Geriatrics

13 pages, 1124 KB

Open AccessArticle

Oculometric Assessment of Sensorimotor Impairment Associated with Liver Disease Is as Sensitive as Standard of Care Cognitive Tests

by Dorion Liston, Katherine Wong, Aaron Yeoh, Shalonda Haywood, Aparna Goel, Paul Kwo, Quinn Kennedy and Philip N. Okafor

Geriatrics 2025, 10(4), 112; https://doi.org/10.3390/geriatrics10040112 - 19 Aug 2025

Viewed by 366

Abstract

Significance: Hepatic encephalopathy (HE) occurs in 20–80% of patients with liver cirrhosis, impacting attention, memory, processing speed, and visuospatial skills. HE standard-of-care psychometric assessments are time-consuming and require staff training. Oculometrics may provide a fast, non-invasive brain health assessment that can be self-administered [...] Read more.

Significance: Hepatic encephalopathy (HE) occurs in 20–80% of patients with liver cirrhosis, impacting attention, memory, processing speed, and visuospatial skills. HE standard-of-care psychometric assessments are time-consuming and require staff training. Oculometrics may provide a fast, non-invasive brain health assessment that can be self-administered in a medical environment. Purpose: We investigated whether an oculometric assessment could measure the severity of HE as accurately as standard-of-care psychometric methods. Methods: Forty-eight participants (19 with decompensated cirrhosis, 10 with compensated cirrhosis, 19 controls) completed a previously validated five-minute oculometric test and the standard-of-care psychometric hepatic encephalopathy (PHE) battery. The oculometric test consists of following a dot as it moves across a computer screen and generates 10 metrics including a summary score called nFit. The PHE battery entails five standard cognitive tests, generating seven metrics including a PHE composite score (PHES). Results: The oculometric summary score, nFit, correlated with the current diagnostic standard, the PHES (r = 0.51, p < 0.001), the presence or absence of HE as determined by PHES composite (r = −0.44, p < 0.001), as well as the severity of cirrhosis (r = −0.59, p < 0.001). Additionally, performance on both nFit and PHES distinguished compensated (ROC: nFit: 0.71, PHES: 0.68) and decompensated (ROC: nFit: 0.88, PHES: 0.85) patient groups from control participants comparably. Finally, compared to participants with decompensated cirrhosis, control participants had better scores for almost all oculometrics: acceleration, catch-up saccade amplitude, proportion smooth, direction noise, and speed noise. Conclusions: Patients with liver disease showed impairment on multiple aspects of visual processing compared to a control group. These functional visual processing impairments correlate with the presence or absence of HE, showing significant sensitivity in distinguishing people with HE from controls. Oculometric tests provide a quick, non-invasive functional assessment of brain health in patients with liver disease, with sensitivity indistinguishable from standard-of-case psychometric tests. Full article

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

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14 pages, 384 KB

Open AccessArticle

Adverse Childhood Experiences and Sarcopenia in Later Life: Baseline Data from the Canadian Longitudinal Study on Aging

by Menelaos M. Dimitriadis, Kitty J. E. Kokkeler, Emiel O. Hoogendijk, Radboud M. Marijnissen, Ivan Aprahamian, Hans W. Jeuring and Richard C. Oude Voshaar

Geriatrics 2025, 10(4), 111; https://doi.org/10.3390/geriatrics10040111 - 15 Aug 2025

Viewed by 506

Abstract

Backgrounds: Adverse Childhood Experiences (ACEs) are linked to early and long-lasting mental health issues and somatic multimorbidity. Emerging evidence suggests ACEs may also accelerate physical frailty in old age. This study examines the association between ACEs and sarcopenia, an ageing-related disease and core [...] Read more.

Backgrounds: Adverse Childhood Experiences (ACEs) are linked to early and long-lasting mental health issues and somatic multimorbidity. Emerging evidence suggests ACEs may also accelerate physical frailty in old age. This study examines the association between ACEs and sarcopenia, an ageing-related disease and core component of frailty. Methods: Baseline data from the Canadian Longitudinal Study on Aging (CLSA), including 25,327 participants aged 45–85 years (50.3% female sex) were analyzed. Sarcopenia was defined using the revised European Working Group of Sarcopenia in Older People (EWGSOP2) guidelines. ACE were assessed via the Childhood Experiences of Violence Questionnaire and the National Longitudinal Study of Adolescent to Adult Health Wave III questionnaire, covering eight ACE categories. Multiple logistic regression models examined the association between the number of ACE count and sarcopenia, which were adjusted for age, sex, education, income, and ethnicity. Results: Given a significant interaction between age and ACE (p < 0.01), analyses were stratified into four age groups (45–54, 55–64, 65–74, and 75–85 years). A significant association only emerged in the oldest group (75–85 years; OR = 0.93 [95% CI: 0.86–1.00], p = 0.043), but this result was in the opposite direction we hypothesized. Sensitivity analyses confirmed findings across different operationalisations of ACE and sarcopenia. Conclusions: Higher ACE exposure was not associated with sarcopenia in middle aged and older adults. The unexpected protective association in the oldest-old subgroup may reflect survival bias. Age-stratified longitudinal studies are needed to clarify this relationship. Full article

(This article belongs to the Section Geriatric Public Health)

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24 pages, 3059 KB

Open AccessReview

Management of Chronic Pain in Elderly Patients: The Central Role of Nurses in Multidisciplinary Care

by Dorina Markovics, Andrea Virág and Klara Gadó

Geriatrics 2025, 10(4), 110; https://doi.org/10.3390/geriatrics10040110 - 14 Aug 2025

Viewed by 978

Abstract

Pain is a fundamental yet complex biological and psychosocial phenomenon. While acute pain serves as a defense mechanism, alerting the body to potential tissue damage, chronic pain loses this protective function and becomes a persistent, independent condition. Chronic pain in the elderly is [...] Read more.

Pain is a fundamental yet complex biological and psychosocial phenomenon. While acute pain serves as a defense mechanism, alerting the body to potential tissue damage, chronic pain loses this protective function and becomes a persistent, independent condition. Chronic pain in the elderly is particularly significant due to age-related changes in pain perception, a higher prevalence of comorbidities, and an increased susceptibility to pharmacological side effects. Diagnosing pain in older adults presents unique challenges owing to cognitive decline, multimorbidity, and impaired communication. This narrative review aims to summarize the current knowledge on chronic pain in the elderly, with a particular emphasis on diagnostic difficulties, therapeutic strategies, and the essential role of nurses in multidisciplinary management. Both objective scales and subjective assessment tools are essential for an accurate evaluation. Effective management requires a multidisciplinary approach that integrates individualized pharmacological and non-pharmacological therapies. Analgesic use must be tailored to account for altered pharmacokinetics and risks such as sedation or falls. Non-drug interventions, including physiotherapy and psychological techniques, are especially valuable in geriatric care. Nurses play a pivotal role in the recognition, assessment, and ongoing management of pain in this population. Developing age-appropriate, personalized strategies is essential for improving the quality of life in older adults living with chronic pain. Full article

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17 pages, 1302 KB

Open AccessArticle

Fallskip^® Parameters and Their Relationship with the Risk of Falls in Older Individuals with and Without Diabetes

by Azahar Castillo-Montesinos, Lorenzo Brognara, Alejandra Mafla-España and Omar Cauli

Geriatrics 2025, 10(4), 109; https://doi.org/10.3390/geriatrics10040109 - 8 Aug 2025

Viewed by 552

Abstract

Background/Objectives: the assessment and prevention of fall risk is an essential component of healthcare, particularly for vulnerable populations such as older adults with or without diabetes. The use of objective and validated tools to assess balance, gait, and other risk factors enables healthcare [...] Read more.

