Search Results (256)

Metabolic syndrome (MetS)—characterized by dyslipidemia, hypertension, hyperglycemia, and abdominal obesity—is a common, modifiable condition that contributes to functional decline and premature mortality in older adults. The accumulation of MetS components increases the risk of cardiovascular, cerebrovascular, and renal diseases, as well as cognitive impairment and polypharmacy in aging populations. A narrative review was conducted focusing on the management of MetS in adults aged 65 and older. Sources were identified through targeted searches of PubMed and relevant guidelines, with an emphasis on literature discussing geriatric-specific considerations. The review was structured using the Institute for Healthcare Improvement’s (IHI) 4Ms Framework: What Matters, Medication, Mentation, and Mobility. Findings highlight that current MetS guidelines are often extrapolated from younger populations and insufficiently account for geriatric-specific factors such as altered pharmacokinetics, multimorbidity, and social determinants of health. The 4Ms Framework provides a comprehensive lens to adapt these guidelines, supporting individualized treatment plans that consider patient goals, cognitive status, and functional capacity. Incorporating social services and aligning interventions with socioeconomic realities can further bridge disparities in care. The 4Ms framework can help healthcare providers communicate effectively with patients, ensuring treatment plans align with evidence-based practices and the patient’s individual priorities. Treatment of MetS must be tailored to individual patient needs based on presented risk factors, severity of risks, and social determinants of health. Adjusting treatment plans in accordance with the socioeconomic status (SES) of patients will allow for systematic improvement of outcomes. Full article

Background/Objectives: Frailty syndrome favors the deterioration of health; therefore, identifying associated factors is essential for establishing preventive measures. Oral candidiasis is a factor that may be related to the onset of frailty. Our objective was to evaluate the association between frailty and oral candidiasis in institutionalized participants. Methods: We conducted a cross-sectional study involving 589 institutionalized individuals aged 65 years or older. A diagnosis of candidiasis was established clinically and with a microbiological study (potassium hydroxide (KOH) test and culture for candidiasis). Assessments of salivary flow and the use of dental prostheses were also performed. Frailty was classified according to Fried’s phenotype criteria. Results: Frailty and prefrailty were found in 28.9% and 66.7% of the participants, respectively. Oral candidiasis was diagnosed in 39.05% of cases and was more frequent among individuals with dental prostheses (49.13%) and hyposalivation (47.54%). Conclusions: Our findings suggest that frailty in institutionalized older adults is associated with the presence of subprosthetic stomatitis associated with candidiasis and hyposalivation, indicating the need for integrated oral health strategies in geriatric care. Full article

Background and Objectives: Transcatheter Aortic Valve Replacement (TAVR) has revolutionized the management of severe aortic stenosis (AS), offering a less invasive alternative to surgical replacement, which is particularly beneficial for elderly and high-risk populations. This narrative review aims to summarize current evidence regarding TAVR’s clinical outcomes, patient selection, the role of cardiac remodeling, and the impact of geriatric syndromes on procedural success. Materials and Methods: This review is based on a comprehensive analysis of the peer-reviewed literature indexed in major scientific databases. We included relevant studies addressing TAVR in older adults, focusing on cardiac biomarkers, imaging, patient stratification, and geriatric syndromes, such as frailty, delirium, and sarcopenia. Results: Evidence indicates that TAVR significantly improves survival and quality of life in elderly patients with severe AS. Advanced cardiac imaging and biomarkers contribute to improved risk stratification and post-procedural management. Geriatric syndromes are prevalent in this population and strongly influence clinical outcomes. Tailored prehabilitation and multidisciplinary approaches are increasingly recognized as critical components of TAVR care. Conclusions: TAVR is an effective and safe option for older adults with severe AS. Optimal outcomes depend not only on procedural expertise but also on recognizing and addressing the complex interplay between cardiac pathology and geriatric vulnerabilities. A holistic, patient-centered approach is essential to maximize the therapeutic benefits in this growing patient population. Full article

