Search Results (524)

Gait analysis is a well-known tool used to evaluate human locomotion. This analysis is usually performed in movement analysis laboratories equipped with optoelectronic cameras. However, many wearable devices based on the use of Inertial Measurement Units (IMUs) have been developed to overcome the limitations of the gold standard technology. LUBU Technologies developed insoles equipped with IMUs and algorithms for the extraction of gait parameters such as gait events, temporal parameters and stride length. The aim of the present study was the validation of these parameters against an optoelectronic reference system. Twenty people were involved in performing a series of indoor walking trials to assess the accuracy of the insole measurements and an additional group of ten people were asked to walk outdoors to preliminarily assess total distance estimation under ecological walking conditions. The results showed low errors and good agreement for all the parameters computed by the insoles. Moreover, the outdoor assessment offered preliminary insights into performance in a more ecological setting. Overall, the findings suggest that LUBU insoles may represent a valid wearable tool for estimating gait spatio-temporal parameters in healthy young adults. However, further investigations are required in older adults or populations with pathological gait patterns. Full article

Introduction: Community-based day center programs may support healthy ageing by promoting functional ability, mental well-being, and social participation among older adults, but real-world evidence from Latin America remains limited. Objective: We aimed to examine changes in functional status, mental health, and quality of life among older adults participating in the CEDIAM program in the Maule Region of Chile in 2022 and 2023. Methods: Pre–post observational study using routinely collected data from 15 CEDIAM centers. The 2022 and 2023 datasets were analyzed as independent cohorts. Functional status was assessed with the Barthel Index, the Lawton and Brody scale, and the Timed Up and Go test; mental health with the Mini-Mental State Examination and the 15-item Geriatric Depression Scale; and quality of life with the EuroQol-5D visual analogue scale. Paired comparisons, category-transition analyses, and multivariable logistic regression models of improvement were performed. Results: Baseline samples included 894 participants in 2022 and 897 in 2023. In 2022, all continuous outcomes improved significantly (all p ≤ 0.001). In 2023, the Barthel Index, the Timed Up and Go test, and the Geriatric Depression Scale improved (all p < 0.0001), and the EuroQol-5D visual analogue scale also improved (p < 0.01), whereas the Lawton and Brody scale (p = 0.204) and the Mini-Mental State Examination (p = 0.725) did not. Category-transition analyses showed significant improvements in basic activities of daily living and mobility in both cohorts (both p < 0.001), while significant categorical changes in instrumental activities of daily living, global cognition, depressive symptoms, and self-rated quality of life were observed only in 2022 (all p ≤ 0.01). Rural residence was associated with higher odds of improvement in basic activities of daily living (OR 1.62, 95% CI 1.17–2.25; p = 0.004), whereas age ≥75 years was associated with lower odds of improvement in depressive symptoms (OR 0.56, 95% CI 0.41–0.76; p < 0.001) and self-rated quality of life (OR 0.65, 95% CI 0.45–0.94; p = 0.023). Conclusions: Participation in CEDIAM was associated with favorable changes, particularly in basic functional status and mobility, although responses varied across outcomes and participant subgroups. Full article

The growing aging population is a primary driver of chronic, long-term health conditions. The rising prevalence of cognitive decline in older populations is a pressing public health issue due to its impact on health and social care and its emotional toll on family members. A lesser-known condition is sarcopenia—the age-related debilitating loss of skeletal muscle mass and function which leads to weakness and loss of mobility, quality of life and social independence. Neither health condition has a clear pharmacological treatment pathway. Diet and nutrition have therefore received the most attention for disease prevention. This review evaluates the research on the association between sarcopenia and cognitive decline and how both conditions may be linked to protein intake. While findings can be inconclusive or contradictory, a higher consumption of protein may protect against declines in physical and cognitive health, either acting separately or synergistically with exercise. The evidence supports the recommendation for a daily intake of protein higher than the current guideline of 0.8 g/kg/d for older people. Evidence suggests that healthy dietary patterns such as the Mediterranean diet appear to positively influence cognitive health in older people. Furthermore, the impact of specific high-protein foods, including egg, soy and dairy foods, on cognitive health has been reviewed, again with a suggestion that their consumption may mitigate against cognitive decline. Functional foods aimed at the aging population who wish to increase their protein intake and avert or delay the onset of these health conditions could play an important role in preventive nutrition, especially if they are formulated around the protein-rich foods which appear to positively impact cognitive health. Full article

