Geriatrics

12 pages, 829 KB

Open AccessCase Report

Interdisciplinary Management of White Coat Hypertension in Geriatric Oral Surgery: Case Report

by Alexandra Allaica Cuenca, Ana Balseca Morales, Jorge López Bundschuh, Luis Chauca-Bajaña and Byron Velasquez Ron

Geriatrics 2025, 10(6), 172; https://doi.org/10.3390/geriatrics10060172 - 18 Dec 2025

Viewed by 2001

Abstract

Introduction: White coat hypertension in geriatric patients can complicate dental procedures in the presence of intense anxiety. Objective: To evaluate the effectiveness of a combined approach of psychological intervention and sedation for the control of the syndrome during multiple extractions. Case presentation: A [...] Read more.

Introduction: White coat hypertension in geriatric patients can complicate dental procedures in the presence of intense anxiety. Objective: To evaluate the effectiveness of a combined approach of psychological intervention and sedation for the control of the syndrome during multiple extractions. Case presentation: A 76-year-old woman with a diagnosis of white coat hypertension (WCH) and a history of dental anxiety. In two previous attempts, the surgery was suspended due to blood pressure elevation. The Dental Perception Reprogramming Protocol (DPRP) was applied along with conscious sedation (midazolam, fentanyl, dexmedetomidine) which allowed agitation, so deep sedation with propofol was used. Result: The patient had stable blood pressure (119/82 mmHg) and successfully completed the intervention without complications. Conclusions: The integration of psycho-behavioral and pharmacological techniques allowed effective hemodynamic control, and a key interdisciplinary approach is suggested for the management of the syndrome in older adults. Full article

(This article belongs to the Section Geriatric Public Health)

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23 pages, 719 KB

Open AccessArticle

EMTReK Model for Advance Care Planning in Long-Term Care: Qualitative Findings from mySupport Study

by Irene Hartigan, Catherine Buckley, Nicola Cornally, Kevin Brazil, Julie Doherty, Catherine Walshe, Andrew J. E. Harding, Nancy Preston, Laura Bavelaar, Jenny T. van der Steen, Paola Di Giulio, Silvia Gonella, Sharon Kaasalainen, Tamara Sussman, Bianca Tétrault, Martin Loučka, Karolína Vlčková, Rene A. Gonzales and on behalf of the mySupport Study Group

Geriatrics 2025, 10(6), 171; https://doi.org/10.3390/geriatrics10060171 - 18 Dec 2025

Viewed by 1098

Abstract

Background/Objectives: Conversations about end-of-life care or advance care planning are often difficult and emotionally challenging to initiate. Tailoring messages to the specific audiences can make these sensitive discussions more manageable and effective. The Evidence-based Model for the Transfer and Exchange of Research [...] Read more.

Background/Objectives: Conversations about end-of-life care or advance care planning are often difficult and emotionally challenging to initiate. Tailoring messages to the specific audiences can make these sensitive discussions more manageable and effective. The Evidence-based Model for the Transfer and Exchange of Research Knowledge (EMTReK), compromising six core components (message, stakeholders, processes, context, facilitation, and evaluation) offers a structured framework for research dissemination and knowledge transfer in palliative and long-term care settings. Knowledge translation bridges research and practice, with its effectiveness depending on stakeholder engagement, tailored communication, and systematic application of evidence in policy and practice. This study explores stakeholder perspectives on a dementia care intervention, using EMTReK as an analytical framework to examine how knowledge transfer and exchange (KTE) actions were implemented across long-term care settings. Methods: A qualitative analysis was conducted on primary data comprising case narratives from multinational research groups involved in the “Caregiver Decision Support” (mySupport) study (2019–2023). Teams from Canada, the Czech Republic, Ireland, Italy, the Netherlands, and the United Kingdom evaluated the mySupport intervention through interviews, with analysis guided by components of the EMTReK model. Results: Facilitated Family Care Conferences were found to be effective mechanisms for supporting knowledge transfer and intervention uptake in dementia care across nursing homes in Europe and Canada. Despite challenges posed by the COVID-19 pandemic, Family Care Conferences adapted through stakeholder engagement, interactive learning, and innovative communication methods. Using EMTReK as an analytical framework, the research team identified key elements that contributed to successful implementation, including the importance of flexibility to accommodate local contexts. Conclusions: The transnational application of the EMTReK model for advance care planning in long-term dementia care highlights the importance of tailored, culturally relevant knowledge translation strategies, which, despite challenges from the COVID-19 pandemic, were successfully implemented through local adaptations and diverse dissemination methods, emphasising the need for further research on their impact on resident and family outcomes. Full article

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17 pages, 1357 KB

Open AccessCase Report

Cooled Radiofrequency at Five Revised Targets for Short-Term Pain and Physical Performance Improvement in Elderly Patients with Knee Osteoarthritis: A Prospective Four-Case Reports

by Rafaela F. Rodrigues, Carlos Marcelo de Barros, André A. V. Lima, Felipe T. Vilela and Vanessa B. Boralli

Geriatrics 2025, 10(6), 170; https://doi.org/10.3390/geriatrics10060170 - 18 Dec 2025

Viewed by 955

Abstract

Background and Objectives: Osteoarthritis (OA) is a common cause of chronic pain. In refractory cases, cooled radiofrequency (CRF) of the genicular nerves is indicated. However, recent studies suggest that traditional targets may be insufficient, proposing the inclusion of the recurrent fibular nerve and [...] Read more.

Background and Objectives: Osteoarthritis (OA) is a common cause of chronic pain. In refractory cases, cooled radiofrequency (CRF) of the genicular nerves is indicated. However, recent studies suggest that traditional targets may be insufficient, proposing the inclusion of the recurrent fibular nerve and the infrapatellar branch of the saphenous nerve. This study reports a prospective four-case series evaluating short-term outcomes of CRF at five revised targets in elderly Brazilian patients. Case Report: The study (CAAE No.: 55647722.5.0000.5142) included four patients (three women, one man; mean age 73.8 years) with moderate to severe refractory knee pain underwent diagnostic nerve block followed by ultrasound-guided CRF. After 30 days, three patients reported pain reduction, including two who experienced substantial improvement. One patient maintained severe pain. Improvements in physical performance, knee flexion, and extension were observed in patients who responded clinically, while individuals with coexisting myofascial pain showed limited functional gains. One patient experienced mild transient pruritus. In this prospective case series, CRF applied to five revised targets appeared feasible and well tolerated, with short-term improvement in pain and function in some patients. These preliminary descriptive findings support further investigation in larger controlled studies. Full article

(This article belongs to the Section Geriatric Rehabilitation)

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12 pages, 251 KB

Open AccessArticle

Telemedicine in the Care of Older Adults with Dementia: Caregivers’ Perceptions and Experiences

by Roni Chaim Mukamal, Viviane Gontijo Augusto, Laiane Moraes Dias, Thiago Dias Sarti and Guilhermina Rego

Geriatrics 2025, 10(6), 169; https://doi.org/10.3390/geriatrics10060169 - 17 Dec 2025

Cited by 1 | Viewed by 1058

Abstract

Background: Population aging has led to a rise in dementia prevalence, increasing the demand for innovative care models. Telemedicine offers an opportunity to improve access, continuity, and caregiver support for older adults with cognitive impairment. Methods: This qualitative descriptive study was conducted at [...] Read more.