Background: Bioelectrical impedance analysis has been used to evaluate phase angle, which predicts cellular health and may even predict survival in people living with HIV. However, the relationship between the phase angle and geriatric syndromes is unclear. This study aims to evaluate geriatric syndromes and how they interact with issues affecting HIV patients by conducting a full geriatric evaluation and comparing phase angles. Methods: Fifty people living with HIV and 52 participants without HIV were included in the study. All participants underwent a comprehensive geriatric assessment. BIA was used to determine the phase angle, which was then predicted from impedance measurements. Results: The mean age of people living with HIV was 60.0 ± 12.0 years, and that of participants without HIV was 60.0 ± 5.0 years in participants without HIV (p = 0.93). The number of drugs used by people living with HIV infection was considerably higher than that used by those in the HIV-negative group (p = 0.018). There was a statistically significant difference in the phase angle between without HIV and with HIV. The median [interquartile range (IQR)] phase angle was 7.4 [4.0] degrees, and it was 5.7 [3.2] degrees (p = 0.004). Conclusions: Phase angle measurements between people living with HIV and without HIV could provide valuable insights into overall health status treatment response and prognosis. Further large-scale research is to corroborate our findings. Full article

This study aimed to describe the risk factors for locomotive syndrome (LS) in Brazilian oldest old individuals. Study subjects were older adults aged ≥80 years who were cognitively healthy, independent for activities of daily living and had been followed since 2011 by a Brazilian cohort study entitled the Longevos Project. A nested case–control study evaluating demographic and clinical characteristics was conducted. Physical tests including the 5 times sit-to-stand, hand-grip strength, 4-m gait speed and two-step test were performed. The World Health Organization Quality of Life Questionnaire short form (WHOQOL-BREF) and Numerical Rating Scale plus Verbal Rating Scale were applied to assess quality of life (QOL) and chronic pain (CP), respectively. LS was diagnosed using the Brazilian version of the 25-question Geriatric Locomotive Function Scale (GLFS-25-p), and sarcopenia by the SARC-F screening tool. The study sample included 52 participants, had a mean age of 89.3 years (±3.9 years) and was predominantly female (76.9%). Of this sample, 24 were diagnosed with LS and 28 were not. The prevalence of osteoporosis (20%), osteoarthritis (22%), depression (13%) and use of a walking device (14%) was higher in the LS group. Participants with LS had worse performance in physical tests. A multivariate logistic regression analysis identified the main risk factors for LS as osteoporosis (OR 10.80, 95%CI 1.08–108.48) and presence of moderate-to-severe chronic musculoskeletal pain (OR 8.92, 95%CI 1.25–63.89). Full article

Background: This study addresses the prevalence and outcomes of sarcopenic diabetes among older adults hospitalized for hip fractures, highlighting its association with nutritional status, frailty, in-hospital outcomes, and mortality. With the global incidence of hip fractures anticipated to rise significantly, understanding these associations is crucial, especially considering the higher prevalence of sarcopenia in diabetic patients, which exacerbates outcomes. Methods: An observational, unicentric case–control study nested within a real-world data cohort was conducted. It included 2631 older adults (aged ≥ 70 years) hospitalized for hip fractures at the Hospital Universitario de la Ribera, Spain, from 2014 to 2021. Diabetic patients were classified as cases, and non-diabetic patients served as controls. The study examined demographic variables, comorbidities, nutritional status, geriatric syndromes, and mortality, using the SARC-F questionnaire for sarcopenia screening. Results: The study found that cases (diabetic patients) presented with higher comorbidities, longer hospital stays, and a higher prevalence of sarcopenia, significantly impacting in-hospital and long-term mortality rates. The prevalence of possible sarcopenia was notably higher at 61.5% among diabetic patients. Sarcopenia was strongly correlated with worse functional outcomes and higher mortality. Conclusions: Sarcopenic diabetes significantly increases the risk of adverse outcomes and mortality in older adults with hip fractures. The findings underscore the importance of routine screening for diabetes and sarcopenia in this patient population to mitigate risks and improve rehabilitation outcomes. Full article