Background/Objectives: Age-related hearing loss (ARHL) is a common sensory impairment in the elderly, and its early prediction and intervention are crucial for improving the quality of life in older adults. This study aims to develop and validate an interpretable machine learning model based on routine blood biomarkers to predict the risk of ARHL occurrence. Methods: A total of 542 participants were selected from the National Health and Nutrition Examination Survey (NHANES) database, including 271 ARHL patients and 271 healthy controls. The samples were randomly divided into a training set (50%) and two independent internal validation sets (25% each). Through systematic comparison of 113 machine learning algorithm combinations, the optimal predictive model (glmBoost+Stepglm[forward]) was constructed, and the SHAP method was employed for feature interpretation. To evaluate the model’s generalization ability, external validation was further performed using a cohort of 92 cases from Chongqing People’s Hospital. Additionally, an openly accessible interactive prediction web page was developed based on the R Shiny framework, supporting real-time clinical risk assessment and visual interpretation. Results: The model achieved an AUC of 0.948 in the training set, with AUCs of 0.893 and 0.945 in two internal validation sets, respectively, and an overall accuracy rate of 86.3%. In the external validation cohort (albeit with a limited sample size of 92 from a single center), the model maintained good performance with an AUC of 0.839 (95% CI: 0.750–0.918) and an accuracy of 77.2%. The model identified nine key predictive features, with the top three being glycated hemoglobin (HbA1c), mean corpuscular volume (MCV), and blood glucose according to SHAP interpretability analysis. Conclusions: This study successfully developed and validated an interpretable machine learning model based on routine blood biomarkers for community-based risk stratification of age-related hearing loss. The model demonstrated robust performance in internal and external validations, including an age-matched elderly subgroup. An interactive web tool was developed to facilitate real-time risk assessment. While the model is intended as a prescreening tool for large-scale populations rather than a diagnostic test for age-matched individuals, it provides a novel approach for early identification of individuals at higher risk of ARHL and offers insights into its systemic pathogenesis. Full article

Background: People living with HIV (PLWH) are increasingly reaching older ages due to the success of antiretroviral therapy. However, aging with HIV is associated with increased risk of multimorbidity, neurocognitive impairment, frailty, psychosocial stress, and functional decline. Multidomain geriatric screening framed within an Age-Friendly 4Ms Framework (Mentation, Medication, Mobility, What Matters Most) and consideration of multi-complexity may help identify aging-related vulnerabilities and guide multidisciplinary care with greater impact on patient outcomes. However, real-world implementation of such programs within HIV clinical settings remains limited. Methods: We conducted a retrospective analysis of adults aged ≥50 years enrolled in a multidisciplinary Healthy Aging Program within a large, integrated HIV care system. Multidomain screening assessments included cognitive evaluation (Montreal Cognitive Assessment), mental health screening (PHQ-2, GAD-2), functional assessment (Katz ADL, Lawton IADL), frailty screening (Edmonton Frail Scale), and intrinsic capacity domains using the WHO Integrated Care for Older People (ICOPE) framework. Screening results, referrals, clinical interventions, and cardiometabolic risk management measures were extracted from clinical program databases and electronic medical records. Results: A total of 317 adults aged ≥50 years completed multidomain screening. Participants had well-controlled HIV infection, with viral suppression in 96.2% and a median CD4 count of 660 cells/mm³. Despite this, aging-related vulnerabilities were common. Overall, 78.4% of participants had at least one abnormal screening domain. Cognitive impairment was identified in nearly half of individuals screened, including mild impairment in 39.8% and moderate impairment in 8.7%. Functional limitations were identified in 10.1% of participants, while anxiety symptoms were present in 9.5%. Sensory impairments were common, including vision impairment in 36.5% of participants. Polypharmacy was prevalent, with 33.2% of participants prescribed five or more chronic medications. Screening frequently generated multidisciplinary referrals, including behavioral health services (42.3%), social work support (42.9%), and pharmacist-led cardiometabolic risk review (56.8%). Age-stratified analyses demonstrated similar prevalence of screening abnormalities across age groups, including individuals aged 50–59 years. Modest improvements in cardiometabolic preventive care were observed during follow-up. Statin utilization increased from 65.6% at baseline to 70.0% at 12 months, and LDL cholesterol declined modestly during the observation period. Conclusions: Multidomain screening integrated into routine HIV care identified a high prevalence of aging-related vulnerabilities among PLWH aged ≥50 years despite excellent virologic control. These findings suggest that aging-related risk in HIV is not adequately captured by chronological age alone and support early, universal implementation of multidomain screening within HIV care models. Full article

