Geriatrics

12 pages, 894 KiB

Open AccessArticle

Association Between Muscle Quality Assessed by the 5-Repetition Sit-to-Stand Test and Falls in Community-Dwelling Older Adults in Japan: A Cross-Sectional Study

by Koji Takimoto, Hideaki Takebayashi, Hiroshi Kondo and Koji Ikeda

Geriatrics 2025, 10(3), 78; https://doi.org/10.3390/geriatrics10030078 - 7 Jun 2025

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Abstract

Background: Falls in older adults are a major barrier to healthy longevity. Recent studies suggest that muscle quality is associated with fall risk. This study aimed to determine whether a functional muscle quality index (MQI) using the 5-repetition sit-to-stand test (5R-STS) reflects fall [...] Read more.

Background: Falls in older adults are a major barrier to healthy longevity. Recent studies suggest that muscle quality is associated with fall risk. This study aimed to determine whether a functional muscle quality index (MQI) using the 5-repetition sit-to-stand test (5R-STS) reflects fall risk in community-dwelling older adults. Methods: This cross-sectional study included 137 community-dwelling older adults (≥65 years) in Japan. Lower limb skeletal muscle mass (SMM) was measured using the BIA method, and muscle function was assessed using the 5R-STS. The MQI was calculated as “(5R-STS (s)/SMM (kg)) × 10”. Fall history was collected using a self-administered questionnaire, and binary logistic regression analysis including gait speed and physical frailty was performed. Results: Participants were divided into fallers (n = 36; age = 78.2 ± 5.6) and non-fallers (n = 101; age = 76.9 ± 5.3). Significant differences were found between the groups in gait speed (p = 0.01), TUG (p < 0.01), 5R-STS (p < 0.01), and MQI (p < 0.01). Binary logistic regression identified MQI (OR = 1.28; p < 0.01) and gait speed (OR = 0.14; p = 0.02) as explanatory variables for fall history. The results of the evaluation using the receiver operating characteristic (ROC) curve showed that the cutoff value for MQI to distinguish fall history was 8.04 s/kg, and the cutoff value for gait speed was 1.21 s. Conclusions: The MQI using the 5R-STS shows promise as an indicator of fall risk in older adults. Further longitudinal studies are needed to clarify the causal relationship. Full article

(This article belongs to the Section Geriatric Public Health)

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18 pages, 278 KiB

Open AccessArticle

Aging Attitudes Among Middle-Aged and Older Adults with Disabilities: Gender Differences and Predictors

by Muna Bhattarai, Gloria K. Lee and Hung Jen Kuo

Geriatrics 2025, 10(3), 77; https://doi.org/10.3390/geriatrics10030077 - 5 Jun 2025

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Abstract

Background/Objectives: Research suggests that attitudes toward aging significantly impact health and well-being outcomes in older adults and are influenced by various factors. Our study aims to identify gender differences in attitudes toward aging among aging individuals with disabilities while also examining the influence [...] Read more.

Background/Objectives: Research suggests that attitudes toward aging significantly impact health and well-being outcomes in older adults and are influenced by various factors. Our study aims to identify gender differences in attitudes toward aging among aging individuals with disabilities while also examining the influence of demographic and psychological factors on these attitudes. Methods: For this cross-sectional study, we collected data from 393 middle-aged and older adults with disabilities via an online Qualtrics survey administered through the Prolific platform in the United States. Participants completed the Attitudes Towards Aging Questionnaire Short Form, Purpose in Life Test Short Form, Mindfulness Attention Awareness Scale, Acceptance of Chronic Health Conditions Scale, and Three-Item Loneliness Scale. Descriptive and correlation analyses, t-tests, and multiple regression analyses were performed. Results: The independent t-test findings reveal significant differences in physical change and psychological growth between men and women, with men scoring higher in physical change and women in psychological growth. In multiple regression analyses, purpose in life significantly predicted all three domains of attitudes toward aging in men, while both purpose in life and acceptance were predictors across all domains in women. Additionally, age, employment, and financial stability contributed to aging attitudes only among women. Conclusions: Attitudes toward aging, specifically physical change and psychological growth, were found to vary by gender, with purpose in life, acceptance, and loneliness influencing these attitudes among both groups, while certain demographic factors influenced aging attitudes only among women. These findings underscore the need for gender-specific interventions addressing these substantial factors. Full article

12 pages, 513 KiB

Open AccessArticle

Relationship Between Metabolic Syndrome Indicators Within Reference Ranges and Sarcopenia in Older Women—A 4-Year Longitudinal Study

by Tadayuki Iida, Reina Taguchi, Ruriko Miyashita, Satomi Aoi, Hiromi Ikeda, Nichika Higa, Keiko Kanagawa, Yoko Okuyama and Yasuhiro Ito

Geriatrics 2025, 10(3), 76; https://doi.org/10.3390/geriatrics10030076 - 3 Jun 2025

Viewed by 135

Abstract

Background: Frailty is a state of increased vulnerability to psychosomatic dysfunction associated with aging, with sarcopenia being a major contributing factor. Metabolic-syndrome-related metabolic diseases are recognized as risk factors for sarcopenia. While previous studies have examined the relationship between metabolic disease history [...] Read more.

