Previous Issue
Volume 9, December
 
 

Geriatrics, Volume 10, Issue 1 (February 2025) – 28 articles

  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list.
  • You may sign up for e-mail alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Reader to open them.
Order results
Result details
Section
Select all
Export citation of selected articles as:
18 pages, 232 KiB  
Article
Engaging Health and Aged Care Workers in Rural and Remote Australia Around Factors Impacting Their Access to and Participation in Dementia Training
by Sandra C. Thompson, Jessica Valentine, Kira Gusterson, Katrina P. Fyfe, Alex Beilby, John A. Woods, Myles Clarkson Fletcher, Pascale Dettwiller and Kathryn W. Fitzgerald
Geriatrics 2025, 10(1), 28; https://doi.org/10.3390/geriatrics10010028 - 14 Feb 2025
Abstract
Objective: To better understand barriers and enablers to uptake of dementia training in rural and remote areas using input from rural and remote aged and health care workers into how dementia training could be offered to better meet their needs. Methods: Roundtable [...] Read more.
Objective: To better understand barriers and enablers to uptake of dementia training in rural and remote areas using input from rural and remote aged and health care workers into how dementia training could be offered to better meet their needs. Methods: Roundtable focus groups were conducted in six diverse rural and remote locations in four jurisdictions around Australia. Sixty-seven workers from predominantly nursing, allied health, and support worker roles involved in dementia care participated. Data were collected by site and used a mixture of face-to-face and virtual facilitated ‘roundtable’ discussions. Each group discussed barriers and enablers to participation in training and their preferences for how dementia training should be provided. Results: Commonalities emerged in barriers for accessing dementia training. Participants emphasised the need for strong organisational support and locally relevant, interactive and flexible delivery methods to address rural challenges. Significant challenges related to staffing levels, time constraints, and competing priorities. Enablers of training uptake included support from employers covering time and costs of training, local collaboration, and training accessibility for all job roles rather than profession specific. Participants emphasised the importance of practical, local training relevant to their scope of practice delivered by experienced trainers. The need for culturally safe aged care practices was noted in all sites. Discussion and Conclusions: Collaborative approaches across organisations and the aged care workforce and training relevant to local rural contexts were favoured. The opportunity to learn from external experts was greatly appreciated. Workers want training that enhances culturally safe practices. Organisational support is critical for training implementation. Full article
(This article belongs to the Section Geriatric Public Health)
13 pages, 3051 KiB  
Review
Tau Imaging: Use and Implementation in New Diagnostic and Therapeutic Paradigms for Alzheimer’s Disease
by Alexandra Gogola, Brian J. Lopresti, Davneet S. Minhas, Oscar Lopez, Ann Cohen and Victor L. Villemagne
Geriatrics 2025, 10(1), 27; https://doi.org/10.3390/geriatrics10010027 - 14 Feb 2025
Viewed by 9
Abstract
Alzheimer’s disease (AD) affects an estimated 6.9 million older adults in the United States and is projected to impact as many as 13.8 million people by 2060. As studies continue to search for ways to combat the development and progression of AD, it [...] Read more.
Alzheimer’s disease (AD) affects an estimated 6.9 million older adults in the United States and is projected to impact as many as 13.8 million people by 2060. As studies continue to search for ways to combat the development and progression of AD, it is imperative to ensure that confident diagnoses can be made before the onset of severe clinical symptoms and new therapies can be evaluated effectively. Tau positron emission tomography (PET) has emerged as one method that may be capable of both, given its ability to recognize the presence of tau, a primary pathologic hallmark of AD; its usefulness in determining the spatial distribution of tau, which is necessary for differentiating AD from other tauopathies; and its association with measures of cognition. This review aims to evaluate the scope of tau PET’s utility in clinical trials and practice. Firstly, the potential of using tau PET for differential diagnoses, distinguishing AD from other dementias, is considered. Next, the value of tau PET as a tool for staging disease progression is investigated. Finally, tau PET as a prognostic method for identifying the individuals most at risk of cognitive decline and, therefore, most in need of, and likely to benefit from, intervention, is discussed. Full article
Show Figures

Figure 1

17 pages, 792 KiB  
Systematic Review
Echocardiographic Assessment of Cardiac Structure and Function of Centenarians: A Systematic Review
by Andrea Sonaglioni, Gian Luigi Nicolosi, Giovanna Elsa Ute Muti-Schünemann, Alessio Polymeropoulos, Michele Lombardo and Paola Muti
Geriatrics 2025, 10(1), 26; https://doi.org/10.3390/geriatrics10010026 - 12 Feb 2025
Viewed by 270
Abstract
Background: During the last two decades, a limited number of studies have provided echocardiographic details regarding the cardiac structure and function of individuals aged ≥100 years. These studies analyzed limited sample sizes of centenarians using different methodologies. The present systematic review was primarily [...] Read more.
Background: During the last two decades, a limited number of studies have provided echocardiographic details regarding the cardiac structure and function of individuals aged ≥100 years. These studies analyzed limited sample sizes of centenarians using different methodologies. The present systematic review was primarily designed to summarize the main findings of these studies and to examine the overall influence of extremely advanced age on cardiac structure and function. Methods: All echocardiographic studies that evaluated the cardiac structure and function in individuals aged ≥100 years, selected from the PubMed, Embase, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL) databases, were included. There was no limitation on the time period. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: A total of eight studies with 1340 centenarians [median age 101.4 years (IQR 101–103 years)] met the eligibility criteria and were analyzed. The centenarians were predominantly females [76.3% (IQR 60–85%)] with a small body surface area, long history of hypertension and slightly impaired renal functional reserve. The centenarian population showed a reduced burden of cardiovascular disease but an increased comorbidity burden, as assessed using the Charlson [median value 3.7 (IQR 1.8–5.5)] and Katz [median value 2.1 (IQR 1.1–3.1)] indexes. The echocardiographic findings comprised left ventricular (LV) concentric remodeling, with first-degree diastolic dysfunction [median E/A ratio 0.8 (IQR 0.7–0.9)], a moderate increase in LV filling pressure [median E/e’ ratio 16.8 (IQR 16.2–17)], normal LV systolic function [median left ventricular ejection fraction (LVEF) 60.9% (IQR 55–84%)] and mild-to-moderate pulmonary hypertension [median systolic pulmonary artery pressure 42.1 mmHg (IQR 37–54 mmHg)]. The pooled prevalence of LV systolic dysfunction (LVEF < 50%) was 15.8%. Moderate-to-severe valvular heart diseases were detected in less than one-third of the centenarians. Compared with the outpatient and in-home cohorts, hospitalized centenarians were less commonly females and were more likely to be affected by significant LV hypertrophy with a supra-normal LVEF, higher degrees of valvulopathies and impaired pulmonary hemodynamics. Conclusions: The evidence currently suggests that centenarians have typical LV concentric remodeling with increased myocardial stiffness and diastolic dysfunction, which predispose them to heart failure with a preserved ejection fraction (HFpEF). Cardioprotective treatment should be considered for personalized implementation and uptitration in this special population. Full article
Show Figures