Background/Objectives: Frailty is a prevalent geriatric syndrome associated with impaired postural control and elevated fall risk. Although conventional exercise is a core strategy for frailty management, adherence remains limited. Virtual reality (VR)-based interventions have emerged as potentially engaging alternatives, but their effects on objective postural control and task-specific confidence in frail populations remain understudied. This study aimed to evaluate the effectiveness of a supervised VR training program using the Nintendo Ring Fit Plus™ on postural control, functional mobility, and balance confidence among frail community-dwelling older adults. Methods: Fifty-one adults aged ≥65 years classified as frail or prefrail were enrolled in a four-week trial. Participants were assigned to either a VR intervention group (n = 28) or control group (n = 23). Participants were non-randomly assigned based on availability and preference. Outcome measures were collected at baseline and post-intervention. Primary outcomes included center of pressure (CoP) metrics—sway area, mean velocity, and sway path. Secondary outcomes were the Timed Up and Go (TUG), Berg Balance Scale (BBS), Activities-specific Balance Confidence (ABC), and Falls Efficacy Scale–International (FES-I). Results: After adjusting for baseline values, age, and BMI, the intervention group showed significantly greater improvements than the control group across all postural control outcomes. Notably, reductions in sway area, mean velocity, and sway path were observed under both eyes-open and eyes-closed conditions, with effect sizes ranging from moderate to very large (Cohen’s d = 0.57 to 1.61). For secondary outcomes, significant between-group differences were found in functional mobility (TUG), balance performance (BBS), and balance confidence (ABC), with moderate-to-large effect sizes (Cohen’s d = 0.53 to 0.73). However, no significant improvement was observed in fear of falling (FES-I), despite a small-to-moderate effect size. Conclusions: A supervised VR program significantly enhanced postural control, mobility, and task-specific balance confidence in frail older adults. These findings support the feasibility and efficacy of VR-based training as a scalable strategy for mitigating frailty-related mobility impairments. Full article

Background: Metabolic syndrome (MetS) and obstructive sleep apnea (OSA) are prevalent and interrelated conditions in older adults, both contributing to decreased quality of life and increased health risks. Nutritional interventions, including dietary changes and probiotic supplementation, may offer effective non-pharmacological strategies to address these conditions. This study aimed to evaluate the impact of diet therapy alone and in combination with probiotics on quality of life and sleep apnea risk in older adults (>60 years) with MetS. Methods: In this controlled interventional study, 192 older adults with metabolic syndrome were assigned to one of three groups: control, diet therapy alone, or diet therapy plus probiotic supplementation. Participants were evaluated at baseline and after the intervention period using the SF-36 quality of life questionnaire and an apnea risk screening tool. Clinical and metabolic parameters, including BMI, HOMA index, and visceral fat, were also assessed. Results: Significant improvements in SF-36 scores were observed in both intervention groups compared to the control group (p < 0.05) (mean difference = −5.31, p = 0.016), with the diet + probiotics group showing the greatest enhancement. Participants who reduced their apnea risk also reported higher post-intervention SF-36 scores. The intervention led to reductions in visceral fat, inflammatory markers (CRP), and insulin resistance (HOMA index), which were correlated with improved quality of life. Conclusions: Integrated nutritional strategies, especially the combination of diet and probiotics, significantly improve quality of life and reduce apnea risk in older adults with metabolic syndrome. These findings support the use of personalized, non-pharmacological interventions targeting both metabolic health and sleep-related outcomes in geriatric populations. Full article

