (1) quantify the impact of stroke on IIV in motor performance, and (2) determine the contribution of IIV and mean motor performance to functional mobility. Methods: Twenty stroke survivors and 20 age-matched controls performed a goal-directed ankle movement task over 30 trials. We measured average accuracy (mean endpoint error) and IIV (within-person SD of endpoint error). Functional mobility was assessed with postural control (sway area during quiet standing) and braking response time in a driving simulator. Results: Stroke participants showed a higher mean (p = 0.04) and greater IIV (p = 0.016) in endpoint error than controls. Sway area did not differ between groups (p = 0.24), but stroke survivors had increased braking response time (p = 0.016). In stroke survivors, IIV significantly predicted sway area (R² = 0.33, p = 0.008) and braking response time (R² = 0.27, p = 0.02), and mean error did not account for any additional variance. Conclusions: Stroke reduces the trial-to-trial consistency of executing motor tasks with precision. IIV in motor performance predicts postural balance and braking response time and can potentially serve as an indicator of increased vulnerability and an important target for stroke rehabilitation. Full article

(This article belongs to the Collection Frailty in Older Adults)

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11 pages, 1168 KiB

Open AccessReview

Rhinitis in the Geriatric Population: Epidemiological and Cytological Aspects

by Matteo Gelardi, Rossana Giancaspro, Elisa Boni, Mario Di Gioacchino, Giulia Cintoli, Michele Cassano and Maria Teresa Ventura

Geriatrics 2025, 10(2), 50; https://doi.org/10.3390/geriatrics10020050 - 20 Mar 2025

Viewed by 442

Abstract

Allergic rhinitis (AR), traditionally considered as a childhood condition, is increasingly recognized among older adults, driven by rising life expectancy and environmental factors. Although allergic sensitization declines with age, AR prevalence in the elderly is underestimated, with 3–12% of geriatric patients affected. Diagnosis [...] Read more.

Allergic rhinitis (AR), traditionally considered as a childhood condition, is increasingly recognized among older adults, driven by rising life expectancy and environmental factors. Although allergic sensitization declines with age, AR prevalence in the elderly is underestimated, with 3–12% of geriatric patients affected. Diagnosis is challenging due to nonspecific symptoms and overlapping conditions, leading to underdiagnosis and inadequate treatment. AR significantly impacts the quality of life (QoL), often exacerbating respiratory comorbidities like asthma and COPD. Presbynasalis, encompassing age-related sinonasal changes, includes reduced allergic responses, increased chronic rhinosinusitis, altered nasal structure, and impaired mucociliary clearance. Non-allergic rhinitis, atrophic rhinitis, and overlapping rhinitis further complicate AR diagnosis in the elderly. Effective management involves personalized pharmacotherapy, allergen-specific immunotherapy (AIT), and addressing comorbidities and polypharmacy risks. Despite safety concerns, recent studies demonstrate AIT efficacy in elderly patients, reducing symptoms and medication use. Given AR’s impact on cognitive and respiratory health, accurate diagnosis and treatment can enhance QoL and mitigate health decline. Greater awareness and further research are essential to understand AR prevalence and improve outcomes for geriatric patients. Full article

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13 pages, 1559 KiB

Open AccessArticle

Evaluation of Convolutional Neural Network-Based Posture Identification Model of Older Adults: From Silhouette of Sagittal Photographs

by Naoki Sugiyama, Yoshihiro Kai, Hitoshi Koda, Toru Morihara and Noriyuki Kida

Geriatrics 2025, 10(2), 49; https://doi.org/10.3390/geriatrics10020049 - 19 Mar 2025

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Abstract

Background/Objectives: Posture is a significant indicator of health status in older adults. This study aimed to develop an automatic posture assessment tool based on sagittal photographs by validating recognition models using convolutional neural networks. Methods: A total of 9140 images were [...] Read more.

Background/Objectives: Posture is a significant indicator of health status in older adults. This study aimed to develop an automatic posture assessment tool based on sagittal photographs by validating recognition models using convolutional neural networks. Methods: A total of 9140 images were collected with data augmentation, and each image was labeled as either Ideal or Non-Ideal posture by physical therapists. The hidden and output layers of the models remained unchanged, while the loss function and optimizer were varied to construct four different model configurations: mean squared error and Adam (MSE & Adam), mean squared error and stochastic gradient descent (MSE & SGD), binary cross-entropy and Adam (BCE & Adam), and binary cross-entropy and stochastic gradient descent (BCE & SGD). Results: All four models demonstrated an improved accuracy in both the training and validation phases. However, the two BCE models exhibited divergence in validation loss, suggesting overfitting. Conversely, the two MSE models showed stability during learning. Therefore, we focused on the MSE models and evaluated their reliability using sensitivity, specificity, and Prevalence-Adjusted Bias-Adjusted Kappa (PABAK) based on the model’s output and correct label. Sensitivity and specificity were 85% and 84% for MSE & Adam and 67% and 77% for MSE & SGD, respectively. Moreover, PABAK values for agreement with the correct label were 0.69 and 0.43 for MSE & Adam and MSE & SGD, respectively. Conclusions: Our findings indicate that the MSE & Adam model, in particular, can serve as a useful tool for screening inspections. Full article

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17 pages, 793 KiB

Open AccessReview

Comprehensive Geriatric Health Assessment Core Competencies and Skills for Primary Care Nurses: A Scoping Review

by Ioanna Dimitriadou, Eloranta Sini, Jekaterina Šteinmiller, Maria Saridi, Anna Lundberg, Magdalena Häger, Ingibjorg Hjaltadottir, Sigrun S. Skuladottir, Nina Korsström, Susanna Mört, Hannele Tuori and Evangelos C. Fradelos

Geriatrics 2025, 10(2), 48; https://doi.org/10.3390/geriatrics10020048 - 18 Mar 2025

Viewed by 1286

Abstract

Objective: This scoping review aims to explore and synthesize the core competencies and skills required for primary care nurses conducting comprehensive geriatric assessments. Comprehensive geriatric assessments have become integral to providing holistic, patient-centered care for older adults with complex health needs, but the [...] Read more.

