Geriatrics

13 pages, 1334 KB

Open AccessArticle

Influence of Age on the Effectiveness of Lee Silverman Voice Treatment^® BIG in Patients with Parkinson’s Disease: A Retrospective Exploratory Observational Study

by Masanobu Iwai, Kazuya Takeda, Soichiro Koyama, Ikuo Motoya, Yuichi Hirakawa, Hiroaki Sakurai, Yoshikiyo Kanada, Nobutoshi Kawamura, Mami Kawamura and Shigeo Tanabe

Geriatrics 2026, 11(3), 63; https://doi.org/10.3390/geriatrics11030063 - 20 May 2026

Abstract

Background/Objectives: Advanced age in Parkinson’s disease (PD) is linked to worse motor function, more severe symptoms, and impaired activities of daily living (ADLs). Lee Silverman Voice Treatment (LSVT)^® BIG may be suitable for older patients, as it can be adapted to individual [...] Read more.

Background/Objectives: Advanced age in Parkinson’s disease (PD) is linked to worse motor function, more severe symptoms, and impaired activities of daily living (ADLs). Lee Silverman Voice Treatment (LSVT)^® BIG may be suitable for older patients, as it can be adapted to individual abilities. This study evaluated whether age affects the effectiveness of LSVT^® BIG on gait speed, motor symptoms, ADLs, and quality of life (QoL) in PD. Methods: In this retrospective, single-center cohort study, 22 patients with PD were divided into an older group (≥65 years; n = 16) and a younger group (<65 years; n = 6). All participants completed 16 one-hour, face-to-face LSVT^® BIG sessions. Gait speed was assessed with the 10-m walk test; motor symptoms with Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III; ADLs with MDS-UPDRS Part II; and QoL with the Parkinson’s Disease Questionnaire-39 Summary Index. Two-way mixed-design analysis of variance with aligned rank transformation was used for statistical analysis. Results: Significant improvements were observed for all outcomes (gait speed, motor symptoms, ADLs, and QoL) after the intervention. A significant effect of age group was found for gait speed, with younger patients walking faster overall. No significant interaction between timepoint and group was observed for any measure. Conclusions: LSVT^® BIG appears to improve gait speed, motor symptoms, ADLs, and QoL in patients with PD, regardless of age, suggesting it is an effective intervention for both older and younger patients. Full article

(This article belongs to the Section Geriatric Neurology)

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14 pages, 551 KB

Open AccessArticle

Frailty Predicts Neurological Outcome in Chronic Subdural Hematoma: A Single-Center Prospective Cohort Study

by Tobias Philip Schmidt, Christian Jacquemain, Jule Rupprecht, Kerstin Jütten, Laura Schlager, Christian Blume, Michael Veldeman, Hans Clusmann, Anke Höllig and Catharina Conzen-Dilger

Geriatrics 2026, 11(3), 62; https://doi.org/10.3390/geriatrics11030062 - 19 May 2026

Abstract

Objectives: Frailty, reflecting reduced physiological reserve, has emerged as a predictor of postoperative outcomes in neurosurgery and may provide greater prognostic value than age. In chronic subdural hematoma (cSDH), prospective data remain scarce. This study investigates the association between preoperative frailty, assessed using [...] Read more.

Objectives: Frailty, reflecting reduced physiological reserve, has emerged as a predictor of postoperative outcomes in neurosurgery and may provide greater prognostic value than age. In chronic subdural hematoma (cSDH), prospective data remain scarce. This study investigates the association between preoperative frailty, assessed using the Clinical Frailty Scale (CFS), and postoperative recovery in cSDH patients. Methods: In this ongoing prospective single-center cohort study, 78 consecutive patients (≥60 years) with cSDH were enrolled between August 2022 and October 2024. After exclusion of four conservatively managed patients, 74 surgically treated patients were included in the analysis. Frailty was defined as Clinical Frailty Scale (CFS) ≥ 5. The primary outcome was the Glasgow Outcome Scale-Extended at 6 months (GOSE6). Secondary outcomes included GOSE at discharge (GOSE0) and three months (GOSE3), revision surgery, intensive care unit (ICU) admission, and mortality after six months. Results: Higher CFS scores significantly correlated with poorer outcome at 6 months (r = −0.68, p_adj = 0.011). In regression analysis, frailty (p < 0.001), age (p_adj = 0.014), and revision surgery (p_adj = 0.009) were significant predictors of outcome. Frailty was associated with a reduced likelihood of a good neurological outcome (OR = 0.02, 95% CI: [0.004, 0.085]). Frail patients had significantly poorer outcomes at all timepoints (all p_adj = 0.014) and none achieved a favorable outcome (GOSE ≥ 6). Six-month mortality was significantly higher in frail patients compared to non-frail patients (32% vs. 4%, p_adj = 0.048, relative risk RR = 3.29, 95% CI [1.67, 5.78]). Conclusions: Our interim results suggest that preoperative frailty, as measured by the CFS, is strongly associated with poorer neurological recovery and higher mortality following surgical treatment of cSDH. Frailty assessment may facilitate individualized treatment strategies and improve risk stratification beyond age or comorbidity burden. Full article