Figure 1

13 pages, 700 KiB  
Article
Analysing Differences in Cognitive Health, Physical Fitness and Brain Activity in Older Women With and Without MCI
by Wookwang Cheon, Jidong Tian and Jinkee Park
Geriatrics 2025, 10(1), 25; https://doi.org/10.3390/geriatrics10010025 - 10 Feb 2025
Viewed by 291
Abstract
The purpose of this study is analyse the differences in cognitive health, geriatric fitness, and brain activity between female elderly people with and without mild cognitive impairment (MCI) to contribute to the development of strategies for the prevention and management of MCI. The [...] Read more.
The purpose of this study is analyse the differences in cognitive health, geriatric fitness, and brain activity between female elderly people with and without mild cognitive impairment (MCI) to contribute to the development of strategies for the prevention and management of MCI. The study included 56 female elderly residents of G city, and the participants were divided into an MCI group (32) and a non-MCI group (24). Cognitive health was assessed by an MMSE, and geriatric physical fitness was measured by various indicators such as strength, flexibility, and balance ability. Brain activity was measured by EEG(Electroencephalogram) to record concentration, stress, and left and right brain activity. Data were processed using independent samples t-tests and multiple regression analyses. The results showed that the MCI group was older, had more chronic diseases, and had a lower MMSE scores compared to the non-MCI group. In geriatric fitness measures, the non-MCI group had higher scores in handgrip strength and balance ability. In brain activity analyses, the MCI group had higher workloads and left brain activity than the non-MCI group, but there was no significant correlation with overall cognitive health. Regression analyses showed that, among the elderly physical fitness variables, vigour had a significant effect on cognitive health, suggesting that physical robustness may enhance cognitive reserve. The MCI group had lower cognitive health and physical fitness compared to the non-MCI group and showed some differences in brain activity. In particular, handgrip strength had a significant effect on cognitive health, suggesting that an exercise programme focused on strength training may be an effective intervention for the prevention and management of MCI. Full article
Show Figures

Figure 1

12 pages, 229 KiB  
Article
Psychometric Properties of the Spanish Versions of the Activity Restriction Scale
by Laura García-García, Lucía Jiménez-Gonzalo, José A. Fernandes-Pires, Brent T. Mausbach, Luis Manuel Pérez-Cardona, Claudia Benito-Rincón and Andrés Losada-Baltar
Geriatrics 2025, 10(1), 24; https://doi.org/10.3390/geriatrics10010024 - 10 Feb 2025
Viewed by 329
Abstract
Introduction: Activity restriction (i.e., feeling limited in performing certain activities) has been studied in relation to psychological distress. The Activity Restriction Scale (ARS) has been widely used, with a two-factor structure obtained in previous studies. However, there is no validated instrument for this [...] Read more.
Introduction: Activity restriction (i.e., feeling limited in performing certain activities) has been studied in relation to psychological distress. The Activity Restriction Scale (ARS) has been widely used, with a two-factor structure obtained in previous studies. However, there is no validated instrument for this measure in Spanish. This study aims to analyze the psychometric properties of the Spanish version of the original ARS and to create an adapted version for older adults. Method: In Phase 1, the original ARS was tested in 143 Spanish family caregivers. In Phase 2, this version was explored through a pilot study with 10 Spanish older adults. In Phase 3, the ARS-Older Adults version (ARS-OA) was tested in a sample of 246 Spanish older adults. Confirmatory factor analysis was conducted in Phases 1 and 3, in addition to testing reliability, and convergent and concurrent validity. A descriptive analysis was carried out in Phase 2. Results: Both factor analyses provided support for a two-factor solution: instrumental and expressive activity restriction. Cronbach’s alpha was 0.86 (Phase 1) and 0.81 (Phase 3). The data also suggested good convergent and concurrent validity. Conclusions: The results revealed good psychometric properties of both versions of the ARS, suggesting that it is a suitable instrument for assessing activity restriction in Spanish-speaking populations. Activity restriction is suggested as a relevant variable to take into account in understanding people’s mental health. Full article
(This article belongs to the Section Geriatric Psychiatry and Psychology)
11 pages, 965 KiB  
Article
Effects of Unpredictable Perturbation Training on a Split-Belt Treadmill on Physical Performance in Older Adults: A Randomized Controlled Trial
by Kap-Soo Han and Myoung-Hwan Ko
Geriatrics 2025, 10(1), 23; https://doi.org/10.3390/geriatrics10010023 - 7 Feb 2025
Viewed by 335
Abstract
Background/Objectives: This clinical trial aimed to determine whether perturbation-based gait training (PBGT) on a split-belt treadmill enhances balance and muscle strength in older adults, comparing its effectiveness with walking-only training on a treadmill. Methods: This single-center, prospective, single-blind (assessor), randomized controlled [...] Read more.
Background/Objectives: This clinical trial aimed to determine whether perturbation-based gait training (PBGT) on a split-belt treadmill enhances balance and muscle strength in older adults, comparing its effectiveness with walking-only training on a treadmill. Methods: This single-center, prospective, single-blind (assessor), randomized controlled trial included 24 older adults from the Rehabilitation Center of Jeonbuk National University Hospital. Participants were equally divided into the PBGT and control groups. Both groups underwent 12 training sessions, three times a week for 4 weeks, for a total of 43 min per session. The outcomes, including the Five Times Sit-to-Stand Test (FTSST), Falls Efficacy Scale International, timed up-and-go (TUG) test, functional reach test, and lower-extremity manual muscle test scores, were measured at three time points: pre-training, post-training, and four weeks after training. Results: While there were no significant differences between the two groups, the PBGT group demonstrated significant improvements in its FTSST and TUG values. Conclusions: Unpredictable perturbation training on a split-belt treadmill can be safely performed by older adults and may serve as an alternative exercise method to enhance physical performance and balance ability for fall prevention. Full article
(This article belongs to the Section Geriatric Rehabilitation)
Show Figures

Figure 1

23 pages, 6390 KiB  
Article
Effects of Twelve Weeks of Square Stepping Exercises on Physical and Cognitive Function and Plasma Content of SMP30: A Randomised Control Trial
by Juan Manuel Franco-García, Jorge Pérez-Gómez, Antonio Castillo-Paredes, Pedro Cosme Redondo, Jorge Rojo-Ramos, Noelia Mayordomo-Pinilla, Santos Villafaina, Mari Carmen Gómez-Álvaro, Maria Melo-Alonso and Jorge Carlos-Vivas
Geriatrics 2025, 10(1), 22; https://doi.org/10.3390/geriatrics10010022 - 7 Feb 2025
Viewed by 343
Abstract
Background: Ageing and sedentary lifestyles affect physical and cognitive function and markers of frailty, increasing the risk of falls in older adults and affecting their quality of life. The aim of this study was to evaluate the effects of a Square Step Exercise [...] Read more.
Background: Ageing and sedentary lifestyles affect physical and cognitive function and markers of frailty, increasing the risk of falls in older adults and affecting their quality of life. The aim of this study was to evaluate the effects of a Square Step Exercise programme on physical and cognitive function and plasma SMP30 levels for the prevention of falls in older adults. Methods: A randomised controlled trial was designed with 44 participants assigned to an experimental group (SSE group) and a control group. The SSE group performed SSE sessions twice a week for three months, with a follow-up in the fourth month. The assessments of physical function included tests such as the Four-Square Step Test, Brisk Walking and its dual-task variant, Time Up and Go and its imagined and dual-task variants, 30 s Sit-to-Stand and its dual-task and imagined variants and a 6 min walking test. Questionnaires were also used to assess the risk and fear of falling. Resting EEG activity was also recorded to assess electrocortical brain activity. SMP30 levels were measured by Western blotting. Results: The SSE group showed significant improvements compared to the control group in the Four-Square Step Test (p < 0.001), Brisk Walking (p < 0.05) and reduction in the fear of falling (p < 0.001) after the training programme, but these adaptations were not maintained one month after the programme ended (p < 0.05). No significant changes were observed in the remaining variables of physical function, cognitive function, fall risk questionnaire, EEG activity or plasma levels of SMP30 compared to the control group (p > 0.05). Conclusions: The SSE programme showed efficacy in improving balance, gait speed and reducing fear of falling in older adults but did not show improvement over the control group in other areas of physical or cognitive function or plasma SMP30 levels for fall prevention. Full article
(This article belongs to the Section Healthy Aging)
Show Figures