Background: Frailty is a state of increased vulnerability to psychosomatic dysfunction associated with aging, with sarcopenia being a major contributing factor. Metabolic-syndrome-related metabolic diseases are recognized as risk factors for sarcopenia. While previous studies have examined the relationship between metabolic disease history or elevated metabolic syndrome indicators and sarcopenia, limited evidence exists regarding the association between metabolic indicators within reference ranges and sarcopenia in the absence of metabolic disease. This study aimed to investigate the relationship between metabolic syndrome indicators within reference ranges and the presence or absence of possible sarcopenia, as well as changes in these indicators over a four-year period, in women aged ≥65 years. Methods: A total of 224 community-dwelling women aged ≥65 years from M City and O Town who participated in health check-ups were included (approval no. 20MH017, 1 October 2020). Data were collected on height, body weight, and metabolic indicators (triglycerides, HDL cholesterol, LDL cholesterol, systolic and diastolic blood pressure, and HbA1c) at baseline and after four years. Physical performance was assessed using calf circumference, grip strength, and the five-time sit-to-stand test. Possible sarcopenia was defined according to AWGS2019 criteria. Results: Higher baseline HDL cholesterol levels were found to be protective against possible sarcopenia. An increase in triglyceride levels over four years was also associated with a reduced likelihood of possible sarcopenia. Conclusions: Maintaining high HDL cholesterol levels and increasing or preserving triglyceride levels may contribute to the prevention of sarcopenia in older women with metabolic indicators within reference ranges. Full article

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

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17 pages, 249 KiB

Open AccessArticle

Understanding the Roles of over 65-Year-Old Male and Female Carers: A Comparative Analysis of Informal Caregiving

by Purificación Ballester, Clara Pérez-Esteve, Alicia Sánchez-García, Eva Gil-Hernández, Mercedes Guilabert and José Joaquín Mira

Geriatrics 2025, 10(3), 75; https://doi.org/10.3390/geriatrics10030075 - 29 May 2025

Viewed by 238

Abstract

Background/Objectives: This study aims to explore how gender influences the role of informal caregivers aged 65 years, considering the increasing involvement of men in caregiving due to longer life expectancy and societal norms. Methods: A two-year cross-sectional study was conducted in [...] Read more.

Background/Objectives: This study aims to explore how gender influences the role of informal caregivers aged 65 years, considering the increasing involvement of men in caregiving due to longer life expectancy and societal norms. Methods: A two-year cross-sectional study was conducted in the Valencian Community, Spain, involving informal caregivers of 65 years of age and older who provided home-based care for dependent individuals with chronic conditions. The participants were recruited through public health schools, carers’ associations, and clinical consultations. The caregivers completed a comprehensive semi-structured interview, which included items from the Zarit Brief Scale (seven items) to assess caregiver burden and questions about their caregiving responsibilities, training, and experience, as well as the self-perceived frequency of medication errors. Results: A sample of 80 caregivers over 65 years old was analyzed, including 23 men (28.8%) and 57 women (71.2%). Male caregivers were significantly less experienced (mean = 3.1 years, SD = 5.9) compared to female caregivers (mean = 10.1 years, SD = 13.0; p = 0.004). Men reported lower emotional and physical burdens than women (p-value = 0.003), as reflected in the Zarit scores. Caregiving performance, measured by self-reported errors, was comparable between genders. Conclusions: This study explores the growing role of older male caregivers, highlighting their lower experience and training compared to those of women but similar caregiving performance and lower burden. Additionally, trained caregivers demonstrated significantly lower odds of experiencing burden, underscoring the importance of training as a modifiable factor. The findings emphasize the need for gender-sensitive support and tailored training programs to address disparities, reduce caregiver burden, and enhance caregiving quality and equity. Full article

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

11 pages, 208 KiB

Open AccessArticle

Predictors of Fall-Related Injuries in Fallers—A Study in Persons with Cognitive Impairment

by Per G. Farup, Knut Hestad and Knut Engedal

Geriatrics 2025, 10(3), 74; https://doi.org/10.3390/geriatrics10030074 - 28 May 2025

Viewed by 201

Abstract

Background/Objectives: Old age and cognitive impairment/dementia are risk factors for falling and fall-related injuries. We have, in a previous study in persons with cognitive impairment, shown that falls were associated with frailty, reduced physical fitness, and cognitive reduction. Falls were independent of the [...] Read more.

Background/Objectives: Old age and cognitive impairment/dementia are risk factors for falling and fall-related injuries. We have, in a previous study in persons with cognitive impairment, shown that falls were associated with frailty, reduced physical fitness, and cognitive reduction. Falls were independent of the disorders causing the impaired functions. Because most falls are innocent, knowledge of predictors of fall-related injuries seems more clinically relevant than the predictors of falls. Predictors of falls and fall-related injuries are not necessarily identical. The aim of this follow-up study to our previous one in the same population was to explore predictors of fall-related injuries in fallers and compare these predictors with those of falls. Methods: This study and our previous study used data from the “The Norwegian Registry of Persons Assessed for Cognitive Symptoms” (NorCog), a Norwegian research and quality registry with a biobank. The registry included consecutive home-dwelling persons referred to Norwegian specialist healthcare units for assessment of cognitive decline. This study included 3774 persons from our previous study who experienced falls last year and compared persons with and without a fall-related injury. A fall-related injury was defined as admittance to a hospital for the injury. Results: The annual incidence of fall-related injuries in the fallers was 884/3774 (23.4%). Female sex, older age, lower BMI, in need of public health service and walking assistance, and low Hb and Ca were independent predictors of fall-related injuries, indicating reduced physical fitness and state of health and a high burden of comorbidity. Injuries were not associated with the degree of cognitive impairment or the dementia diagnosis. Conclusions: In home-dwelling persons with impaired cognitive functions and falls, fall-related injuries were associated with reduced physical fitness and state of health. In contrast to predictors of falls, neither the degree of cognitive impairment nor the dementia diagnosis was associated with fall-related injuries. The difference is comprehensible. Persons with cognitive impairment or dementia might have reduced power of judgment and be inattentive, unconcerned and careless, which increases the fall incidence but not the risk of injury once falling. Prevention of fall-related injuries should focus on relieving comorbidities, improving physical fitness and general health rather than on cognitive improvement. Full article