Objective: This scoping review aims to explore and synthesize the core competencies and skills required for primary care nurses conducting comprehensive geriatric assessments. Comprehensive geriatric assessments have become integral to providing holistic, patient-centered care for older adults with complex health needs, but the specific competencies required in primary care remain underresearched. Design: The review followed Arksey and O’Malley’s five-stage scoping review framework, incorporating studies from PubMed, CINAHL, EMBASE, and the Cochrane Library. A comprehensive search was conducted from May 2014 to May 2024, and a population–concept–context (PCC) framework was used to identify relevant studies. Results: Nineteen studies met the inclusion criteria, revealing six key competency domains for nurses involved in comprehensive geriatric assessments: Clinical Assessment and Diagnostic Competencies, Care Planning and Coordination, Professional and Interpersonal Competencies, Environmental and Systemic Competencies, Technical and Procedural Competencies, and Quality Improvement and Evidence-Based Practice. These competencies are essential for providing high-quality care to older adults and supporting integrated, multidisciplinary approaches to geriatric care. Conclusions: The identified competency domains provide a structured framework that can enhance primary care nurses’ ability to deliver more effective, individualized, and coordinated care to older adults. However, the standardization of these competencies remains crucial for ensuring consistency in practice. Full article

(This article belongs to the Section Geriatric Public Health)

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9 pages, 212 KiB

Open AccessArticle

Establishment of a Mandarin Chinese Version of the Oral Frailty Index-8 and Exploration of the Association Between Oral Frailty and Sarcopenia

by Chen-Cheng Yang, Hsiang-Tai Chen, Katsuya Iijima, Tomoki Tanaka, Chia-Yen Dai, Sang-Ju Yu and Hung-Yi Chuang

Geriatrics 2025, 10(2), 47; https://doi.org/10.3390/geriatrics10020047 - 17 Mar 2025

Viewed by 411

Abstract

Objective: The aim of our study was to introduce a Mandarin Chinese version of the oral frailty assessment and explore the relationship between oral frailty and sarcopenia. A total of 409 elders (171 male, 238 female) participated in surveys using the Mandarin Chinese [...] Read more.

Objective: The aim of our study was to introduce a Mandarin Chinese version of the oral frailty assessment and explore the relationship between oral frailty and sarcopenia. A total of 409 elders (171 male, 238 female) participated in surveys using the Mandarin Chinese version of the Oral Frailty Index-8 (OFI-8) in Kaohsiung, Taiwan. Method: The translation of the Mandarin Chinese version of OFI-8 adhered to the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) reporting guidelines. The eight-item questionnaire assessed tooth status, oral function, and other subjective measures. Additionally, sarcopenia was evaluated using the SARC-F questionnaire. Result: Among the participants, 195 participants were classified as non-oral frailty and 214 participants were oral frailty. Significant differences were observed in age, gender, body mass index (BMI), education level, and scores on the SARC-F questionnaire between the non-oral frailty and oral frailty populations. In logistic regression model, oral frailty showed a significant and positive association with the SARC-F score (adjusted odds ratio 2.130, 95% confidence interval 1.580–2.872, p-value < 0.001), even after adjusting for age, gender, BMI, and education level. Conclusion: This study has developed a valuable Mandarin Chinese version of the oral frailty screening questionnaire, the OFI-8. Oral frailty is significantly and positively associated with a higher risk of sarcopenia, particularly among the elderly, males, and those with lower education levels. This measure proves to be practical for assessing oral health status in the Chinese community, promoting oral frailty research within the Mandarin Chinese population, and addressing the challenges associated with defining oral frailty in future studies. Full article

(This article belongs to the Topic One Health Approach in Global Health and Clinical Medicine)

12 pages, 582 KiB

Open AccessArticle

Impact of an Interprofessional Collaboration Between Physicians and Pharmacists on Fall-Risk-Increasing Drugs in Older Patients with Trauma in the Emergency Department

by Benjamin J. Hellinger, André Gries, Thilo Bertsche and Yvonne Remane

Geriatrics 2025, 10(2), 46; https://doi.org/10.3390/geriatrics10020046 - 17 Mar 2025

Viewed by 306

Abstract

Background/Objectives: In older patients, falls constitute a significant public health concern and a major cause of hospital admission. Fall-risk-increasing drugs (FRIDs) represent a key risk factor for falls. Therefore, modifying these drugs represents an important strategy for preventing recurrent falls and further [...] Read more.