Age-related declines in balance and cognitive function increase fall risk and reduce quality of life in older adults and people with neurological disorders. Studying these changes in unimpaired adults provides a normative reference for identifying pathological deviations. However, most dual-task studies focus on single cognitive tasks and static conditions, specifically during gait, limiting understanding of how cognitive demand interacts with postural control while standing and during dynamic challenges. This study identified cognitive and motor outcomes most sensitive to age-related differences during motor–cognitive dual tasks of varying complexity across static and dynamic balance conditions, accounting for minimal detectable change. Sixty healthy adults performed dual-tasks ranging from simple motor activities to complex cognitive challenges (Stroop Test) while standing on a robotic platform. Cognitive performance (reaction time) and balance outcomes, including trunk and center of pressure (CoP) sway area, were assessed. Reaction time was sensitive to aging, with standardized estimates ranging from 0.014 to 0.036. The highest values occurred in the most demanding dual-task condition, enabling detection of meaningful change over short timeframes. Age effects on balance were modest under static conditions but amplified during dynamic perturbations across all dual tasks. In the SCWT 3 condition, standardized estimates for CoP sway area increased from 0.006 in the static condition to 0.047 in the passive condition, reflecting an approximately eightfold increase in age sensitivity. Trunk sway primarily reflected cognitive load, whereas CoP sway was most sensitive to balance perturbations and exceeded minimal detectable thresholds over only a couple of years. These findings support sensitive task–condition combinations for early detection and monitoring of age-related cognitive and balance decline. Full article

Background/Objectives: Studies evaluating the impact of diet quality on nutrition- and muscle-related outcomes in cancer are limited. This study aimed to understand the diet quality of people with lung cancer and its cross-sectional associations with malnutrition, low muscle mass and (probable)-sarcopenia. Methods: Three-day food records were collected from 47 adults (mean ± SD age 70.6 ± 8.6 years; 58% male) with lung cancer prior to, or within one week, of curative-intent (chemo)radiotherapy. Dietary Guidelines Index (DGI-2013) and Mediterranean Diet Score (MDS) estimated diet quality, reflecting established healthy eating patterns. Malnutrition was determined using Patient Generated Subjective Global Assessment (PG-SGA). Low muscle mass was estimated using diagnostic third lumbar vertebra computed tomography (CT) images. (Probable)-sarcopenia was determined using the revised European Working Group for Sarcopenia in Older People definition, including low muscle (grip) strength, muscle mass and impaired function. Multivariate adjusted logistic regression analyses estimated odds ratios (OR) and 95% confidence intervals (CI) for associations between diet quality and outcomes. Results: Prevalence of malnutrition, low muscle mass and (probable)-sarcopenia were 36.2%, 50.0% and 13.6%, respectively. Mean ± SD DGI-2013 score was 53.0 ± 13.0. Adherence to the DGI-2013 was not significantly associated with malnutrition (OR, 0.67 [95%CI 0.35, 1.28]), low muscle mass (0.90 [95%CI 0.47, 1.70]) or (probable)-sarcopenia (0.73 [95%CI 0.29, 1.80]). Mean ± SD MDS was 3.6 ± 1.5. Adherence to the MDS was not significantly associated with malnutrition (0.75 [95%CI 0.37, 1.49]), low muscle mass (0.98 [95%CI 0.51, 1.88]) or (probable)-sarcopenia (1.82 [95%CI 0.72, 4.85]). Conclusions: Diet quality was not associated with malnutrition, low muscle mass or (probable)-sarcopenia. Given that overall diet quality was poor, it remains unclear whether high diet quality may be associated with nutritional status or muscle-related outcomes. Further research is needed to determine whether diet quality should be considered in nutritional interventions during lung cancer treatment. Full article