20 pages, 540 KiB

Open AccessArticle

‘I Knew Nothing About Parkinson’s’: Insights into Receiving a Diagnosis of Parkinson’s Disease and the Impact of Self-Management, Self-Care, and Exercise Engagement, from People with Parkinson’s and Family Members’ Perspectives: Qualitative Study

by Leanne Ahern, Catriona Curtin, Suzanne Timmons, Sarah E. Lamb and Ruth McCullagh

Geriatrics 2025, 10(3), 73; https://doi.org/10.3390/geriatrics10030073 - 25 May 2025

Viewed by 264

Abstract

This paper draws on stories of receiving the diagnosis of Parkinson’s disease, which emerged from a broader narrative study exploring beliefs about exercise and challenges facing people with Parkinson’s disease. Background/Objectives: By interviewing people with Parkinson’s disease (PwPD) and their family members, this [...] Read more.

This paper draws on stories of receiving the diagnosis of Parkinson’s disease, which emerged from a broader narrative study exploring beliefs about exercise and challenges facing people with Parkinson’s disease. Background/Objectives: By interviewing people with Parkinson’s disease (PwPD) and their family members, this paper aimed to gain insights into PwPD’s experiences with diagnosis, its influence on exercise engagement, and access to services in Ireland. Methods: This study employed a qualitative research design, using purposeful and maximum variation sampling. PwPD (varying in age, sex, geographical setting, and disease severity) were recruited from urban physiotherapy services. Semi-structured interviews with 12 PwPD and a group interview with four family members were conducted between November 2022 and January 2023. The interviews were recorded, transcribed, and analysed using thematic analysis. Results: Four themes emerged: (1) firstly, there was disempowerment and emotional shock at diagnosis: PwPD expressed frustration with delays in diagnosis and with how language and empathy affected their ability to cope initially. (2) There was a lack of signposting and services access: a strong need exists for clear information on services and resources to prevent social disengagement. (3) In terms of exercise education and self-management support, PwPD lacked early exercise education and guidance, relying on self-education. (4) With regard to the emotional burden on family caregivers, family members manage care logistics and face emotional burdens, which they try to conceal. Conclusions: The delivery of a Parkinson’s diagnosis could be improved by recognising its psychosocial impact on PwPD and families. Providing clear information on services within weeks of diagnosis was considered crucial. Limited exercise education affected PwPD’s ability to self-manage. Early physiotherapy access is strongly recommended to help delay functional decline and encourage an active lifestyle. Full article

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13 pages, 668 KiB

Open AccessReview

Comprehensive Strategies for Preventive Periodontal Care in Older Adults

by Alice Kit Ying Chan, Yiu-Cheung Tsang, Stephanie Chu and Chun-Hung Chu

Geriatrics 2025, 10(3), 72; https://doi.org/10.3390/geriatrics10030072 - 25 May 2025

Viewed by 264

Abstract

Background: Periodontal health is closely related to systemic health and crucial for healthy aging. Periodontal disease is prevalent among older adults due to declined systemic conditions, medication side effects, and reduced dexterity and cognition. Effective preventive care is essential to maintain periodontal health [...] Read more.

Background: Periodontal health is closely related to systemic health and crucial for healthy aging. Periodontal disease is prevalent among older adults due to declined systemic conditions, medication side effects, and reduced dexterity and cognition. Effective preventive care is essential to maintain periodontal health and promote oral and general health. Objective: The aim of this narrative review is to examine preventive periodontal care tailored for older individuals, with a focus on strategies to reduce the incidence of periodontal disease, maintain periodontal health, and improve the overall well-being of older adults. Findings: Preventive periodontal care includes mechanical plaque control, use of chemotherapeutic agents, lifestyle modifications, and regular professional periodontal care. Mechanical plaque control through regular toothbrushing and interdental cleaning remains the cornerstone of prevention. The use of adaptive aids and caregiver support is essential for maintaining the oral hygiene of older adults with physical limitations. Chemotherapeutic agents, such as chlorhexidine mouth rinses, can be used as adjunctive agents for plaque control. Lifestyle modifications, like smoking cessation and dietary adjustments, are crucial components of risk factor control. Professional periodontal care, including periodontal evaluation, risk factor control, tailored oral hygiene instruction, and professional mechanical plaque removal, are essential for the prevention and early detection and management of periodontal disease in older adults. Conclusions: This review underscores the importance of a multidisciplinary approach involving oral healthcare professionals, primary care providers, and caregivers to ensure patient-centered, integrated and comprehensive geriatric care to improve periodontal outcomes and overall well-being of older adults. Full article

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9 pages, 624 KiB

Open AccessArticle

Pain Localization Shift During the Convalescence Period of Osteoporotic Vertebral Compression Fracture

by Oded Hershkovich, Mojahed Sakhnini and Raphael Lotan

Geriatrics 2025, 10(3), 71; https://doi.org/10.3390/geriatrics10030071 - 24 May 2025

Viewed by 205

Abstract

Introduction: Vertebral Compression Fractures (VCF) are the most common vertebral fractures, usually osteoporotic, with rising incidence. The natural history of VCFs-related pain remains unclear, and treatment protocols are still being evaluated, ranging from conservative to surgical. Patient-reported measures have been proven inaccurate and [...] Read more.