Background/Objectives: In older patients, falls constitute a significant public health concern and a major cause of hospital admission. Fall-risk-increasing drugs (FRIDs) represent a key risk factor for falls. Therefore, modifying these drugs represents an important strategy for preventing recurrent falls and further patient harm. The objective of this study was to evaluate a structured interprofessional collaboration between physicians and pharmacists on managing FRIDs in older patients who present to the emergency department (ED) after a fall. Methods: This study was performed in the ED of a tertiary care hospital. Patients who were >65 years old and presented to the ED after a fall were included. A routine care group was included between 1 March 2020 and 31 May 2020. A pharmaceutical care group was included between 1 September 2023 and 30 November 2023. In the pharmaceutical care group, a clinical pharmacist supported the physicians in identifying and managing FRIDs. Possible solutions for improving FRID prescription were discussed interprofessionally. The number of FRIDs at ED admission and discharge, as well as the number of FRID modifications, were evaluated. Results: A total of 107 patients were enrolled in each group. There were 85 patients in the routine care group and 89 patients in the pharmaceutical care group, with at least 1 FRID prescribed at ED admission (p = 0.483). At ED discharge, there were 85 patients in the routine care group and 68 patients in the pharmaceutical care group, with at least 1 FRID prescribed at (p = 0.010). There were seven FRID modifications in the routine care group compared to 125 FRID modifications in the pharmaceutical care group. Conclusions: In this study, the interprofessional collaboration between physicians and pharmacists led to a reduced number of FRIDs being prescribed and more FRID modifications in older patients at ED discharge. Further research is required to ascertain the feasibility of integrating this single intervention into a multifactorial fall prevention program. Full article

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25 pages, 2639 KiB

Open AccessArticle

by Yusuke Shizuka, Shin Murata, Akio Goda, Shun Sawai, Shoya Fujikawa, Ryosuke Yamamoto, Takayuki Maru, Kotaro Nakagawa and Hideki Nakano

Geriatrics 2025, 10(2), 45; https://doi.org/10.3390/geriatrics10020045 - 17 Mar 2025

Viewed by 354

Abstract

Background/Objectives: The steady increase in the global older adult population highlights critical challenges, including the development of preventive strategies to extend healthy life expectancy and support independence in activities of daily living. Although there is an aging-related reduction in manual dexterity, the difference [...] Read more.

Background/Objectives: The steady increase in the global older adult population highlights critical challenges, including the development of preventive strategies to extend healthy life expectancy and support independence in activities of daily living. Although there is an aging-related reduction in manual dexterity, the difference in bimanual coordination performance between young and older adults remains unclear. We aimed to elucidate the characteristics of bimanual coordination among young, young-old, and old-old adult participants. Methods: The participants performed in-phase (tapping the thumb and index finger together as fast as possible) and anti-phase (alternating movement between the left and right fingers) bimanual coordination tasks, and intergroup comparison of the task parameters was performed. The receiver operating characteristic curve was also conducted to calculate age cut-off points for bimanual coordination. Results: The number and frequency of taps significantly decreased sequentially in young, young-old, and old-old adults, whereas the average of tap interval significantly increased in this order (p < 0.05). There was no significant difference between the young-old and old-old groups in the average local maximum distance (p > 0.05). These findings indicate that bimanual coordination task performance varies depending on specific parameters. Furthermore, the age cut-off points for bimanual coordination were determined as 68.5 years for the right-hand number of taps (AUC = 0.73) in the anti-phase task, 73.5 years for the right-hand average of tapping interval (AUC = 0.72) in the anti-phase task, and 65.5 years for the left-hand frequency of taps (AUC = 0.72) of the anti-phase task. Conclusions: the number of taps, average of tapping interval, and frequency of taps are potential indicators of aging-related changes in bimanual coordination. Full article

(This article belongs to the Section Healthy Aging)

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13 pages, 298 KiB

Open AccessArticle

Prevalence of Poor Diet Quality and Associated Factors Among Older Adults from the Bagé Cohort Study of Ageing, Brazil (SIGa-Bagé)

by Tainã Dutra Valério, Rosália Garcia Neves, Elaine Thumé, Karla Pereira Machado and Elaine Tomasi

Geriatrics 2025, 10(2), 44; https://doi.org/10.3390/geriatrics10020044 - 17 Mar 2025

Viewed by 411

Abstract

(1) Background: The accelerated aging of the population raises concerns about the diet of older adults due to its relationship with health and quality of life. This study aimed to investigate the prevalence of poor diet quality and its association with sociodemographic factors [...] Read more.

(1) Background: The accelerated aging of the population raises concerns about the diet of older adults due to its relationship with health and quality of life. This study aimed to investigate the prevalence of poor diet quality and its association with sociodemographic factors and health status among older adults residing in the city of Bagé, located in southern Brazil; (2) Methods: A cross-sectional analysis was conducted using data from the 2016/2017 follow-up of the Bagé Aging Cohort Study (SIGa-Bagé). Diet quality was assessed using the Elderly Diet Quality Index. Descriptive analysis and Poisson regression with robust variance adjustment, based on hierarchical levels, were used to calculate crude and adjusted prevalence ratios with their respective 95% confidence intervals; (3) Results: The sample included 728 older adults (65.7% female; mean age: 77.2 years). Poor diet quality was observed in 41.5% of participants. After adjustment, male sex, black or brown skin color, absence of multimorbidity, and presence of depressive symptoms were significantly associated with poor diet quality; (4) Conclusions: The findings highlight the most vulnerable groups and the need for investments in strategies to promote mental health and healthy eating habits among the older adults, particularly among men and racial minority groups. Full article

(This article belongs to the Special Issue Nutrition Care and Support in Geriatrics)

21 pages, 1416 KiB

Open AccessReview

Anemia in Elderly Patients: Contribution of Renal Aging and Chronic Kidney Disease

by Simone Santos, Irina Lousa, Márcia Carvalho, Maria Sameiro-Faria, Alice Santos-Silva and Luís Belo

Geriatrics 2025, 10(2), 43; https://doi.org/10.3390/geriatrics10020043 - 14 Mar 2025

Viewed by 960

Abstract

Renal aging is a physiological process characterized by structural and functional changes in the kidneys. The presence of disorders or pathologies can exacerbate these age-related changes, potentially leading to organ dysfunction. Chronic kidney disease (CKD), a significant global public health issue, is particularly [...] Read more.