Background/Objectives: the assessment and prevention of fall risk is an essential component of healthcare, particularly for vulnerable populations such as older adults with or without diabetes. The use of objective and validated tools to assess balance, gait, and other risk factors enables healthcare professionals to make informed clinical decisions and design personalized prevention programs. An observational cross-sectional study was conducted with a probabilistic sample of older patients, with and without diabetes, attending a podiatric clinic (Valencia, Spain). Methods: fall risk was assessed using the Tinetti Scale and the FallSkip^® device, which measures posture (i.e., medial-lateral and anterior-posterior displacements), gait (vertical and medial-lateral ranges), turn-to-sit (time) and sit-to-stand (power) tests, total time and gait reaction time. Results: the results showed a significant association between the values obtained with FallSkip^® and the Tinetti Scale (p < 0.001), identifying the older individuals at high risk of falls. The “reaction time” parameter measured by FallSkip^® showed a significant difference between diabetic and non-diabetic patients (p < 0.05), as well as the balance score assessed by the Tinetti Scale (p < 0.05). Having experienced falls in the previous year had a strong (p < 0.001) significant influence on the results evaluated using both the Tinetti Scale and FallSkip^®. Among the FallSkip^® parameters in the multivariate analysis, the ‘Total Time (%)’ parameter significantly (p < 0.01, Exp(B) = 0.974 (CI 95%: 0.961–0.988) discriminates individuals with or without falls in the previous year. Conclusions: this study supports the usefulness of the FallSkip^® device as an objective, efficient, and easy-to-use tool for fall risk assessment in primary care settings. Full article

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12 pages, 258 KB

Open AccessArticle

Effect of Anti-Diabetic Medication Use on Sepsis Risk in Type 2 Diabetes Mellitus: A Multivariate Analysis

by Battamir Ulambayar, Amr Sayed Ghanem and Attila Csaba Nagy

Geriatrics 2025, 10(4), 108; https://doi.org/10.3390/geriatrics10040108 - 7 Aug 2025

Viewed by 615

Abstract

Background: Type 2 diabetes mellitus (T2DM) increases sepsis risk due to immune dysfunction and chronic inflammation. Antidiabetic medications, while primarily used for glycemic control, may modulate sepsis susceptibility through immune and inflammatory pathways. This study investigates the association between antidiabetic medication use and [...] Read more.

Background: Type 2 diabetes mellitus (T2DM) increases sepsis risk due to immune dysfunction and chronic inflammation. Antidiabetic medications, while primarily used for glycemic control, may modulate sepsis susceptibility through immune and inflammatory pathways. This study investigates the association between antidiabetic medication use and sepsis risk in T2DM patients. Methods: A longitudinal cohort study was conducted using clinical registry data from 5009 T2DM patients at the University Hospital, Debrecen, Hungary (2016–2020). Sepsis cases were identified via ICD-10 code A41, and antidiabetic medication use was categorized using ATC codes. Baseline comorbidities and laboratory parameters were extracted. Chi-square and Wilcoxon rank–sum tests assessed associations between sepsis and categorical/numerical variables, respectively. Time-adjusted multivariate logistic regression evaluated predictors of sepsis risk, with odds ratios (ORs) and 95% confidence intervals (CIs) reported. Results: Age, hypertension, ischemic heart disease, nephropathy, elevated blood glucose, C-reactive protein, and creatinine also independently increased sepsis risk. Insulin use was associated with a 2.6-fold increased sepsis risk (OR = 2.6, 95% CI: 2.09–3.34, p < 0.001), while SGLT2 inhibitors (OR = 0.56, 95% CI: 0.34–0.91, p = 0.02) and GLP-1 receptor agonists (OR = 0.39, 95% CI: 0.19–0.79, p = 0.009) were protective. Conclusions: Insulin-treated patients may require closer infection monitoring, while SGLT2 inhibitors and GLP-1 RAs could be prioritized in high-risk individuals. These findings highlight the potential to inform risk stratification and guide personalized antidiabetic therapy to reduce sepsis risk in T2DM. Full article

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11 pages, 671 KB

Open AccessArticle

Impact of Mattress Use on Sacral Interface Pressure in Community-Dwelling Older Adults

by Hye Young Lee, In Sun Jang, Jung Eun Hong, Je Hyun Kim and Seungmi Park

Geriatrics 2025, 10(4), 107; https://doi.org/10.3390/geriatrics10040107 - 6 Aug 2025

Viewed by 520

Abstract

Background/Objectives: Pressure injuries are a significant concern among older adults, particularly in community-based long-term care settings where prolonged immobility is prevalent. This study aimed to identify factors influencing sacral interface pressure in community-dwelling older adults, with an emphasis on support surface usage and [...] Read more.

Background/Objectives: Pressure injuries are a significant concern among older adults, particularly in community-based long-term care settings where prolonged immobility is prevalent. This study aimed to identify factors influencing sacral interface pressure in community-dwelling older adults, with an emphasis on support surface usage and clinical risk indicators. Methods: A total of 210 participants aged 65 years and older, all receiving long-term care services in South Korea, were enrolled in this study. Sacral interface pressure was measured in the supine position using a portable pressure mapping device (Palm Q7). General characteristics, Braden Scale scores, Huhn Scale scores, and mattress usage were assessed. Data were analyzed using descriptive statistics, t-tests, chi-square tests, and logistic regression. Results: Mattress non-use was identified as the strongest predictor of elevated sacral interface pressure (OR = 6.71, p < 0.001), followed by Braden Scale scores indicating moderate risk (OR = 4.8, p = 0.006). Huhn Scale scores were not significantly associated with interface pressure. These results suggest that support surface quality and skin condition have a stronger impact on interface pressure than mobility-related risk factors. Conclusions: The findings highlight the importance of providing high-quality pressure-relieving mattresses and implementing standardized nursing assessments to reduce the risk of pressure injuries. Integrating smart technologies and expanding access to advanced support surfaces may aid in developing tailored preventive strategies for vulnerable older adults. Full article

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11 pages, 215 KB

Open AccessArticle

Personalised Prevention of Falls in Persons with Dementia—A Registry-Based Study

by Per G. Farup, Knut Hestad and Knut Engedal

Geriatrics 2025, 10(4), 106; https://doi.org/10.3390/geriatrics10040106 - 6 Aug 2025

Viewed by 580

Abstract

Background/Objectives: Multifactorial prevention of falls in persons with dementia has minimal or non-significant effects. Personalised prevention is recommended. We have previously shown that gait speed, basic activities of daily living (ADL), and depression (high Cornell scores) were independent predictors of falls in persons [...] Read more.

Background/Objectives: Multifactorial prevention of falls in persons with dementia has minimal or non-significant effects. Personalised prevention is recommended. We have previously shown that gait speed, basic activities of daily living (ADL), and depression (high Cornell scores) were independent predictors of falls in persons with mild and moderate cognitive impairment. This study explored person-specific risks of falls related to physical, mental, and cognitive functions and types of dementia: Alzheimer’s disease (AD), vascular dementia (VD), mixed Alzheimer’s disease/vascular dementia (MixADVD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB). Methods: The study used data from “The Norwegian Registry of Persons Assessed for Cognitive Symptoms” (NorCog). Differences between the dementia groups and predictors of falls, gait speed, ADL, and Cornell scores were analysed. Results: Among study participants, 537/1321 (40.7%) reported a fall in the past year, with significant variations between dementia diagnoses. Fall incidence increased with age, comorbidity/polypharmacy, depression, and MAYO fluctuation score and with reduced physical activity, gait speed, and ADL. Persons with VD and MixADVD had high fall incidences and impaired gait speed and ADL. Training of physical fitness, endurance, muscular strength, coordination, and balance and optimising treatment of comorbidities and medication enhance gait speed. Improving ADL necessitates, in addition, relief of cognitive impairment and fluctuations. Relief of depression and fluctuations by psychological and pharmacological interventions is necessary to reduce the high fall risk in persons with DLB. Conclusions: The fall incidence and fall predictors varied significantly. Personalised interventions presuppose knowledge of each individual’s fall risk factors. Full article

14 pages, 649 KB

Open AccessArticle

Investigating the Moderating Effect of Attitudes Toward One’s Own Aging on the Association Between Body Mass Index and Executive Function in Older Adults

by Akihiko Iwahara, Taketoshi Hatta, Reiko Nakayama, Takashi Miyawaki, Seiji Sakate, Junko Hatta and Takeshi Hatta

Geriatrics 2025, 10(4), 105; https://doi.org/10.3390/geriatrics10040105 - 6 Aug 2025

Viewed by 361

Abstract

Background: This cross-sectional study examined the association between body mass index (BMI) and executive function (EF) in older adults, with a focus on the moderating role of attitudes toward own aging (ATOA). Method: A total of 431 community-dwelling elderly individuals from Yakumo Town [...] Read more.