Introduction: Vertebral Compression Fractures (VCF) are the most common vertebral fractures, usually osteoporotic, with rising incidence. The natural history of VCFs-related pain remains unclear, and treatment protocols are still being evaluated, ranging from conservative to surgical. Patient-reported measures have been proven inaccurate and carry significant biases. This study examines maximal tenderness location (MTL) to palpation and percussion on physical examination during VCF healing and the postoperative period. Methods: A prospective study included 40 patients treated for VCFs per the NICE guidelines (2013) from 2019 to 2021. Treatment was either conservative (n = 12) or surgical (n − 28), Balloon Kyphoplasty (BKP). All patients’ MTL were recorded in EMR (Electronic Medical Record) on every visit. BKP was offered for severe ongoing pain after a recent, unhealed vertebral fracture despite optimal pain management, progressive fracture collapse, or lack of union. Follow-up was six months. Pain evolution was analyzed using Kaplan–Meier survival curves, Log-Rank tests, Mann–Whitney U tests, t-tests, and logistic regression models. A p-value < 0.05 was considered statistically significant. Results: 12 patients were treated conservatively, and 28 underwent BKP for T12-L2 VCFs, accounting for 75% of fractures, mostly single-level fractures. All initially suffered MTL over the VCF; BKP patients showed local VCF pain resolution after 3.5 weeks following surgery while lasting seven weeks under conservative treatment. Lumbosacral pain was more prevalent following BKP (OR = 4, p = 0.05) and developed earlier. Conclusions: This study is novel in relating physical examination findings to fracture age and treatment provided, suggesting that VCFs-related pain is a time-related shift from local fracture pain to lumbosacral pain. Patient-reported pain scales may not reliably distinguish between these varying pain patterns. These findings suggest that only local VCF pain should be considered for surgical treatment. Future studies evaluating VCF outcomes should address physical examination and not rely solely on patient-reported metrics. Full article

(This article belongs to the Section Geriatric Rehabilitation)

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23 pages, 634 KiB

Open AccessSystematic Review

Implementation Outcomes for Agitation Detection Technologies in People with Dementia: A Systematic Review

by Nicolas Farina, Lorna Smith, Melissa Rajalingam and Sube Banerjee

Geriatrics 2025, 10(3), 70; https://doi.org/10.3390/geriatrics10030070 - 24 May 2025

Viewed by 176

Abstract

Background: Experiencing agitation can be particularly distressing for people with dementia and their caregivers. Using technologies to detect agitation can help monitor and intervene when agitation occurs, potentially reducing overall care and support needs. This systematic review aims to explore the implementation [...] Read more.

Background: Experiencing agitation can be particularly distressing for people with dementia and their caregivers. Using technologies to detect agitation can help monitor and intervene when agitation occurs, potentially reducing overall care and support needs. This systematic review aims to explore the implementation outcomes related to the use of agitation detection technologies in people with dementia. By adopting a taxonomy of implementation outcomes, this review seeks to provide insights valuable for the real-world adoption of such technologies for people with dementia. Methods: Searches were conducted in the following databases: SCOPUS, PubMed, PsychINFO, IEEEXplore, and CINAHL Plus. Included studies were required to have implemented, evaluated, or validated technology with the intention to detect agitation in people with dementia in real-time. Results: On 14 May 2024, 1697 records were identified, and 19 were included in the review. The median sample size was 10, and around two-thirds of the records (n = 12, 63%) used ‘multimodal’ technologies for detecting agitation. Over half of the records (n = 10, 53%) were reporting from two studies. Across technologies, there was evidence of acceptability and feasibility, though there was a general absence of primary data related to implementation outcomes. There were, however, a number of technical issues and limitations that affected the fidelity and appropriateness of the technology, albeit not unique to people with dementia. Conclusions: There is a need for more empirical data on this topic to maximise uptake and adoption. Future research needs to ensure that the voice of the person with dementia is integrated within the evaluation process. Full article

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11 pages, 196 KiB

Open AccessArticle

Risk Factors for Non-Carbapenemase-Producing Carbapenem-Resistant Enterobacterales Infections: A Retrospective Cohort Study

by Sayaka Mabuchi, Tsukasa Nakamura, Toshihiro Imada, Junji Mashino and Takeshi Morimoto

Geriatrics 2025, 10(3), 69; https://doi.org/10.3390/geriatrics10030069 - 22 May 2025

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Abstract

Background/Objectives: Carbapenem-resistant Enterobacterales (CRE) infections are widespread, and the risk factors for carbapenemase-producing CRE (CP-CRE) infections are known. Non-CP-CRE (NCP-CRE) infections occur frequently; however, the associated risk factors remain elusive. Therefore, we investigated the risk factors for NCP-CRE infections, especially those caused by [...] Read more.

