Geriatrics

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

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

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

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

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

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

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

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

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

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

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

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

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

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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40 pages, 1012 KB

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

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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12 pages, 381 KB

Open AccessArticle

The Longitudinal Association Between Social Factors, Edentulism, and Cluster of Behaviors

by Fatimah Alobaidi, Ellie Heidari and Wael Sabbah

Geriatrics 2025, 10(6), 142; https://doi.org/10.3390/geriatrics10060142 - 31 Oct 2025

Abstract

Objective: This study aimed to explore the direct relationships between social determinants and behavioral clusters, as well as their potential indirect associations mediated by edentulism. Methods: Information on social variables (collected in Wave 3, 2006/07), edentulism (Wave 5, 2010/11), and health-related behaviors (Wave [...] Read more.

Objective: This study aimed to explore the direct relationships between social determinants and behavioral clusters, as well as their potential indirect associations mediated by edentulism. Methods: Information on social variables (collected in Wave 3, 2006/07), edentulism (Wave 5, 2010/11), and health-related behaviors (Wave 7, 2014/15) was drawn from the English Longitudinal Study of Ageing (ELSA). Baseline sociodemographic characteristics, including age, gender, ethnicity, education, and wealth, were accounted for. Latent class analysis (LCA) was applied to four behavioral indicators—smoking status, alcohol consumption, fruit and vegetable intake, and physical activity—to identify behavioral clusters. A confirmatory factor analysis (CFA) was then used to construct a latent variable representing social support and social networks. Two structural equation models (SEM) were developed to examine both the direct associations between social support/network and behavioral clusters, and the indirect associations mediated by edentulism. Results: In LCA, the two-class model was the best fit for the data. Class 1 (risky behaviors) had 7%, while Class 2 (healthy behaviors) had 93%. In SEM Model 1, higher social support/network levels predicted being in the healthy cluster directly (SC = 0.147) and indirectly (SC = 0.009). In Model 2, accounting for wealth and education, higher levels of social support/network maintained the direct association with the healthy cluster (SC = 0.132), but the indirect path lost significance. Conclusions: This study found that greater social support was associated with healthier behaviors, and this relationship may be mediated by edentulism. Health policies that encourage social interaction could therefore improve both general and oral health. Full article

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13 pages, 396 KB

Open AccessArticle

Validity of the Loewenstein–Acevedo Scales of Semantic Interference and Learning (LASSI-L) for Mexican Subjects with Mild and Moderate Cognitive Impairments

by A. Kammar-García, P. Peña-Gonzalez, J. Sigg-Alonso, T. Álvarez-Cisneros and P. Roa-Rojas

Geriatrics 2025, 10(6), 141; https://doi.org/10.3390/geriatrics10060141 - 30 Oct 2025

Abstract

Background/Objectives: Alzheimer’s disease (AD) often begins with episodic memory deficits, detectable in Mild Cognitive Impairment (MCI). The Loewenstein–Acevedo Scales of Semantic Interference and Learning (LASSI-L) shows promise for early detection, but lacks validation in Mexico. Methods: We assessed 355 adults ≥ 60 [...] Read more.

Background/Objectives: Alzheimer’s disease (AD) often begins with episodic memory deficits, detectable in Mild Cognitive Impairment (MCI). The Loewenstein–Acevedo Scales of Semantic Interference and Learning (LASSI-L) shows promise for early detection, but lacks validation in Mexico. Methods: We assessed 355 adults ≥ 60 years, classified as cognitively healthy (CHG), MCI, or mild AD, using DSM-V criteria. Participants completed neuropsychological testing including the LASSI-L. Construct, concurrent, and predictive validity were analyzed via ANOVA, correlations with the Hopkins Verbal Learning Test (HVLT), and logistic regression models controlling for age, education, and comorbidity. Results: LASSI-L scores significantly differed between groups (p < 0.0001), with recovery from proactive interference best discriminating CHG from MCI and mild AD. Strong correlations with HVLT indices supported concurrent validity. Predictive models identified semantically cued recall and free recall (CRA2 and FRB1) as robust markers, independent of education. Conclusions: LASSI-L is a valid, accessible tool for identifying typical AD-related memory impairment in older Mexican adults, supporting earlier diagnosis in low-biomarker-access settings. Full article

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17 pages, 548 KB

Open AccessReview

Older Transgender People’s Discrimination in Healthcare: A Scoping Review

by Costas S. Constantinou and Monika Nikitara

Geriatrics 2025, 10(6), 140; https://doi.org/10.3390/geriatrics10060140 - 28 Oct 2025

Abstract

Background: Given the healthcare challenges older people and people who identify as LGBTQ+ are faced with, it becomes critical to explore how older transgender individuals experience discrimination in healthcare settings. Objectives: We followed the PRISMA guidelines for scoping reviews to map [...] Read more.

Background: Given the healthcare challenges older people and people who identify as LGBTQ+ are faced with, it becomes critical to explore how older transgender individuals experience discrimination in healthcare settings. Objectives: We followed the PRISMA guidelines for scoping reviews to map existing literature, and identify key themes, specific to transgender adults aged 65 and older and how they experience discrimination in healthcare. Eligibility criteria: This scoping review explored studies that focused on discrimination against transgender people older than 65 in any healthcare settings, which were published in English in the last twenty years. Sources of evidence: Evidence was extracted from Scopus, ProQuest Central, Health & Medical Collection, PubMed, CINAHL, Medline, and Psychology and Social Sciences databases. Charting methods: We used streams of search with specific keywords. Two researchers were involved in the screening of articles, coding and analysis. Results: The search showed that research focusing on transgender people older than 65 and discrimination in healthcare was rather limited. The findings revealed that older transgender individuals frequently anticipated or experienced discrimination in healthcare settings, resulting in service avoidance and adverse health outcomes. Despite sometimes reporting lower overt discrimination than younger cohorts, older trans people faced comparable levels of victimization, compounded by age-related vulnerabilities and socioeconomic marginalization. Structural barriers, such as misaligned documentation, lack of provider competence, and financial constraints, further hindered access to healthcare. However, the presence of empathetic, culturally competent providers and access to LGBTQ+-specialized services might improve care engagement and outcomes. Conclusions: This review concluded that targeted policy reforms, inclusive clinical practices, and community-based support systems were essential to address these disparities. It called for greater institutional accountability and interdisciplinary research to ensure safe, affirming, and equitable healthcare for aging transgender populations. Full article