Background: This cross-sectional study examined the association between body mass index (BMI) and executive function (EF) in older adults, with a focus on the moderating role of attitudes toward own aging (ATOA). Method: A total of 431 community-dwelling elderly individuals from Yakumo Town and Kyoto City, Japan, participated between 2023 and 2024. EF was assessed using the Digit Cancellation Test (D-CAT), and ATOA was measured via a validated subscale of the Philadelphia Geriatric Center Morale Scale. Results: Multiple linear regression analyses adjusted for demographic and health covariates revealed a significant interaction between BMI and ATOA in the younger-old cohort. Specifically, higher BMI was associated with lower executive function only in individuals with lower ATOA scores. No such association was observed in those with more positive views on aging. Conclusions: These results indicate that positive psychological constructs, particularly favorable self-perceptions of aging, may serve as protective factors against the detrimental cognitive consequences of increased body mass index in younger-old populations. Full article

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16 pages, 875 KB

Open AccessReview

Cardiorenal Syndrome in the Elderly: Challenges and Considerations

by Matthew Jarocki, Sophie Green, Henry H. L. Wu and Rajkumar Chinnadurai

Geriatrics 2025, 10(4), 104; https://doi.org/10.3390/geriatrics10040104 - 4 Aug 2025

Viewed by 1525

Abstract

Cardiorenal syndrome (CRS) is a term used to describe the combined dysfunction of the heart and kidneys. This complex disorder is widely acknowledged to be challenging in both its diagnosis and management, and this is the case particularly in the elderly population, due [...] Read more.

Cardiorenal syndrome (CRS) is a term used to describe the combined dysfunction of the heart and kidneys. This complex disorder is widely acknowledged to be challenging in both its diagnosis and management, and this is the case particularly in the elderly population, due to multi-morbidity, polypharmacy, and age-related physiological changes. Given advancements in medicine and more prolonged cumulative exposure to risk factors in the elderly population, it is likely that the prevalence of chronic kidney disease (CKD) and heart failure (HF) will continue to rise going forward. Hence, understanding the mechanisms involved in the development of CRS is paramount. There are five different CRS types—they are categorised depending on the primary organ involved the acuity of disease. The pathophysiological process behind CRS is complex, involving the interplay of many processes including hemodynamic changes, neurohormonal activation, inflammation, oxidative stress, and endothelial dysfunction and vascular stiffness. The numerous diagnostic and management challenges associated with CRS are significantly further exacerbated in an elderly population. Biomarkers used to aid the diagnosis of CRS, such as serum creatinine and brain natriuretic peptide (BNP), can be challenging to interpret in the elderly population due to age-related renal senescence and multiple comorbidities. Polypharmacy can contribute to the development of CRS and therefore, before initiating treatment, coordinating a patient-centred, multi-speciality, holistic review to assess potential risks versus benefits of prescribed treatments is crucial. The overall prognosis of CRS in the elderly remains poor. Treatments are primarily directed at addressing the sequelae of the underlying aetiology, which often involves the removal of fluid through diuretics or ultrafiltration. Careful considerations when managing elderly patients with CRS is essential due to the high prevalence of frailty and functional decline. As such, in these patients, early discussions around advance care planning should be prioritised. Full article

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13 pages, 892 KB

Open AccessArticle

Waist–Calf Circumference Ratio Is Associated with Body Composition, Physical Performance, and Muscle Strength in Older Women

by Cecilia Arteaga-Pazmiño, Alma L. Guzmán-Gurrola, Diana Fonseca-Pérez, Javier Galvez-Celi, Danielle Francesca Aycart, Ludwig Álvarez-Córdova and Evelyn Frias-Toral

Geriatrics 2025, 10(4), 103; https://doi.org/10.3390/geriatrics10040103 - 1 Aug 2025

Viewed by 966

Abstract

Background: The waist–calf circumference ratio (WCR) is an index that combines waist and calf circumference measurements, offering a potentially effective method for evaluating the imbalance between abdominal fat and leg muscle mass in older adults. Objective: To assess the association between WCR and [...] Read more.

Background: The waist–calf circumference ratio (WCR) is an index that combines waist and calf circumference measurements, offering a potentially effective method for evaluating the imbalance between abdominal fat and leg muscle mass in older adults. Objective: To assess the association between WCR and indicators of body composition, muscle strength, and physical performance in community-dwelling older women. Methods: This was a cross-sectional study involving 133 older women (≥65 years) from an urban-marginal community in Guayaquil, Ecuador. The WCR was categorized into quartiles (Q1: 2.07–2.57; Q2: 2.58–2.75; Q3: 2.76–3.05; Q4: 3.06–4.76). Body indicators included fat-free mass (FFM), skeletal muscle mass (SMM), appendicular muscle mass (ASM), appendicular muscle mass index (ASMI), visceral fat (VF), fat mass (FM), and fat mass index (FMI). Handgrip strength (HGS) and the Short Physical Performance Battery test (SPPB) score were used to assess muscle strength and function, respectively. Results: The median age of the participants was 75 [IQR: 65–82] years. The mean WCR was 2.92 ± 0.93. Statistically significant associations were found between WCR and VF (p < 0.001), WCR and SMM (p = 0.039), and WCR and ASM (p = 0.016). Regarding muscle function, WCR was associated with HGS (p = 0.025) and SPPB score (p = 0.029). Conclusions: A significant association was observed between WCR and body composition, and muscle strength and function in older women. Full article

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14 pages, 806 KB

Open AccessArticle

Beat-to-Beat Blood Pressure Monitoring and Orthostatic Hypotension-Related Falls in Two Cohorts of Older Adults

by Liping Wang, Eveline P. van Poelgeest, Marjolein Klop, Jurgen A. H. R. Claassen, Alfons G. Hoekstra and Nathalie van der Velde

Geriatrics 2025, 10(4), 102; https://doi.org/10.3390/geriatrics10040102 - 26 Jul 2025

Viewed by 611

Abstract

Background: Falls are a major public health issue among older adults, often related to postural or orthostatic hypotension (OH). The optimal timing and methods for measuring blood pressure (BP) to assess OH and its relationship with falls are uncertain. Methods: We analyzed data [...] Read more.