NORC (Naturally Occurring Retirement Community) programs and senior cohousing are two community-based, sustainable initiatives for aging in place associated with cooperative housing in New York and Spain, which are spreading rapidly as an alternative to institutionalization. This paper examines how NORC programs and senior cohousing support aging in place using a conceptual framework derived from theories on active aging and the ecological model of aging, which suggests specific dimensions to characterize the processes through which these initiatives potentially achieve their goal of promoting healthy, active aging, including aspects of the physical and social environment. Our framework was applied to a selection of case studies from each model, allowing us to conceptualize their strengths and weaknesses as developed in cooperatives in these two contexts. Findings show that NORC programs help older people stay in familiar neighborhoods and take advantage of economies of scale; however, dwellings are not adapted for reduced mobility. Spanish senior cohousing is an affordable and accessible alternative; however, existing communities are relatively isolated. Future research should consider hybrid models that incorporate the characteristics of various initiatives best suited to each context’s housing policies and welfare system. Full article

Background: Dementia is a growing global public health concern and identifying modifiable risk and protective factors is crucial for its prevention. Fruits and vegetables, due to their antioxidant and anti-inflammatory properties, may offer neuroprotective benefits. This study aims to investigate the prevalence of adequate fruit and vegetable consumption and its association with dementia and cognitive impairment no dementia (CIND) in individuals aged 50 years and older. Methods: This cross-sectional, population-based study analysed data from 2865 participants in the second wave (2019–2021) of the Brazilian Longitudinal Study of Ageing (ELSI-Brazil). CIND was defined as a global cognitive Z-score ≤ −1.5, and dementia as cognitive decline with impairment in at least one instrumental activity of daily living. Adequate consumption of fruits, vegetables, and both combined (FV) was defined as daily intake on all seven days of the week. Associations were assessed using multivariate Poisson regression models, with prevalence ratios (PRs) and 95% confidence intervals (CIs). Results: The study sample consisted of 2865 participants. The prevalence of adequate fruit consumption was 58.08% (95% CI: 56.3–59.9), vegetables 44.14% (95% CI: 42.31–45.9), and FV 32.18% (95% CI: 30.5–33.9). Adequate vegetable consumption was significantly associated with CIND (PR: 0.19; 95% CI: 0.07–0.50; p < 0.001), while adequate fruit consumption was associated with higher prevalence of CIND (PR: 1.47; 95% CI: 1.22–1.77) and FV (PR: 0.20; 95% CI: 0.07–1.58; p = 0.003). No significant association was observed between fruit, vegetable, and FV consumption and dementia. Conclusions: Adequate vegetable and combined FV consumption were protective against CIND, though not associated with dementia. Nonetheless, overall adequate intake remains low in older Brazilian adults. Full article