Figure 1

12 pages, 6429 KiB  
Article
The Use and Understanding of Mild Cognitive Impairment in Routine Specialist Care: A Survey Among German Memory Clinics
by Gloria S. Benson, Claudia Bartels, Feride Stamatis, Michael Belz, Hermann Esselmann, Lutz Frölich and Lucrezia Hausner
Geriatrics 2025, 10(1), 21; https://doi.org/10.3390/geriatrics10010021 - 2 Feb 2025
Viewed by 540
Abstract
Objectives: Mild cognitive impairment (MCI) is a heterogeneous clinical syndrome and is important for the diagnosis and management of Alzheimer’s disease (AD). With the expansion of biomarker-based diagnostics, the aim of this study is to clarify the current attitudes towards and the [...] Read more.
Objectives: Mild cognitive impairment (MCI) is a heterogeneous clinical syndrome and is important for the diagnosis and management of Alzheimer’s disease (AD). With the expansion of biomarker-based diagnostics, the aim of this study is to clarify the current attitudes towards and the use of MCI, and MCI due to AD, in German memory clinics. Methods: An online survey (50 items) was performed in 2022 among specialized clinicians (N = 45) in German memory clinics to assess the use of MCI and biomarkers in current diagnosis and treatment. Attitudinal and frequency items were assessed with a five-point numeric scale (strongly disagree = 1 to completely agree = 5 and never = 1 to always = 5, respectively). Results: All respondents used MCI as a clinical diagnosis. The benefits of diagnosing MCI were labeling deficits as disease symptoms (M = 4.4, SD = 0.7), improving coping with symptoms (M = 4.1, SD = 0.9), and motivating risk reduction activities (M = 4.0, SD = 0.9). Overall, 37 respondents used specialized diagnostic criteria for MCI due to AD, and all had access to biomarker diagnostics. Patients with MCI due to AD received more frequent counseling on memory training (p < 0.001), other non-pharmacological treatments (p < 0.001), and antidementive drug treatment (p < 0.001) than patients with MCI of other etiologies. Acetylcholinesterase inhibitors were prescribed significantly more frequently to patients with MCI due to AD (p < 0.001) compared to other MCI patients. Conclusions: MCI is commonly used as a clinical diagnosis in German memory clinics. AD biomarker assessment is well established and influences patient counseling and treatment recommendations. Full article
(This article belongs to the Section Geriatric Psychiatry and Psychology)
Show Figures

Figure 1

33 pages, 13159 KiB  
Review
The Implementation of Infant Anoesis and Adult Autonoesis in the Retrogenesis and Staging System of the Neurocognitive Disorders: A Proposal for a Multidimensional Person-Centered Model
by Alessandro Pirani
Geriatrics 2025, 10(1), 20; https://doi.org/10.3390/geriatrics10010020 - 2 Feb 2025
Viewed by 478
Abstract
Background: Retrogenesis is the process by which the degenerative and vascular mechanisms of dementia reverse the order of acquisition in the normal development. Objective: The development of memory/knowledge after birth may help to know the biopsychosocial and functional characteristics (biosphere) of the retrogenesis. [...] Read more.
Background: Retrogenesis is the process by which the degenerative and vascular mechanisms of dementia reverse the order of acquisition in the normal development. Objective: The development of memory/knowledge after birth may help to know the biopsychosocial and functional characteristics (biosphere) of the retrogenesis. Methods: A literature review was performed in the PubMed, Google Scholar, and Scopus databases using 43 keywords related to retrogenesis: 234 eligible records were selected. Results: The infantile amnesia, characterized from anoesis, was described along the infant/child’s biosphere in which the limbic system progressively develops the acquisition of the body knowledge (Anoetic Body Consciousness, AnBC). Anoesis is the infant memory state characterized by the absence of long-term memories of the many stressful/painful experiences that accompany the acquisition under the long-life voluntary control of the long-term memories fundamental for the body growth and survival (mainly chewing/swallowing and walking). At the age of 3–4 years, usually, the AnBC evolves, as a continuum, into the adulthood autonoesis with the emergence, in the child/adolescent, of the consciousness of “self” trough the development of the Episodic Autobiographic Memory (EAM) and the Autonoetic Mind Consciousness (AuMC). The development of cognition and knowledge is due to the progressive maturation of the whole limbic system and not only of the hippocampus. In the biopsychosocial retrogenesis, the EAM/AuMC vanishes progressively along the mild, moderate, and severe stages of dementia when the infant AnBC resurfaces, losing progressively the basic activities of daily living in a retrogenetic order of acquisition where the last functions to disappear are chewing/swallowing. Conclusion: The transition from the adult EAM-AuMC to the infant AnBC, as a continuum in the individual biosphere, adds a contribution to the assessment of the retrogenesis in dementia from a multidimensional person-centered model. Full article
(This article belongs to the Topic Translational Advances in Neurodegenerative Dementias)
Show Figures

Figure 1

12 pages, 212 KiB  
Article
Hindering Factors and Perceived Needs for the Decision Making of Advanced Directives Among People with Dementia and Their Families
by Hsiu-Ching Lin, Yu-Fang Lu, Ching-Hsueh Yeh, Jy-Jing Wang and Ya-Ping Yang
Geriatrics 2025, 10(1), 19; https://doi.org/10.3390/geriatrics10010019 - 1 Feb 2025
Viewed by 547
Abstract
Making advanced directives is challenging in Asia. The hindering factors and perceived needs for advanced directives for people with dementia and their families have not been fully explored in Taiwan. In this study, we aimed to identify the barriers and perceived needs of [...] Read more.
Making advanced directives is challenging in Asia. The hindering factors and perceived needs for advanced directives for people with dementia and their families have not been fully explored in Taiwan. In this study, we aimed to identify the barriers and perceived needs of people with mild dementia and the families of people with dementia within the cultural context of Taiwan for advanced directives. A qualitative descriptive design with purposive sampling and content analysis was used to collect and analyze the data. Thirteen people with mild dementia and thirty-two families of people with dementia were recruited. Our findings indicated that the hindering factors for people with mild dementia and the families of people with dementia to make advanced directives included “talking about death is a taboo”, “the timing is not right”, “cultural values of filial piety”, “male protagonist’s social status”, and “insufficient information on advanced directive”. The perceived needs for participants in making advanced directive decisions were “a wish to die without suffering”, “wanting to rely on others to make a decision”, and “an increased awareness of information”. This research offers valuable insights into the barriers and needs related to advanced directives for people with mild dementia and the families of people with dementia in Taiwan. These findings address the identified challenges and needs to develop effective solutions to help healthcare providers to better facilitate the decision-making process for advanced directives. Full article
18 pages, 1159 KiB  
Article
Identification of Barriers and Needs in the Discontinuation of Benzodiazepine Receptor Agonists in Elderly Patients of a Rural Community—A Qualitative Study
by Tiago de Barros Mendes, Marta Nazha, Ana Luísa Neves and Paula Broeiro-Gonçalves
Geriatrics 2025, 10(1), 18; https://doi.org/10.3390/geriatrics10010018 - 1 Feb 2025
Viewed by 380
Abstract
Background/Objectives: The predictors of successful discontinuation of benzodiazepine agonist receptors (BZRA) in elderly patients are not well known due to lack of research on the subject, and there is a need for further investigation, with more focus from the patients’ point of [...] Read more.
Background/Objectives: The predictors of successful discontinuation of benzodiazepine agonist receptors (BZRA) in elderly patients are not well known due to lack of research on the subject, and there is a need for further investigation, with more focus from the patients’ point of view. No previous studies were identified that have been conducted in Portugal on this subject. We proposed to identify the barriers and facilitators in the discontinuation of BZRA from the perceptions of elderly patients under prolonged prescription of BZRA, belonging to the same rural community. The contributions for further research are intended to be the identification of potential intervention targets directed at patients to reduce the prevalence of elderly patients under prolonged prescription of BZRA. Methods: A set of 15 semi-structured interviews with patients under prolonged prescription of BZRA was conducted. Content analysis was done by the main researcher and a reviewer to identify original emerging themes for the two underlying domains. Results: Four themes were identified as barriers to the discontinuation of BZRA: (1) patient characteristics, (2) clinical factors, (3) medication-related factors, and (4) context and external factors. Seven themes were identified as facilitators to the discontinuation of BZRA: (1) motivation, (2) patients’ knowledge, (3) perception of BZRA insufficiency, (4) access to written information, (5) access to alternatives, (6) time for decision-making, and (7) attitudes of health professionals. Conclusions: The findings highlight the challenging nature of BZRA discontinuation and the range of barriers and facilitators that impact patients’ behaviour towards this purpose. We subdivided the elements identified in two areas, therefore aiming at producing significant knowledge to outline potential intervention targets. Full article
Show Figures