Background: Falls are a major public health issue among older adults, often related to postural or orthostatic hypotension (OH). The optimal timing and methods for measuring blood pressure (BP) to assess OH and its relationship with falls are uncertain. Methods: We analyzed data from two older cohorts: the PROHEALTH study (n = 30, aged ≥ 65 years) and the NILVAD-CBF trial (n = 58, aged ≥ 50 years). Continuous beat-to-beat BP was measured during active stand tests. We assessed orthostatic BP responses during sit-to-stand and supine-to-stand maneuvers and calculated the associations between orthostatic BP response variables and falls. Results: In the PROHEALTH cohort, participants with a history of falls exhibited a significantly lower baseline BP (115 ± 13/68 ± 10 vs. 142 ± 21/79 ± 11 mmHg; p = 0.004/0.018) and lower systolic BP (SBP) nadir (90 ± 22 vs. 112 ± 25 mmHg; p = 0.043) than non-fallers. SBP recovery within three minutes post-stand was delayed in fallers but rapid in non-fallers. A lower resting BP was associated with fall risk, and a lower BP nadir within 10 s after standing showed a trend toward a higher fall risk. No significant associations were found in the NILVAD-CBF cohort (prospective falls). Conclusions: Our findings demonstrate that a lower resting SBP and diastolic BP (DBP) are associated with an increased fall risk in older adults, with a lower SBP and DBP nadir after standing also showing a potential association. Persistent OH or delayed BP recovery is identified as a potentially relevant fall risk factor. The supine-to-stand test was more sensitive in detecting OH than the sit-to-stand test. Continuous BP monitoring provides the advantage of detecting pathophysiologic orthostatic BP responses for fall risk assessment in older adults. Further research with larger cohorts is warranted to validate our findings. Full article

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12 pages, 480 KB

Open AccessBrief Report

Treated but Uncontrolled: Characterizing Hypertension in a Sample of 357 Older Adults in the Southeastern United States

by Rachel Helms, Laura A. Robinson, Paul S. Fiore, Kelly P. Strickland, Sarah O. Watts, Felicia J. Tuggle, Jennifer L. Slay, Jeanna Sewell and Andrew D. Frugé

Geriatrics 2025, 10(4), 101; https://doi.org/10.3390/geriatrics10040101 - 26 Jul 2025

Viewed by 402

Abstract

Background/Objectives: Hypertension (HTN) continues to be a leading cause of death and disability in older adults, especially in the southeastern United States. A cross-sectional study was conducted to evaluate the relationships among measured, diagnosed, and treated (HTN) in community-dwelling adults participating in [...] Read more.

Background/Objectives: Hypertension (HTN) continues to be a leading cause of death and disability in older adults, especially in the southeastern United States. A cross-sectional study was conducted to evaluate the relationships among measured, diagnosed, and treated (HTN) in community-dwelling adults participating in student-led health screenings in eastern Alabama. Methods: Between 2017 and 2019, students from health-related disciplines facilitated screenings at 23 community and independent living sites to conduct health assessments, including measuring blood pressure (BP), obtaining medical history, and evaluating current prescriptions. Statistical analyses including chi-square tests, t-tests, and backward stepwise linear regression were performed. Results: The current sample includes data from 357 adults aged 60 to 99 years (mean age 74.6 ± 8.7), who were 70.9% females, 60.8% identifying as Black/African American (BA), and 36.8% residing in rural areas. The majority of clients had a prior HTN diagnosis (71.1%) and/or currently measured HTN (78.7%). Forty-three percent of adults screened had measured, diagnosed, and pharmaceutically treated HTN, while 31% had measured but untreated HTN. Black clients had higher measured systolic and diastolic BP and were more likely to also have been diagnosed with HTN (p < 0.05 for all). Linear regression indicated that lower systolic BP was predicted by not living alone (p = 0.003), White race (p = 0.004), and previous HTN diagnosis (p = 0.012), while female gender (p = 0.079) and decreasing body mass index (p = 0.053) had marginal predictive value. Conclusions: These results indicate that awareness and screening of HTN in this population are noteworthy, though management of the disease through ongoing screening and referrals is essential to reduce disparities. Full article

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16 pages, 1396 KB

Open AccessArticle

Diet Therapy and Probiotics to Improve Sleep Apnea Risk and Quality of Life in Older Adults (>60 Years) with Metabolic Syndrome: A Study from Romania

by Amina Venter, Amin-Florin El-kharoubi, Mousa El-kharoubi, Evelin Claudia Ghitea, Marc Cristian Ghitea, Timea Claudia Ghitea and Ciprian Florian Venter

Geriatrics 2025, 10(4), 100; https://doi.org/10.3390/geriatrics10040100 - 25 Jul 2025

Viewed by 534

Abstract

Background: Metabolic syndrome (MetS) and obstructive sleep apnea (OSA) are prevalent and interrelated conditions in older adults, both contributing to decreased quality of life and increased health risks. Nutritional interventions, including dietary changes and probiotic supplementation, may offer effective non-pharmacological strategies to address [...] Read more.

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

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19 pages, 4504 KB

Open AccessArticle

Development and Evaluation of an Immersive Virtual Reality Application for Road Crossing Training in Older Adults

by Alina Napetschnig, Wolfgang Deiters, Klara Brixius, Michael Bertram and Christoph Vogel

Geriatrics 2025, 10(4), 99; https://doi.org/10.3390/geriatrics10040099 - 24 Jul 2025

Viewed by 703

Abstract

Background/Objectives: Aging is often accompanied by physical and cognitive decline, affecting older adults’ mobility. Virtual reality (VR) offers innovative opportunities to safely practice everyday tasks, such as street crossing. This study was designed as a feasibility and pilot study to explore acceptance, usability, [...] Read more.

Background/Objectives: Aging is often accompanied by physical and cognitive decline, affecting older adults’ mobility. Virtual reality (VR) offers innovative opportunities to safely practice everyday tasks, such as street crossing. This study was designed as a feasibility and pilot study to explore acceptance, usability, and preliminary effects of a VR-based road-crossing intervention for older adults. It investigates the use of virtual reality (VR) as an innovative training tool to support senior citizens in safely navigating everyday challenges such as crossing roads. By providing an immersive environment with realistic traffic scenarios, VR enables participants to practice in a safe and controlled setting, minimizing the risks associated with real-world road traffic. Methods: A VR training application called “Wegfest” was developed to facilitate targeted road-crossing practice. The application simulates various scenarios commonly encountered by older adults, such as crossing busy streets or waiting at traffic lights. The study applied a single-group pre-post design. Outcomes included the Timed Up and Go test (TUG), Falls Efficacy Scale-International (FES-I), and Montreal Cognitive Assessment (MoCA). Results: The development process of “Wegfest” demonstrates how a highly realistic street environment can be created for VR-based road-crossing training. Significant improvements were found in the Timed Up and Go test (p = 0.002, d = 0.784) and fall-related self-efficacy (FES-I, p = 0.005). No change was observed in cognitive function (MoCA, p = 0.56). Participants reported increased subjective safety (p < 0.001). Discussion: The development of the VR training application “Wegfest” highlights the feasibility of creating realistic virtual environments for skill development. By leveraging immersive technology, both physical and cognitive skills required for road-crossing can be effectively trained. The findings suggest that “Wegfest” has the potential to enhance the mobility and safety of older adults in road traffic through immersive experiences and targeted training interventions. Conclusions: As an innovative training tool, the VR application not only provides an engaging and enjoyable learning environment but also fosters self-confidence and independence among older adults in traffic settings. Regular training within the virtual world enables senior citizens to continuously refine their skills, ultimately improving their quality of life. Full article

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16 pages, 546 KB

Open AccessReview

Moving as We Age: Effects of Physical Activity Programmes on Older Adults—An Umbrella Review

by Ruth D. Neill, Louise Bradley and Roger O’Sullivan

Geriatrics 2025, 10(4), 98; https://doi.org/10.3390/geriatrics10040098 - 23 Jul 2025

Viewed by 908

Abstract

Background: This paper aims to conduct an umbrella review of the effects of physical activity programmes for older adults (aged 70 and above). Methods: Comprehensive literature searches were conducted in MEDLINE, PubMed, EMBASE, PsychINFO, and Cochrane Library databases for English SRs. [...] Read more.