Renal aging is a physiological process characterized by structural and functional changes in the kidneys. The presence of disorders or pathologies can exacerbate these age-related changes, potentially leading to organ dysfunction. Chronic kidney disease (CKD), a significant global public health issue, is particularly prevalent in the elderly and is often associated with the age-related decline in kidney function. Anemia is one of the most frequent complications of CKD and is also highly prevalent in the elderly. Mild anemia, often multifactorial, is the most common presentation. Understanding the mechanisms driving anemia in this population is crucial to ensure appropriate treatment. The primary etiologies include nutritional deficiency, anemia of unknown cause, and anemia of chronic diseases, including CKD. This review provides an in-depth exploration of the complex pathophysiological mechanisms underlying anemia in elderly patients with CKD. Full article

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14 pages, 1469 KiB

Open AccessArticle

Effect of Protein Supplementation on Orthostatic Hypotension in Older Adult Patients with Heart Failure

by Gohar Azhar, Amanda K. Pangle, Karen Coker, Shakshi Sharma and Jeanne Y. Wei

Geriatrics 2025, 10(2), 42; https://doi.org/10.3390/geriatrics10020042 - 13 Mar 2025

Viewed by 525

Abstract

Purpose: Heart failure (HF) impairs physical performance and increases the incidence of orthostatic hypotension (OH). Individuals with OH have a higher risk of falls, which are a major source of morbidity and mortality in older adults. Dietary protein supplementation can improve physical performance [...] Read more.

Purpose: Heart failure (HF) impairs physical performance and increases the incidence of orthostatic hypotension (OH). Individuals with OH have a higher risk of falls, which are a major source of morbidity and mortality in older adults. Dietary protein supplementation can improve physical performance in healthy older adult individuals; however, its effect on OH in older adult patients with HF is unknown. Methods: Twenty-one older adult patients with mild-to-moderate HF were randomized to placebo or protein supplementation. Dietary protein was supplemented with whey protein so the total protein intake for each participant was 1.2 g/kg bodyweight/day, plus 1 g/day of the amino acid l-carnitine for 16 weeks. Susceptibility to OH was assessed using a head-up tilt test, blood markers, and a functional test (6 min walk) at baseline and 16 weeks. Results: There were no differences in tilt test responses or 6 min walk test (6MWT) distances. The protein-supplement group had a significant increase in 6MWT pulse pressures post-walk after 16 weeks of treatment as compared to placebo. However, the tachycardia observed at baseline after 6MWT in the protein group was not seen at the end of the study. There was also a trend towards lower levels of brain naturetic peptide (proBNP) in the protein group vs. placebo at 16 weeks. Conclusions: The improved pulse-pressure response to exertion and positive trends in proBNP in this pilot study suggest that dietary supplementation may improve cardiovascular function and general health in individuals with HF and that larger future studies are justifiable. Full article

(This article belongs to the Section Geriatric Nutrition)

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10 pages, 1251 KiB

Open AccessCase Report

Case Report: Weakness and Recurrent Falls in an Older Patient

by Mercedes Galloway, Nannette Hoffman, Christopher Lawrence Bray, Ahmed Ebrahim, Brittany Puebla and David Ritchie

Geriatrics 2025, 10(2), 41; https://doi.org/10.3390/geriatrics10020041 - 13 Mar 2025

Viewed by 504

Abstract

Background/Objectives: Lower-extremity weakness in older adults is often overlooked, yet it can have reversible or medical causes that contribute to increased falls. Common factors include vision disturbances, impaired balance due to otolith dysfunction, arthritis-related immobility, and lower-extremity neuropathy. This case presents a unique [...] Read more.

Background/Objectives: Lower-extremity weakness in older adults is often overlooked, yet it can have reversible or medical causes that contribute to increased falls. Common factors include vision disturbances, impaired balance due to otolith dysfunction, arthritis-related immobility, and lower-extremity neuropathy. This case presents a unique diagnostic challenge in evaluating bilateral lower-extremity weakness and recurrent falls in an older adult, highlighting the complexity of diagnosing conditions with overlapping symptoms. Case Presentation: The patient, a woman with a history of a neuroendocrine tumor, experienced progressive weakness in her lower extremities, along with oculomotor and facial muscle involvement, despite extensive testing. Key clinical findings included elevated protein levels in cerebrospinal fluid, suggesting the possibility of an infectious or autoimmune process. A thorough investigation was conducted, including testing for both common and rare conditions such as Guillain–Barré syndrome, Lyme disease, and tuberculosis. Results: Despite comprehensive diagnostic efforts, no clear etiology was identified. The patient’s condition was eventually considered to be related to carcinomatosis meningoencephalitis, a rare complication from a previous cancer diagnosis. Given the progressive nature of her symptoms and lack of treatment options, she was transitioned to palliative care. Conclusions: This case highlights the importance of a comprehensive differential diagnosis in older patients with unexplained weakness and falls. Rare neurological conditions should not be overlooked, even when more common causes are suspected. Clinicians should remain aware that falls and weakness in older adults may stem from various pathologies, some of which are reversible if identified early, and rare causes must always be considered when standard treatments fail. Full article