(This article belongs to the Special Issue Comprehensive Geriatric Assessment of Older Surgical Patients)

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15 pages, 255 KB

Open AccessArticle

Fibromyalgia and Risk of Alzheimer’s DiseaseRelated Dementia: A Nationwide Bidirectional Case–Control Study

by Eli Magen, Israel Magen, Eugene Merzon, Ilan Green, Avivit Golan-Cohen, Shlomo Vinker and Ariel Israel

Geriatrics 2026, 11(3), 61; https://doi.org/10.3390/geriatrics11030061 - 18 May 2026

Abstract

Background/Objectives: To evaluate the association between fibromyalgia and dementia, with emphasis on temporal directionality and Alzheimer’s disease-related dementia. Methods: We conducted a nationwide, population-based matched case–control study including 9232 patients with fibromyalgia and 46,160 age- and sex-matched controls. Diagnoses in the Leumit Health [...] Read more.

Background/Objectives: To evaluate the association between fibromyalgia and dementia, with emphasis on temporal directionality and Alzheimer’s disease-related dementia. Methods: We conducted a nationwide, population-based matched case–control study including 9232 patients with fibromyalgia and 46,160 age- and sex-matched controls. Diagnoses in the Leumit Health Services database are recorded using a hybrid coding scheme that combines ICD-9-CM and WHO ICD-10 codes; the specific codes used to ascertain fibromyalgia and each dementia subtype are listed in the Methods. Outcomes were assessed within two predefined windows: up to 20 years before and up to 10 years after fibromyalgia diagnosis. Alzheimer disease-related dementia was defined as the primary outcome. Multivariable logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs). Results: During the 20 years preceding fibromyalgia diagnosis, no increased dementia prevalence was observed; Alzheimer disease-related dementia was less frequent among fibromyalgia patients (0.16% vs. 0.31%; absolute difference −0.15 percentage points; OR 0.52, 95% CI 0.31–0.89). In contrast, during the 10 years following diagnosis, fibromyalgia was associated with a higher prevalence of Alzheimer’s disease-related dementia (1.43% vs. 0.99%; absolute difference +0.44 percentage points; OR 1.45, 95% CI 1.18–1.78). No consistent associations were found for other dementia subtypes, which should be interpreted as exploratory given low event counts. Conclusions: Fibromyalgia is associated with a higher prevalence of Alzheimer’s disease-related dementia in the years following diagnosis, with no evidence of pre-diagnostic elevation. Although this temporal pattern argues against reverse causation, the prevalence-based design and residual confounding preclude causal inference. Fibromyalgia should be regarded as a potential risk marker for subsequent Alzheimer-related neurodegeneration rather than a demonstrated causal factor. Full article

(This article belongs to the Section Geriatric Rheumatology)

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10 pages, 212 KB

Open AccessArticle

Personality Traits and Attention in Israeli Older Adults: An Exploratory Study

by Dubi Lufi and Iris Haimov

Geriatrics 2026, 11(3), 60; https://doi.org/10.3390/geriatrics11030060 - 18 May 2026

Abstract

Background/Objectives: The purpose of the present study was to assess the relationships between attention level and personality traits among 44 older adults aged from 65 to 75 in the Israeli population. The participants were 19 females and 25 males, with a mean age [...] Read more.

Background/Objectives: The purpose of the present study was to assess the relationships between attention level and personality traits among 44 older adults aged from 65 to 75 in the Israeli population. The participants were 19 females and 25 males, with a mean age of 68.13 years, and 12.32 years average of formal education, who provided clinical history for screening. Methods: The participants completed the 44-item Big Five Inventory, the d2 Test of Attention, and the Mathematics Continuous Performance Test (MATH-CPT), a computerized test that measures participants’ attention levels by recording their responses to visual stimuli. Results: The results showed significant correlations between attention and the domains of Conscientiousness and Neuroticism. Linear regression analysis, with the MATH-CPT measures as the dependent variable and the Big Five personality factors as independent variables, revealed a significant model explaining 41.60% of the variance in MATH-CPT performance. Linear regression analysis of the measures of the d2 test of attention as dependent variables and the Big Five factors as independent variables showed a significant model that explained 47.70% of the variance. No association was found between age and the domains of the Big Five personality traits. Conclusions: This study discusses the implications of the significant correlations between personality domains and measures of attention in older adults. The findings suggest that individuals who are organized, task-oriented, goal-focused, responsible, imaginative, creative, and interested in educational experiences may be better able to perform attention-related tasks in older age. Full article

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

22 pages, 1264 KB

Open AccessArticle

Ultrasound-Based Wearable for Older Chronic Back Pain Patients: A Requirement Analysis of a User Interface for Biofeedback

by Luis Perotti, Oskar Stamm, Susan Vorwerg-Gall, Lisa Mesletzky, Drin Ferizaj, Steffen Dißmann, Sandra Stube-Lahmann, Marc Fournelle, Nils Lahmann and Ursula Müller-Werdan

Geriatrics 2026, 11(3), 59; https://doi.org/10.3390/geriatrics11030059 - 15 May 2026

Abstract

Purpose: This study explores how older adults with chronic back pain (CBP) evaluate different user interface (UI) designs and gamification elements for an ultrasound-based wearable providing real-time biofeedback during segmental stabilization exercises (SSE). The aim is to identify design preferences and motivational factors [...] Read more.