Background: This paper aims to conduct an umbrella review of the effects of physical activity programmes for older adults (aged 70 and above). Methods: Comprehensive literature searches were conducted in MEDLINE, PubMed, EMBASE, PsychINFO, and Cochrane Library databases for English SRs. Inclusion criteria were systematic reviews that included randomised controlled trials examining physical activity interventions in older adults. The data extracted were participant characteristics, physical activity interventions, and outcomes examined. A synthesis of results was conducted using the PRISMA guidelines, and the quality of the studies was assessed using the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2). Results: Ten systematic reviews on 186 research articles were included. The AMSTAR-2 revealed that 4 out of 10 reviews were of high quality and 1 out of 10 were of moderate quality. The study samples in each systematic review ranged from 6 to 1254 participants. The total overall sample size for the 10 included studies was 22,652 participants. Across the included reviews, there was mixed evidence on whether physical activity interventions could improve outcomes in older adults across various settings. Conclusions: Sample sizes and findings in each included systematic review varied. The findings of this review emphasise the importance of physical activity as a vital component in maintaining and enhancing health, as well as combating poor health as we age. It also highlights the need for a deeper understanding of the specific physical activity requirements for those aged 70 and above. Future systematic reviews may focus on streamlined reporting of dosing of physical activity and specific intervention types, such as group versus single. Full article

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15 pages, 795 KB

Open AccessReview

Behavioural Change Interventions for Preventing Periodontal Disease in Older Adults: A Literature Review

by Stephanie Chu, Chun Hung Chu and Alice Kit Ying Chan

Geriatrics 2025, 10(4), 97; https://doi.org/10.3390/geriatrics10040097 - 22 Jul 2025

Cited by 1 | Viewed by 722

Abstract

Periodontal disease is a common and serious oral disease among older adults. As the global older population increases, preventing periodontal disease is vital for healthy ageing. Poor oral hygiene, uncontrolled diabetes, and smoking are key risk factors of periodontal disease. Improving oral hygiene, [...] Read more.

Periodontal disease is a common and serious oral disease among older adults. As the global older population increases, preventing periodontal disease is vital for healthy ageing. Poor oral hygiene, uncontrolled diabetes, and smoking are key risk factors of periodontal disease. Improving oral hygiene, diabetes management, and quitting smoking are essential health behavioural change interventions to manage periodontal disease. The objective of this study is to review the prevention of periodontal disease among older adults through health behavioural change interventions. Effective strategies to improve oral hygiene include personalised education on proper brushing and interdental cleaning. Educating caregivers is equally important as they supervise care-dependent older adults to maintain oral health. For those with diabetes, physical activity improves glycated haemoglobin levels and clinical periodontal parameters by reducing reactive oxygen species and systemic inflammation. Smoking cessation could be achieved through a multi-faceted approach. Effective smoking cessation combines brief interventions with intensive behavioural/pharmacological support for long-term success, especially in highly dependent individuals. Tailored strategies for older adults, integrated care, and expanded research improve outcomes and health equity in ageing populations. In conclusion, health behavioural change interventions are non-invasive preventive measures that include oral hygiene reinforcement, diabetic management, and smoking cessation. Prioritising these interventions empowers older adults to maintain oral health, reducing disease burden and enhancing overall well-being for healthy ageing. Full article

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16 pages, 417 KB

Open AccessReview

Potential Biological and Genetic Links Between Dementia and Osteoporosis: A Scoping Review

by Abayomi N. Ogunwale, Paul E. Schulz, Jude K. des Bordes, Florent Elefteriou and Nahid J. Rianon

Geriatrics 2025, 10(4), 96; https://doi.org/10.3390/geriatrics10040096 - 20 Jul 2025

Viewed by 702

Abstract

Background: The biological mediators for the epidemiologic overlap between osteoporosis and dementia are unclear. We undertook a scoping review of clinical studies to identify genetic and biological factors linked with these degenerative conditions, exploring the mechanisms and pathways connecting both conditions. Methods: Studies [...] Read more.

Background: The biological mediators for the epidemiologic overlap between osteoporosis and dementia are unclear. We undertook a scoping review of clinical studies to identify genetic and biological factors linked with these degenerative conditions, exploring the mechanisms and pathways connecting both conditions. Methods: Studies selected (1) involved clinical research investigating genetic factors or biomarkers associated with dementia or osteoporosis, and (2) were published in English in a peer-reviewed journal between July 1993 and March 2025. We searched Medline Ovid, Embase, PsycINFO, the Cochrane Library, the Web of Science databases, Google Scholar, and the reference lists of studies following the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). Results: Twenty-three studies were included in this review. These explored the role of the APOE polymorphism (n = 2) and the APOE4 allele (n = 13), associations between TREM2 mutation and late onset AD (n = 1), and associations between amyloid beta and bone remodeling (n = 1); bone-related biomarkers like DKK1, OPG, and TRAIL as predictors of cognitive change (n = 2); extracellular vesicles as bone–brain communication pathways (1); and the role of dementia-related genes (n = 1), AD-related CSF biomarkers (n = 1), and parathyroid hormone (PTH) (n = 1) in osteoporosis–dementia pathophysiology. Conclusions: Bone-related biomarkers active in the Wnt/β-Catenin pathway (Dkk1 and sclerostin) and the RANKL/RANK/OPG pathway (OPG/TRAIL ratio) present consistent evidence of involvement in AD and osteoporosis development. Reports proposing APOE4 as a causal genetic link for both osteoporosis and AD in women are not corroborated by newer observational studies. The role of Aβ toxicity in osteoporosis development is unverified in a large clinical study. Full article

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9 pages, 600 KB

Open AccessArticle

by Josef Yayan and Christian Biancosino

Geriatrics 2025, 10(4), 95; https://doi.org/10.3390/geriatrics10040095 - 18 Jul 2025

Viewed by 444

Abstract

Background: Pleural empyema remains a serious clinical condition with high morbidity and mortality, especially in elderly patients. As life expectancy increases, a growing number of older individuals require surgical treatment. This retrospective single-center study investigated age-related differences in clinical presentation, perioperative features, [...] Read more.

Background: Pleural empyema remains a serious clinical condition with high morbidity and mortality, especially in elderly patients. As life expectancy increases, a growing number of older individuals require surgical treatment. This retrospective single-center study investigated age-related differences in clinical presentation, perioperative features, and postoperative outcomes in patients undergoing surgery for pleural empyema. Methods: We conducted this retrospective study at Helios University Hospital Wuppertal, Witten Herdecke University in Germany, from December 2019 to May 2024. We stratified the patients into two age groups: <65 and ≥65 years. We compared baseline characteristics, American Society of Anesthesiologists (ASA) physical status classification, empyema stage, hospital stay, drainage duration, complication rates, and in-hospital mortality. Results: A total of 103 patients were included, of whom 43 (41.7%) were aged ≥ 65 years. Older patients had significantly higher ASA scores and presented with more advanced empyema stages. Hospital stay was significantly longer in this group. However, complication rates (60.0% vs. 44.9%; p = 0.25), drainage duration, ICU admissions (91.4% vs. 83.7%; p = 0.48), and in-hospital mortality (0% in both groups) did not differ significantly. Conclusions: Although older patients had higher perioperative risks, their surgical outcomes were similar to those of younger patients. Chronological age alone should not be a limiting factor for surgical treatment of pleural empyema. Surgical decisions should be based on clinical condition rather than chronological age. Full article

(This article belongs to the Section Geriatric Pulmonology)

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25 pages, 624 KB

Open AccessArticle

Development of a Specialized Telemedicine Protocol for Cognitive Disorders: The TeleCogNition Project in Greece

by Efthalia Angelopoulou, Ioannis Stamelos, Evangelia Smaragdaki, Kalliopi Vourou, Evangelia Stanitsa, Dionysia Kontaxopoulou, Christos Koros, John Papatriantafyllou, Vasiliki Zilidou, Evangelia Romanopoulou, Efstratia-Maria Georgopoulou, Paraskevi Sakka, Haralampos Karanikas, Leonidas Stefanis, Panagiotis Bamidis and Sokratis Papageorgiou

Geriatrics 2025, 10(4), 94; https://doi.org/10.3390/geriatrics10040094 - 16 Jul 2025

Viewed by 2062

Abstract

Background/Objectives: Access to specialized care for patients with cognitive impairment in remote areas is often limited. Despite the increasing adoption of telemedicine, standardized guidelines have not yet been specified. This study aimed to develop a comprehensive protocol for the specialized neurological, neuropsychological, and [...] Read more.