Background: Population aging has led to a rise in dementia prevalence, increasing the demand for innovative care models. Telemedicine offers an opportunity to improve access, continuity, and caregiver support for older adults with cognitive impairment. Methods: This qualitative descriptive study was conducted at the Geriatrics and Gerontology Service of Cassiano Antônio de Moraes University Hospital (HUCAM-UFES), Brazil. Semi-structured interviews were carried out with 11 caregivers of older adults living with dementia who participated in telemedicine consultations. Data was analyzed thematically using a reflexive thematic analysis approach. Results: Caregivers considered telemedicine useful, accessible, and safe, facilitating the continuity of care and strengthening the caregiver–professional relationship. The main limitations were the absence of physical examination and occasional technical difficulties. Most caregivers favored a hybrid care model, combining remote and in-person visits. Conclusions: Telemedicine proved to be a feasible and well-accepted strategy for the care of older adults with dementia, improving caregiver support and communication with healthcare teams. Public policies should foster digital inclusion and training for both caregivers and professionals, consolidating hybrid, person-centered models of care. Full article

(This article belongs to the Special Issue Care, Connection and Equity: Advancing the Science of Caregiving in Aging)

14 pages, 808 KB

Open AccessArticle

UnderstandingDelirium.ca: A Mixed-Methods Observational Evaluation of an Internet-Based Educational Intervention for the Public and Care Partners

by Randi Shen, Dima Hadid, Stephanie Ayers, Sandra Clark, Rebekah Woodburn, Roland Grad and Anthony J. Levinson

Geriatrics 2025, 10(6), 168; https://doi.org/10.3390/geriatrics10060168 - 16 Dec 2025

Viewed by 736

Abstract

Background/Objectives: Delirium, an acute cognitive disturbance, is often unrecognized by family or friend care partners, contributing to delayed interventions and negative health outcomes. UnderstandingDelirium.ca is an e-learning lesson developed to address this gap by improving delirium knowledge among the public, patients, and family/friend [...] Read more.

Background/Objectives: Delirium, an acute cognitive disturbance, is often unrecognized by family or friend care partners, contributing to delayed interventions and negative health outcomes. UnderstandingDelirium.ca is an e-learning lesson developed to address this gap by improving delirium knowledge among the public, patients, and family/friend care partners. Our objective was to evaluate the acceptability, intention to use, and perceived impact of Understanding Delirium e-learning among public users. Methods: A convergent mixed-methods observational evaluation combining survey-based quantitative data and thematic analysis was conducted. The survey included the Net Promoter Score (NPS), the short-form Information Assessment Method for patients and consumers (IAM4all-SF), and an open-text feedback item. Descriptive statistics were used to summarize IAM4all-SF responses, assessing perceived relevance, understandability, intended use, and anticipated benefit. Open-text comments were analyzed thematically by two independent reviewers who reached consensus through discussion. Subgroup analysis of qualitative themes was performed by age, gender, and NPS category. Results: Among 629 survey respondents, over 90% of respondents agreed that the lesson was relevant, understandable, likely to be used, and beneficial. The NPS was rated ‘excellent’ (score of 71), and lesson uptake included over 7000 unique users with a 35% completion rate. Qualitative analysis revealed themes of high educational value, emotional resonance, and perceived gaps in prior healthcare communication. Respondents emphasized the lesson’s clarity, intent to share, and potential for wider dissemination. Conclusions: UnderstandingDelirium.ca is a promising, guideline-aligned digital intervention that has potential to enhance delirium literacy and reduce care partner distress. Findings suggest that the Understanding Delirium e-learning can effectively improve public delirium literacy and should be integrated into care partner and clinical workflows. Full article

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14 pages, 735 KB

Open AccessArticle

Recovery Trajectories of Motor Function After Hip Fracture Surgery in Older Patients: A Multicenter Growth Mixture Modeling Study in Acute Care Hospitals

by Keisuke Nakamura, Yasushi Kurobe, Keita Sue, Shuhei Yamamoto and Kimito Momose

Geriatrics 2025, 10(6), 167; https://doi.org/10.3390/geriatrics10060167 - 15 Dec 2025

Cited by 1 | Viewed by 1189

Abstract

Background/Objective: Hip fractures in older adults are a major public health concern due to their high rates of morbidity, mortality, and long-term disability. Although surgical and postoperative care have improved, recovery outcomes remain highly variable. Identifying early functional recovery patterns could support [...] Read more.

Background/Objective: Hip fractures in older adults are a major public health concern due to their high rates of morbidity, mortality, and long-term disability. Although surgical and postoperative care have improved, recovery outcomes remain highly variable. Identifying early functional recovery patterns could support individualized rehabilitation and discharge planning. This study aimed to identify distinct early recovery trajectories of motor function within 30 days after hip fracture surgery using growth mixture modeling (GMM) and to examine patient- and hospital-level factors associated with these patterns. Methods: A retrospective cohort study was conducted using data from the Nagano Hip Fracture Database, including 2423 patients aged ≥65 years across 17 acute care hospitals in Japan (2019–2024). Functional recovery was measured using the motor subscale of the Functional Independence Measure (FIM-motor) at 0, 7, and 28 days post-admission. Latent trajectory model was used to identify distinct recovery patterns. Multinomial logistic regression analyzed predictors of class membership. Results: Three recovery trajectories were identified: high/rapid improvement (26.7%), intermediate (32.6%), and poor/flat recovery (40.7%). Older age, cognitive impairment, and lower baseline mobility were strongly associated with membership in the poor-recovery class. Early trajectory classes significantly predicted discharge outcomes, including FIM-motor scores and discharge destination. Sensitivity analysis confirmed the robustness of findings, with minimal impact from hospital-level clustering. Conclusions: Distinct early recovery trajectories exist after hip fracture surgery and are strongly influenced by baseline cognitive and functional status. Early identification of recovery patterns can enhance personalized rehabilitation and inform discharge planning, offering valuable insights for clinical practice. Full article

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13 pages, 616 KB

Open AccessArticle

Impact of Music Interventions on Depression in Care Home Residents with Dementia: UK Results from Music Interventions for Depression and Dementia in Elderly Care RCT

by Justine Schneider, Joanne Ablewhite, Jodie Bloska, Martin Orrell, Helen Odell-Miller, Jorg Assmus, Christian Gold and Vigdis Sveinsdottir

Geriatrics 2025, 10(6), 166; https://doi.org/10.3390/geriatrics10060166 - 15 Dec 2025

Cited by 2 | Viewed by 1381

Abstract

Background: We report UK findings from Music Interventions for Depression and Dementia in Elderly care (MIDDEL), a cross-national, clustered, randomised trial undertaken in 2018–2023 to evaluate the effectiveness of music interventions for depression symptoms in care home residents living with dementia (NCT03496675, clinicaltrials.gov [...] Read more.

Background: We report UK findings from Music Interventions for Depression and Dementia in Elderly care (MIDDEL), a cross-national, clustered, randomised trial undertaken in 2018–2023 to evaluate the effectiveness of music interventions for depression symptoms in care home residents living with dementia (NCT03496675, clinicaltrials.gov (accessed on 1 December 2024)). The trial compared the effects of Group Music Therapy (GMT) with Recreational Choir Singing (RCS); GMT and RCS combined; and treatment as usual (TAU). Methods: In the intervention arms, the protocolized music interventions were delivered in care home units twice per week for three months, then once per week for three months. The primary outcome was depressive symptoms after six months, measured by MADRS. Secondary outcomes included well-being—EQ-5D-5L, Visual Analogue Scale (VAS); quality of life—QOL-AD; symptoms of dementia—SIB-8, NPI-Q; and caregiver distress—NPI-Q. The change in MADRS score from baseline to 6 months was assessed using a linear mixed-effects model. We report the multivariate model having both treatments as predictors, both unadjusted and adjusted, for the interaction between the treatments. Results: The UK trial started in 2022 after the pandemic lockdown, when 16 care home units were recruited and randomised, four per arm; 192 residents aged over 65 with depression and dementia participated. An ITT analysis of 146 participants retained at 6 months found neither intervention had a significant positive effect on any outcome. Significant unfavourable effects were found for RCS participants on MADRS, NPI symptom severity, and EQ-VAS. The combination of RCS + GMT had a detrimental effect on caregiver distress. Conclusions: MIDDEL UK findings do not support the use of GMT or RCS to alleviate depression in care home residents with dementia. Full article

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12 pages, 227 KB

Open AccessArticle

Prevalence of Major Bleeding in Elderly Patients on Oral Anticoagulants for Non-Valvular Atrial Fibrillation: A Single-Center 12-Year Retrospective Review

by How Foong Kwan, Hazlina Mahadzir, Nor Rafeah Tumian, Azimatun Noor Aizuddin and Shue Hong Kong

Geriatrics 2025, 10(6), 165; https://doi.org/10.3390/geriatrics10060165 - 15 Dec 2025

Viewed by 1042

Abstract

Background/Objectives: Non-valvular atrial fibrillation (NVAF) is a common arrhythmia in the elderly and carries a high risk of cardioembolic stroke. Oral anticoagulation is central to prevention, with direct oral anticoagulants (DOACs) increasingly replacing warfarin due to better safety and convenience. However, major bleeding [...] Read more.