Purpose: This study explores how older adults with chronic back pain (CBP) evaluate different user interface (UI) designs and gamification elements for an ultrasound-based wearable providing real-time biofeedback during segmental stabilization exercises (SSE). The aim is to identify design preferences and motivational factors to enhance usability, engagement, and adherence in this specific population. Methods: We conducted a mixed-methods study with 15 older adults (aged ≥ 65) experiencing CBP. Participants interacted with three UI mockups (simple, anatomical, and playful) via a Wizard-of-Oz simulation and evaluated additional motivational elements (e.g., points, badges, progress charts). Semi-structured interviews and the Technology Usage Inventory (TUI) subscales were used to assess usability, acceptance, and intention to use. Results: Participants preferred the simple and anatomical UI designs, citing clarity, professionalism, and ease of interpretation. The playful design was viewed as less appropriate due to perceived infantilization. Game elements such as progress tracking, points, and levels were positively received, while competitive features like leaderboards were viewed critically. Most participants expressed interest in integrating pain education, favoring multimedia formats. Conclusions: Digital health tools for older adults must prioritize intuitive, medically reliable interfaces and allow personalization of motivational and educational components. The findings highlight the need for age-appropriate UI design and suggest that well-balanced gamification and educational features may enhance perceived acceptance and have the potential to support long-term use, which should be evaluated in longitudinal studies. Full article

(This article belongs to the Special Issue Digital Innovations in Geriatric and Gerontological Care)

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14 pages, 363 KB

Open AccessArticle

Knowledge, Attitudes, and Practices of Oral Care for Residential Older People Among Healthcare Providers in Macao

by Miffy M. F. Lam and Florence M. F. Wong

Geriatrics 2026, 11(3), 58; https://doi.org/10.3390/geriatrics11030058 - 13 May 2026

Abstract

Background/Objectives: Oral health is integral to the overall well-being and quality of life of older adults. For institutionalized older residents who depend on staff for daily care, the knowledge, attitudes, and practices (KAP) of healthcare providers directly influence oral health outcomes. This [...] Read more.

Background/Objectives: Oral health is integral to the overall well-being and quality of life of older adults. For institutionalized older residents who depend on staff for daily care, the knowledge, attitudes, and practices (KAP) of healthcare providers directly influence oral health outcomes. This study aimed to assess oral care KAP among healthcare providers in Macao’s residential care facilities and to examine the relationships between KAP and personal characteristics. Methods: A cross-sectional study was conducted from September to December 2023 using a structured KAP questionnaire. Data were collected from 225 healthcare providers across four nursing homes in Macao. Results: Significant positive correlations were found among KAP (Spearman’s γ = 0.293–0.419; p < 0.001). Mean scores were 15.60 (SD = 2.27)/19 for knowledge, 52.13 (SD = 5.75)/65 for attitudes, and 45.87 (SD = 5.93)/55 for practices. Denture care was the major knowledge deficit. Knowledge was associated with age 18–20 (p = 0.002), age 31–40 (p = 0.015), and university education (p = 0.003). Attitudes were associated with age 18–20 (p = 0.002), female gender (p = 0.005), and primary education (p = 0.044). Practice was associated with training programme attendance (p = 0.006) and female gender (p = 0.016). All associations involving the age 18–20 subgroup (n = 3) and male gender (n = 16) should be interpreted with caution due to very small sample sizes. Conclusions: Oral care KAP among HAs and PCWs in Macao’s residential care homes are positively but modestly correlated. Most providers acquired knowledge through induction training with verified competency outcomes and personal experience. These findings highlight the need for structured, repeatable training and suggest that Macao’s data can contribute to international efforts to improve oral care in institutionalized aging populations. Future research should employ longitudinal or observational designs and include all elderly care facilities in Macao. Full article

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11 pages, 605 KB

Open AccessBrief Report

Metabolic Changes After the Implementation of a Recreational Physical Activity Program at Mexican Elderly Adults’ Welfare Homes

by Moisés Martínez Briseño, Manuel Abraham Gómez-Martínez, Diana Rodríguez-Vera, Kenneth Rubio Carrasco, Raúl Lugo Villegas, María de los Ángeles Frías Fernández, Marco A. Loza-Mejía, José A. Morales-González, Rodolfo Pinto-Almazán, Etzel Cruz Cruz and Arely Vergara-Castañeda

Geriatrics 2026, 11(3), 57; https://doi.org/10.3390/geriatrics11030057 - 7 May 2026

Abstract

Background/objective: Hypertension and type 2 diabetes are major causes of morbidity in older adults. Although pharmacological treatments remain the cornerstone of management, structured physical activity has been shown to provide additional benefits, yet evidence from institutionalized populations in Latin America is limited. This [...] Read more.