Figure 1

15 pages, 845 KiB  
Systematic Review
Nutritional Support in the Prevention and Treatment of Pressure Ulcers in Healthy Aging: A Systematic Review of Nursing Interventions in Community Care
by Giovanni Cangelosi, Francesco Sacchini, Federico Biondini, Stefano Mancin, Sara Morales Palomares, Gaetano Ferrara, Gabriele Caggianelli, Marco Sguanci and Fabio Petrelli
Geriatrics 2025, 10(1), 17; https://doi.org/10.3390/geriatrics10010017 - 22 Jan 2025
Viewed by 925
Abstract
Introduction: Pressure ulcers (PUs) represent a significant challenge in chronic care, particularly among the elderly with reduced mobility. They result in substantial socio-healthcare costs and negatively impact patients’ psychological well-being. Malnutrition is a key risk factor, hindering healing and increasing the risk of [...] Read more.
Introduction: Pressure ulcers (PUs) represent a significant challenge in chronic care, particularly among the elderly with reduced mobility. They result in substantial socio-healthcare costs and negatively impact patients’ psychological well-being. Malnutrition is a key risk factor, hindering healing and increasing the risk of complications. As such, appropriate nutritional interventions are crucial for managing PUs. However, these interventions are often underestimated in clinical practice, underscoring the need for a more comprehensive approach to elder care and healthy aging. Objectives: The primary objective of this study was to identify the best scientific evidence on nutritional interventions implemented by nurses in community settings to prevent complications related to PUs. Additionally, qualitative and quantitative outcomes reported in the included studies were analyzed. Method: This systematic review was conducted following PRISMA international guidelines. Searches were performed in PubMed, Scopus, Embase, and CINAHL databases. A predefined search strategy using Boolean operators was employed, and two researchers independently selected papers, with a third researcher resolving any discrepancies. Additional sources and manual reviews were conducted to minimize selection bias. Results: Out of 1003 records, 6 studies were included. Findings indicate that nurses play a fundamental role in managing PUs in community settings through specific nutritional intervention assistance processes. These healthcare professionals are pivotal in the prevention, care, and rehabilitation of vulnerable individuals with PUs. Conclusions: Nurses are strategic in the management of PUs within community care for frail populations. With nutritional support that plays a key role in both preventing and accelerating the healing of PUs. Policymakers are encouraged to invest in nursing roles to enhance assistance in community contexts, supporting healthy aging and lifestyle medicine approaches. Full article
Show Figures

Figure 1

9 pages, 214 KiB  
Article
A Retrospective Study of the Influence of Life Events and Social Support on Relapses and Recurrences in Older Patients with Bipolar Disorder
by Hanna Cusell and Rob Kok
Geriatrics 2025, 10(1), 16; https://doi.org/10.3390/geriatrics10010016 - 17 Jan 2025
Viewed by 590
Abstract
Background/Objectives: Life events and lack of social support are risk factors for a relapse or recurrence in patients with a bipolar disorder, yet studies focusing on older adults remain limited. Our aim was to investigate the influence of life events and social [...] Read more.
Background/Objectives: Life events and lack of social support are risk factors for a relapse or recurrence in patients with a bipolar disorder, yet studies focusing on older adults remain limited. Our aim was to investigate the influence of life events and social support on the course of bipolar disorder in older adults. Methods: A retrospective cohort study included patients aged 55 years and older in treatment for bipolar disorder and who used lithium. During a follow-up of maximum 5 years, relapses and recurrences, life events and six social support variables were constructed based on patients’ electronic medical files. Results: We included 100 older patients with a mean age of 68.1 (SD 8.6) years; 69% were female. At least one relapse or recurrence was observed within the 5 years of observation in 52% of our patients. Life events were noted in the medical files in 24 out of these 52 (46.2%) patients. Living alone, a lower quality of social support and having at least two children was significantly associated with the onset of a relapse or recurrence (p = 0.024, p < 0.001, p = 0.022, respectively). Conclusions: Older adults with bipolar disorder have a high rate of relapses or recurrences within 5 years of observation, and half of the relapses or recurrences were preceded by life events. Social factors may also play a significant role in the onset of relapses and recurrences. Our results underline the necessity for incorporating social and environmental factors into prevention of relapses or recurrences for older bipolar patients. Full article
(This article belongs to the Topic Psychopathology and Developmental Trajectories)
Show Figures

Graphical abstract

22 pages, 2308 KiB  
Article
Short- and Long-Term Effects on Physical Fitness in Older Adults: Results from an 8-Week Exercise Program Repeated in Two Consecutive Years
by Manne Godhe, Johnny Nilsson and Eva A. Andersson
Geriatrics 2025, 10(1), 15; https://doi.org/10.3390/geriatrics10010015 - 16 Jan 2025
Viewed by 630
Abstract
Introduction: Information on the long-term maintenance of short-term exercise fitness gains measured by field-based tests is scarce in older adults. This study aimed to investigate short- and long-term changes in various physical fitness parameters after an 8-week exercise program. Methods: In [...] Read more.
Introduction: Information on the long-term maintenance of short-term exercise fitness gains measured by field-based tests is scarce in older adults. This study aimed to investigate short- and long-term changes in various physical fitness parameters after an 8-week exercise program. Methods: In this longitudinal study, a total of 265 participants (62% women; mean age 71.4 ± 4.7 years) completed a field-based test battery of 12 fitness tests (22 parameters) at 2 pre-tests and 1 post-test following an 8-week exercise program (2 sessions/week, combining aerobic and strength activities) in 2 consecutive years. The tests assessed muscle endurance, muscle strength, cardiorespiratory fitness, and motor fitness. Results: Significant short-term improvements were observed, e.g., in isometric trunk flexion and extension endurance (21–37%) for both sexes in both years. Lower-body muscular endurance improved in the first year (9–12%) for both sexes, while cardiorespiratory fitness (6-min walk test) improved only for men in both years (3%). No changes were seen in submaximal cycle test heart rates or any balance tests in any year. Most fitness parameters did not significantly decrease during the 9-month inter-intervention period, with a few exceptions in trunk strength and walking distance. Conclusions: This study demonstrates physical fitness improvements in older adults following short-term exercise interventions and that some of these improvements were maintained long term, whereas a few of these physical fitness test improvements decreased significantly over 9 months in older adults. Full article
(This article belongs to the Section Geriatric Public Health)
Show Figures