Background/Objectives: Non-valvular atrial fibrillation (NVAF) is a common arrhythmia in the elderly and carries a high risk of cardioembolic stroke. Oral anticoagulation is central to prevention, with direct oral anticoagulants (DOACs) increasingly replacing warfarin due to better safety and convenience. However, major bleeding remains a key concern, particularly in older patients. This study aimed to determine the prevalence of major bleeding among elderly patients (≥65 years) with NVAF treated with oral anticoagulants. Methods: A retrospective cohort study was conducted on 886 elderly NVAF patients managed at a tertiary hospital between January 2012 and December 2023. Data on demographics, anticoagulant type, comorbidities, and bleeding events were collected. Associations between categorical variables were tested using Chi-square or Fisher’s exact tests, while logistic regression identified predictors of major bleeding. Results: The mean age was 78.4 ± 7.2 years, with equal gender distribution. Most patients (87.1%) received DOACs, while 12.9% were prescribed warfarin. A total of 63 patients (7.1%) experienced major bleeding, including 51 (6.6%) in the DOAC group and 12 (10.5%) in the warfarin group. Intracranial and intra-/retroperitoneal hemorrhages were most common. Logistic regression showed older age, prior bleeding, a higher HASBLED score, and antiplatelet use as significant predictors. Among patients with a recorded weight (n = 70), dosing adherence was better for apixaban and edoxaban compared to dabigatran and rivaroxaban. Conclusions: DOACs were associated with fewer major bleeding events than warfarin. Bleeding risk was strongly linked to age, prior bleeding, HASBLED score, and concomitant antiplatelet therapy, highlighting the importance of appropriate DOAC dosing for safety. Full article

13 pages, 613 KB

Open AccessArticle

The Clock Drawing Test: A Valid Screening Instrument for Dementia Detection in Low-Educated Patients?

by Janique Boots-van der Heiden, Jos van Campen, Tessa Kooistra, Irene van de Vorst and Miriam Goudsmit

Geriatrics 2025, 10(6), 164; https://doi.org/10.3390/geriatrics10060164 - 12 Dec 2025

Viewed by 2379

Abstract

Objective: The non-verbal nature of the Clock Drawing Test (CDT) suggests it is a suitable cognitive screening instrument for populations with lower educational levels and/or language barriers. This study evaluates whether the CDT is a valid screening instrument for low-educated patients and includes [...] Read more.

Objective: The non-verbal nature of the Clock Drawing Test (CDT) suggests it is a suitable cognitive screening instrument for populations with lower educational levels and/or language barriers. This study evaluates whether the CDT is a valid screening instrument for low-educated patients and includes a qualitative analysis of CDT errors. Method: A total of 503 participants were included, divided into four groups (dementia, MCI, no cognitive impairment, and other diagnosis), based on a clinical diagnosis by a geriatrician. Educational levels were categorized into four groups: no education and low, middle, and high education. CDT scores were assessed using the seven-point scoring system (Freedman), and two cutoff points were evaluated. Results: Results showed that in all education categories, the dementia group scored significantly lower on the CDT compared to the non-dementia group. The difference was smallest in participants with no education. Two cut-off points were assessed: <4 and <3. A cut-off of <4 showed better sensitivity versus <3, particularly for low-educated groups. A cut-off of <3 provided better specificity versus <4. Error analysis showed that errors made by low-educated participants without dementia were similar to those of patients with dementia. Conclusions: These findings show that the CDT (both total score and qualitative error analysis) has limited value in dementia case-finding in low-educated groups. The CDT is recommended primarily for middle- and high-educated groups. Full article

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

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10 pages, 211 KB

Open AccessArticle

Analysis of Clinical Characteristics and Rehabilitation Outcomes in Elderly Patients with Parkinson’s Disease: A Retrospective Study

by Toshiya Shimamoto, Yohei Misumi, Katsuhisa Uchino, Akira Mori, Takuya Motoshima, Makoto Uchino and Mitsuharu Ueda

Geriatrics 2025, 10(6), 163; https://doi.org/10.3390/geriatrics10060163 - 5 Dec 2025

Viewed by 1457

Abstract

Background: Parkinson’s disease (PD) is a prevalent neurodegenerative disorder among the elderly, with its incidence increasing as the population ages. Despite the predominance of patients with PD aged 75 years and older in clinical settings, limited research has focused on their rehabilitation. [...] Read more.

Background: Parkinson’s disease (PD) is a prevalent neurodegenerative disorder among the elderly, with its incidence increasing as the population ages. Despite the predominance of patients with PD aged 75 years and older in clinical settings, limited research has focused on their rehabilitation. This study aimed to compare the clinical characteristics and rehabilitation outcomes of elderly patients aged 75 years and older. Methods: A retrospective analysis was conducted on 141 patients with PD aged 65 years and older who underwent intensive inpatient rehabilitation. Patients were categorized into two subgroups: the young-old group (65–74 years, n = 58) and the old-old group (≥75 years, n = 83). The rehabilitation program included daily 2 h sessions, 6 days a week, combining physical, occupational, and speech–language–hearing therapies to enhance functional impairments and activities of daily living (ADL). Clinical characteristics and rehabilitation outcomes were compared between these groups. Results: The old-old group exhibited significantly higher rates of sarcopenia, higher Unified Parkinson’s Disease Rating Scale (UPDRS) scores, poorer balance scores and cognitive function, and lower ADL scores compared with the young-old group. However, both groups demonstrated significant improvements in UPDRS, Berg Balance Scale, 10 m walk test, and Functional Independence Measure scores, indicating enhanced motor function and ADL. Conclusions: Our retrospective study suggests that inpatient rehabilitation is associated with improvement in parkinsonism, motor symptoms, and ADL in patients with PD aged 75 years or older, highlighting the potential benefits of intensive rehabilitation even in advanced age. These findings underscore the need for prospective studies to confirm these effects. Trial registration: UMIN000056042 (last amendment 5 November 2024, retrospectively registered). Full article

9 pages, 531 KB

Open AccessArticle

Reevaluating Calf Circumference as an Indicator of Muscle Mass in Malnutrition Among Community-Dwelling Older Adults: A Cross-Sectional Analysis

by Emanuele Marzetti and Hélio José Coelho-Júnior

Geriatrics 2025, 10(6), 162; https://doi.org/10.3390/geriatrics10060162 - 5 Dec 2025

Viewed by 1447

Abstract

Aim: The present study aimed to evaluate the agreement between calf circumference (CC) and dual-energy X-ray absorptiometry (DEXA) in assessing muscle mass, and to determine how possible discrepancies influence the diagnosis of malnutrition and its relationship with frailty and disability in older adults. [...] Read more.

Aim: The present study aimed to evaluate the agreement between calf circumference (CC) and dual-energy X-ray absorptiometry (DEXA) in assessing muscle mass, and to determine how possible discrepancies influence the diagnosis of malnutrition and its relationship with frailty and disability in older adults. Methods: We analyzed cross-sectional data from 1048 adults aged 65 years and older who participated in the 2001–2002 National Health and Nutrition Examination Survey (NHANES). Malnutrition was defined using the Global Leadership Initiative on Malnutrition (GLIM) criteria, and muscle mass was estimated using both DEXA and CC. Agreement between the two assessment methods was tested with Kappa statistics, while multivariable logistic regression models were used to explore the associations between malnutrition (as determined by each method) and frailty or disability, controlling for age, sex, physical activity, polypharmacy, and urinary albumin levels. Results: CC and DEXA-based appendicular skeletal muscle mass (ASM) showed a moderate correlation (r = 0.592). The prevalence of malnutrition was 10.3% when defined by CC and 9.1% when defined by DEXA (κ = 0.635, p = 0.001). In both cases, malnutrition was significantly associated with frailty (OR: 1.56; 95% CI: 1.240, 1.970, p < 0.001), but not with disability. Adjusting for albumin levels did not substantially change these associations. Conclusions: CC and DEXA demonstrate moderate concordance in estimating ASM. While this level of agreement slightly affects malnutrition prevalence estimates, it does not alter the observed relationship between malnutrition and frailty or disability in older adults. Full article

(This article belongs to the Section Geriatric Nutrition)

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14 pages, 757 KB

Open AccessArticle

Qualitative Evaluation of an Online Technology to Support Rural Caregivers of People with Dementia

by Carmela Leone, Clare Wilding, Tshepo Rasekaba, Megan E. O’Connell, Debra Morgan and Irene Blackberry

Geriatrics 2025, 10(6), 161; https://doi.org/10.3390/geriatrics10060161 - 5 Dec 2025

Viewed by 896

Abstract

Background/Objectives: In rural communities, caregivers of people living with dementia face limited access to support services. Digital interventions offer potential solutions for support. This paper reports on the evaluation of Verily Connect, a web-based multicomponent intervention developed to support caregivers. The aim [...] Read more.