Background/objective: Hypertension and type 2 diabetes are major causes of morbidity in older adults. Although pharmacological treatments remain the cornerstone of management, structured physical activity has been shown to provide additional benefits, yet evidence from institutionalized populations in Latin America is limited. This study evaluated the impact of a 12-month supervised exercise program on blood pressure (BP), glycated hemoglobin (HbA1c), and body composition in elderly people attending welfare homes in Mexico. Methods: A community-based intervention trial was conducted (February 2018–January 2019) with 260 adults (aged > 60 years) with hypertension and/or diabetes. Participants were allocated based on shelter site to either a control group (n = 129; pharmacological treatment only) or an intervention group (n = 131; pharmacological treatment plus five one-hour supervised recreational physical activity sessions per week). Monthly anthropometric, clinical, and biochemical measurements were analyzed using parametric/non-parametric tests and estimation of effect size (Cohen’s d). Results: Median age was 70 years (86% female). After 12 months, systolic BP decreased from 148.4 to 129.7 mmHg in the intervention group vs. 147.7 to 131.3 mmHg in controls. Diastolic BP showed greater reduction in the intervention group (−25%; 93.1 to 68.9 mmHg) than in controls (−13.5%; 88.1 to 76.2 mmHg). HbA1c reductions were also superior in the intervention group (–2.28% vs. –1.86%). Both groups lost fat mass, but lean mass preservation was limited. Conclusions: Structured community-based physical activity significantly improves BP, glycemic control, and body composition, supporting its integration into routine institutional care with limited resources. Full article

(This article belongs to the Special Issue Exercise Interventions for Healthy Aging)

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20 pages, 812 KB

Open AccessArticle

Anodal Transcranial Direct Current Stimulation Enhances Short-Term Balance During Locomotive Training in Older Adults with Locomotive Syndrome: A Pilot Randomized Controlled Trial

by Hitoshi Shitara, Tsuyoshi Tajika, Eiji Takasawa and Hirotaka Chikuda

Geriatrics 2026, 11(3), 56; https://doi.org/10.3390/geriatrics11030056 - 7 May 2026

Abstract

Background/Objectives: Locomotive syndrome (LS) is associated with impaired balance and functional decline in older adults. Although locomotive training (LT) improves mobility, whether central neuromodulation enhances short-term balance adaptation remains unclear. This pilot randomized controlled trial examined the additive effect of anodal transcranial [...] Read more.

Background/Objectives: Locomotive syndrome (LS) is associated with impaired balance and functional decline in older adults. Although locomotive training (LT) improves mobility, whether central neuromodulation enhances short-term balance adaptation remains unclear. This pilot randomized controlled trial examined the additive effect of anodal transcranial direct current stimulation (tDCS) with LT on balance. Methods: Sixteen community-dwelling adults aged ≥ 65 years with LS were randomized (1:1:1) to anodal tDCS + LT (n = 6), sham tDCS + LT (LT group, n = 6), or anodal tDCS alone (n = 4). Participants underwent five consecutive days of intervention. The primary outcome was eyes-open single-leg stance time, assessed before stimulation and at 10, 20, 50, and 80 min during and after stimulation on days 1–5. Group × time interactions were evaluated using linear mixed-effects models adjusted for baseline and age. Long-term outcomes were assessed on days 1, 5, and 12. Results: In the primary analysis, a significant group × time interaction for right-sided single-leg stance time was observed between the anodal tDCS + LT and the LT groups (F(1,58) = 6.08, p = 0.017; β = 0.966), indicating greater within-day improvement with combined therapy, but not in sensitivity analyses treating time as a categorical variable. No significant interactions were observed on the left side. Secondary outcomes showed time-dependent improvements without consistent group-specific effects or significant group × day interactions over the long term. No serious adverse events occurred. Conclusions: Anodal tDCS with LT improved short-term balance in the primary analysis; however, these effects were model-sensitive and not sustained over 12 days. These findings should be considered preliminary and hypothesis-generating. Larger trials are needed to determine optimal stimulation dosing and long-term efficacy. Full article

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11 pages, 1188 KB

Open AccessArticle

Patient-Centred Care for Older Patients Considering Surgery: An Evaluation of the Perioperative Care of Older Patients Service at an Australian Tertiary Hospital

by Rachel Aitken, Katherine Gregorevic, Michelle Preeo, Ross Bicknell, Alyssa Griffiths, Jared Tower, Ned Douglas, Chuan-Whei Lee, Janette Wright, Jai Darvall and Wen Kwang Lim

Geriatrics 2026, 11(3), 55; https://doi.org/10.3390/geriatrics11030055 - 28 Apr 2026

Abstract

Background/Objectives: As mounting numbers of older people consider surgery, the importance of aligning treatments with patient values and goals is paramount. This has led to the growth of POPS (Perioperative care of Older Patients) services internationally and across Australia. An observational pilot [...] Read more.