Background/Objectives: Carbapenem-resistant Enterobacterales (CRE) infections are widespread, and the risk factors for carbapenemase-producing CRE (CP-CRE) infections are known. Non-CP-CRE (NCP-CRE) infections occur frequently; however, the associated risk factors remain elusive. Therefore, we investigated the risk factors for NCP-CRE infections, especially those caused by Enterobacter and Citrobacter species. Methods: We conducted a retrospective cohort study of patients aged ≥ 18 years with Enterobacter or Citrobacter infections who were admitted to the Department of General Medicine of a tertiary care hospital in Japan from October 2014 to September 2020. We used the data at first detection and performed univariate and multivariate logistic regression analyses to assess the associations between NCP-CRE infections and risk factors such as patient characteristics and antibiotics. Results: In total, 1416 participants were evaluated. The mean age of the patients was 74 ± 17 (range: 18–107) years, of whom 746 (53%) were men. Past use of antibiotics (≥4 days before specimen collection) was not significantly associated with NCP-CRE infections (133 [84%] vs. 1034 [82%], p = 0.5); however, recent use (≤3 days before sample collection) was significantly associated with NCP-CRE infections (42 [27%] vs. 245 [19%], p = 0.036). In the multivariate logistic model, recent use of antibiotics (odds ratio: 1.50, 95% confidence interval: 1.03–2.18) was an independent risk factor for NCP-CRE infections. Conclusions: NCP-CRE infection may be associated with recent antibiotic exposure, but not with the host’s immune status. Therefore, alternative risk factors for NCP-CRE infection may exist. Full article

(This article belongs to the Section Basic Science)

18 pages, 2134 KiB

Open AccessCase Report

Case Report: Multifactorial Intervention for Safe Aging in Place

by Ashwini Kulkarni

Geriatrics 2025, 10(3), 68; https://doi.org/10.3390/geriatrics10030068 - 20 May 2025

Viewed by 320

Abstract

Background/Objectives: Falls are a leading cause of morbidity in older adults, particularly those with multiple comorbidities. A multidisciplinary approach addressing physical, psychological, and environmental factors is essential for reducing fall risk and supporting aging in place. This report evaluates the effectiveness of [...] Read more.

Background/Objectives: Falls are a leading cause of morbidity in older adults, particularly those with multiple comorbidities. A multidisciplinary approach addressing physical, psychological, and environmental factors is essential for reducing fall risk and supporting aging in place. This report evaluates the effectiveness of a multidisciplinary, multifactorial approach in managing high fall risk in an older adult with diabetes, hypertension, and osteoporosis. Methods: A 72-year-old woman with a recurrent history of falls participated in an 8-week intervention as part of the American Physical Therapy Association (APTA) balance and falls prevention credential program. This study was conducted in Virginia Beach, USA, at the participant’s residence. A single-subject design investigation was conducted, measuring outcomes including the Balance Evaluation Systems Test (BESTest), gait speed, Timed Up and Go (TUG), fear of falling, and balance confidence at baseline and post-intervention. Results: The participant had impaired baseline values across various variables and was classified as a recurrent high-risk faller. After 8 weeks of intervention, clinically meaningful improvements with large effect sizes were observed: self-selected gait speed improved by 25%, BESTest scores improved by 50%, Falls Efficacy—International (FES I) scores improved by 26%, and Activity Balance Confidence (ABC) scores improved by 26%. No falls or adverse events occurred during the intervention period, and the patient reported enhanced mobility and safety at home. Conclusions: A tailored multidisciplinary approach effectively addressed the physical, psychological, and environmental factors contributing to high fall risk. This highlights the importance of patient-centered interventions in managing fall risk and promoting safe aging in place. Continued education, environmental adaptations, and regular follow-up are essential for long-term fall prevention. Full article

(This article belongs to the Topic Exercise and Human Aging: Physiological and Psychological Functions)

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22 pages, 675 KiB

Open AccessArticle

Effect of a Six-Month Dance Intervention on Postural Control and Fall-Related Outcomes in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial

by Ulrich Thiel, Nicole Halfpaap, Berit K. Labott, Fabian Herold, Corinna Langhans, Kristinn Heinrichs, Patrick Müller, Notger G. Müller and Anita Hökelmann

Geriatrics 2025, 10(3), 67; https://doi.org/10.3390/geriatrics10030067 - 17 May 2025

Viewed by 356

Abstract

Background/Objectives: Older adults with mild cognitive impairment often exhibit reduced postural control and increased fall risk. As fall-related injuries consume substantial healthcare resources, the development of fall-preventive interventions is of public health relevance. This study aims to investigate the effects of a six-month [...] Read more.

Background/Objectives: Older adults with mild cognitive impairment often exhibit reduced postural control and increased fall risk. As fall-related injuries consume substantial healthcare resources, the development of fall-preventive interventions is of public health relevance. This study aims to investigate the effects of a six-month dance intervention on postural control and fall-related measures in older adults with mild cognitive impairment. Methods: In this randomized controlled trial, 55 participants were allocated to either an intervention group or a control group. The intervention group performed two 90-min dance training sessions per week for six months, while the control group maintained their usual activities of daily living. Postural control was operationalized via balance performance, which was measured with the Sensory Organization Test and the Limits of Stability Test. Neuromuscular function of the lower extremities was assessed via muscle contraction velocity using tensiomyography. Fear of falling was quantified with the Falls Efficacy Scale, and participants reported fall history over the past year. It was hypothesized that older adults with mild cognitive impairment participating in the six-month dance training would show significantly greater improvements in postural control and fall-related outcomes than those in the control group. Results: A mixed analysis of variance (time × group) revealed no significant improvements in balance performance or neuromuscular function following the dance intervention (p > 0.05). However, several main effects for time were observed in the Sensory Organization Test, Limits of Stability Test, and muscle contraction velocity. Scores on the Falls Efficacy Scale improved significantly in the intervention group, reflecting reduced fear of falling, although only shown by a paired-samples t-test (t(23)= 2.276, p = 0.032, d = 0.465). Conclusions: This study did not provide evidence that a six-month dance intervention improves postural or neuromuscular functions. However, it cannot be ruled out that such null findings are related to confounding factors, such as insufficient training specificity or duration. Nonetheless, the fear of falling was significantly reduced in the intervention group, suggesting potential benefits for perceived fall risk in older adults with mild cognitive impairment. Full article