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13 pages, 401 KiB

Open AccessArticle

Assessing Frailty in the Older: The Role of Bite Force as an Independent Indicator

by Luciano Maia Alves Ferreira, José Brito, Josie Resende Torres da Silva, Marcelo Lourenço da Silva, Maia e Maia Fischel e Andrade, André Júdice, José João Mendes, Vanessa Machado, João Thiago Botelho and Simone Cecílio Hallak Regalo

Geriatrics 2025, 10(2), 40; https://doi.org/10.3390/geriatrics10020040 - 13 Mar 2025

Viewed by 452

Abstract

Background: This study investigates the relationship between bite force and grip strength as indicators of frailty in older adults. Frailty syndrome, characterized by increased vulnerability to adverse health outcomes, poses significant challenges in geriatric care. Objectives: This research builds on previous findings linking [...] Read more.

Background: This study investigates the relationship between bite force and grip strength as indicators of frailty in older adults. Frailty syndrome, characterized by increased vulnerability to adverse health outcomes, poses significant challenges in geriatric care. Objectives: This research builds on previous findings linking oral health to frailty risk, emphasizing the need for targeted interventions. Methods: A total of 59 older participants, aged 60 years and older, were enrolled in this cross-sectional study conducted at the Egas Moniz School of Health and Science. The participants underwent assessments of bite force using an electric dynamometer and grip strength using a specialized device. Body composition was also measured using bioelectrical impedance analysis (BIA). Results: Statistical analysis revealed a significant positive correlation between bite force and grip strength, even after adjusting for age and body mass index (BMI). Age was significantly correlated with bite and grip force (p < 0.05), while BMI was correlated only with handgrip force but not with bite force (coefficient = −0.047, p = 0.737). Notably, bite force was found to be independent of BMI, unlike grip strength, which is generally influenced by body composition. This independence highlights the potential of bite force as a reliable and distinct marker for frailty that is not confounded by BMI-related factors. This study highlights the importance of oral health in maintaining overall well-being in older adults. Reduced bite force may indicate an increased risk of frailty, which can lead to malnutrition and decreased quality of life. These findings suggest that integrating bite force measurements into clinical assessments may improve the assessment of frailty and inform interventions aimed at improving health outcomes in the older population. Conclusions: This research provides new insights into the association between bite force and grip strength, emphasizing the unique value of bite force as an independent marker of frailty. It advocates for further studies to explore its role in geriatric care strategies. Full article

(This article belongs to the Section Healthy Aging)

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11 pages, 285 KiB

Open AccessArticle

Cognitive Performance Among Older Adults with Subjective Cognitive Decline

by Ramón López-Higes, Susana Rubio-Valdehita, David López-Sanz, Sara M. Fernandes, Pedro F. S. Rodrigues and María Luisa Delgado-Losada

Geriatrics 2025, 10(2), 39; https://doi.org/10.3390/geriatrics10020039 - 13 Mar 2025

Viewed by 572

Abstract

Objectives: The main objective of this cross-sectional study was to investigate if there are significant differences in cognition between a group of older adults with subjective cognitive decline (SCD) and cognitively intact controls. Methods: An initial sample of 132 older people underwent an [...] Read more.

Objectives: The main objective of this cross-sectional study was to investigate if there are significant differences in cognition between a group of older adults with subjective cognitive decline (SCD) and cognitively intact controls. Methods: An initial sample of 132 older people underwent an extensive neuropsychological evaluation (memory, executive functions, and language) and were classified according to diagnostic criteria. Two groups of 33 subjects each, controls and SCD, were formed using an a priori case-matching procedures in different variables: age, biological sex, years of education, cognitive reserve, and Mini-Mental State Exam. Results: The mean age and standard deviation in the control group were equal to 70.39 ± 4.31 years, while in the SCD group, they were 70.30 ± 4.33 years. The number of males (n = 9) and females (n = 24) was equal in both groups; the means of years of education were also quite similar. SCD participants have a significantly lower mood than the controls. Significant differences between groups were obtained in delayed recall, inhibitory control, and comprehension of sentences not fitted to canonical word order in Spanish. A logistic regression revealed that a lower score on the Stroop’s interference condition is associated with a higher likelihood of having SCD. Finally, ROC analysis provided a model that performs better than random chance, and a cut-off score in Stroop’s interference condition equal to 49 was suggested for clinically differentiating the two groups. Conclusions: This study highlights that, compared to a matched control group, participants with SCD showed subtle but significant neuropsychological differences. Full article

(This article belongs to the Special Issue Subjective Cognitive Decline (SCD): Nature, Trajectories, and Preventive Intervention Strategies)

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10 pages, 467 KiB

Open AccessArticle

Validation of the Italian Version of the Rapid Geriatric Assessment in Community-Dwelling Older Adults

by Carlotta Tacchino, Luca Carmisciano, Elena Page, Silvia Ottaviani, Luca Tagliafico, Alda Boccini, Alessio Signori, Chiara Giannotti, Alessio Nencioni and Fiammetta Monacelli

Geriatrics 2025, 10(2), 38; https://doi.org/10.3390/geriatrics10020038 - 8 Mar 2025

Viewed by 688

Abstract

Background/Objectives: The Rapid Geriatric Assessment (RGA) is a tool designed to screen for frailty, sarcopenia, anorexia related to aging, and cognitive impairment. This study aimed to translate and validate the RGA for use among Italian community-dwelling older adults. Methods: This cross-cultural [...] Read more.