Background/Objectives: As mounting numbers of older people consider surgery, the importance of aligning treatments with patient values and goals is paramount. This has led to the growth of POPS (Perioperative care of Older Patients) services internationally and across Australia. An observational pilot evaluation of the Melbourne Health POPS service was conducted throughout 2022, with the aims of describing the population, measuring patient-reported outcomes and comparing postoperative outcomes to a matched historical cohort. Methods: Data were sourced from clinical review, electronic medical records and health intelligence. Patients who pursued surgery were matched 2:1 with a 2020 control cohort on up to 10 characteristics ranked on clinical judgement. Patient-reported outcomes were collected at 3 months post-surgery or at the clinic in consenting participants. Results: There were 128 participants, of whom 64 (50%) pursued non-surgical management. Participants were older (median 79 [13] years), frail (median CFS 5 [2]), and multimorbid (median CCI 5 [2.25]). Despite increased perioperative risk amongst the POPS surgical group (ASA-4 23.4% vs. 5.5%, p < 0.001), increased incidence of postoperative delirium (15% vs. 5.8%, p = 0.042) and ICU admission (21.7% vs. 7.5%, p = 0.006) compared to the control group, median length of stay was similar (4.3 [6.7] vs. 4.3 [5.1] days, p = 0.537). Patient-reported outcomes were similar between surgical and non-surgical POPS groups (90.7% vs. 88.1% would make the same surgical decision, p = 0.697). Conclusions: Patients attending POPS were multimorbid with geriatric syndromes and elevated perioperative risk. A high proportion pursued non-operative care. Patient-reported feedback was high with low decisional regret. Full article

(This article belongs to the Special Issue Comprehensive Geriatric Assessment of Older Surgical Patients)

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15 pages, 431 KB

Open AccessReview

Day Surgery in Older Adults: Safety, Effectiveness, and Best Practices for Patient Selection and Perioperative Care—A Narrative Review

by Judit Groman, Zsolt Viktor Göböl, Andrea Virág, Gyula Domján and Klara Gadó

Geriatrics 2026, 11(3), 54; https://doi.org/10.3390/geriatrics11030054 - 28 Apr 2026

Abstract

Background: The growing number of older adults undergoing surgical procedures requires care models that minimise hospital exposure, optimise safety, and support rapid recovery. Day surgery has become an increasingly attractive option for selected older patients, provided their medical, functional and psychosocial needs are [...] Read more.

Background: The growing number of older adults undergoing surgical procedures requires care models that minimise hospital exposure, optimise safety, and support rapid recovery. Day surgery has become an increasingly attractive option for selected older patients, provided their medical, functional and psychosocial needs are carefully assessed. Recent developments in prehabilitation, geriatric-focused perioperative pathways and enhanced post-discharge follow-up have further expanded its potential. This narrative review aims not only to synthesise current evidence, but also to provide a clinically oriented framework for patient selection, perioperative optimisation, and safe implementation of day surgery pathways in older adults. Main findings: Evidence from the past decade indicates that day surgery can be safe and effective for adults aged ≥65 when supported by structured preoperative assessment, targeted optimisation, and clear discharge criteria. Older patients benefit particularly from reduced risks of hospital-acquired complications, including infection, delirium, immobility and functional decline. Prehabilitation programmes focusing on nutrition, strength, balance and medication review are associated with improved postoperative stability and faster return to baseline function. Multidisciplinary teamwork, integrating surgeons, anaesthetists, geriatricians, nurses, physiotherapists, dietitians and caregivers, play a key role in identifying modifiable risks and ensuring continuity of care. Studies also highlight the value of post-discharge telephone follow-up, caregiver engagement and close collaboration with primary care in preventing readmissions. Conclusions: Day surgery is a viable and patient-centred option for many older adults when careful selection and preparation are combined with age-sensitive perioperative care. Most adverse outcomes can be mitigated through systematic prehabilitation, thoughtful anaesthetic planning, early mobilisation and structured follow-up. The evidence suggests that older patients may benefit from reduced hospital stay, less exposure to harm, and faster functional recovery. Implications for practice: The findings support broader integration of geriatric day surgery into routine care pathways, especially within health systems facing capacity constraints. Clinicians should consider implementing standardised geriatric assessment, multidisciplinary optimisation strategies, and robust discharge and follow-up protocols to enhance safety and effectiveness. With appropriate preparation and coordinated teamwork, day surgery can contribute meaningfully to safer, more efficient and more patient-centred surgical care for older adults. Full article

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13 pages, 807 KB

Open AccessArticle

Effects of Dual Tasking on Intersegmental Coordination During Walking in People with Parkinson’s Disease: A Cross-Sectional Case–Control Study

by Valéria Feijó Martins, Edilson Fernando de Borba, Lucas de Liz Alves, Leonardo A. Peyré-Tartaruga and Flávia Gomes Martinez

Geriatrics 2026, 11(3), 53; https://doi.org/10.3390/geriatrics11030053 - 28 Apr 2026

Abstract

Background: In dual-task (DT) conditions, individuals must walk while simultaneously engaging in cognitive or motor tasks, which impacts gait performance, especially in older adults and individuals with Parkinson’s disease (PD). Gait impairments in PD under DT conditions have implications for intersegmental coordination. Research [...] Read more.