(This article belongs to the Section Geriatric Public Health)

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14 pages, 534 KiB

Open AccessArticle

Osteoporosis Is Associated with Cerebral Small Vessel Disease in Stroke-Free Individuals: A Retrospective Observational Study

by Xueling Xiao, Luling Chen, Manxiang Deng, Jingqi Liu, Jiayan Cai and Chuhan Su

Geriatrics 2025, 10(3), 66; https://doi.org/10.3390/geriatrics10030066 - 9 May 2025

Viewed by 373

Abstract

Objectives: This study aimed to investigate the relationship between osteoporosis and cerebral small vessel disease (CSVD) burden in stroke-free individuals, as well as its specific imaging markers, including lacunes, enlarged perivascular spaces (EPVSs), white matter hyperintensities (WMHs), and brain atrophy (BA). Methods [...] Read more.

Objectives: This study aimed to investigate the relationship between osteoporosis and cerebral small vessel disease (CSVD) burden in stroke-free individuals, as well as its specific imaging markers, including lacunes, enlarged perivascular spaces (EPVSs), white matter hyperintensities (WMHs), and brain atrophy (BA). Methods: A total of 684 stroke-free patients who underwent both bone mineral density (BMD) assessments and brain MRI were included. Clinical data, CSVD burden scores, imaging markers of CSVD, and bone density parameters were collected. Logistic regression models were used to evaluate the relationship between BMD and CSVD burden and imaging markers. Results: Osteoporosis, including hip and vertebral osteoporosis, was independently associated with CSVD burden (OR = 2.332, 95%CI: [1.345, 4.039], p = 0.003; OR = 2.598, 95%CI: [1.540, 4.384], p < 0.001; OR = 1.515, 95%CI: [1.010, 2.272], p = 0.044). Increased BMD in the hip and spine correlated with reduced CSVD burden (OR = 0.929, 95%CI: [0.887, 0.972], p = 0.001; OR = 0.952, 95%CI: [0.917, 0.989], p = 0.012). Hip osteoporosis was a risk factor for lacunes (OR = 2.215, 95%CI: [1.197, 4.1], p = 0.011), multiple lacunes (OR = 2.274, 95%CI: [1.039, 4.980], p = 0.04), severe WMH (OR = 2.611, 95%CI: [1.171, 5.823], p = 0.019), and EPVS ≥ 2 (OR = 1.99, 95%CI: [1.133, 3.495], p = 0.017). No significant association was found between osteoporosis and BA (p = 0.928). In sex-stratified analyses, both hip and vertebral osteoporosis were independently associated with a higher CSVD burden in female patients (hip: OR = 2.529, 95%CI: [1.122, 5.703], p = 0.025; vertebral: OR = 3.129, 95%CI: [1.517, 6.455], p = 0.002; general osteoporosis: OR = 1.755, 95%CI: [1.057, 2.912], p = 0.03), whereas no significant association was observed in male patients (all p > 0.05). Conclusions: Osteoporosis was independently associated with an increased burden of CSVD, particularly evident in female patients. These findings suggest that bone health may be important in CSVD management, particularly for women. Full article

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14 pages, 924 KiB

Open AccessSystematic Review

A Systematic Review on Subjective Cognitive Complaints: Main Neurocognitive Domains, Myriad Assessment Tools, and New Approaches for Early Detection

by Felipe Webster-Cordero and Lydia Giménez-Llort

Geriatrics 2025, 10(3), 65; https://doi.org/10.3390/geriatrics10030065 - 9 May 2025

Viewed by 483

Abstract

Background/Objectives: Neuropsychological testing is key in defining cognitive profiles at early stages of dementia. More importantly, the detection of subtle cognitive changes, such as subjective cognitive complaints (SCCs), an understudied phenomenon, is critical for early detection and preventive interventions. Methods: This systematic review [...] Read more.

Background/Objectives: Neuropsychological testing is key in defining cognitive profiles at early stages of dementia. More importantly, the detection of subtle cognitive changes, such as subjective cognitive complaints (SCCs), an understudied phenomenon, is critical for early detection and preventive interventions. Methods: This systematic review analyzes the empirical data on the cognitive domains and neuropsychological tests used in studies addressing SCC in the last 15 years (2009–2024). Results: A selection of 15 papers with exploratory, cross-sectional, and prospective scope in this field was obtained from PubMed and Embase databases. They used screening tests (17%) and a broad spectrum of neurocognitive domains. Yet, we identified three main targeted cognitive domains: executive functions (28%), language (17%), and memory (17%). Myriad assessment tools were also applied, but the most commonly used was a set of eight tests: Mini-mental Scale Examination (MMSE), Trail Making Test (A-B), Stroop test, Digit span test (DST), Semantic and Phonological fluency test, Rey Auditory Verbal Learning Test (RAVLT), Weschler Memory Scale (WMS), and Boston Naming Test (BNT). New approaches involved including the Geriatric Depression Scale (GDS) and self/informant reports. Conclusions: Despite scarce agreement in the assessment protocols, the identification of early neurocognitive symptoms to objectivate the SCC phenomenon envisions a broad field of research. Full article

(This article belongs to the Special Issue Current Issues in Cognitive Testing of Older Adults)

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23 pages, 804 KiB

Open AccessSystematic Review

Overview of Systematic Reviews on Factors Related to the Structure and Functioning of Residential Long-Term Care Facilities for Older Adults

by Aurélio Matos Andrade, Karine Rodrigues Afonseca, Tatiana de Almeida Jube, Suelen Meira Góes, Maíra Catharina Ramos and Flavia Tavares da Silva Elias

Geriatrics 2025, 10(3), 64; https://doi.org/10.3390/geriatrics10030064 - 3 May 2025

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Abstract

Objective: To identify factors influencing the structure and functioning of long-term residential care facilities for older adults worldwide, in order to uncover practices and support evidence-based improvements in care delivery. Method: An overview of systematic reviews was performed according to the PRISMA protocol [...] Read more.