Background/Objectives: In rural communities, caregivers of people living with dementia face limited access to support services. Digital interventions offer potential solutions for support. This paper reports on the evaluation of Verily Connect, a web-based multicomponent intervention developed to support caregivers. The aim of this qualitative study was to critically evaluate the implementation of Verily Connect to better understand its barriers and enablers. Methods: Using the Consolidated Framework for Implementation Research (CFIR), qualitative data were collected through semi-structured interviews with 24 health service professionals across 12 rural Australian communities. Thematic analysis was conducted to identify barriers and facilitators to implementation. Results: Key barriers included limited digital literacy, resistance to technology and privacy concerns, as well as competing organisational priorities, and inadequate technological infrastructure. Facilitators included organisational alignment and supportive management. Conclusions: The perceived relevance and usability of Verily Connect were enhanced by its co-design with caregivers and integration into health service models. Addressing digital literacy for caregivers, infrastructure limitations, and organisational readiness is essential for future technology-based health interventions in rural dementia care. Full article

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13 pages, 237 KB

Open AccessArticle

An Artificial Intelligence-Assisted Smartphone Application for Improving Dietary Quality Among Frail Older Adults: A Quasi-Experimental Study

by Kayo Kurotani, Hikaru Tanabe, Keiji Yanai, Kazunori Sakamoto and Kazunori Ohkawara

Geriatrics 2025, 10(6), 160; https://doi.org/10.3390/geriatrics10060160 - 4 Dec 2025

Viewed by 1687

Abstract

Background/Objectives: Although information and communication technology (ICT) offers opportunities to address challenges, evidence among frail populations is limited. We aimed to evaluate the effectiveness and feasibility of an ICT-based intervention incorporating an artificial intelligence (AI)-assisted smartphone dietary application and group communication tools [...] Read more.

Background/Objectives: Although information and communication technology (ICT) offers opportunities to address challenges, evidence among frail populations is limited. We aimed to evaluate the effectiveness and feasibility of an ICT-based intervention incorporating an artificial intelligence (AI)-assisted smartphone dietary application and group communication tools to improve dietary quality and social connection among community-dwelling older adults with frailty. Methods: A non-randomized, quasi-experimental study was conducted among 29 older adults (≥65 years) in Tokyo, Japan. Participants were assigned to the intervention (n = 11) or control (n = 18) group. The 3-month intervention included weekly photo uploads of meals via an AI-based dietary application providing automated image analysis and personalized feedback, supervised by registered dietitians, along with peer communication through a group chat. The primary outcome was dietary quality. The secondary outcomes included body weight, body mass index (BMI), skin carotenoid score, and loneliness. Results: The adjusted Japanese Food Guide Spinning Top Score at 3-month follow-up was 49.0 (standard error [SE] = 2.6) and 39.5 (SE = 2.0) in the intervention and control groups, respectively. The adjusted mean difference between groups was +9.5 (95% confidence interval: 2.3 to 16.7, p = 0.01). After using analysis of covariance for adjusting for respective baseline values, age, education status, and antihypertension drug use, no statistically significant between-group differences were observed at 3-month follow-up for any secondary outcomes. Conclusions: AI-based dietary intervention and peer communication effectively improved dietary quality among older adults, highlighting the potential of such an intervention to promote healthier eating habits in this population. Full article

(This article belongs to the Topic AI-Driven Smart Elderly Care: Innovations and Solutions)

1 pages, 124 KB

Open AccessCorrection

Correction: Farhat et al. Impact of Pomegranate Extract Supplementation on Physical and Cognitive Function in Community-Dwelling Older Adults Aged 55–70 Years: A Randomised Double-Blind Clinical Trial. Geriatrics 2025, 10, 29

by Grace Farhat, Jhama Malla, Emad A. S. Al-Dujaili, Jay Vadher, Pradeepa Nayak and Kenneth Drinkwater

Geriatrics 2025, 10(6), 159; https://doi.org/10.3390/geriatrics10060159 - 4 Dec 2025

Viewed by 623

Abstract

There was an error in the original publication [...] Full article

11 pages, 214 KB

Open AccessCase Report

Challenges and Strategies in Managing Recurrent Clostridioides difficile Infection in Older Adults

by Imaan Hirji, Divya John, Jeena Jith, Hiro Khoshnaw and Myooran Ganeshananthan

Geriatrics 2025, 10(6), 158; https://doi.org/10.3390/geriatrics10060158 - 2 Dec 2025

Viewed by 1887

Abstract

Background: Clostridioides difficile infections (CDIs) are caused by a Gram-positive, spore-forming bacillus and are defined by more than three episodes of watery diarrhoea per day. CDI is a major cause of morbidity and mortality in older adults, particularly over 65 years. Recurrent CDI [...] Read more.

Background: Clostridioides difficile infections (CDIs) are caused by a Gram-positive, spore-forming bacillus and are defined by more than three episodes of watery diarrhoea per day. CDI is a major cause of morbidity and mortality in older adults, particularly over 65 years. Recurrent CDI leads to higher mortality and prolonged, debilitating illness. Case Presentations: This article presents two patients, aged over 80 years old, who developed recurrent CDI causing complicated and prolonged treatment courses. Patient 1 required an extended course of antibiotics for treatment of discitis and a congruent psoas abscess. Patient 2 developed CDI after multiple short courses of antibiotics for urinary tract infections (UTIs) in the context of multiple comorbidities. Both patients experienced three distinct episodes of CDI and were treated in collaboration with microbiology specialists. Following the third episode, both were successfully treated with oral capsule faecal microbiome transplants (FMTs). Their cases highlight the challenge of balancing systemic antibiotic use against CDI risk. Discussions: These cases underscore known risk factors for recurrent CDI, including advanced age and prolonged antibiotic exposure. Recurrence rates in patients over 65 can reach 58%. The British Society of Gastroenterology and Healthcare Infection Society support the use of FMTs in recurrent cases. Environmental decontamination, including terminal cleaning with sporicidal agents, is critical in reducing reinfection in hospital settings. Conclusions: Recurrent CDI in elderly patients reflects a complex interplay between infection control and managing comorbidities. New guidelines suggest that FMTs can significantly reduce morbidity and mortality. These cases emphasise the need for individualised, multidisciplinary care, adherence to guidelines, and further research to improve safe, effective CDI management in older adults. Full article

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10 pages, 561 KB

Open AccessArticle

Allostatic Load, Social Participation, and Healthy Ageing: Longitudinal Evidence on the Impact of Chronic Stress

by Lujain Sahab, Jonathon Timothy Newton and Wael Sabbah

Geriatrics 2025, 10(6), 157; https://doi.org/10.3390/geriatrics10060157 - 27 Nov 2025

Cited by 4 | Viewed by 2353

Abstract

Background/Objectives: The study aimed to examine the impact of allostatic load on healthy ageing over a decade and whether social participation attenuates this relationship among older American adults. Methods: Data were extracted from three waves (wave 8, wave 10, wave 13) [...] Read more.