Background/Objectives: Access to specialized care for patients with cognitive impairment in remote areas is often limited. Despite the increasing adoption of telemedicine, standardized guidelines have not yet been specified. This study aimed to develop a comprehensive protocol for the specialized neurological, neuropsychological, and neuropsychiatric assessment of patients with cognitive disorders in remote areas through telemedicine. Methods: We analyzed data from (i) a comprehensive literature review of the existing recommendations, reliability studies, and telemedicine models for cognitive disorders, (ii) insights from a three-year experience of a specialized telemedicine outpatient clinic for cognitive movement disorders in Greece, and (iii) suggestions coming from dementia specialists experienced in telemedicine (neurologists, neuropsychologists, psychiatrists) who took part in three focus groups. A critical synthesis of the findings was performed in the end. Results: The final protocol included: technical and organizational requirements (e.g., a high-resolution screen and a camera with zoom, room dimensions adequate for gait assessment, a noise-canceling microphone); medical history; neurological, neuropsychiatric, and neuropsychological assessment adapted to videoconferencing; ethical–legal aspects (e.g., data security, privacy, informed consent); clinician–patient interaction (e.g., empathy, eye contact); diagnostic work-up; linkage to other services (e.g., tele-psychoeducation, caregiver support); and instructions for treatment and follow-up. Conclusions: This protocol is expected to serve as an example of good clinical practice and a source for official telemedicine guidelines for cognitive disorders. Ultimate outcomes include the potential enhanced access to specialized care, minimized financial and logistical costs, and the provision of a standardized, effective model for the remote diagnosis, treatment, and follow-up. This model could be applied not only in Greece, but also in other countries with similar healthcare systems and populations living in remote, difficult-to-access areas. Full article

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9 pages, 214 KB

Open AccessArticle

The Communication Satisfaction of Geriatric Patients Treated by Dental Students and Dentists in a University Dental Clinic: A Cross-Sectional Study

by Carla Semedo, Joana Costa and Elisa Kern de Castro

Geriatrics 2025, 10(4), 93; https://doi.org/10.3390/geriatrics10040093 - 14 Jul 2025

Cited by 1 | Viewed by 1325

Abstract

Background/Objectives: With aging linked to increased oral health conditions, the communication skills of dental professionals are vital to ensure patient satisfaction and improve the quality of geriatric dental care. This cross-sectional study evaluated geriatric patients’ satisfaction with communication at a university dental [...] Read more.

Background/Objectives: With aging linked to increased oral health conditions, the communication skills of dental professionals are vital to ensure patient satisfaction and improve the quality of geriatric dental care. This cross-sectional study evaluated geriatric patients’ satisfaction with communication at a university dental clinic, comparing interactions with dentists and fifth-year dental students. Methods: A self-report questionnaire was administered to 111 patients, assessing sociodemographic data, general health, and satisfaction across six communication dimensions: verbal and nonverbal communication, empathy, respect, problem-solving, and support materials. The data were analyzed using Mann–Whitney U tests (α = 0.05). Results: The geriatric patients exhibited higher levels of satisfaction when interacting with dentists compared to students, particularly in the domains of nonverbal communication (p = 0.007), empathy (p = 0.035), and respect (p = 0.017). However, no statistically significant differences (p > 0.05) were observed in terms of verbal communication, problem-solving, and support materials. Conclusions: The geriatric patients demonstrated greater satisfaction with interactions with practicing dentists. These findings indicate that an attending dentist’s clinical experience enhances interpersonal interactions with geriatric patients. Therefore, developing the interpersonal skills of future dentistry professionals, as well as adapting communication to the needs of the elderly, is essential to provide more satisfactory experiences in geriatric dental care. Full article

5 pages, 485 KB

Open AccessCase Report

Lifesaving Treatment for DISH Syndrome in the Tenth Decade of Patient’s Life

by Bartosz Krolicki, Victor Mandat and Tomasz S. Mandat

Geriatrics 2025, 10(4), 92; https://doi.org/10.3390/geriatrics10040092 - 7 Jul 2025

Viewed by 532

Abstract

Background/Objectives: Diffuse idiopathic skeleton hyperostosis (DISH) is also known as Forestier–Rotes-Querol syndrome. The etiology of DISH is unknown. DISH is characterized by ossification of the anterior longitudinal ligaments of the spine. The area most frequently involved in the disease is the thoracic [...] Read more.

Background/Objectives: Diffuse idiopathic skeleton hyperostosis (DISH) is also known as Forestier–Rotes-Querol syndrome. The etiology of DISH is unknown. DISH is characterized by ossification of the anterior longitudinal ligaments of the spine. The area most frequently involved in the disease is the thoracic region of the spine. DISH in most cases is asymptomatic. If the cervical spine is involved, the most common symptoms are dysphagia and dyspnea. The ossifications in the cervical region of the spine are localized most frequently in its lower segments. Case presentation: The authors present the case of a 92-year-old cachectic female patient (body mass index (BMI) of 17; lost 13% of her body weight within the last 6 months). The patient underwent resection of the anterior osteophytes C2-T1. Results: At one-year follow up, the patient had gained weight (BMI—20) and regained her ability to consume solid products. To our knowledge, this is the oldest patient treated surgically for DISH. Conclusions: If dysphagia or dyspnea appears among elderly patients, cervical spine inspection should be conducted. If DISH is diagnosed safe, effective surgical treatment should be considered. Full article

(This article belongs to the Topic The Imperative of Patient Safety and Safety Culture in Contemporary Healthcare)

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15 pages, 522 KB

Open AccessSystematic Review

Deepening Physical Exercise Intervention Protocols for Older People with Sarcopenia Following Establishment of the EWGSOP2 Consensus: A Systematic Review

by Eduard Minobes-Molina, Sandra Rierola-Fochs, Carles Parés-Martínez, Pau Farrés-Godayol, Mirari Ochandorena-Acha, Eva Heras, Jan Missé, Fabricio Zambom-Ferraresi, Fabiola Zambom-Ferraresi, Joan Ars, Marc Terradas-Monllor and Anna Escribà-Salvans

Geriatrics 2025, 10(4), 91; https://doi.org/10.3390/geriatrics10040091 - 4 Jul 2025

Viewed by 951

Abstract

Background/Objectives: Sarcopenia is an age-related muscle disease that reduces strength and function in older adults. Exercise is a key intervention, but existing protocols vary widely and often lack adaptation to sarcopenia severity. The present study aims to review the effectiveness of exercise protocols [...] Read more.

Background/Objectives: Sarcopenia is an age-related muscle disease that reduces strength and function in older adults. Exercise is a key intervention, but existing protocols vary widely and often lack adaptation to sarcopenia severity. The present study aims to review the effectiveness of exercise protocols developed after the EWGSOP2 consensus and evaluate their adaptation to sarcopenia severity stages. Methods: This systematic review followed PRISMA guidelines. PubMed and Scopus were searched for studies published after the EWGSOP2 consensus involving participants of 65 years and over with primary sarcopenia and managed through exercise-only interventions. Risk of bias was assessed with the Cochrane Risk of Bias tool, and quality and transparency of exercise intervention were assessed with the Consensus on Exercise Reporting Template. Results: Ten studies met the inclusion criteria, with a total of 558 participants. Most interventions included resistance training, often within multicomponent programs. Statistically significant improvements were reported in muscle strength, mass, and physical performance. Additional benefits included enhancements in sleep quality, respiratory function, and specific biomarkers. However, only two studies classified sarcopenia severity, and reporting quality varied considerably. Conclusions: Exercise interventions, especially multicomponent and individualized protocols, are effective at improving outcomes related to sarcopenia in older adults. However, better alignment with diagnostic classifications and standardized reporting are needed to improve clinical translation and program replication. Full article

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16 pages, 240 KB

Open AccessArticle

The Relationship Between Willingness to Forgive and Health-Related Quality of Life in Older Adults in Portugal and Spain

by Cristiane Pavanello Rodrigues Silva, Fausto J. Barbero-Iglesias, Luis Polo-Ferrero and José I. Recio-Rodríguez

Geriatrics 2025, 10(4), 90; https://doi.org/10.3390/geriatrics10040090 - 2 Jul 2025

Viewed by 991

Abstract

Objectives: To describe, understand, and correlate willingness to forgive with self-perceived health-related quality of life, including the components of quality of physical health and mental health. Methods: Conducted with 30 older individuals, ≥65 years old, with preserved cognitive abilities, literacy ≥ four years [...] Read more.