Figure 1

13 pages, 446 KiB  
Article
Genetic Predisposition to Hippocampal Atrophy and Risk of Amnestic Mild Cognitive Impairment and Alzheimer’s Dementia
by Ioannis Liampas, Vasileios Siokas, Niki Mourtzi, Sokratis Charisis, Stefanos N. Sampatakakis, Ioannis Foukarakis, Alex Hatzimanolis, Alfredo Ramirez, Jean-Charles Lambert, Mary Yannakoulia, Mary H. Kosmidis, Efthimios Dardiotis, Georgios M. Hadjigeorgiou, Paraskevi Sakka, Konstantinos Rouskas and Nikolaos Scarmeas
Geriatrics 2025, 10(1), 14; https://doi.org/10.3390/geriatrics10010014 - 16 Jan 2025
Viewed by 575
Abstract
Background: There is a paucity of evidence on the association between genetic propensity for hippocampal atrophy with cognitive outcomes. Therefore, we examined the relationship of the polygenic risk score for hippocampal atrophy (PRShp) with the incidence of amnestic mild cognitive impairment (aMCI) and [...] Read more.
Background: There is a paucity of evidence on the association between genetic propensity for hippocampal atrophy with cognitive outcomes. Therefore, we examined the relationship of the polygenic risk score for hippocampal atrophy (PRShp) with the incidence of amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD) as well as the rates of cognitive decline. Methods: Participants were drawn from the population-based HELIAD cohort. Comprehensive neuropsychological assessments were performed at baseline and at follow-up. PRShp was derived from the summary statistics of a large genome-wide association study for hippocampal volume. Cox proportional hazards models as well as generalized estimating equations (GEEs) were used to evaluate the association of PRShp with the combined incidence of aMCI/AD and cognitive changes over time, respectively. All models were adjusted for age, sex, education, and apolipoprotein E (APOE) genotype. Results: Our analysis included 618 older adults, among whom 73 developed aMCI/AD after an average follow-up of 2.96 ± 0.8 years. Each additional SD of PRShp elevated the relative hazard for incident aMCI/AD by 46%. Participants at the top quartile of PRShp had an almost three times higher risk of converting to aMCI/AD compared to the lowest quartile group. Higher PRShp scores were also linked to steeper global cognitive and memory decline. The impact of PRShp was greater among women and younger adults. Conclusions: Our findings support the association of PRShp with aMCI/AD incidence and with global cognitive and memory decline over time. The PRS association was sex- and age-dependent, suggesting that these factors should be considered in genetic modelling for AD. Full article
(This article belongs to the Section Geriatric Neurology)
Show Figures

Figure 1

13 pages, 1172 KiB  
Article
Healthcare Workers’ Attitudes Toward Older Adults’ Nutrition: A Descriptive Cross-Sectional Study in Italian Nursing Homes
by Milko Zanini, Gianluca Catania, Marco Di Nitto, Lara Delbene, Stefania Ripamonti, Maria Emma Musio and Annamaria Bagnasco
Geriatrics 2025, 10(1), 13; https://doi.org/10.3390/geriatrics10010013 - 16 Jan 2025
Viewed by 497
Abstract
Background: Malnutrition is a widespread issue among older people, significantly impacting health outcomes. Nutritional interventions can improve health, but their success often depends on the attitudes and knowledge of healthcare workers. Aim: This study assesses healthcare workers’ attitudes toward older people’s nutrition using [...] Read more.
Background: Malnutrition is a widespread issue among older people, significantly impacting health outcomes. Nutritional interventions can improve health, but their success often depends on the attitudes and knowledge of healthcare workers. Aim: This study assesses healthcare workers’ attitudes toward older people’s nutrition using the validated Italian version of the Staff Attitudes to Nutritional Nursing Geriatric care scale (SANN-G), focusing on staff in nursing homes in Northern Italy. Methods: A cross-sectional study was conducted with 1789 healthcare workers from 41 facilities. The SANN-G questionnaire measured attitudes across five dimensions: nutritional norms, habits, assessment, intervention, and individualization. Data were collected online and on paper, with descriptive and inferential statistical analyses (chi-square and ANOVA) performed using R software (R-4.4.2 for Windows). Results: Most healthcare workers were female (68.59%) and aged 41–50 (33.31%), with nursing assistants comprising 35.83%. Only 23.48% scored positively on the SANN-G scale, with most exhibiting neutral or negative attitudes. Healthcare workers who attended a malnutrition course were more likely to exhibit positive attitudes toward nutrition, particularly in the dimension of norms, assessment, intervention, and individualization. Younger healthcare workers, with the role of nurses and who attended a course on malnutrition, were more likely to have positive attitudes, while older healthcare workers and with the role of physicians tended to show neutral or negative attitudes. Conclusions: Education on malnutrition improves healthcare workers’ attitudes toward older adults’ nutrition, especially among younger nurses. The low percentage of positive attitudes (23.48%) underscores the need for broader education programs to enhance nutritional care quality. Full article
(This article belongs to the Section Geriatric Nutrition)
Show Figures

Figure 1

21 pages, 697 KiB  
Systematic Review
Effects of Aquatic Exercise in Older People with Osteoarthritis: Systematic Review of Randomized Controlled Trials
by Carlos Ayán-Pérez, Daniel González-Devesa, Beatriz Montero-García and Silvia Varela
Geriatrics 2025, 10(1), 12; https://doi.org/10.3390/geriatrics10010012 - 13 Jan 2025
Viewed by 866
Abstract
Objective: In this study, the objective is to analyze the efficacy of different aquatic physical exercise programs in the treatment of osteoarthritis in older people. Material and Methods: The systematic review was conducted until April 2024 and updated in November 2024 in five [...] Read more.
Objective: In this study, the objective is to analyze the efficacy of different aquatic physical exercise programs in the treatment of osteoarthritis in older people. Material and Methods: The systematic review was conducted until April 2024 and updated in November 2024 in five electronic databases. Randomized controlled studies in people over 60 years of age with a diagnosis of osteoarthritis were included. Water-based exercise interventions were assessed for their impact on osteoarthritis symptoms, walking ability, muscle strength, depressive symptoms, range of motion, body composition, fear of falling, fall risk, quality of life, range of motion, and dual task function. The methodological quality of included studies was assessed using the Physiotherapy Evidence Database. Results: A total of 12 studies were included, with sample sizes ranging from 35 to 312 participants. The presence of osteoarthritis in the sample was manifested in different joints. The methodological quality of the included studies varied from fair to good. Based on the results of this review, aquatic exercise significantly improved balance, stiffness, pain, and walking ability compared to non-exercise controls (p < 0.05). Compared with land-based exercise groups, only one study found significant differences between the two groups. Conclusions: Water-based exercise programs do not provide significantly superior benefits compared to other exercise modalities and appear to have limited effectiveness in the management of OA. However, the feasibility and high adherence make these programs a recommendable option for older people with OA. Future studies should investigate the impact of exercise intensity on the short- and long-term efficacy of aquatic therapy. Full article
Show Figures

Graphical abstract

13 pages, 598 KiB  
Article
Participation as a Pillar of Active Ageing: The Role of Eudaimonic Psychological and Health Factors
by Teresa Paniagua-Granados, Virginia Fernández-Fernández and María Ángeles Molina-Martínez
Geriatrics 2025, 10(1), 11; https://doi.org/10.3390/geriatrics10010011 - 13 Jan 2025
Viewed by 698
Abstract
Background/Objectives: With ageing population projections, promoting positive ageing trajectories is critical. While health is often emphasised, eudaimonic psychological factors remain underexamined. A qualitative study presented throughout the main text highlighted the importance of psychological factors like purpose in life and resilience in fostering [...] Read more.
Background/Objectives: With ageing population projections, promoting positive ageing trajectories is critical. While health is often emphasised, eudaimonic psychological factors remain underexamined. A qualitative study presented throughout the main text highlighted the importance of psychological factors like purpose in life and resilience in fostering participation and subjective well-being, even amidst declining health. This model bridges the most recent updates from governmental organisations—the International Longevity Center, Brazil and the World Health Organization. Building on this model, the current research seeks to empirically assess the impact of health and eudaimonic psychological factors on the frequency and satisfaction of participation among older adults. Methods: This study involved 289 participants (56.74% women) aged 65+ in Madrid. Data on participation, self-perceived health, and eudaimonic factors were collected through an online survey. Hierarchical regression and cluster analyses explored the predictors and profiles of participation. Results: Resilience, positive relationships, and autonomy explained 8.8% of variance in participation frequency. Satisfaction was influenced by health, meaning in life, and autonomy, accounting for 11% of variance. Profiles showed the highest participation and satisfaction in individuals with high eudaimonic scores, despite moderate health. Conclusions: Eudaimonic factors significantly influence participation and mitigate health limitations, reinforcing the qualitative study model mentioned. By uniting updates from governmental organisations proposals, this model underscores the role of psychological well-being in active ageing. Future research should explore hedonic well-being as a key outcome of active ageing. Full article
(This article belongs to the Section Healthy Aging)
Show Figures