Background/Objectives: The study aimed to examine the impact of allostatic load on healthy ageing over a decade and whether social participation attenuates this relationship among older American adults. Methods: Data were extracted from three waves (wave 8, wave 10, wave 13) of the Health and Retirement Study, a longitudinal survey of American adults. The analysis included allostatic load, socioeconomic (education) and demographic (gender, age, ethnicity, and marital status) factors at baseline, social participation in wave 10, and healthy ageing in wave 10 and wave 13. A latent variable was created for allostatic load that included waist circumference, C-reactive protein, glycated hemoglobin, and blood pressure. Healthy ageing was defined as an aggregate measure including freedom from disability, freedom from cognitive impairment, and high physical functioning. Social participation was a dichotomous variable that included individuals’ work status, perceived neighbourhood safety, and partaking in volunteer work. Structural equation modelling was used to examine the direct and indirect relationships between these factors and healthy ageing. Results: A total of 14,537 participants with complete data in all waves were included in the analysis. The mean age at baseline was 68.7 years. Results showed a significant association between higher allostatic load and lower healthy ageing (estimate = −0.12, 95% CI: −0.14, −0.11). Allostatic load was negatively associated with social participation (estimate = −0.32, 95% CI: −0.34, −0.30). Social participation showed a positive significant association with healthy ageing, indicating partial buffering that accounted for 12% of the total effect. Higher educational attainment was associated with better healthy-ageing outcomes, whereas non-Black ethnicity was linked to poorer healthy ageing. Conclusions: Elevated allostatic load was associated with poorer ageing outcomes, with social participation partially attenuating the relationship. Higher education predicted more favourable trajectories, while ethnic differences suggested resilience among older Black adults. These results indicate that both physiological and social factors contribute to variations in healthy ageing. Full article

(This article belongs to the Section Healthy Aging)

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18 pages, 1533 KB

Open AccessArticle

Pet Ownership, Pet Attachment, and Longitudinal Changes in Psychological Health—Evidence from the Baltimore Longitudinal Study of Aging

by Erika Friedmann, Nancy R. Gee, Eleanor M. Simonsick, Barbara Resnick, Merve Gurlu, Ikmat Adesanya and Soyeon Shim

Geriatrics 2025, 10(6), 156; https://doi.org/10.3390/geriatrics10060156 - 25 Nov 2025

Cited by 2 | Viewed by 2272

Abstract

Introduction: While pet ownership (PO) is generally associated with better psychological health, research does not consistently demonstrate this relationship among community living older adults. Pet attachment has been suggested as a mechanism for the health benefits associated with pet ownership. We examine the [...] Read more.

Introduction: While pet ownership (PO) is generally associated with better psychological health, research does not consistently demonstrate this relationship among community living older adults. Pet attachment has been suggested as a mechanism for the health benefits associated with pet ownership. We examine the contributions of PO and pet attachment to maintaining psychological health among generally healthy, cognitively intact, community-dwelling older adults as they age. Methods: Older adults (N = 596; age: ≥50, M = 67.6, SD = 9.5 years, pet owners N = 178) completed PO history and assessments of anxiety, depression, happiness, and mental wellbeing every 1–4 years. Pet owners completed demographic and pet attachment assessments. Linear mixed models with random intercepts and covariates of initial age, sex, race, live alone, married, and comorbidities quantified longitudinal changes (M = 7.5, SD = 3.6 years) according to time-varying PO, pet attachment, and dog walking to these changes. Results: PO moderated changes in anxiety (p = 0.011) and happiness (p = 0.037), which improved in pet owners and deteriorated in non-owners, and in mental wellbeing (p = 0.007), which deteriorated faster in pet owners; PO was not related to changes in depression. Pet attachment was related to worsening mental wellbeing (p = 0.012). Dog walking was related to slower increases in anxiety (p = 0.005) and depression (p = 0.004). Conclusions: This study provides important longitudinal evidence that PO may reduce age-related decline in owners’ psychological health later in life. Pet attachment does not appear to be the mechanism for the advantages of PO. We suggest potential reasons. Additional research is needed to confirm mechanisms. Full article

(This article belongs to the Section Geriatric Psychiatry and Psychology)

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12 pages, 1287 KB

Open AccessArticle

Efficacy and Safety of IncobotulinumtoxinA in Older Patients with Upper Limb Spasticity: A Pooled Analysis

by Michael C. Munin, Alexandre Camões-Barbosa, Carlos Cordero-García, Alessio Baricich, Stefano Carda, Michael Althaus, Georg Comes, Matteo Vacchelli and Jörg Wissel

Geriatrics 2025, 10(6), 155; https://doi.org/10.3390/geriatrics10060155 - 24 Nov 2025

Cited by 1 | Viewed by 1224

Abstract

Background/Objectives: The aim of this study was to compare the efficacy and safety of a single cycle of incobotulinumtoxinA versus placebo in pooled data from older patients (aged ≥65 years) with upper limb spasticity (ULS). Methods: This study was a post [...] Read more.

Background/Objectives: The aim of this study was to compare the efficacy and safety of a single cycle of incobotulinumtoxinA versus placebo in pooled data from older patients (aged ≥65 years) with upper limb spasticity (ULS). Methods: This study was a post hoc analysis of pooled data from seven prospective, multicenter, phase II or III trials of incobotulinumtoxinA in adult patients aged ≥65 years from across the world with post-stroke ULS or upper and lower limb spasticity, including a subgroup with moderate-to-severe ULS. Changes from baseline in ULS severity were evaluated using the (modified) Ashworth Scale across different spasticity patterns at 4 and 12 weeks after incobotulinumtoxinA injection. Results: In 267 older patients with ULS, including a subgroup of 207 with moderate-to-severe ULS, all ULS patterns statistically analyzed (elbow flexion, thumb-in-palm, clenched fist, wrist flexion, and pronated forearm) were improved more by incobotulinumtoxinA than placebo at week 4 (p < 0.05). For most of these patterns, the difference remained significant at week 12 (p < 0.05). IncobotulinumtoxinA was generally well tolerated. Conclusions: This study, which analyzed data from the largest cohort of older patients in the literature, provides information regarding the use of incobotulinumtoxinA in ULS, the efficacy and favorable safety profile of incobotulinumtoxinA for the treatment of ULS in older patients, particularly in those with moderate-to-severe spasticity, was confirmed. Full article

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21 pages, 1834 KB

Open AccessSystematic Review

A Multidimensional Perspective on Resilience in Later Life: A Systematic Literature Review of Protective Factors and Adaptive Processes in Ageing

by Benjamin A. Jacob, Cameron Walker, Michael O’Sullivan, Paul Rouse and Matthew Parsons

Geriatrics 2025, 10(6), 154; https://doi.org/10.3390/geriatrics10060154 - 21 Nov 2025

Cited by 3 | Viewed by 2501

Abstract

Background: With the global population rapidly aging, resilience has emerged as a critical determinant of healthy aging. While many factors are associated with resilience, a comprehensive synthesis is needed to inform targeted interventions and policy. Objectives: This systematic review aimed to identify and [...] Read more.

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

(This article belongs to the Section Healthy Aging)

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11 pages, 1019 KB

Open AccessArticle

The Preoperative Waiting Time on Long-Term Survival Following Elderly Hip Fracture Surgery

by Chunyuan X. Qiu, Priscilla H. Chan, Kathryn E. Royse, Ronald A. Navarro, Glenn R. Diekmann, Kent T. Yamaguchi, Elizabeth W. Paxton and Vimal Desai

Geriatrics 2025, 10(6), 153; https://doi.org/10.3390/geriatrics10060153 - 20 Nov 2025

Cited by 1 | Viewed by 2295

Abstract

Background/Objective: The first-year postoperative mortality in elderly hip fracture patients is between 15 and 36%. Current scientific evidence indicates that morbidity and mortality are impacted by time of admission to surgery in hip fracture patients, although anticoagulation (AC) medication status specific optimization is [...] Read more.