This narrative review examines the effects of caffeine on brain health in older adults, with particular attention to its potential for dependence—an often-overlooked issue in geriatric care. Caffeine acts on central adenosine, dopamine, and glutamate systems, producing both stimulating and rewarding effects that can foster tolerance and habitual use. Age-related pharmacokinetic and pharmacodynamic changes prolong caffeine’s half-life and increase physiological sensitivity in the elderly. While moderate consumption may enhance alertness, attention, and possibly offer neuroprotective effects—especially in Parkinson’s disease and Lewy body dementia—excessive or prolonged use may lead to anxiety, sleep disturbances, and cognitive or motor impairment. Chronic exposure induces neuroadaptive changes, such as adenosine receptor down-regulation, resulting in tolerance and withdrawal symptoms, including headache, irritability, and fatigue. These symptoms, often mistaken for typical aging complaints, may reflect a substance use disorder yet remain under-recognized due to caffeine’s cultural acceptance. The review explores caffeine’s mixed role in neurological disorders, being beneficial in some and potentially harmful in others, such as restless legs syndrome and frontotemporal dementia. Given the variability in individual responses and the underestimated risk of dependence, personalized caffeine intake guidelines are warranted. Future research should focus on the long-term cognitive effects and the clinical significance of caffeine use disorder in older populations. Full article

Osteoporosis and sarcopenia are two aspects of the geriatric syndrome that frequently occur together and affect one another in a condition referred to as osteosarcopenia. Preventive and treatment options for osteosarcopenia exist but are mainly focused on the treatment of osteoporosis, as there is still no FDA-approved treatment for sarcopenia. Drugs for osteoporosis include antiresorptive and anabolic drugs and hormonal replacement therapies and are prescribed based on age, BMD and other patient characteristics, which, however, do not include the possible co-existence of sarcopenia. As several studies and clinical trials have shown that the pharmacological treatment of osteoporosis can also affect muscle tissue, in either a positive or negative manner, sarcopenia should be another factor affecting the choice of treatment, especially when facing equal treatment options for osteoporosis. The aim of this review was to summarize our current knowledge on the effects of FDA-approved drugs for the treatment of osteoporosis on muscle quality, mass and function. A better understanding of the effects that certain drugs have on muscle tissue might in the future help us to simultaneously at least partially also address the wasting of muscle tissue and avoid further pharmacologically induced decline. Full article

Background/Objectives: Osteosarcopenia, the coexistence of osteoporosis and sarcopenia, in older adults, is an emerging geriatric syndrome linked to functional decline, increased frailty, and higher mortality. Evidence supports the benefits of interventions such as physical exercise and dietary supplementation with vitamin D, calcium, and protein in this population. Additionally, emerging supplements—such as creatine, β-hydroxy-β-methylbutyrate (HMB), probiotics, and prebiotics—are being investigated for their potential to enhance bone density, muscle mass, and physical function. This review aims to examine the current evidence on these novel nutritional strategies and provide a comprehensive synthesis of how these factors may synergistically influence both muscle and bone health. Methods: A comprehensive literature search was conducted across the PubMed/MEDLINE, Embase, Scopus, and Google Scholar databases. Relevant observational studies, clinical trials, systematic reviews, and meta-analyses published from January 2020 to June 2025 were included, and then a reverse search in the bibliography was used to expand on definitions and concepts. Conclusions: Nutritional interventions for osteosarcopenia play a pivotal role in not only improving bone and muscle composition but also enhancing functional outcomes in older adults. Emerging strategies involving creatine monohydrate, HMB, probiotics, and prebiotics show potential as part of a comprehensive patient-centered approach. However, further research is needed to determine the most effective strategies and to identify which patients are most likely to benefit from each supplement. Full article