Background: In dual-task (DT) conditions, individuals must walk while simultaneously engaging in cognitive or motor tasks, which impacts gait performance, especially in older adults and individuals with Parkinson’s disease (PD). Gait impairments in PD under DT conditions have implications for intersegmental coordination. Research question: Intersegmental coordination and gait biomechanics during the DTs were compared between people with PD and older adults. Methods: Thirty-two individuals (16 PD, H&Y 1–3; and 16 older adults) participated in this study and were asked to walk under the following self-selected conditions: single task, DT with a math component, and texting on a cell phone. Spatiotemporal, angular, and intersegmental coordination data were collected using a markerless motion analysis system (OpenCap). Results: Dual-task conditions significantly affected spatiotemporal and kinematic variables, as well as intersegmental coordination. A significant task effect was observed for thigh–shank coordination, whereas no significant group effect was found for the main coordination outcomes. Significance: Significant task effects were observed for intersegmental coordination (thigh–shank CRP), with no significant group differences. The concurrent demands of processing visual and motor information for texting and walking lead to significant reductions in gait speed and lower limb movement, as well as altered intersegmental coordination, with task demands rather than disease status being the primary driver of coordination changes. Full article

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

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13 pages, 799 KB

Open AccessArticle

Two Months of Active Video Game Training Improves Selected Lipid Profile Markers in Older Adults: A Preliminary Study

by Agali Y. López-Miguel, Ángel E. Brizuela-Araujo, Omar A. López-López, Juan J. Calleja-Núñez, Roberto Espinoza-Gutiérrez, Elena C. Guzmán-Gutiérrez, Aracely Serrano-Medina, José Moncada-Jiménez and Jorge A. Aburto-Corona

Geriatrics 2026, 11(3), 52; https://doi.org/10.3390/geriatrics11030052 - 23 Apr 2026

Abstract

Background: The purpose of this study was to compare the effects of two months of exergaming, conventional resistance exercise training, and no exercise on body composition and cardiometabolic risk factors in physically inactive older adults. Methods: For the preliminary study, twenty-four [...] Read more.

Background: The purpose of this study was to compare the effects of two months of exergaming, conventional resistance exercise training, and no exercise on body composition and cardiometabolic risk factors in physically inactive older adults. Methods: For the preliminary study, twenty-four physically inactive adults aged 60–74 yrs. were allocated to an active video game training group (AVG n = 8), a conventional exercise group (CEG n = 7), or a non-exercising control group (CON n = 9). The AVG and CEG completed 24 supervised exercise training sessions over two months (three sessions per week) at self-selected, predominantly moderate-to-vigorous intensity, while the CON maintained usual daily activities. Body weight, skeletal muscle mass, body fat percentage, phase angle, and fasting blood biomarkers (glucose, total cholesterol, LDL, HDL, VLDL, and triglycerides) were assessed before and after the intervention. Results: No significant interactions were observed for body composition variables. Body weight decreased significantly following exercise training in both the AVG and CEG (p < 0.05). Significant interactions were found for total cholesterol (p = 0.001) and LDL cholesterol (p = 0.009). The AVG demonstrated significant reductions in fasting glucose, total cholesterol, and LDL cholesterol (p < 0.05), whereas the CEG showed a significant reduction only in total cholesterol. In contrast, the CON exhibited a significant increase in total cholesterol over the same period (p < 0.05). Conclusions: Two months of exergaming-based exercise training may lead to greater improvements in lipid-related cardiometabolic risk factors compared with conventional resistance exercise training in physically inactive older adults. These findings suggest that exergaming could be a promising exercise modality for supporting cardiometabolic health in aging populations. Full article

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

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15 pages, 516 KB

Open AccessArticle

Sarcopenia Severity and the Accumulation of Geriatric Syndromes Among Older Adults: A Cross-Sectional Study from Vietnam

by Huong Thi Thu Nguyen, Vasi Naganathan, Thanh Xuan Nguyen, Tam Ngoc Nguyen, Thu Thi Hoai Nguyen, Huyen Thi Thanh Vu, Anh Lan Nguyen, Vien Chi Le, Narelle Warren, Hoa Lan Nguyen, Robert J. Goldberg and Anh Trung Nguyen

Geriatrics 2026, 11(3), 51; https://doi.org/10.3390/geriatrics11030051 - 23 Apr 2026

Abstract

Background/Objectives: Sarcopenia frequently coexists with other geriatric syndromes, and its severity may influence their clinical manifestation. This study examines the prevalence of geriatric syndromes in older adults with non-severe and severe sarcopenia and explores the associations between sarcopenia severity and individual geriatric syndromes [...] Read more.