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13 pages, 392 KB

Open AccessArticle

Health Consequences of COVID-19 Pandemic in Older Adults with Musculoskeletal Conditions: A Cross-Sectional Path Analysis Model

by Suparb Areeue, Inthira Roopsawang, Rick Yiu Cho Kwan and Ladda Thiamwong

Geriatrics 2025, 10(6), 139; https://doi.org/10.3390/geriatrics10060139 - 27 Oct 2025

Abstract

Background/Objective: The sequelae of COVID-19 on geriatric health is profound, yet its consequences on mental well-being remain insufficiently elucidated, particularly in older adults with musculoskeletal conditions. This study aimed to explore the interrelationships and magnitude of the effects of fear of COVID-19, [...] Read more.

Background/Objective: The sequelae of COVID-19 on geriatric health is profound, yet its consequences on mental well-being remain insufficiently elucidated, particularly in older adults with musculoskeletal conditions. This study aimed to explore the interrelationships and magnitude of the effects of fear of COVID-19, fear of falls, physical activity, and social frailty on depressive symptoms in this population. Methods: Purposive sampling was applied to recruit 292 older adults with musculoskeletal conditions. Data were collected through structured interviews (face-to-face and telephone) using standard questionnaires. Path analysis with Satorra–Bentler correction examined the relationships in the proposed model of depressive symptoms. The model fit indices were evaluated using the chi-square (χ²); the goodness-of-fit test was assessed with standard criteria of the comparative fit index (CFI ≥ 0.95), the Tucker–Lewis index (TLI ≥ 0.95), the root mean squared error of approximation (RMSEA < 0.08), and the standardized root mean square residual (SRMR < 0.05). Results: Mean participant age was 70.30 ± 6.56 years, with 74.3% female. The path analysis model demonstrated an excellent fit indicating χ² = 0.007 (p = 0.933), CFI and TLI = 1.000, RMSEA = 0.000, SRMR = 0.001. Fear of COVID-19 negatively indirectly impacted depressive symptoms (β = −0.07, p = 0.017), while physical activity had a positive direct effect (β = 0.16, p = 0.004). Fear of COVID-19 directly influenced social frailty (β = 0.18, p = 0.003) but had a negative direct impact on physical activity (β = −0.37, p = 0.000). However, fear of falling did not show a significant relationship with the other study variables. Conclusions: Depressive symptoms entail physical and psychosocial consequences. Physical activity has a positive effect on depressive symptoms. Fear of COVID-19 increases social frailty, while increasing physical activity reduces this fear. Future research should evaluate longitudinal effects and investigate evidence-based public health interventions or tailored cognitive–behavioral interventions to reduce pandemic-related fear and prevent mental health sequelae. Full article

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10 pages, 216 KB

Open AccessArticle

Associations Between Decision-Making Biases and Swallowing and Physical Functions in Community-Dwelling Older Adults: A Cross-Sectional Study

by Ayane Horike, Kohei Yamaguchi, Kanako Toda Shibahara, Jun Aida, Rieko Moritoyo, Kanako Yoshimi, Kazuharu Nakagawa and Haruka Tohara

Geriatrics 2025, 10(6), 138; https://doi.org/10.3390/geriatrics10060138 - 24 Oct 2025

Abstract

Background/Objective: In the context of global aging, maintaining daily habits such as adequate nutrition and regular exercise are essential to achieve healthy aging. Therefore, the preservation of swallowing and physical functions is fundamental. Jaw-opening force, an important swallowing function, is linked to physical [...] Read more.

Background/Objective: In the context of global aging, maintaining daily habits such as adequate nutrition and regular exercise are essential to achieve healthy aging. Therefore, the preservation of swallowing and physical functions is fundamental. Jaw-opening force, an important swallowing function, is linked to physical function. Daily health behaviors are shaped by decision-making biases, which influence decision-making. Individuals with high procrastination tendencies may be less likely to engage in health-promoting behaviors, potentially leading to functional decline. While such tendencies are associated with general health behaviors, little is known about their associations with swallowing and physical functions among older adults. The objective of this study was to examine the associations between decision-making biases and swallowing and physical functions in community-dwelling older adults. Methods: A questionnaire survey was conducted to collect basic information and assess decision-making biases. The jaw-opening force (swallowing function) and grip strength (physical function) were measured. Associations of decision-making biases with jaw-opening force and grip strength were examined using multivariable linear regression analysis. We further conducted sex-stratified sensitivity analyses. Results: This cross-sectional study targeted 107 community-dwelling older adults. There was a significant negative association between procrastination tendency and jaw-opening force (B = −0.715, p = 0.005), and grip strength (B = −1.552, p = 0.003), indicating that individuals with a propensity for procrastination had lower jaw-opening force and grip strength. Conclusions: Procrastination tendency may be used as an indicator to detect swallowing and physical functions. Moreover, incorporating this modifiable factor to promote behavior change may prevent functional decline. The study results highlight the significance of considering individuals’ decision-making biases—particularly procrastination tendency—in clinical settings. Full article

(This article belongs to the Section Dysphagia)

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