Background/Objective: The first-year postoperative mortality in elderly hip fracture patients is between 15 and 36%. Current scientific evidence indicates that morbidity and mortality are impacted by time of admission to surgery in hip fracture patients, although anticoagulation (AC) medication status specific optimization is unknown. Our objectives were to identify an ideal preoperative wait time by anticoagulation status in patients before hip fracture repair based on the incidence of postoperative morbidity and mortality. Methods: A total of 35,463 patients age ≥ 65 undergoing hip fracture repair were selected from a United States hip fracture registry (2009–2019). Patients were separated into strata (yes/no) based on whether they received anticoagulation (AC) medications ≤ 100 days prior to surgery. Multivariable logistic regression was adjusted for non-linear surgical wait time trends with prespecified percentiles using cubic splines. Results: A total of 87.1% (N = 30,902) of patients did not have AC preoperatively. Their median wait time was 20.3 h (IQR 13–27 h), and a positive linear trend was observed between surgical wait time and mortality. In patients with pre-operative AC, there was a “U”-shaped trend for all mortality time points although the breakpoint slopes were not significantly different from zero. Conclusions: In the study of more than 30,000 patients, short-term mortality was lowest for non-AC patients, undergoing surgery within the first 6–15 h of admission but remained uniform throughout the first 24 h of admission. These findings can be used to optimize patients prior to hip fracture surgery based on preoperative AC use and can positively affect resource planning and perioperative protocols. Full article

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15 pages, 396 KB

Open AccessArticle

Dual Disease Burden: Growing Older with Congenital Heart Disease and Hereditary Metabolic and Connective Tissue Disorders—Data from the PATHFINDER-CHD Registry on Heart Failure

by Ann-Sophie Kaemmerer-Suleiman, Frank Harig, Annika Freiberger, Oliver Dewald, Stephan Achenbach, Aysenur Akyol, Helena Dreher, Anna Engel, Peter Ewert, Sebastian Freilinger, Jürgen Hörer, Christopher Hohmann, Stefan Holdenrieder, Robert David Pittrow, Harald Kaemmerer, Renate Kaulitz, Frank Klawonn, Christian Meierhofer, Steffen Montenbruck, Nicole Nagdyman, Rhoia Neidenbach, Elsa Ury, Leonard Bernhard Pittrow, Benjamin Alexander Pittrow, Fabian von Scheidt, Nicole Wolfrum, Michael Huntgeburth, Pelagija Zlatic, Mathieu N. Suleiman and Fritz Mellert Show full author list Hide full author list

Geriatrics 2025, 10(6), 152; https://doi.org/10.3390/geriatrics10060152 - 20 Nov 2025

Cited by 1 | Viewed by 1432

Abstract

Background: Advances in diagnosis and treatment have led to a growing population of adults with congenital heart disease (ACHD). Despite increasing life expectancy, their clinical needs—especially in older age—remain poorly defined. Cardiac and non-cardiac comorbidities are prevalent, and emerging evidence suggests accelerated biological [...] Read more.

Background: Advances in diagnosis and treatment have led to a growing population of adults with congenital heart disease (ACHD). Despite increasing life expectancy, their clinical needs—especially in older age—remain poorly defined. Cardiac and non-cardiac comorbidities are prevalent, and emerging evidence suggests accelerated biological aging compared to the general population. However, data on older patients and geriatric patients with CHD are limited. Objectives: This study aimed to characterize patients with CHD aged ≥50 years, focusing on functional status, comorbidities, sex-specific differences, and therapeutic patterns. Methods: The PATHFINDER-CHD Registry is a prospective, observational, multicenter registry enrolling patients with CHD with manifest heart failure (HF), HF history, or high HF risk. Data include anatomy, prior treatments, comorbidities, and medication use. Results: Among 1935 patients, 297 were ≥50 years old. Most had acyanotic CHD (62%); Tetralogy of Fallot (21%) was the most frequent diagnosis. A morphologic right systemic ventricle was present in 12%, and 5% had univentricular hearts. HF was manifest in 21%; 44% were classified as ACC/AHA stage B, 51% as stage C, yet 77% were in Perloff class I/II. Common cardiovascular comorbidities included aortopathy (55%), hypertension (37%), and arrhythmia (33%). Non-cardiac comorbidities included thyroid dysfunction (25%), renal impairment (18%), and neurological disease (13%). Sex-specific differences were observed. Despite HF burden, SGLT2 inhibitors and ARNIs were used in only 17% and 8.4%, respectively. Conclusions: Older patients with CHD represent a clinically complex cohort with high comorbidity burden. The findings support the concept of accelerated aging and emphasize the need for tailored interdisciplinary care strategies. Full article

(This article belongs to the Section Cardiogeriatrics)

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10 pages, 303 KB

Open AccessOpinion

But Is Ageing Really All Bad? Conceptualising Positive Ageing

by Miriam Sang-Ah Park, Blake Webber, Stephen P. Badham, Christian U. Krägeloh, Vincenza Capone, Anna Rosa Donizzetti, Mohsen Joshanloo, Szabolcs Gergő Harsányi, Monika Kovács and Emily Hellis

Geriatrics 2025, 10(6), 151; https://doi.org/10.3390/geriatrics10060151 - 18 Nov 2025

Viewed by 1686

Abstract

Ageing literature, while growing in huge volume in the past decades, is still largely dominated by frameworks and topics of frailty and decline. A shift in attention to conceptualising ageing more holistically to include psychosocial and emotional aspects as well as subjective experience [...] Read more.

Ageing literature, while growing in huge volume in the past decades, is still largely dominated by frameworks and topics of frailty and decline. A shift in attention to conceptualising ageing more holistically to include psychosocial and emotional aspects as well as subjective experience is much needed, in order to better account for the ageing (well) experience and processes in today’s times. There is a large portion of older adults with relatively good health. As life expectancy increases around the world, many older adults are living longer and healthier overall, often wishing for their lives to continue being active, meaningful, and fulfilling. With this changing demographic in mind, we argue for a framework of positive ageing. We define positive ageing as a subjective, intentional experience, which includes the multi-dimensional construction of ageing well. The notion of positive ageing has the potential to widen the scope of gerontological research and to help guide policy and intervention development. Furthermore, this conceptual framework and a cyclic model of positive ageing presented in the current work can effectively complement current models and practices of care in geriatrics by taking a more person-centred and holistic approach to understanding and managing health and well-being. Full article

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13 pages, 266 KB

Open AccessArticle

Patterns of Healthcare Use and Disease Burden Among Older Adults in Poland: A Large-Scale Retrospective Study of Primary Care Utilization

by Krzysztof Marcin Zakrzewski, Paulina Mularczyk-Tomczewska, Tytus Koweszko, Łukasz Czyżewski and Andrzej Silczuk

Geriatrics 2025, 10(6), 150; https://doi.org/10.3390/geriatrics10060150 - 13 Nov 2025

Viewed by 1382

Abstract

Background: Population aging in Poland has led to rising healthcare needs, but comprehensive evidence on long-term utilization patterns is limited. This study aimed to analyze healthcare use and disease burden among older adults, with particular focus on the impact of the COVID-19 [...] Read more.

Background: Population aging in Poland has led to rising healthcare needs, but comprehensive evidence on long-term utilization patterns is limited. This study aimed to analyze healthcare use and disease burden among older adults, with particular focus on the impact of the COVID-19 pandemic, including its effects on care pathways, continuity of services, and differences between urban and rural populations. Methods: We conducted a retrospective study using anonymized medical records from a primary healthcare network in Poland between January 2020 and December 2024. The sample included 42,844 patients aged 60 years or older patients aged ≥60 years, with a total of 738,300 consultations. Data on demographics, visit type, prescriptions, referrals, diagnostic tests, and follow up were analyzed using chi-square tests, logistic regression, and nonparametric comparisons. Results: The mean age of patients was 77.5 years (SD 9.4), and 63.7% were women. The mean number of visits in the preceding 12 months was 10.3 (range 0–460). Prescriptions were issued in 56.9% of visits, referrals in 33.5%, and diagnostic tests in 21.4%. Patients with chronic diseases were more likely to receive diagnostic tests than those without (32.4% vs. 21.1%, χ² = 1570.42, p < 0.0001), but less likely to return within 30 days (23.4% vs. 39.4%, χ² = 2243.76, p < 0.0001). First visits generated more referrals than follow ups (41.6% vs. 32.9%, χ² = 1620.51, p < 0.0001). Completed visits were strongly associated with prescription issuance (63.2% vs. 16.4%, χ² = 1048.76, p < 0.0001). Return analyses showed that patients with more prior visits were significantly more likely to re-engage at 30, 60, and 90 days (all p < 0.0001). Age correlated positively with total number of visits (ρ = 0.136, p < 0.05) with the oldest adults more likely to return at 60 and 90 days. Visit realization decreased during early pandemic phases but increased significantly post-COVID (OR = 1.76, p < 0.001). Psychiatric referrals increased the odds of return within 30 days (OR = 1.42) and 60 days (OR = 1.36). Conclusions: Older adults in Poland demonstrate high healthcare utilization, with patterns shaped by age, chronic disease status, and pandemic-related disruptions. While statistical associations were robust, effect sizes were small, highlighting the need to focus on clinically meaningful differences in planning geriatric care. The findings highlight that COVID-19 acted as a major modifying factor of healthcare engagement, revealing the vulnerability of geriatric care continuity to system-level disruptions. Full article

(This article belongs to the Section Geriatric Public Health)

17 pages, 475 KB

Open AccessArticle

Psychometric Properties of the Adjustment to Aging Scale (Atas) in Iranian Older Adults

by Parisa Mollaei, Yadollah-Abolfathi Momtaz, Malihe Saboor and Nasibeh Zanjari

Geriatrics 2025, 10(6), 149; https://doi.org/10.3390/geriatrics10060149 - 10 Nov 2025

Viewed by 999

Abstract

Background/Objectives: Adjustment to aging is a key indicator of positive aging and psychological maturity, influenced by cultural and social contexts. This study aimed to translate and evaluate the psychometric properties of the Adjustment to Aging Scale (AtAS) among Iranian older adults. Material and [...] Read more.