Background/Objectives: Sarcopenia frequently coexists with other geriatric syndromes, and its severity may influence their clinical manifestation. This study examines the prevalence of geriatric syndromes in older adults with non-severe and severe sarcopenia and explores the associations between sarcopenia severity and individual geriatric syndromes in Vietnam. Methods: A cross-sectional study was conducted among 726 older outpatients with sarcopenia. Non-severe and severe sarcopenia were diagnosed according to the Asian Working Group for Sarcopenia algorithm. Fifteen geriatric conditions spanning physical and psychological health, functional status, and social circumstances were assessed using components of the Comprehensive Geriatric Assessment. Logistic regression models were used to examine associations between sarcopenia severity and geriatric syndromes. Results: A total of 726 older patients with sarcopenia (mean age 74.4 years, 77.4% females) were included, of whom 53.4% had severe sarcopenia. A significantly higher prevalence of geriatric syndromes was observed in patients with severe compared with non-severe sarcopenia, including sleep disturbances (79.4% vs. 67.5%), frailty (71.4% vs. 54.7%), malnourishment/risk of malnutrition (61.9% vs. 50.0%), depression (54.9% vs. 34.9%), polypharmacy (49.5% vs. 42.0%), impairment in activities of daily living (52.8% vs. 32.5%), and impairment in instrumental activities of daily living (58.2% vs. 39.3%). After adjustment for potential confounders, severe sarcopenia remained associated with sleep disturbance (adjusted OR 1.49, 95%CI 1.02–2.18, p = 0.046), depression (adjusted OR 1.90, 95%CI 1.36–2.66, p < 0.001), and mobility impairment (adjusted OR 3.01, 95%CI 2.12–4.27, p < 0.001). Conclusions: Older Vietnamese adults with sarcopenia had a high burden of geriatric syndromes, particularly among those with severe disease. Severe sarcopenia was independently associated with sleep disturbance, depression, and impaired mobility—clinically relevant and potentially modifiable conditions. These findings highlight the importance of evaluating sarcopenia within a broader geriatric framework and may inform early identification and prioritization of coexisting geriatric syndromes, especially in resource-limited settings. Full article

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13 pages, 398 KB

Open AccessArticle

Appropriateness and Outcome of a Statin Deprescription Intervention in Hospitalized Frail Older Adults: A Retrospective Study

by Giuseppe Castiglia, Nicola Veronese, Gianluca Gortan Cappellari, Erica Voinovich, Paolo De Colle and Michela Zanetti

Geriatrics 2026, 11(2), 50; https://doi.org/10.3390/geriatrics11020050 - 20 Apr 2026

Abstract

Background/Objectives: The appropriateness of statin treatment in frail older adults is controversial because of insufficient evidence on its efficacy. The aim of this study was to assess the appropriateness of statin prescription at admission and discharge from hospital and the association of [...] Read more.

Background/Objectives: The appropriateness of statin treatment in frail older adults is controversial because of insufficient evidence on its efficacy. The aim of this study was to assess the appropriateness of statin prescription at admission and discharge from hospital and the association of deprescription with one-year mortality in a cohort of older patients. Methods: Monocentric retrospective observational study of older (≥65 year) adults admitted to a Geriatric Unit. Patients underwent comprehensive geriatric assessment and prevalence of statin prescription at admission and discharge was recorded. Appropriateness of prescription was determined using the Medication Appropriateness Index (MAI), multidimensional frailty using the Multidimensional Prognostic Index (MPI). Mortality at 12 months was recorded. Results: Among 528 consecutively admitted patients, 112 (mean age 83.6 ± 6.2 years) were treated with statins and were included in the study. In addition, 87.5% of patients showed at least one inappropriate criterion for statin prescription at admission and 91.7% at discharge. Deprescription occurred in 46.4% of patients at discharge, particularly in those who were older and in MPI high mortality risk class. Mean MAI did not differ between admission and discharge in the whole study cohort, but it decreased in patients at highest mortality risk (from 3.2 ± 4.0 to 2.0 ± 1.2). In multivariate analysis, compared with patients who continued statins after discharge, those who were deprescribed did not show increased one-year mortality risk. Conclusions: Inappropriate statin prescription is common at hospital admission in frail older patients and deprescription does not affect one-year residual survival. Therefore, rigorous assessment of mortality risk and medication appropriateness should be encouraged. Full article

(This article belongs to the Section Cardiogeriatrics)

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11 pages, 747 KB

Open AccessArticle

Screening for Pre-Frailty Using Phase Angle Derived from Bioelectrical Impedance Analysis in Community-Dwelling Older Adults

by Masayuki Hoshi, Tomoka Ogata, Maaya Chiguchi, Ayane Nakamaru, Tatsuya Nakanowatari, Akihiko Asao, Natsumi Kimura, Maki Ogasawara, Yuko Horikoshi, Rie Sakuraba-Hirata, Akiomi Yoshihisa, Hiroshi Hayashi, Toshimasa Sone and Yoshitaka Shiba

Geriatrics 2026, 11(2), 49; https://doi.org/10.3390/geriatrics11020049 - 20 Apr 2026

Abstract

Background/Objectives: To evaluate the utility of phase angle (PhA) derived from bioelectrical impedance analysis as a screening indicator for pre-frailty in community-dwelling older adults. Methods: This cross-sectional study included 171 participants (36 men and 135 women) in Japan in 2023. PhA at 50 [...] Read more.