Figure 1

14 pages, 464 KiB  
Article
SPING Block Analgesia in Non-Operative Management of Proximal Femur Fractures in Older Adults Living with Frailty: A Retrospective Cohort Study
by Miriam W. A. van der Velden, Thamar Kroes, Nick J. G. Visschers, Frank P. J. F. de Loos, Pleun Janssens, Bart Spaetgens, Miriam C. Faes, Marieke H. J. van den Beuken-van Everdingen and Arnela Suman
Geriatrics 2025, 10(1), 10; https://doi.org/10.3390/geriatrics10010010 - 10 Jan 2025
Viewed by 931
Abstract
Background/Objectives: Spinal Phenol IN Glycerol (SPING) block is a novel palliative pain treatment for the non-operative management of proximal femur fractures (PFFs) in older adults living with frailty. Effective pain management that aligns with patient preferences and minimizes opioid use is critical [...] Read more.
Background/Objectives: Spinal Phenol IN Glycerol (SPING) block is a novel palliative pain treatment for the non-operative management of proximal femur fractures (PFFs) in older adults living with frailty. Effective pain management that aligns with patient preferences and minimizes opioid use is critical in this setting. This study evaluated the patient, safety, and process outcomes of SPING block in this population. Methods: A retrospective cohort study was conducted in a suburban teaching hospital from March 2021 to June 2024, which included sixty-eight older adults living with frailty that suffered from a PFF and received SPING block. Data were collected from the Electronic Patient Records. The patient living situation was visualized with a Sankey diagram. Changes in pain scores and opioid use were assessed using the Wilcoxon Signed Rank test. Results: The median patient age was 89 years (Interquartile range (IQR) 83–92). Most were severely or terminally ill (American Society of Anesthesiologists (ASA) ≥ 4, 72%) and had cognitive impairment or dementia (68%). SPING block was effective in 93% of patients, significantly reducing median pain scores (4 [IQR 3–5] to 0 [IQR 0–1], p < 0.001) and opioid use (15 mg/day [IQR 4–30] to 0 mg/day [IQR 0–0], p < 0.001). Within 24 h, 84% could sit upright and 44% could transfer between their bed and chair. The median time to discharge was one day (IQR 0–3), with a median survival of 13 days (IQR 7–44). Conclusions: This study supports SPING block as a viable option for older adults living with frailty suffering from a PFF who opt for non-operative management in a palliative setting. SPING block for PFFs in a palliative setting offers effective pain relief, reduces opioid use, and enables mobility for older adults living with frailty. Follow-up is essential to monitor efficacy and safety. Prospective studies are needed to confirm these findings. Full article
Show Figures

Figure 1

15 pages, 440 KiB  
Article
Comparing the PRISMA-7 and a Modified Version (PRISMA-6) for Frailty Screening: Addressing Sex Bias in Community-Dwelling Older Adults
by Dietmar Ausserhofer, Angelika Mahlknecht, Verena Barbieri, Adolf Engl, Giuliano Piccoliori and Christian J. Wiedermann
Geriatrics 2025, 10(1), 9; https://doi.org/10.3390/geriatrics10010009 - 7 Jan 2025
Viewed by 573
Abstract
Background/Objectives: Frailty screening facilitates the identification of older adults at risk of adverse health outcomes. The Program of Research to Integrate Services for the Maintenance of Autonomy 7 (PRISMA-7) is a widely utilised frailty tool; however, concerns regarding its potential sex bias persist [...] Read more.
Background/Objectives: Frailty screening facilitates the identification of older adults at risk of adverse health outcomes. The Program of Research to Integrate Services for the Maintenance of Autonomy 7 (PRISMA-7) is a widely utilised frailty tool; however, concerns regarding its potential sex bias persist due to item 2, which assigns a frailty point for male sex. This study compared the PRISMA-7 with a modified version, the PRISMA-6 (excluding item 2), to assess their suitability for frailty screening in South Tyrol, Italy. Objectives included evaluating the impact of item 2 on frailty classification and exploring the feasibility of the PRISMA-6 as a more equitable alternative. Methods: A cross-sectional survey of 1695 community-dwelling older adults aged ≥75 years was conducted in South Tyrol. Frailty was assessed using both the PRISMA-7 and PRISMA-6. Sociodemographic, health, and lifestyle data were collected to examine associations with frailty classifications. Logistic regression was applied to identify predictors of frailty for each tool. Agreement between the PRISMA-7 and PRISMA-6 was assessed, and internal consistency was evaluated using Cronbach’s alpha. Results: Frailty prevalence was 33.9% with the PRISMA-7 and 27.0% with the PRISMA-6. The PRISMA-7 classified men as frail more frequently than women (34.7% vs. 33.0%), while the PRISMA-6 reversed this trend (men, 21.4%; women, 33.0%). Excluding item 2 improved internal consistency (Cronbach’s alpha: PRISMA-7, 0.64; PRISMA-6, 0.75) and aligned frailty classifications with predictors such as age, health status, and physical activity. Logistic regression revealed significant sex differences with the PRISMA-7 but not with the PRISMA-6. Conclusions: The PRISMA-7 introduces sex bias by overestimating frailty in men, whereas the PRISMA-6 provides a more equitable and consistent alternative. The findings highlight the PRISMA-6’s potential as a reliable tool for unbiased frailty screening. Future research should validate the PRISMA-6 against established frailty tools to support its integration into primary care settings. Full article
(This article belongs to the Collection Frailty in Older Adults)
Show Figures

Figure 1

20 pages, 600 KiB  
Article
Exploring Context Allows Us to Better Understand Physical Activity in People with and Without Parkinson’s Who Have Fallen: A Mixed Methods Study
by Katherine Baker, Julia Das, Lynn Rochester, Silvia Del Din and Jenni Naisby
Geriatrics 2025, 10(1), 8; https://doi.org/10.3390/geriatrics10010008 - 7 Jan 2025
Viewed by 582
Abstract
Background: Falls are a frequent and serious problem for older adults, especially for those living with Parkinson’s. The relationship between falls and physical activity is complex, and people often restrict activity following a fall. Exercise is an important aspect of reducing further risk [...] Read more.
Background: Falls are a frequent and serious problem for older adults, especially for those living with Parkinson’s. The relationship between falls and physical activity is complex, and people often restrict activity following a fall. Exercise is an important aspect of reducing further risk of a fall and a key component of the management of Parkinson’s. The aim of this study was to understand the types of activity they are engaged in, the environments in which they take place, and the experience of people with and without Parkinson’s who have fallen. Method: Seventeen people with Parkinson’s and thirteen older adults who had experienced at least one fall in the previous year were recruited to this mixed methods study. Activity levels were captured over one week using accelerometers and body-worn cameras, allowing the type and location of activity to be recorded and analysed. This information informed an interview. Results: Findings showed that although both groups often achieved up to 10,000 steps per day, this was in very short bouts of activity. Sedentary activity, such as watching television, dominated the findings. Participants were aware of the benefits of being active but described many barriers to achieving the level of activity they would like to. Full article
(This article belongs to the Special Issue Physical Activity and Exercise in Older Adults)
Show Figures