Background/Objectives: The Rapid Geriatric Assessment (RGA) is a tool designed to screen for frailty, sarcopenia, anorexia related to aging, and cognitive impairment. This study aimed to translate and validate the RGA for use among Italian community-dwelling older adults. Methods: This cross-cultural study involved 100 community-dwelling older adults randomly recruited through convenience sampling from general practitioner offices in Genoa (Italy), between January and June 2019. The RGA includes the Simple FRAIL Questionnaire Screening Tool, SARC-F Screening for Sarcopenia, Simplified Nutritional Assessment Questionnaire (SNAQ), and Rapid Cognitive Screening (RCS). These were validated against gold-standard tools: the Abbreviated Comprehensive Geriatric Assessment (aCGA) and Multidimensional Prognostic Index (MPI). Additional assessments included the Timed Up and Go (TUG) and Handgrip test. The validation process included forward–backward translation, synthesis, and consensus by independent reviewers. Psychometric properties, internal consistency (Cronbach alpha), and validity correlations were analyzed. Results: The RGA demonstrated satisfactory psychometric properties, with internal consistency (Cronbach alpha = 0.59) and significant validity correlations (RGA and aCGA, rho = 0.34, p = 0.001; RGA and MPI, rho = 0.49, p < 0.001). Discriminant validity was confirmed by significant correlations between specific subitems and reference measures: FRAIL with TUG (p < 0.05), SARC-F with Handgrip strength (p = 0.013), SNAQ with BMI, and RCS with MMSE (p < 0.001). Conclusions: The Italian version of the RGA is a reliable screening tool for geriatric syndromes in community-dwelling older adults. While it does not replace a CGA, the RGA may identify individuals who may benefit from further evaluation using a complete CGA. Full article

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18 pages, 3781 KiB

Open AccessArticle

Aging Gut-Brain Interactions: Pro-Inflammatory Gut Bacteria Are Elevated in Fecal Samples from Individuals Living with Alzheimer’s Dementia

by Alison I. C. Donaldson, Claire L. Fyfe, Jennifer C. Martin, Ellen E. Smith, Graham W. Horgan, Phyo K. Myint, Alexandra M. Johnstone and Karen P. Scott

Geriatrics 2025, 10(2), 37; https://doi.org/10.3390/geriatrics10020037 - 7 Mar 2025

Viewed by 870

Abstract

Background/Objectives: Alzheimer’s disease (AD) is the most common form of dementia, characterized by an irreversible decline in cognitive function. The pathogenesis of several neurodegenerative disorders has been linked to changes in the gut microbiota, transmitted through the gut-brain axis. Methods: We [...] Read more.

Background/Objectives: Alzheimer’s disease (AD) is the most common form of dementia, characterized by an irreversible decline in cognitive function. The pathogenesis of several neurodegenerative disorders has been linked to changes in the gut microbiota, transmitted through the gut-brain axis. Methods: We set out to establish by case-control study methodology whether there were any differences in the composition and/or function of the gut microbiota between older resident adults in care homes with or without an AD diagnosis via analysis of the microbial composition from fecal samples. Results: The microbial composition, determined by 16S rRNA gene profiling, indicated that AD sufferers had significantly increased proportions of Escherichia/Shigella and Clostridium_sensu_stricto_1, and significantly decreased proportions of Bacteroides, Faecalibacterium, Blautia, and Roseburia species. The increase in potentially pro-inflammatory bacteria was consistent with slightly higher concentrations of calprotectin, a biomarker of gut inflammation. Fecal concentrations of most microbial metabolites measured were similar across groups, although participants with AD had significantly increased proportions of the branched-chain fatty acid, iso-butyrate, and lower overall concentrations of total short chain fatty acids. Conclusions: Participants with Alzheimer’s disease have several key differences within their gut microbiota profile, in contrast to care home residents without Alzheimer’s disease. The altered microbiome included both compositional and functional changes linked to poorer health and gut inflammation. Full article

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11 pages, 588 KiB

Open AccessArticle

Health Professional Support for Friends and Family Members of Older People Discharged from Hospital After a Fracture: A Survey Study

by Toby O. Smith, Susanne Arnold and Mark Baxter

Geriatrics 2025, 10(2), 36; https://doi.org/10.3390/geriatrics10020036 - 7 Mar 2025

Viewed by 567

Abstract

Background/Objectives: Friends and family members of people who are discharged from hospital after a fracture often take on caring roles, since these patients have reduced independence during recovery. Previous literature suggests that these individuals are rarely supported in their adoption of these roles. [...] Read more.