Objectives: To describe, understand, and correlate willingness to forgive with self-perceived health-related quality of life, including the components of quality of physical health and mental health. Methods: Conducted with 30 older individuals, ≥65 years old, with preserved cognitive abilities, literacy ≥ four years of education, living in Portugal and Spain. The 12-Item Short-Form Health Survey (SF-12) was used to assess self-perceived health-related quality of life, and the Heartland Forgiveness Scale (HFS) was used to measure willingness to forgive. Results: There was a direct positive correlation between willingness to forgive and perception of health-related quality of life, especially for the mental health component, educational level, cohabitation, and work activity. Conclusions: Forgiveness could play a significant role in the emotional health and quality of life of the elderly. Strategies to develop forgiveness can benefit the active aging process, contributing to improved health-related quality of life in older individuals. Full article

(This article belongs to the Topic Psychopathology and Developmental Trajectories)

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13 pages, 532 KB

Open AccessArticle

Exploring the Role of Cognitive Reserve and Human–Animal Interaction in Late-Life Depression: A Moderation Analysis

by Nathália Saraiva de Albuquerque, Natália Silva Sessegolo, Carmen Moret-Tatay and Tatiana Quarti Irigaray

Geriatrics 2025, 10(4), 89; https://doi.org/10.3390/geriatrics10040089 - 1 Jul 2025

Viewed by 510

Abstract

Background/Objectives: Depression impairs the quality of life in older adults and represents a significant public health issue. Cognitive reserve may act as a protective factor against depressive symptoms in older adults. Additionally, interaction with pets may serve as another potential protective factor against [...] Read more.

Background/Objectives: Depression impairs the quality of life in older adults and represents a significant public health issue. Cognitive reserve may act as a protective factor against depressive symptoms in older adults. Additionally, interaction with pets may serve as another potential protective factor against these symptoms. Thus, this study aimed to evaluate whether higher cognitive reserve could predict a reduction in depressive symptoms in older adults and to investigate the moderating role of pet companionship in this relationship. Methods: The following instruments were used: a Sociodemographic Data Sheet, the Modified Telephone Interview for Cognitive Status (TICS-M), the Cognitive Reserve Index Questionnaire (CRIq), and the Geriatric Depression Scale (GDS-15). Data were collected via video calls through WhatsApp and analyzed using a moderation analysis with PROCESS for SPSS. Results: The final sample consisted of 215 older adults with a mean age of 69.13 years (SD = 6.89). Among the participants, 53% owned pets and 47% did not. The overall model revealed a significant association between the predictor variables and the outcome (F(3, 211) = 4.24, p < 0.01). For the group without pets, the effect was not significant (β = −0.1082, p = 0.2916), but for the group with pets, the effect was substantial and negative on the GDS (β = −0.1936, p < 0.05). Conclusions: We concluded that the relationship between cognitive reserve and depressive symptoms is moderated by the presence of pets in individuals’ lives. These findings highlight the role of pets in protecting against depressive symptoms in older adults. Future studies should explore this relationship with more diverse samples. Full article

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11 pages, 556 KB

Open AccessArticle

Trends and Mortality Predictors of Delirium Among Hospitalized Older Adults: A National 5-Year Retrospective Study in Thailand

by Manchumad Manjavong, Panita Limpawattana, Jarin Chindaprasirt and Poonchana Wareechai

Geriatrics 2025, 10(4), 88; https://doi.org/10.3390/geriatrics10040088 - 1 Jul 2025

Viewed by 822

Abstract

Background: Delirium frequently manifests in hospitalized geriatric patients and is associated with negative health outcomes. Available large-scale data regarding its prevalence rate and impact on older Thai patients are limited. This study aimed to analyze trends in the prevalence rate, its consequences, and [...] Read more.

Background: Delirium frequently manifests in hospitalized geriatric patients and is associated with negative health outcomes. Available large-scale data regarding its prevalence rate and impact on older Thai patients are limited. This study aimed to analyze trends in the prevalence rate, its consequences, and the factors contributing to death at discharge among this population. Methods: A retrospective study of inpatients over the age of 60 who received a diagnosis of delirium was conducted, utilizing inpatient medical expense documentation for the fiscal years 2019–2023. The identification of delirium was conducted by the National Health Security Office using the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification (ICD-10-TM) code F05. Results: The 5-year prevalence rate and mortality rate of delirium were 215.1 and 18.7/100,000 population, respectively, and tended to rise over the studied periods. The average hospitalization was 10 days, and the average healthcare expenditure was about 1470 USD/visit. Respiratory disease emerged as the most common primary diagnosis in delirious patients (23.5%). Factors associated with mortality were individuals aged >80 years when juxtaposed with the cohort aged 61–70 years (adjusted odds ratio [AOD] 1.07), being female (AOR 1.13), and a primary diagnosis of respiratory disease (AOR 2.72), cardiovascular disease (AOR 1.68), musculoskeletal disease (AOR 0.61), systemic infection/septicemia (AOR 2.08); or malignancy (AOR 2.97). Conclusions: There was an upward trend in rates of both prevalence and mortality associated with delirium among hospitalized geriatric patients. Advancing age, gender, and particular primary diagnoses were associated with mortality at hospital discharge. Full article

(This article belongs to the Section Geriatric Neurology)

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11 pages, 234 KB

Open AccessArticle

Health Information-Seeking Behavior in Older Adults with Vision Impairment Among Different Stages of Eye Care: A Cross-Sectional Comparative Study

by Ya-Ping Wang, Ping Ouyang, Yan-Hua Zhao, Liu-Ming Lu, Hua-Ying Liu, Can Dai and Hong-Zhen Zhou

Geriatrics 2025, 10(4), 87; https://doi.org/10.3390/geriatrics10040087 - 1 Jul 2025

Viewed by 428

Abstract

Background/Objectives: Visual impairment (VI) represents a significant health challenge among older adults, particularly due to their limited understanding of health information. This study aimed to investigate and compare the health information-seeking behavior (HISB) of older adults with VI across different stages of [...] Read more.

Background/Objectives: Visual impairment (VI) represents a significant health challenge among older adults, particularly due to their limited understanding of health information. This study aimed to investigate and compare the health information-seeking behavior (HISB) of older adults with VI across different stages of eye care. Methods: A cross-sectional comparative study was conducted in 248 older adults with VI in various stages of eye care, including the pre-visit stage (n = 84), treatment stage (n = 83), and follow-up stage (n = 81) at the Shenzhen Eye Hospital from July to October 2024. Participants completed an HISB questionnaire encompassing four dimensions: attitude, needs, sources, and barriers. Results: The overall mean score of HISB varied significantly among the different eye care stages. The treatment stage had the highest scores (3.70 ± 0.32), particularly in attitudes toward health information and information needs. Poor self-reported overall health facilitated HISB in each stage. In the pre-visit stage, higher income was associated with increased HISB, while a lack of internet access reduced it. In the treatment stage, higher education was associated with higher HISB, whereas moderate-to-severe VI and certain income levels were associated with negative effects. In the follow-up stage, rural residence and spousal or child caregiving emerged as key facilitators of HISB. Conclusions: The treatment stage is a critical period for HISB engagement in older adults with VI. Healthcare providers should consider stage-specific factors of HISB to optimize health information delivery. Full article