Background/Objectives: Adjustment to aging is a key indicator of positive aging and psychological maturity, influenced by cultural and social contexts. This study aimed to translate and evaluate the psychometric properties of the Adjustment to Aging Scale (AtAS) among Iranian older adults. Material and methods: This cross-sectional study was conducted in Tehran, 2024. Following translation and cross-cultural adaptation, face validity, content validity, and reliability of the questionnaire were assessed. The WHO-5 well-being index was used to assess concurrent validity. A total of 328 older adults aged 60 years and above completed the study instruments. Data were analyzed using Confirmatory Factor Analysis (CFA), Cronbach’s alpha, Pearson correlation, independent t-tests, and ANOVA via SPSS version 22 and AMOS 24. The significance level was set at p ≤ 0.05. Results: The mean (SD) age of the participants was 69.42 (6.8) years. Face and content validity were confirmed by fourteen experts (CVI = 0.94). CFA supported the five-factor structure of the questionnaire (χ²/df = 2.06, GFI = 0.90, PCLOSE = 0.07, RMSEA = 0.05), indicating a good model fit. The total questionnaire showed acceptable internal consistency (Cronbach’s alpha = 0.80) and excellent test–retest reliability (ICC = 0.98). Pearson’s correlation revealed a significant positive relationship between the WHO-5 Well-Being Index and AtAS scores (r = 0.56, p < 0.05), supporting criterion validity. Conclusions: The Persian AtAS showed strong psychometric properties, supporting its use in both research and clinical settings, although further studies are recommended to strengthen evidence for its clinical application. Full article

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12 pages, 356 KB

Open AccessArticle

Perceptions of Aging and Control Beliefs: A Study on Older Patients’ Views of Aging

by Aline Schönenberg, Charlotte Kobus, Marlene Günther, Luise Umfermann and Tino Prell

Geriatrics 2025, 10(6), 148; https://doi.org/10.3390/geriatrics10060148 - 10 Nov 2025

Viewed by 2180

Abstract

Background: Locus of control (LoC) may shape how older adults appraise aging, particularly in acute geriatric rehabilitation. Evidence linking internal/external LoC to domain-specific Views on Aging (VoA, containing Physical Loss, Social Loss, Personal Growth, Self-awareness/Gains) remains limited. Methods: We analyzed a cross-sectional cohort [...] Read more.

Background: Locus of control (LoC) may shape how older adults appraise aging, particularly in acute geriatric rehabilitation. Evidence linking internal/external LoC to domain-specific Views on Aging (VoA, containing Physical Loss, Social Loss, Personal Growth, Self-awareness/Gains) remains limited. Methods: We analyzed a cross-sectional cohort of patients aged 70 and above from an acute geriatric rehabilitation unit (N = 103) and contextualized findings with a 1:1 Mahalanobis-matched subsample from the German Ageing Survey. Internal and external LoC and covariates (age, sex, Barthel, cognitive function, depressive symptoms, health satisfaction) were standardized (z). Associations were estimated using (i) ordinary least squares (OLS) regression across eight LoC effects, as well as (ii) proportional-odds ordinal models (quartiles; logit link), as a complementary, distribution-robust approach. Results: For the Physical VoA domain, higher internal LoC related to more positive appraisals (OLS β = 0.133, 95% CI 0.043–0.223, p = 0.035; OR = 3.52), whereas higher external LoC related to less positive appraisals (β = −0.165, 95% CI −0.285 to −0.045, p = 0.035; OR = 0.274). Internal LoC also increased the odds of more positive Personal Growth (OR = 1.64, 95% CI 1.04–2.72), while effects on Social Loss (external LoC OR = 0.649, 95% CI 0.418–0.991) and Gains were smaller. Univariate Spearman correlations were directionally consistent. In the DEAS comparison, older patients showed greater endorsement of both physical losses and gains. Conclusions: In acute geriatric rehabilitation, internal control beliefs align with more positive views of physical aging and growth, whereas external control aligns with less positive physical (and modestly social) views. The results position LoC as a clinically relevant correlate of aging appraisals. Full article

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10 pages, 702 KB

Open AccessCommunication

Impact of Abdominal Obesity on Frailty Development: A Web-Based Survey Using a Smartphone Health App

by Hisayo Yokoyama

Geriatrics 2025, 10(6), 147; https://doi.org/10.3390/geriatrics10060147 - 8 Nov 2025

Cited by 1 | Viewed by 1375

Abstract

Background/Objectives: Identifying adults at high risk of frailty and implementing appropriate interventions are critical for extending healthy life expectancy. This retrospective cohort study examined whether abdominal obesity predicts frailty progression over one year among 2962 community-dwelling adults aged 30–79 years in Osaka [...] Read more.

Background/Objectives: Identifying adults at high risk of frailty and implementing appropriate interventions are critical for extending healthy life expectancy. This retrospective cohort study examined whether abdominal obesity predicts frailty progression over one year among 2962 community-dwelling adults aged 30–79 years in Osaka Prefecture, Japan. Methods: Data were collected from 2962 individuals (mean age, 62.7 ± 8.8 years) who completed annual surveys through a health application in both 2023 and 2024 and had available waist circumference data. Frailty was assessed using the Kihon Checklist. Logistic regression analysis was performed to identify predictors of frailty progression. Results: At baseline (2023), 23% of participants had abdominal obesity, and 18% were categorized as frail. Among 2431 participants who were non-frail at baseline, the incidence of frailty after one year was significantly higher among those with abdominal obesity than those without (10.5% vs. 7.2%, p = 0.011). However, in the multivariate logistic regression analysis, frailty awareness (“know well” vs. “do not know,” adjusted odds ratio [aOR] = 0.341, 95% confidence interval [CI] 0.212–0.548), regular exercise habits (aOR = 0.596, 95% CI 0.382–0.930), and prefrailty status (aOR = 1.767, 95% CI 1.602–1.950) were significant predictors of frailty development, whereas abdominal obesity was not independently associated with frailty progression after adjustment. Conclusions: Although abdominal obesity was associated with frailty onset in crude analyses, this association became non-significant after adjustment. Greater frailty awareness and regular exercise appear to reduce the risk of frailty development, suggesting that lifestyle education and public awareness initiatives may help mitigate the impact of abdominal obesity on frailty progression. Full article

(This article belongs to the Section Geriatric Public Health)

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17 pages, 3359 KB

Open AccessArticle

The Development of a Program to Identify and Manage Apathy in Residents with Korsakoff’s Syndrome: A Qualitative Exploration of Patient, Family Caregiver, and Professional Caregiver Perspectives

by Maud E. G. van Dorst, Julia Roosenschoon, Johanna M. H. Nijsten, Annette O. A. Plouvier, Raymond T. C. M. Koopmans, Debby L. Gerritsen, Yvonne C. M. Rensen and Roy P. C. Kessels

Geriatrics 2025, 10(6), 146; https://doi.org/10.3390/geriatrics10060146 - 6 Nov 2025

Viewed by 1056

Abstract

Background: Apathy is a neuropsychiatric symptom that is frequently present in nursing-home residents, including residents with Korsakoff’s syndrome (KS). Although apathy is common in KS, treatment guidelines are lacking. The Shared Action for Breaking through Apathy (SABA) program, developed for people with [...] Read more.