Background/Objectives: Friends and family members of people who are discharged from hospital after a fracture often take on caring roles, since these patients have reduced independence during recovery. Previous literature suggests that these individuals are rarely supported in their adoption of these roles. No studies have previously explored the use of carer training interventions to support friends/family members by health professionals in this setting. This survey study aimed to address this. Methods: A cross-sectional online survey was conducted among health professionals who treat people in hospital following fractures. Respondents were asked about the use of care training for friends/family members of people discharged from hospital after fracture, and whether a clinical trial would be useful to test such carer training interventions. Results: A total of 114 health professionals accessed the survey. Fifty respondents (44%) reported that carer training was not offered in their practice. When it was offered, respondents reported this was not consistently provided. Less than 12% of respondents reported offering carer training to most of their patients following a fracture. What was offered in these instances was largely based on education provision (69%), practical skills in exercise prescription (55%) and manual handling (51%). Ninety-eight percent of respondents reported that a clinical trial would be, or would potentially be, valuable to aid a change in practice to include carer training in routine clinical care. Conclusions: Carer training programmes are not routinely provided in clinical practice for people following a fracture. The results indicate that health professionals see a potential value in these programmes, but further research is recommended to provide an evidence base for these interventions. Full article

(This article belongs to the Section Geriatric Rehabilitation)

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12 pages, 1135 KiB

Open AccessArticle

Involving Family Caregivers in Developing an Intervention for Assessing Risk of Dental Pain in Individuals Living with Dementia

by Carrie Stewart, Nicole Thomas, Robert Witton, Ewen McColl and Patricia Schofield

Geriatrics 2025, 10(2), 35; https://doi.org/10.3390/geriatrics10020035 - 5 Mar 2025

Viewed by 542

Abstract

Background: Experiences of dental pain among older people living with dementia, particularly those residing in care homes, have been identified as an under-researched area. There is an urgent need for initiatives, co-developed with experts according to their experience, to address key challenges [...] Read more.

Background: Experiences of dental pain among older people living with dementia, particularly those residing in care homes, have been identified as an under-researched area. There is an urgent need for initiatives, co-developed with experts according to their experience, to address key challenges for oral health improvement among older people living with dementia. This paper reports the findings from a participatory activity which informed the development of an intervention. Methods: Informed by discussions with a prominent PPI representative in the field of caring for persons with dementia and a prior multi-disciplinary stakeholder event, a discussion involving ten caregivers of individuals with dementia was conducted. Caregivers were invited from different regions of the UK, with seven joining an online group discussion and three engaging in one-on-one conversations. Transcripts of the conversations based on three topics of discussion (dental experiences, dental challenges and thoughts on a dental pain risk assessment tool) were analysed using thematic analysis to inform a proposed co-developed model of an intervention which can improve dental care for those living with dementia. Results: Areas which informed the next phase of discussions and intervention development were access to dental services, lack of alignment between dental care services and health and social care, and low support for carers in how to carry out mouthcare, specific to the type of dementia lived with. Carers felt that preventing, monitoring and managing dental pain should form part of the care package and that it should not be the responsibility of the carer to conduct a dental pain risk assessment. The key recommendation made by carers was the need for a multi-component intervention. This should be flexible according to individual needs and provide education and support to carers to assist with mouthcare, with responsibility for assessing dental pain risk sitting firmly with a nominated professional. Conclusions: Our findings from this discussion group with carers of persons living with dementia identified which areas of mouthcare responsibility should be part of the unpaid caring role and which should form part of a healthcare professional role. This shaped a final stakeholder event and facilitated the development of a grant proposal (which includes one of the caregivers as a co-investigator) to test a co-developed intervention for the prevention of dental pain in persons living with dementia. Full article

(This article belongs to the Special Issue Advancing Oral Health Care for the Ageing Population: Exploring Gerodontology and Geriatric Dentistry)

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14 pages, 1447 KiB

Open AccessArticle

Mitigating Diarrhoea-Related Inflammation in Frail Older Adults with Postbiotic-Enhanced Oral Rehydration Solution: Insights from a Randomised, Double-Blind, Placebo-Controlled Study

by Julian Andrés Mateus Rodríguez, Patricia Rodríguez Sanz, Edgar Kostandyan, Rubén Palacios Sanchez, María Luz Pino Roque, Patricia Chaves Vasquez and Pedro Roy Millán

Geriatrics 2025, 10(2), 34; https://doi.org/10.3390/geriatrics10020034 - 1 Mar 2025

Viewed by 753

Abstract

Background/Objectives: Diarrhoea in older adults can lead to dehydration and malnutrition, impaired gut barrier function, and reduced quality of life. Unresolved inflammation during diarrhoea episodes contributes to relapse and complications. This randomised study evaluated the effects of a novel oral rehydration solution (ORS) [...] Read more.

Background/Objectives: Diarrhoea in older adults can lead to dehydration and malnutrition, impaired gut barrier function, and reduced quality of life. Unresolved inflammation during diarrhoea episodes contributes to relapse and complications. This randomised study evaluated the effects of a novel oral rehydration solution (ORS) with the postbiotic ABB C22^®, known for its anti-inflammatory properties, on diarrhoea-associated inflammation in an elderly population. Methods: A randomised, double-blind, placebo-controlled, parallel-group trial was conducted at two hospital centres in Barcelona, Spain. Forty-seven participants aged ≥65 years with diarrhoea (n = 47) were randomised (1:1) to receive either ABB C22^®-enriched ORS or placebo ORS for up to 14 days. Randomization was stratified by centre using a computer-generated sequence. Participants, caregivers, and outcome assessors were blinded. Primary endpoints were changes in faecal inflammatory biomarkers (calprotectin and lactoferrin) and blood immunoglobulin A. Secondary endpoints included changes in stool consistency (Bristol Stool Scale) and treatment tolerability. Results: Of the 47 participants, 42 completed the trial (21 per group). At day 14, the ORS + ABB C22^® group showed greater reductions in faecal calprotectin and lactoferrin levels compared to the placebo group. Lactoferrin-positive cases were halved by day 3 in the intervention group. Stool consistency improved in both groups. No adverse events were reported in either group. Conclusions: ABB C22^®-enriched ORS exhibited superior anti-inflammatory effects compared to standard ORS while achieving similar improvements in stool consistency. These findings suggest that postbiotic-enriched formulations represent a promising approach to better address the management of diarrhoea which is often accompanied by gut inflammation. The study protocol was registered in ClinicalTrials.gov (NCT06738420; date: 16 December 2024). Full article