Figure 1

11 pages, 957 KiB  
Article
Effect of Early Postoperative Gait Parameters After Total Hip Arthroplasty on Forgotten Joint Score-12 at 2-Year Follow-Up
by Kazuya Okazawa, Satoshi Hamai, Tsutomu Fujita, Shinya Kawahara, Daisuke Hara, Yasuharu Nakashima and Hiroshi Katoh
Geriatrics 2025, 10(1), 7; https://doi.org/10.3390/geriatrics10010007 - 6 Jan 2025
Viewed by 665
Abstract
Purpose: This study aimed to elucidate the relationship between early postoperative gait parameters after total hip arthroplasty (THA) and the Forgotten Joint Score-12 (FJS-12) score at the 2-year follow-up after surgery. In addition, the cutoff gait parameter values for predicting discomfort using specific [...] Read more.
Purpose: This study aimed to elucidate the relationship between early postoperative gait parameters after total hip arthroplasty (THA) and the Forgotten Joint Score-12 (FJS-12) score at the 2-year follow-up after surgery. In addition, the cutoff gait parameter values for predicting discomfort using specific FJS-12 subitems were evaluated. Methods: Among 313 patients who underwent THA between April and December 2019, 44 (14.0%) who responded to the FJS-12 questionnaire at 2 years postoperatively were included in this study. Gait parameters, including walking speed, stride length, and their coefficients of variation (CVs), were measured at 13.8 ± 3.6 (mean ± standard deviation) days postoperatively. The FJS-12 was used to evaluate patients at 2 years after surgery. The correlation between the FJS-12 score and gait parameters was analyzed using Spearman’s rank correlation coefficient. To determine the significant predictors of the FJS-12 score, multiple regression analysis was performed after adjusting for age as a covariate. Furthermore, receiver operating characteristic curves were used to determine the cutoff gait parameter values for predicting discomfort using specific FJS-12 subitems. Results: The FJS-12 score was significantly positively correlated with walking speed (rs = 0.38, p < 0.05) and stride length (rs = 0.51, p < 0.01). Meanwhile, the FJS-12 score was significantly negatively correlated with the CVs of walking speed (rs = −0.34, p < 0.05) and stride length (rs = −0.35, p < 0.05). Based on multiple regression analysis, stride length was a significant predictor of discomfort assessed using the FJS-12 score (β = 0.48, p < 0.01). According to the receiver operating characteristic curves, the cutoff stride length values for predicting discomfort using the FJS-12 subitems 9, 10, 11, and 12 showed moderate accuracy (area under the curve > 0.7). Conclusions: Improved walking ability of patients who underwent THA through early rehabilitation is linked to joint discomfort and patient satisfaction in daily life 2 years postoperatively. Full article
(This article belongs to the Section Geriatric Rehabilitation)
Show Figures

Figure 1

19 pages, 2377 KiB  
Article
Predicting Hospitalization in Older Adults Using Machine Learning
by Raymundo Buenrostro-Mariscal, Osval A. Montesinos-López and Cesar Gonzalez-Gonzalez
Geriatrics 2025, 10(1), 6; https://doi.org/10.3390/geriatrics10010006 - 4 Jan 2025
Viewed by 875
Abstract
Background/Objectives: Hospitalization among older adults is a growing challenge in Mexico due to the high prevalence of chronic diseases and limited public healthcare resources. This study aims to develop a predictive model for hospitalization using longitudinal data from the Mexican Health and [...] Read more.
Background/Objectives: Hospitalization among older adults is a growing challenge in Mexico due to the high prevalence of chronic diseases and limited public healthcare resources. This study aims to develop a predictive model for hospitalization using longitudinal data from the Mexican Health and Aging Study (MHAS) using the random forest (RF) algorithm. Methods: An RF-based machine learning model was designed and evaluated under different data partition strategies (ST) with and without variable interaction. Variable importance was assessed based on the mean decrease in impurity and permutation importance, enhancing our understanding of predictors of hospitalization. The model’s robustness was ensured through modified nested cross-validation, with evaluation metrics including sensitivity, specificity, and the kappa coefficient. Results: The model with ST2, incorporating interaction and a 20% test proportion, achieved the best balance between sensitivity (0.7215, standard error ± 0.0038), and specificity (0.4935, standard error ± 0.0039). Variable importance analysis revealed that functional limitations (e.g., abvd3, 31.1% importance), age (12.75%), and history of cerebrovascular accidents (12.4%) were the strongest predictors. Socioeconomic factors, including education level (12.08%), also emerged as critical predictors, highlighting the model’s ability to capture complex interactions between health and socioeconomic variables. Conclusions: The integration of variable importance analysis enhances the interpretability of the RF model, providing novel insights into the predictors of hospitalization in older adults. These findings underscore the potential for clinical applications, including anticipating hospital demand and optimizing resource allocation. Future research will focus on integrating subgroup analyses for comorbidities and advanced techniques for handling missing data to further improve predictive accuracy. Full article
Show Figures

Figure 1

24 pages, 823 KiB  
Article
COVID-19 and Mental Distress and Well-Being Among Older People: A Gender Analysis in the First and Last Year of the Pandemic and in the Post-Pandemic Period
by M. Pilar Matud
Geriatrics 2025, 10(1), 5; https://doi.org/10.3390/geriatrics10010005 - 3 Jan 2025
Viewed by 895
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic seriously threatened the health and well-being of the population. This study aims to investigate the relevance of the COVID-19 pandemic on the stress, mental distress, and well-being of older people in Spain. The design was quantitative repeated [...] Read more.
The Coronavirus disease 2019 (COVID-19) pandemic seriously threatened the health and well-being of the population. This study aims to investigate the relevance of the COVID-19 pandemic on the stress, mental distress, and well-being of older people in Spain. The design was quantitative repeated cross-sectional. The sample was non-probability and consisted of 1436 persons from the general population divided into two groups: (1) the study group, composed of 718 women (61.3%) and men aged 60 to 89; (2) the comparison group, composed of the same number of women and men aged 30 to 45. All were assessed in three phases of the COVID-19 pandemic: the first pandemic year, the last pandemic year, and the post-pandemic period. The results showed that during the first year of the pandemic, the prevalence of mental distress was higher in older women (50%) than in older men (37.2%), while the rates in the comparison group were 57.2% for women and 53.2% for men. In the post-pandemic period, the rates of mental distress were 30.2% for older women and 29.8% for older men while in the comparison group, the rates were 48.5% for women and 26.5% for men. No significant differences in well-being were found between the groups or between the different phases of the pandemic. The most common stressors reported by older people were illness and death of family and/or loved ones, followed by personal illness. In the post-pandemic period, more stressful events and lower stress resilience were found to predict mental distress in older women and men. Greater perceived vulnerability to infection was another important predictor for women. Low self-esteem and younger age were also predictors of mental distress for men. High self-esteem, high social support, greater stress resilience and fewer stressful events were predictors of well-being for both genders. The results of this study are relevant for the design of policies, programs, and strategies to improve the health and well-being of older people. Full article
(This article belongs to the Section Geriatric Psychiatry and Psychology)
Show Figures

