Geriatrics

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

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

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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Graphical abstract

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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