Background: Comprehensive geriatric assessments (CGAs) are necessary to address the needs of people with human immunodeficiency virus infection (PWH) aged ≥ 50 years and ensure that they receive high-quality care. We aimed to identify the most effective tests from an extensive CGA to develop a short CGA. Methods: This observational, cross-sectional, and analytical study was conducted in three phases: (1) describing PWH aged ≥ 50 and matched controls; (2) jointly analyzing data to identify the most effective tests from the original CGA and develop a short version; and (3) applying the short CGA separately to both groups. Results: The most effective tests—the Lawton scale, SPPB, Barber questionnaire, Pittsburgh Sleep Quality Index, and Cognitive Complaints questionnaire—were used to create a short CGA. It identified abnormalities in 77% of PWH flagged by the full CGA, though 65% with the normal short CGA results had at least one abnormal result in the full version. Most false negatives were due to the excluded Hearing-Dependent Activities scale. Conclusions: These findings represent an initial step toward developing a short CGA for an easy and rapid identification of PWH aged ≥ 50, beyond a frailty assessment, who may benefit from early clinical management. Full article

Because the number of elderly people is increasing worldwide, and the prevalence of cardiovascular risk factors and cardiovascular diseases increase with age, in current clinical practice we are faced with a large number of geriatric patients requiring oral anticoagulant treatment. Our review highlights some of the particularities of using direct oral anticoagulants (DOACs) in the geriatric population. We focused on the difficulties of managing DOAC treatment in the presence of geriatric syndromes. We highlighted the practical steps needed to overcome the challenges related to the risk of falling, cognitive impairment, swallowing disorders, and polypragmasy to improve patient care. We provided data to help guide the choice of anticoagulant and dose. Full article

Background: Locomotive syndrome (LS), a condition characterized by impaired mobility due to locomotive organ dysfunction, is highly prevalent among patients with cancer. The phase angle (PhA), measured via bioelectrical impedance analysis (BIA), reflects cellular health and nutritional status. This study aimed to investigate the association between LS and the PhA in patients with cancer. Methods: This cross-sectional study included hospitalized patients who underwent cancer treatment. The assessed variables included age, sex, body mass index (BMI), gait speed, grip strength, PhA, and the outcomes of LS risk assessment using the stand-up test, two-step test, and the 25-Geriatric Locomotive Function Scale (GLFS25). Results: A total of 190 patients (57 females, 133 males; mean age, 62.6 ± 17.2 years) were analyzed. The PhA was significantly negatively correlated with the LS stage (rs = −0.507, p < 0.001). Similarly, a significant negative correlation was observed between the PhA and each LS risk test, namely, the stand-up test, two-step test, and GLFS25. Furthermore, the PhA was identified as an independent and significant factor associated with LS progression (odds ratio, 0.361; 95% confidence interval, 0.221–0.588; p < 0.001). More effective and rapid than completing the full range of LS risk tests, measuring the PhA represents a convenient and practical tool for the early screening of mobility decline. Conclusions: The PhA is a simple and effective parameter for assessing mobility decline in patients with cancer. It is a potential clinical indicator for initiating rehabilitation interventions aimed at preventing the onset and progression of LS. Full article

Technologies for frail elderly individuals facilitate the integration of care services, support the post-discharge period, and enhance independence and quality of life while reducing isolation. However, the lack of methodological rigor in studies on technologies for diagnosing and treating geriatric syndromes limits applied research. This study aimed to develop and validate a checklist considering technical readiness, clinical needs, and context to support the use of technologies primary in clinical practice and also in research settings. To this aim, a Delphi procedure was conducted in four rounds, followed by a pilot test assessing the checklist’s practical effectiveness. Twenty-nine items were defined and discussed. Among them, no item was deleted, while a total of eight items were reformulated. At the end of the assessment steps, 73% of items showed a high median relevance rating. The pilot test showed the difficulty in finding relevant information to complete the checklist as the only critical issue. This tool represents the first validated checklist in the field of technology-based healthcare for elderly individuals and supports the application of technologies in the diagnosis and treatment of geriatric syndromes by clinicians and researchers. Full article