Figure 1

10 pages, 749 KiB  
Article
Improving Sleep Quality and Well-Being in Institutionalized Older Adults: The Potential of NESA Non-Invasive Neuromodulation Treatment
by Aníbal Báez-Suárez, Virginia Báez-Suárez, Laissa Saldanha, Martín Vílchez-Barrera, Andrea Hernández-Pérez and Raquel Medina-Ramírez
Geriatrics 2025, 10(1), 4; https://doi.org/10.3390/geriatrics10010004 - 3 Jan 2025
Viewed by 757
Abstract
Background/Objectives: Ageing is associated with several cognitive, physical, and emotional changes, including a decrease in sleep quality and mental health issues. This study studies NESA (Spanish acronym for Neuromodulación Superficial Aplicada) non-invasive neuromodulation using microcurrents as something that may provide a potential [...] Read more.
Background/Objectives: Ageing is associated with several cognitive, physical, and emotional changes, including a decrease in sleep quality and mental health issues. This study studies NESA (Spanish acronym for Neuromodulación Superficial Aplicada) non-invasive neuromodulation using microcurrents as something that may provide a potential improvement in the quality of sleep and general health of older adults and residents in a healthcare institution. Methods: This observational study recruited 24 people who were residents at a long-term care facility. Participants were divided into two groups: one intervention group, who underwent NESA therapy twice a week for a total of 20 sessions, and a control group, who did not receive this treatment. The outcomes measured include sleep quality (Pittsburgh Sleep Quality Index), diary of sleep, symptoms of depressed mood (Yesavage Geriatric Depression Scale), and quality of life with the World Health Organization Quality of Life-Old (WHOQOL-OLD). Scores were collected at baseline, after 10 and 20 sessions, and 3 months after finishing the treatment. Results: The intervention group exhibited a notable improvement in sleep quality (p = 0.05). Additionally, there were fewer nocturnal awakenings. The quality of life also showed better scores, especially in relation to social relations and physical and mental health, which matches the slight decrease in scores and clinical improvement regarding depressive symptoms. In contrast, the control group demonstrated no improvement in symptoms, and in some cases, there was a worsening of symptoms. Conclusions: Our findings indicate that NESA non-invasive neuromodulation therapy is likely to enhance sleep quality and health-related measures in institutionalized older adults. Despite the limitations of the current study, the results support the potential of NESA microcurrents to enhance the well-being of this population. Full article
(This article belongs to the Section Healthy Aging)
Show Figures

Figure 1

12 pages, 191 KiB  
Article
“We Work in an Industry Where We’re Here to Care for Others, and Often Forget to Take Care of Ourselves”: Aged-Care Staff Views on Self-Care
by Anna P. Lane and Jennifer Tieman
Geriatrics 2025, 10(1), 3; https://doi.org/10.3390/geriatrics10010003 - 2 Jan 2025
Viewed by 885
Abstract
Objective: This study aimed to explore self-care understanding and behaviours among aged-care workers in Australia. It was conducted as part of a project to co-produce a self-care resource for the Australian aged-care workforce. Methods: Semi-structured interviews with eleven aged-care staff and [...] Read more.
Objective: This study aimed to explore self-care understanding and behaviours among aged-care workers in Australia. It was conducted as part of a project to co-produce a self-care resource for the Australian aged-care workforce. Methods: Semi-structured interviews with eleven aged-care staff and a focus group with four staff at an aged-care facility were undertaken to understand how staff understand and practice self-care and how death and dying affect workers. Thematic analysis was performed using software to generate a data coding tree. Results: Aged-care workers view self-care as taking care of oneself and as being a way to manage and maintain wellbeing so that they can continue to care. As practiced in daily life, self-care is highly individualised, with actions at work and at home having significant impact on a person’s wellbeing. Supportive organisational cultures and collegial teams were found to be particularly relevant in helping staff to deal with death and dying. Conclusions: Aged-care workers may benefit from an online self-care resource tailored to their specific needs and based on their first-hand experiences of working in aged-care. Organisations can support aged-care workers by creating space and time for self-care. Full article
12 pages, 458 KiB  
Article
The Classification and Language Description of Patients with Primary Progressive Aphasia Using the Mini Linguistic State Examination Test
by Elena Herrera, Claudia Acevedo and María González-Nosti
Geriatrics 2025, 10(1), 2; https://doi.org/10.3390/geriatrics10010002 - 26 Dec 2024
Viewed by 584
Abstract
Introduction. Primary progressive aphasia (PPA) is a clinical syndrome characterized by a progressive deterioration in language and speech. It is classified into three variants based on symptom patterns: logopenic, semantic, and non-fluent. Due to the lack of fully reliable and valid screening tests [...] Read more.
Introduction. Primary progressive aphasia (PPA) is a clinical syndrome characterized by a progressive deterioration in language and speech. It is classified into three variants based on symptom patterns: logopenic, semantic, and non-fluent. Due to the lack of fully reliable and valid screening tests for diagnosing PPA and its variants, a Spanish version of the Mini Linguistic State Examination (MLSE) has recently been introduced. Materials and methods. This study aimed to describe the language impairments in a small sample of six patients with PPA and classify them into the three variants using the decision tree and syndrome guide proposed by the MLSE authors. Results. The findings demonstrate the test’s utility in classifying some PPA variants through a qualitative analysis of patient performance and error types. The study revealed a 50% accuracy rate for the decision tree and an 83.33% accuracy rate when using the syndrome guide. Discussion. This discrepancy arises because the decision tree often classified cases as logopenic variant PPA (lvPPA) when working memory was significantly impaired. Specifically, it tended to misclassify patients with semantic, motor, or speech impairments as having lvPPA due to its reliance on the sentence repetition task for assessing working memory. Full article
(This article belongs to the Section Geriatric Psychiatry and Psychology)
Show Figures

Figure 1

10 pages, 225 KiB  
Article
Impairment of the Functional Status and Decrease in Albumin in Frail Older People After a COVID-19 Outbreak: A Descriptive Study in a Long-Term Care Facility in Chile
by Lidia Castillo-Mariqueo, Alejandro Aedo Lagos, Lydia Giménez-Llort and Neftalí Guzmán Oyarzo
Geriatrics 2025, 10(1), 1; https://doi.org/10.3390/geriatrics10010001 - 25 Dec 2024
Viewed by 659
Abstract
Introduction. Frailty is a common condition among older individuals and is associated with increased vulnerability to adverse health outcomes. The COVID-19 pandemic further highlighted the impact of viral infections on frail populations. The present work aimed to determine frailty, functional and cognitive status, [...] Read more.
Introduction. Frailty is a common condition among older individuals and is associated with increased vulnerability to adverse health outcomes. The COVID-19 pandemic further highlighted the impact of viral infections on frail populations. The present work aimed to determine frailty, functional and cognitive status, and clinical analysis of older persons in a long-term care facility in Chile, before and following the outbreak of COVID-19. Methods. A single-center, pre–post, and Pearson’s correlational study was conducted in a cohort of 20 persons positive for COVID-19 from a total of 45 residents. Data on demographic, clinical, functional (Barthel Index (BI) and Katz) and cognitive (Mini mental Examination) status, and physiological function (hematology, lipidic and biochemical profiles) were collected. Results. The mean age was 84 ± 2.4 years, and 80% were females. The most common comorbidities were Arterial Hypertension, Diabetes Mellitus type II, and Alzheimer’s disease. Physical frailty was confirmed by body weight, body mass index, and calf circumference. Pre-infection, BI was negatively correlated with lipidic profile and erythrocyte sedimentation rate (ESR), and positively with frailty (calf circumference). Pre–post analysis showed that frailty and most analytical results were not modified. However, functional dependence on daily live activities significantly increased as measured by BI, with worse grooming and bowel and bladder controls. Post-infection, correlations were lost except between BI and ESR, and decreased albumin levels were found. Conclusions. The worsening of specific functional limitations emphasizes the need for targeted interventions that can be correlated with ESR. Albumin appears as a potential biomarker for physiological dysfunction associated with their infectious/inflammatory processes. Full article
Previous Issue
Back to TopTop