(This article belongs to the Section Geriatric Ophthalmology)

1 pages, 131 KB

Open AccessCorrection

Correction: Báez-Suárez et al. Improving Sleep Quality and Well-Being in Institutionalized Older Adults: The Potential of NESA Non-Invasive Neuromodulation Treatment. Geriatrics 2025, 10, 4

by Aníbal Báez-Suárez, Virginia Báez-Suárez, Laissa Saldanha, Martín Vílchez-Barrera, Andrea Hernández-Pérez and Raquel Medina-Ramírez

Geriatrics 2025, 10(4), 86; https://doi.org/10.3390/geriatrics10040086 - 30 Jun 2025

Viewed by 217

Abstract

In the original publication [...] Full article

14 pages, 1320 KB

Open AccessArticle

The Impact of Age on the Effectiveness of Immune Checkpoint Inhibitors Therapy in Patients with Metastatic Non-Small-Cell Lung Cancer

by Yuliia Moskalenko, Oleksandr Yazykov, Olena Vasylieva, Kateryna Smiian, Tetiana Ivakhniuk, Hanna Budko and Roman Moskalenko

Geriatrics 2025, 10(4), 85; https://doi.org/10.3390/geriatrics10040085 - 27 Jun 2025

Viewed by 653

Abstract

The global aging population has led to a growing incidence of malignancies, including metastatic non-small-cell lung cancer (mNSCLC). Immunosenescence may affect the efficacy of immune checkpoint inhibitors (ICIs). The prognostic role of age in ICI-treated mNSCLC remains uncertain. Objectives: This study aims [...] Read more.

The global aging population has led to a growing incidence of malignancies, including metastatic non-small-cell lung cancer (mNSCLC). Immunosenescence may affect the efficacy of immune checkpoint inhibitors (ICIs). The prognostic role of age in ICI-treated mNSCLC remains uncertain. Objectives: This study aims to assess whether age independently influences survival, response, and toxicity in mNSCLC patients treated with ICIs, and to examine potential interactions with clinical factors. Methods: In this retrospective cohort study, 105 patients with mNSCLC treated with ICIs were enrolled. Patients were stratified into four groups based on age quartiles. Clinical, pathological, and treatment data were collected. Survival outcomes were analyzed using Kaplan–Meier curves, ROC curve and multivariable Cox regression models adjusted for confounders. Interaction and restricted cubic spline analyses were performed to explore age-related effects. The p < 0.05 was considered as statistically significant. Results: The median age was 60.8 years. Clinical benefit—defined as objective response rate (51.4%) and disease control rate (86.6%)—did not significantly differ across age quartiles (p = 0.551 and p = 0.257, respectively). Median overall survival also did not differ significantly (p = 0.2853). Cox regression and spline modeling demonstrated no independent association between chronological age and all-cause mortality (Model 3: HR = 1.00, 95% CI: 0.95–1.04, p = 0.889). However, interaction analyses revealed that poor ECOG performance status (p = 0.001), longer duration of ICI treatment (p < 0.0001), and low PD-L1 expression (p = 0.017) were stronger predictors of mortality in older patients. Age was associated with increased immune-related adverse events and higher Charlson Comorbidity Index scores, suggesting the need for age-specific management strategies. Conclusions: Age alone does not predict survival in mNSCLC patients receiving ICIs. However, functional status, treatment duration and PD-L1 expression may modify age-related outcomes. Full article

(This article belongs to the Section Geriatric Oncology)

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11 pages, 727 KB

Open AccessArticle

The Longitudinal Relationship Between Allostatic Load and Multimorbidity Among Older Americans

by Rolla Mira, Jonathon Timothy Newton and Wael Sabbah

Geriatrics 2025, 10(4), 84; https://doi.org/10.3390/geriatrics10040084 - 26 Jun 2025

Viewed by 895

Abstract

Background: To examine the association between allostatic load and the progression of multimorbidity and the role of socioeconomic factors among older Americans. Methods: Data from the Health and Retirement Study (HRS), a longitudinal study of older American adults, were used. Data were included [...] Read more.

Background: To examine the association between allostatic load and the progression of multimorbidity and the role of socioeconomic factors among older Americans. Methods: Data from the Health and Retirement Study (HRS), a longitudinal study of older American adults, were used. Data were included from waves 8 (2006), 10 (2010), 11 (2012), and 13 (2016). Self-reported diagnoses of five chronic conditions (diabetes, heart disease, lung diseases, cancer, and stroke) indicated multimorbidity and were dichotomised to reflect having two or more conditions versus one or fewer. Multimorbidity in 2006 was subtracted from that in 2016 to calculate ten-year change in multimorbidity. Sociodemographic data (age, gender, education, and wealth) were from wave 8 (2006). Behaviours (physical activity and smoking) were from wave 10 (2010). Allostatic load, indicated by five biomarkers (waist circumference, high blood pressure, glycosylated haemoglobin, high-density lipoprotein, and c-reactive protein), was from wave 11 (2012). Structural Equation Modelling (SEM) was used to assess the longitudinal association between the aforementioned factors and the incidence of multimorbidity in 2016. Results: Given that allostatic load was assessed in a subsample of HRS, 8222 were excluded for lack of relevant data. A total of 3336 participants were included in the final analysis. The incidence of multimorbidity in 2016 was 19%. Allostatic load in 2012 was significantly associated with the incidence of multimorbidity in 2016 (estimate 0.10, 95% Confidence Interval (CI) 0.07, 0.14); in other words, for an additional marker of allostatic load, there was an average 0.1 change in the incidence of multimorbidity. Wealth and education (2006) were indirectly associated with multimorbidity through allostatic load and behaviours. Smoking (2010) was positively associated with multimorbidity in 2016, while physical activity showed a negative association. Conclusions: Biological markers of stress indicated by allostatic load were associated with multimorbidity. Adverse socioeconomic conditions appear to induce allostatic load and risk behaviours, which impact the progression of multimorbidity. Full article

(This article belongs to the Section Geriatric Public Health)

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18 pages, 734 KB

Open AccessReview

Psychological and Sociodemographic Variables Associated with Increased Anxiety and Anxiety Symptoms in Older Adults: A Scoping Review

by Jesús Enrique Sotelo-Ojeda, Christian Oswaldo Acosta-Quiroz, Raquel García-Flores, Ana Luisa Mónica González-Celis Rangel and Erick Alberto Medina-Jiménez

Geriatrics 2025, 10(4), 83; https://doi.org/10.3390/geriatrics10040083 - 23 Jun 2025

Viewed by 592

Abstract

Background/Objectives: There is a high prevalence of anxiety and anxiety symptoms in older adults, which can have cognitive, emotional, and physical repercussions on older adults. It is important to understand the risk factors from psychological variables and sociodemographic variables that may be influencing [...] Read more.

Background/Objectives: There is a high prevalence of anxiety and anxiety symptoms in older adults, which can have cognitive, emotional, and physical repercussions on older adults. It is important to understand the risk factors from psychological variables and sociodemographic variables that may be influencing anxiety symptoms to generate more effective interventions based on modifiable variables. In this context, the objective of this review was to identify psychological and sociodemographic variables as risk factors for anxiety and anxiety symptoms in older adults. Methods: The Scoping review followed the guidelines of the (PRISMA-ScR 2018). Five databases were used to reduce bias and identify relevant evidence: Medline via Ovid, PUBMED, CINAHL, PsycINFO, and Web of Science. Results: A total of 2150 articles were identified across the five databases; 16 articles were included for data synthesis and methodological quality assessment. Conclusions: The variables that maintain the strongest association as both risk and protective factors are age, female sex, physical activity, physical health or medical conditions, depression, perceived and family support, and social and family participation. However, methodological limitations—including inconsistent definitions, diverse and often inadequate measurement tools, and lack of causal inference—restrict the generalizability of findings. These results underscore the need for validated age-appropriate instruments and more rigorous research designs in geriatric anxiety studies. Full article

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