Background: Apathy is a neuropsychiatric symptom that is frequently present in nursing-home residents, including residents with Korsakoff’s syndrome (KS). Although apathy is common in KS, treatment guidelines are lacking. The Shared Action for Breaking through Apathy (SABA) program, developed for people with dementia, was previously shown to be feasible in that group. The applicability of this program for the KS population seems promising, yet it was expected that the program would need to be adapted. This study aims to 1) explore what is important in identifying and managing apathy in individuals with KS, and 2) investigate the appropriate adjustments to the SABA program. Methods: This qualitative study consisted of semi-structured interviews with people with KS (n = 3), family caregivers (one spouse and one sibling) and professional caregivers (two nurses), and a multidisciplinary focus group meeting with professional caregivers (n = 12) experienced in care for people with KS. The focus group meeting was performed to deepen the understanding of the interview findings and further explore recommendations for adjustments to the SABA program. Thematic analysis was used to process the data. Results: Addressing aim 1, two themes were identified: (1) the challenge to appraise signals of apathy, and (2) the challenge to assess the needs of people with KS. Based on these themes, specific adjustments were formulated to respond to aim 2. Conclusions: The themes that were identified in this study gave direction to a KS tailored SABA program, the feasibility of which needs to be studied next. Full article

(This article belongs to the Section Geriatric Psychiatry and Psychology)

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15 pages, 273 KB

Open AccessArticle

Equine-Assisted Interventions: Cross Perspectives of Beneficiaries and Their Caregivers from a Qualitative Perspective

by Léa Badin, Elina Van Dendaele and Nathalie Bailly

Geriatrics 2025, 10(6), 145; https://doi.org/10.3390/geriatrics10060145 - 6 Nov 2025

Viewed by 987

Abstract

Background: Although equine-assisted interventions (EAI) are gaining growing attention, their scientific evaluation among individuals with Alzheimer’s disease (AD) living in nursing homes remains limited. This study aimed to explore the lived experiences of an EAI program from the perspectives of the participants [...] Read more.

Background: Although equine-assisted interventions (EAI) are gaining growing attention, their scientific evaluation among individuals with Alzheimer’s disease (AD) living in nursing homes remains limited. This study aimed to explore the lived experiences of an EAI program from the perspectives of the participants living with AD as well as their families and professional caregivers. Methods: Thirty non-directive interviews were conducted between June and July 2024 across several nursing homes in the Centre-Val de Loire region (France). The interviews were recorded, transcribed, and analyzed using thematic analysis. Results: Four main themes emerged from the analysis: (1) the experience with the horse, reflecting a unique relationship with the animal, the activities carried out, and perceived personality traits; (2) the environment of EAI sessions, offering a break from daily routines, encouraging contact with nature, and taking place in a setting specific to this type of intervention; (3) the implementation of the program within the institutional context, highlighting logistical aspects, environmental factors, and the adherence; (4) the effects of the intervention, including enhanced social interactions, memory stimulation, emotional engagement, and behavioral benefits. Conclusions: These findings provide insight into the multiple dimensions involved in an EAI program. By giving voice to both participants and their caregivers, this study emphasizes the value of qualitative approaches in deeply understanding the meaning and impact of these non-pharmacological interventions. Full article

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9 pages, 224 KB

Open AccessArticle

Clinical Inertia in SGLT2 Inhibitor Use Among Elderly Patients with Type 2 Diabetes and Chronic Kidney Disease: A Comparison of Regional and University Hospital Practice

by Kyriaki Vafeidou, Ourania Psoma, Evangelos Apostolidis, Anastasia Sarvani, Michael Doumas, Kalliopi Kotsa, Vasileios Tsimihodimos and Theocharis Koufakis

Geriatrics 2025, 10(6), 144; https://doi.org/10.3390/geriatrics10060144 - 6 Nov 2025

Cited by 3 | Viewed by 1660

Abstract

Background/Objectives: Type 2 diabetes (T2D) and chronic kidney disease (CKD) frequently coexist in older adults. Sodium–glucose cotransporter-2 inhibitors (SGLT2i) are recommended for renal and heart protection, yet their use in routine care remains inconsistent. We aimed to investigate differences in SGLT2i prescribing between [...] Read more.

Background/Objectives: Type 2 diabetes (T2D) and chronic kidney disease (CKD) frequently coexist in older adults. Sodium–glucose cotransporter-2 inhibitors (SGLT2i) are recommended for renal and heart protection, yet their use in routine care remains inconsistent. We aimed to investigate differences in SGLT2i prescribing between regional and university hospital settings and assess whether such disparities persist after accounting for patient characteristics. Methods: In this retrospective analysis, patients were stratified by follow-up site (regional vs. university hospital). The primary outcome was SGLT2i use. Logistic regression models were adjusted for strong determinants of prescribing decisions, including age, sex, hypertension, dyslipidemia, heart failure, and estimated glomerular filtration rate. We tested the robustness of the results using additional analyses, including exclusion of frail patients and adjustment with propensity score methods, such as matching and inverse probability weighting (IPTW). Results: The study included 135 patients, of whom 80 were followed at the regional hospital and 55 at the university hospital. SGLT2i use was significantly lower in the regional setting (27.5% vs. 63.6%, p < 0.001). In adjusted models, university follow-up remained strongly associated with SGLT2i prescription [odds ratio 3.60, 95% confidence interval (CI) 1.61–8.03, p = 0.0018]. IPTW demonstrated 4.40-fold higher odds of SGLT2i use in the university hospital setting (95% CI 2.07–9.36, p < 0.001). Conclusions: These findings indicate that the lower use of SGLT2i among older adults with T2D and CKD followed in regional hospitals may reflect patterns consistent with clinical inertia, underscoring the importance of efforts to promote equitable and guideline-aligned prescribing practices across levels of care. Full article

(This article belongs to the Special Issue Chronic Kidney Disease and Pharmacoepidemiology in Older Individuals: Challenges, Insights, and Therapeutic Advances)

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Open AccessReview

Move to Remember: The Role of Physical Activity and Exercise in Preserving and Enhancing Cognitive Function in Aging—A Narrative Review

by Alexandra Martín-Rodríguez, Athanasios A. Dalamitros, Rubén Madrigal-Cerezo, Paula Sánchez-Conde, Vicente Javier Clemente Suárez and José Francisco Tornero Aguilera

Geriatrics 2025, 10(6), 143; https://doi.org/10.3390/geriatrics10060143 - 5 Nov 2025

Cited by 3 | Viewed by 9174

Abstract

Background/Objectives: The global aging population faces rising rates of cognitive decline and neurodegenerative disorders. This review explores how physical exercise influences brain health in aging, focusing on mechanisms, moderators, and personalized strategies to enhance cognitive resilience. Methods: A narrative review methodology [...] Read more.

Background/Objectives: The global aging population faces rising rates of cognitive decline and neurodegenerative disorders. This review explores how physical exercise influences brain health in aging, focusing on mechanisms, moderators, and personalized strategies to enhance cognitive resilience. Methods: A narrative review methodology was applied. Literature published between 2015 and 2025 was retrieved from PubMed, Scopus, and Web of Science using keywords and MeSH terms related to exercise, cognition, neuroplasticity, aging, and dementia. Inclusion criteria targeted peer-reviewed original studies in humans aged ≥60 years or aged animal models, examining exercise-induced cognitive or neurobiological outcomes. Results: Evidence shows that regular physical activity improves executive function, memory, and processing speed in older adults, including those with mild impairment or genetic risk (e.g., APOE ε4). Exercise promotes neuroplasticity through increased levels of BDNF, IGF-1, and irisin, and enhances brain structure and functional connectivity. It also improves glymphatic clearance and modulates inflammation and circadian rhythms. Myokines act as messengers between muscle and brain, mediating many of these effects. Cognitive benefits vary with exercise type, intensity, and individual factors such as age, sex, chronotype, and baseline fitness. Combined interventions—physical, cognitive, nutritional—show synergistic outcomes. Digital tools (e.g., tele-exercise, gamification) offer scalable ways to sustain engagement and cognitive function. Conclusions: Physical exercise is a key non-pharmacological strategy to support cognitive health in aging. It acts through diverse systemic, molecular, and neurofunctional pathways. Tailored exercise programs, informed by individual profiles and emerging technologies, hold promise for delaying or preventing cognitive decline. Full article

(This article belongs to the Special Issue Neurodegenerative Diseases, Physical Fitness, and Exercise Interventions in Aging)

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Geriatrics, Volume 10, Issue 6 (December 2025) – 38 articles

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