Objective: To identify factors influencing the structure and functioning of long-term residential care facilities for older adults worldwide, in order to uncover practices and support evidence-based improvements in care delivery. Method: An overview of systematic reviews was performed according to the PRISMA protocol and registered on the PROSPERO platform (no. CRD42023486204). Research was carried out on 21 September 2023, using the following databases: PubMed (via MedLine), EMBASE, Web of Science, Scopus, Virtual Health Library (VHL), and Epistemonikos. Results: The search yielded 12,040 articles, including 61 systematic reviews. Analyzing the primary outcomes, personnel structure, and risk management were the most-studied outcomes of the systematic reviews, followed by pharmaceuticals, food services, mobility/accessibility, and technological and physical structures. In terms of primary outcomes of the systematic reviews, the personnel structure was the most highlighted (in 39.34%), followed by risk management (in 32.79%), while the least highlighted was physical structure (in 9.84%). Conclusions: Personnel are critical to the safe and effective functioning of Long-Term Care Facility (LTCF) operations. Future research is needed to identify associations between models of care and structural concerns, including physical environment, as they relate to quality of care in LTCFs, particularly in low and middle-income countries (LMIC). Full article

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

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13 pages, 1177 KiB

Open AccessArticle

What Combination of Generic Bedside Screening Tools Is Optimal to Capture Patients with Penetration/Aspiration Due to Dysphagia? Comparing Single Bedside Tools Versus Combinations of Tools for Sensitivity and Specificity

by Albert Westergren, David Smithard, Johannes Riis, Christina Emborg, Anne Lund Krarup and Dorte Melgaard

Geriatrics 2025, 10(3), 63; https://doi.org/10.3390/geriatrics10030063 - 30 Apr 2025

Viewed by 385

Abstract

Background/Objectives: This study aimed to explore the validity of various generic bedside screening tools, and combinations of these, for capturing dysphagia as compared to aspiration/penetration found through the Flexible Endoscopic Evaluation of Swallowing (FEES). Methods: In this cross-sectional study, participants diagnosed [...] Read more.

Background/Objectives: This study aimed to explore the validity of various generic bedside screening tools, and combinations of these, for capturing dysphagia as compared to aspiration/penetration found through the Flexible Endoscopic Evaluation of Swallowing (FEES). Methods: In this cross-sectional study, participants diagnosed with chronic pulmonary disease (n = 25), Parkinson’s disease (n = 26), multiple sclerosis (n = 24), or stroke (n = 25) participated. Patient-reported outcomes and clinical-rated assessments included: the four-question test (4QT), the Minimal Eating Observation Form—II, the Volume–Viscosity Swallow Test (V-VST), the Penetration–Aspiration Scale, and the FEES. Activities in daily living were assessed with the Barthel Index. The sensitivity, specificity, negative predictive value (NPV), positive predictive value, and accuracy were calculated. Results: The 100 participants’ median age was 72 years, and 42 were women. In total, 78 patients had eating difficulties (MEOF-II). According to the 4QT, 69 patients had dysphagia while 62 had it according to the V-VST. Furthermore, 29 patients had penetration/aspiration according to the FEES. All generic bedside tools performed better when combined with another tool, when compared to the identification of penetration/aspiration according to the FEES. The combination of the MEOF-II and 4QT as well as the combination of the MEOF-II and V-VST proved to have very high sensitivity (96.1–96.3%) and NPVs (92.3% in both instances). Combining the three tools, the MEOF-II, 4QT, and V-VST, did not improve the sensitivity or NPV. Conclusions: A combination of the MEOF-II and 4QT or the MEOF-II and V-VST bedside tools is recommended for identifying patients at risk of penetration/aspiration and in need of further in-depth clinical assessment. Full article

(This article belongs to the Section Dysphagia)

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10 pages, 344 KiB

Open AccessArticle

Validity and Reliability of the Self-Administered Timed Up and Go Test in Assessing Fall Risk in Community-Dwelling Older Adults

by Magda Reis, Maria Teixeira, Carlota Carvão and Anabela Correia Martins

Geriatrics 2025, 10(3), 62; https://doi.org/10.3390/geriatrics10030062 - 29 Apr 2025

Viewed by 732

Abstract

Objectives: This study aimed to evaluate the validity and reliability of the self-administered Timed Up and Go (TUG) test—a gold standard for fall risk screening—by comparing it to the traditional face-to-face assessment conducted by a physiotherapist. Methods: A total of 37 community-dwelling adults—mean [...] Read more.