Background and objectives: Low bone mineral density (BMD) is a recognized complication in people living with HIV (PLHIV) that remains under-addressed, particularly in Malaysia. Known contributing factors for low BMD include advanced age, HIV infection itself, and prolonged use of anti-retroviral therapy (ART), particularly tenofovir-based regimens. There are limited data on the burden of low BMD in the HIV population in Malaysia. This study aimed to determine the prevalence of low BMD among men living with HIV on tenofovir disoproxil fumarate (TDF) and to identify the possible associated factors compared to a group of healthy individuals matched for age and ethnicity. Methods: This is single-center cross-sectional study involved 112 men (56 HIV-positive individuals and 56 uninfected individuals matched for age and ethnicity) who underwent dual-energy X-ray absorptiometry (DXA) scans of the femoral neck and lumbar spine. Sociodemographic, clinical lifestyle, and laboratory data, including FRAX scores for those aged more than 40 years old, were collected. Results: The prevalence of low BMD at the femoral neck in HIV-infected men on tenofovir disoproxil fumarate was significantly higher compared to healthy individuals (32.1% vs. 16.1%; p < 0.05). Low BMD prevalence at the lumbar spine was higher in the HIV group (8.9% vs. 3.6%; p = 0.463) but was not statistically significant. Older age and low body mass index (BMI) were found to be significantly associated with reduced BMD in HIV patients. Chronic kidney disease stage 2 and 3a was linked with low femoral neck BMD. HIV-related factors (duration of illness, duration of ART exposure, and CD4+ counts) showed no significant associations to low BMD. The 10-year risk of major osteoporotic and hip fractures estimated by the FRAX tool was low in both groups, and no participant exceeded the recommended intervention threshold. Conclusions: Men with HIV on tenofovir disoproxil fumarate have a higher prevalence of low BMD, particularly at the femoral neck. Traditional risk factors were more closely associated with low BMD compared to HIV-related factors and specific markers, supporting the need for routine bone health screening and preventive strategies in this population. Full article

Background/Objectives: Accumulation of cerumen (earwax) in the auditory canal is a common condition, particularly in children and older adults, and often causes temporary hearing loss. While chronic hearing loss is known to affect mood and cognition, little is known about the psychological impact of short-term auditory deprivation. This pilot study aimed to examine the emotional and cognitive effects of simulated temporary hearing loss. Methods: Thirty healthy adults (16 females, aged 18–60) participated. Temporary hearing loss was simulated by placing earplugs in both ears for two hours. Participants completed four tests, assessing anxiety, mood, and attention at three time points: before wearing earplugs, during the blocked condition, and after earplug removal. Results: Participants showed a significant increase in state anxiety and a decrease in mood during the earplug condition. Interestingly, visual attention performance improved while hearing was obstructed and remained elevated even after earplug removal. Conclusions: Short-term simulated hearing loss produces measurable emotional and cognitive changes, including increased anxiety but enhanced visual attention. Clinicians should consider these effects when assessing patients with temporary hearing obstruction, such as those with cerumen impaction. The results carry implications for the broader population wearing earplugs on a temporary basis including musicians, construction employees, and, in general, people working in noisy environments. Full article

Background/Objectives: Some Japanese people still adhere to a systematic traditional Japanese diet pattern (the Shokuyo diet) consisting mainly of brown rice, vegetables, legumes, and small amounts of fish. We investigated the impact of this dietary pattern on the intestinal microbiota of its female consumers. Methods: The intestinal microbiota of 19 Japanese females in their 60s and 70s consuming the Shokuyo diet (Shokuyo diet group) and 50 females of the same age consuming a normal Japanese diet (NJ diet group) were compared. The NJ diet group was further subdivided into a healthy NJ diet H subgroup, comprising females (n = 19) without any diseases, and an unhealthy NJ diet UH subgroup (n = 31) consisting of females with certain diseases, and a subgroup analysis was performed. Intestinal microbiota analysis was performed using 16S rRNA gene amplicon sequencing. Results: The β-diversity of the intestinal microbiota significantly differed between the Shokuyo diet and NJ diet groups. Similarly, in the subgroup analysis, β-diversity also significantly differed between the NJ diet UH subgroup and the Shokuyo diet group. However, no significant difference was observed between the NJ diet H and Shokuyo diet groups. These results indicate that the intestinal microbial composition of the Shokuyo diet group resembled that of the healthy participants, and that differences in intestinal microbial composition between the Shokuyo and NJ diet groups were strongly influenced by the presence of participants with diseases in the NJ diet group. That is, differences in β-diversity may have been strongly mediated by the health status of the participants. Conclusions: Consumption of the Shokuyo diet may be associated with a healthy intestinal microbial composition in older Japanese female, suggesting its potential as a viable dietary intervention option. Full article