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11 pages, 697 KiB

Open AccessArticle

Impact of SARS-CoV-2 Infection on Erythropoietin Resistance Index in Hemodialysis Patients

by Guido Gembillo, Luca Soraci, Luigi Peritore, Rossella Siligato, Vincenzo Labbozzetta, Alfio Edoardo Giuffrida, Felicia Cuzzola, Claudia Spinella, Adolfo Romeo, Vincenzo Calabrese, Alberto Montesanto, Andrea Corsonello and Domenico Santoro

Geriatrics 2025, 10(2), 33; https://doi.org/10.3390/geriatrics10020033 - 24 Feb 2025

Viewed by 576

Abstract

Background/Objectives: Hemodialysis (HD) patients with advanced chronic kidney disease (CKD) are highly vulnerable to complications from SARS-CoV-2 infection. Anemia management in this population is complex, particularly due to erythropoietin resistance, which may be exacerbated by COVID-19-related inflammation. To this aim, in this small-scale [...] Read more.

Background/Objectives: Hemodialysis (HD) patients with advanced chronic kidney disease (CKD) are highly vulnerable to complications from SARS-CoV-2 infection. Anemia management in this population is complex, particularly due to erythropoietin resistance, which may be exacerbated by COVID-19-related inflammation. To this aim, in this small-scale retrospective study, we investigated trends in the erythropoietin resistance index (ERI) over time in patients with and without SARS-CoV-2 infection. Methods: This single-center retrospective study included 25 HD patients, divided into two groups: 15 with a history of SARS-CoV-2 infection (CoV2 group) and 10 without (nonCoV2 group). The ERI was assessed over four visits, with 70–100-day intervals between them. Linear mixed models were used to evaluate factors associated with ERI changes. Results: Patients in the CoV2 group exhibited significantly higher ERI increases between T1 (baseline) and T2 (post-infection) compared to the nonCoV2 group (median ΔERI: +4.65 vs. −0.27, p < 0.001). During the T2–T4 recovery period, CoV2 patients demonstrated a delayed but substantial decline in the ERI, converging to baseline levels by T4. Male sex and hemoglobin levels were negatively associated with the ERI. Conclusions: SARS-CoV-2 infection induces transient but significant erythropoietin resistance in HD patients, likely due to inflammation and disrupted erythropoiesis. Tailored anemia management strategies, including the potential use of hypoxia-inducible factor stabilizers, are warranted. Larger, multicenter studies are needed to validate these findings and improve treatment protocols. Full article

(This article belongs to the Special Issue Chronic Kidney Disease and Pharmacoepidemiology in Older Individuals: Challenges, Insights, and Therapeutic Advances)

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22 pages, 1150 KiB

Open AccessReview

Choline Alphoscerate: A Therapeutic Option for the Management of Subthreshold Depression in the Older Population

by Nicolò Granata, Marco Vercesi, Annamaria Bonfanti, Claudio Mencacci, Ilaria Coco, Mario Mangrella, Roberto Piazza and Giancarlo Cerveri

Geriatrics 2025, 10(2), 32; https://doi.org/10.3390/geriatrics10020032 - 20 Feb 2025

Viewed by 939

Abstract

Background and Objectives: Subthreshold depression (StD) presents with depressive symptoms similar to major depressive disorder (MDD) but of lower intensity. Despite its milder form, StD is significantly prevalent in the older population, affecting up to 12.9%. StD is associated with adverse outcomes, such [...] Read more.

Background and Objectives: Subthreshold depression (StD) presents with depressive symptoms similar to major depressive disorder (MDD) but of lower intensity. Despite its milder form, StD is significantly prevalent in the older population, affecting up to 12.9%. StD is associated with adverse outcomes, such as an increased risk of MDD and mild cognitive impairment (MCI). Treating StD in older adults is challenging due to the limited efficacy and side effects of traditional antidepressants. As a result, clinicians often adopt a “watchful waiting” strategy, which increases the risk of StD progressing into MDD or MCI. Choline alphoscerate (α-GPC), a cholinergic drug, is indicated in the treatment of pseudodepression in the elderly, a condition that corresponds to the actual definition of StD. This review highlights the role of α-GPC in the treatment of StD in older subjects. Methods: A comprehensive review of preclinical and clinical studies was conducted, focusing on the efficacy of α-GPC in improving cognitive and behavioral functions in mental conditions and in modulating neurotransmitter systems involved in depression, such as dopamine and serotonin. Results: Evidence points to the therapeutic benefits of using α-GPC in StD as it acts on cholinergic dysfunction and cognitive impairment. Additionally, it may improve mood regulation and motivation, key factors in StD and in depressive disorders. These findings suggest that α-GPC may reduce the risk of progression from StD to MDD or MCI. Conclusions: α-GPC represents an effective and safe therapeutic option for the treatment of StD in the older population, improving clinical outcomes and enhancing the quality of life in this high-risk group. Full article

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Geriatrics, Volume 10, Issue 2 (April 2025) – 28 articles

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