Objectives: This study aimed to evaluate the validity and reliability of the self-administered Timed Up and Go (TUG) test—a gold standard for fall risk screening—by comparing it to the traditional face-to-face assessment conducted by a physiotherapist. Methods: A total of 37 community-dwelling adults—mean age 61.78 ± 6.88, 73% female—who took part in fall risk screening actions in the central region of Portugal were assessed. The protocol included sociodemographic and history of falls questions, the Self-Efficacy for Exercise questionnaire, the Activities and Participation Profile Related to Mobility (PAPM), and three functional tests, namely the 10-Metre Walking Speed (10-MWS), TUG, and 30 Seconds Sit to Stand (30 s STS) tests. Within an interval of 18–24 h after the face-to-face moment, the participants were instructed to self-administer the TUG test at home. The validity and reliability of self-administered TUG test were examined using the limits of agreement, clinically acceptable limit, intra-class correlation coefficients (ICCs), paired t-tests, and Pearson’s coefficient correlation (r). Results: The limits of agreement for self-administered assessment were within the clinically acceptable limits. The average result of the face-to-face TUG test and the self-administered TUG test was 7.47 ± 2.45 and 7.57 ± 3.10 s, respectively. When comparing the two evaluations, they were strongly associated (r = 0.716, p < 0.001), with an excellent ICC of 0.82 (0.65–0.91), for a 95% confidence interval and significance level of 0.05 (p ≤ 0.05). Conclusions: The use of the self-administered TUG test for the screening of risk of fall, using low-cost technology, appears to be valid and reliable in community-dwelling adults aged 50 and above. Enabling older adults to perform the TUG test at home can empower them to take an active role in managing their health and ageing process, while also offering physiotherapists regular feedback for fall prevention. Full article

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12 pages, 547 KiB

Open AccessArticle

Home Caregivers of Elderly People: Perceptions and Quality of Life

by Luís Eduardo Genaro, José Victor Marconato, Aylton Valsecki Júnior, Tânia Adas Saliba and Fernanda Lopez Rosell

Geriatrics 2025, 10(3), 61; https://doi.org/10.3390/geriatrics10030061 - 29 Apr 2025

Viewed by 548

Abstract

Objective: In this study, we aimed to identify the main factors that influence the quality of life of caregivers in the context of home care for the elderly. Methodology: This is a mixed-methods study with a qualitative–quantitative approach, conducted with 138 home caregivers [...] Read more.

Objective: In this study, we aimed to identify the main factors that influence the quality of life of caregivers in the context of home care for the elderly. Methodology: This is a mixed-methods study with a qualitative–quantitative approach, conducted with 138 home caregivers from the city of Itatiba, São Paulo, Brazil. Individual interviews were conducted, and the qualitative data were analyzed using the Collective Subject Discourse technique. Simultaneously, the quantitative approach involved the application of the EQ-5D questionnaire to assess health-related quality of life, and the data were analyzed using descriptive statistics and significance tests. Results: The majority of caregivers were female, accounting for 92.03% of the total, with the predominant age group being over 50 years old (49.28%). The interviews highlighted the regularity of home visits by healthcare professionals, emphasizing the importance of these visits for the continuity of treatment at home. However, some caregivers expressed feelings of loneliness due to social isolation and emotional burden, reporting difficulties in resting at night and experiencing pain. In the quality of life assessment, statistically significant differences were identified in various dimensions of the EQ-5D. Women showed a higher proportion of extreme problems in usual activities (p < 0.001) and pain/discomfort (p = 0.02), while men reported more moderate problems with anxiety/depression (p = 0.03). Conclusions: This study highlights the importance of personalized and accessible care for patients. It underscores the need for emotional support and educational resources for caregivers to mitigate the negative impacts of prolonged caregiving on their physical and emotional health. Full article

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15 pages, 468 KiB

Open AccessArticle

Recognition of Serious Infections in the Elderly Visiting the Emergency Department: The Development of a Diagnostic Prediction Model (ROSIE)

by Thomas Struyf, Lisa Powaga, Marc Sabbe, Nicolas Léonard, Ivan Myatchin, Ben Van Calster, Jos Tournoy, Frank Buntinx, Laurens Liesenborghs, Jan Y. Verbakel and Ann Van den Bruel

Geriatrics 2025, 10(3), 60; https://doi.org/10.3390/geriatrics10030060 - 25 Apr 2025

Viewed by 410

Abstract

Background/Objectives: Serious infections in older adults are associated with substantial mortality and morbidity. Diagnosis is challenging because of the non-specific presentation and overlap with pre-existing comorbidities. The objective of this study was to develop a clinical prediction model using clinical features and [...] Read more.

Background/Objectives: Serious infections in older adults are associated with substantial mortality and morbidity. Diagnosis is challenging because of the non-specific presentation and overlap with pre-existing comorbidities. The objective of this study was to develop a clinical prediction model using clinical features and biomarkers to support emergency care physicians in diagnosing serious infections in acutely ill older adults. Methods: We conducted a prospective cross-sectional diagnostic study, consecutively including acutely ill patients (≥65 year) presenting to the emergency department. Clinical information and blood samples were collected at inclusion by a trained study nurse. A prediction model for any serious infection was developed based on ten candidate predictors that were further reduced to four ad interim using a penalized Firth multivariable logistic regression model. We assessed discrimination and calibration of the model after internal validation using bootstrapping. Results: We included 425 participants at three emergency departments, of whom 215 were diagnosed with a serious infection (51%). In the final model, we retained systolic blood pressure, oxygen saturation, and C-reactive protein as predictors. This model had good discriminatory value with an Area Under the Receiver Operating Characteristic (AUROC) curve of 0.82 (95% CI: 0.78 to 0.86) and a calibration slope of 0.96 (95% CI: 0.76 to 1.16) after internal validation. Addition of procalcitonin did not improve the discrimination of the model. Conclusions: The ROSIE model uses three predictors that can be easily and quickly measured in the emergency department. It provides good discriminatory power after internal validation. Next steps should include external validation and an impact assessment. Full article

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Geriatrics, Volume 10, Issue 3 (June 2025) – 19 articles

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