Background: Interpretation of cognitive performance in older patients with depression is challenging considering the association between late-life depression and (early-stage) neurodegenerative disease. The Montreal Cognitive Assessment (MoCA) is widely used to screen for mild cognitive impairment in community-dwelling older adults. Objective: The aim of the present study was to examine the need for and to develop dedicated MoCA norms for older people with depressive disorder. Methods: We used data from the Routine Outcome Monitoring for Geriatric Psychiatry & Science (ROM-GPS) study and the Advanced Neuropsychological Diagnostics Infrastructure (ANDI) database, which consisted of 859 patients with a depressive disorder according to DSM-5 criteria and 320 healthy controls, aged ≥60 years. Linear regression was used to examine the relationship between late-life depression and MoCA scores, adjusted for age, sex, and education. Results: The presence of a depressive disorder was associated with lower MoCA scores, and this effect was larger for persons with 12 years or less of education than for those with more education (B = −0.76 [95% CI −0.61; −0.91] vs. −0.53 [−0.36; −0.70]). Among depressed patients, depressive symptom severity was not associated with the MoCA score. Regression-based normative data for the MoCA were computed and adjusted for age, education, sex, and type of depressive disorder. Conclusions: Our findings demonstrate that depressive disorder, but not symptom severity within depression, is associated with lower MoCA scores. Clinical interpretation of MoCA scores in depressed older persons can be facilitated by using MoCA reference tables stratified by age, sex and level of education. Full article

Objective: To compare self-reported functioning, disability, and health care-seeking behavior of previously healthy and unhealthy participants after SARS-CoV-2 infection. Design: Cross-sectional design conducted in 2021–2022. Subjects/Patients: Participants 18 years or older were asked to participate in an anonymous survey after acute SARS-CoV-2 infection (at least 28 days passed). Methods: The survey was conducted using an Internet-based questionnaire distributed through Lithuanian websites, including Facebook groups, city/town/district hospitals, and media outlets. Results: The final cohort consisted of 1945 participants, almost 90% being women with higher education and approximately 89% working at the time of survey. The mean age was 43 years. Among them, 53% reported to be healthy before SARS-CoV-2 infection and 5% were hospitalized during acute infection. Individuals with chronic diseases prior to infection rated their health status significantly lower but reported similar functional capacity before infection. After infection, they reported more restricted activities and more often sought health care due to remaining symptoms. In total, 16% of the cohort applied for rehabilitation services and only 7% were accepted, more often those with chronic diseases before infection. Conclusions: Results indicate a small proportion of participants receiving rehabilitation services, more often these with prior chronic diseases. The results increase awareness of rehabilitation needs after infection, particularly for previously unhealthy people. Full article

Background: With the global population rapidly aging, resilience has emerged as a critical determinant of healthy aging. While many factors are associated with resilience, a comprehensive synthesis is needed to inform targeted interventions and policy. Objectives: This systematic review aimed to identify and synthesize the conceptual models and key protective factors associated with resilience in older people. Methods: Following PRISMA guidelines, a systematic literature search was conducted in Web of Science, PubMed, PsycNet, and JSTOR for studies published between 2017 and 2025. Search terms included (including synonyms and closely related words) “resilience,” “older people,” and “models.” Studies were screened based on relevance to resilience models, measurement tools, and associated factors. Included studies underwent a formal risk of bias assessment. Results: From 7109 initial records, 54 studies met the inclusion criteria. Ten studies explored conceptual models, while 44 investigated contributing factors. Resilience was predominantly assessed using standardized psychometric tools. Findings were synthesized by mapping key determinants across Macro-Environmental, Meso-Social, Micro-Individual and Bio-Physiological domains. Conclusions: Resilience in later life is a dynamic and multifactorial process, not a fixed trait. The evidence suggests a range of modifiable factors at various levels that can be targeted to support wellbeing. An integrated, systems-based perspective is essential for guiding future research and developing effective interventions to promote resilience across the aging trajectory. Full article