Background/Objectives: To evaluate the utility of phase angle (PhA) derived from bioelectrical impedance analysis as a screening indicator for pre-frailty in community-dwelling older adults. Methods: This cross-sectional study included 171 participants (36 men and 135 women) in Japan in 2023. PhA at 50 kHz was measured using bioelectrical impedance analysis and evaluated as a potential screening indicator for pre-frailty. Assessments included body composition, physical function tests (maximum walking speed, Timed Up and Go (TUG), grip strength, knee extension strength, and one-leg stance time with eyes open), cognitive function (MoCA-J), and the Motor Fitness Scale (MFS), a questionnaire assessing physical function, along with the Kihon Checklist (KCL). Frailty status was defined using KCL scores (4–7: pre-frailty; ≥8: frailty), and participants were classified into robust and pre-frail/frail groups. Results: PhA was significantly correlated with physical function measures, including grip strength (r = 0.54, p < 0.01), MFS (r = 0.36, p < 0.01), maximum walking speed (r = 0.20, p < 0.05), knee extension strength (r = 0.16, p < 0.05), and TUG (r = −0.17, p < 0.05). In women, logistic regression analysis showed that PhA was independently associated with pre-frailty (age-adjusted odds ratio: 2.38; 95% CI: 1.08–5.23; p < 0.05). ROC analysis yielded an area under the curve of 0.65 (95% CI: 0.56–0.74), indicating modest discriminative ability. Age-adjusted cutoff values of PhA were 4.19° and 4.74°, corresponding to points prioritizing sensitivity and specificity, respectively. Conclusions: PhA is associated with physical function and may serve as a simple, non-invasive indicator for identifying pre-frailty in community settings. However, given its modest discriminative ability, PhA alone may not be sufficient as a standalone screening tool and should be used in combination with other clinical indicators for clinical application. Full article

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12 pages, 472 KB

Open AccessArticle

Effects of Intraoperative Prone Versus Supine Positioning on Postoperative Delirium

by Theresa E. Hering, Maria Wittmann, Vera Guttenthaler, Robert Pflugmacher and Rudolf Hering

Geriatrics 2026, 11(2), 48; https://doi.org/10.3390/geriatrics11020048 - 19 Apr 2026

Abstract

Background: Postoperative delirium (POD) is a common complication in geriatric patients. This prospective cohort study evaluated a possible influence of intraoperative positioning on the occurrence of POD, as intraoperative prone positioning could affect cerebral perfusion. Methods: We included 760 patients of ≥60 [...] Read more.

Background: Postoperative delirium (POD) is a common complication in geriatric patients. This prospective cohort study evaluated a possible influence of intraoperative positioning on the occurrence of POD, as intraoperative prone positioning could affect cerebral perfusion. Methods: We included 760 patients of ≥60 years scheduled for elective surgery in prone or supine positions. The primary outcome was POD incidence on the first five days after surgery, assessed via 3D-Confusion Assessment Method (3-D CAM) or Confusion Assessment Method for Intensive Care Units (CAM-ICU). Preoperative assessments included the American Society of Anesthesiologists (ASA) and New York Heart Association (NYHA) classifications as well as short screenings for the cognitive (modified Montreal Cognitive Assessment (MoCA)) and self-care status of the patient. Secondary outcomes were length of hospital stay (LOS) and mortality rates. Results: Postoperative delirium rates were similar in prone and supine patients (7.6% vs. 5.5%; p = 0.31), and logistic regression analysis revealed no association of intraoperative prone positioning with POD (odds ratio 1.42 (95% CI 0.68–2.92; p = 0.342)). The overall incidence of POD was 6.1% and was associated with older age (81.5 (CI 76.2–84.8) vs. 72.0 (CI 67.0–79.0) years; p < 0.01), higher ASA and NHYA classifications, lower preoperative modified MoCA, reduced independence in self-care (p < 0.001, respectively), and longer incision-to-suture times (107.0 (CI 73.0–173.0) vs. 85.0 (CI 60.0–130.0) minutes; p < 0.01). Postoperative delirium resulted in longer LOS (14.5 (CI 9.0–27.0) vs. 7.0 (CI 4.0–9.0) days; p < 0.001), and increased mortality (13.0% vs. 1.7%; p < 0.001). Conclusions: Intraoperative prone positioning was not associated with POD in patients aged 60 years or older (OR 1.42; CI 0.68–2.92; p < 0.340), and LOS and mortality as secondary outcome parameters were also similar in patients after prone and supine surgery. Future studies assessing additional and possible confounding factors and intraoperative systemic and regional hemodynamics and oxygenation are needed to verify this result and to evaluate cerebral hypoperfusion as a possible mechanism of POD. Full article

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21 pages, 1446 KB

Open AccessReview

Constipation in Older Adults: Pathophysiology, Clinical Impact, and Management Strategies

by Shima Mimura, Asahiro Morishita, Atsuo Kitaoka, Kota Sasaki, Hiroki Tai, Rie Yano, Mai Nakahara, Kyoko Oura, Tomoko Tadokoro, Koji Fujita, Joji Tani, Takashi Himoto and Hideki Kobara

Geriatrics 2026, 11(2), 47; https://doi.org/10.3390/geriatrics11020047 - 16 Apr 2026

Abstract

Background/Objectives: Constipation is a common gastrointestinal problem in older adults and is associated with reduced quality of life, functional decline, frailty, and an increased risk of delirium and cognitive impairment. Its pathogenesis is multifactorial, involving age-related changes in gastrointestinal motility, neural regulation, comorbidities, [...] Read more.

Background/Objectives: Constipation is a common gastrointestinal problem in older adults and is associated with reduced quality of life, functional decline, frailty, and an increased risk of delirium and cognitive impairment. Its pathogenesis is multifactorial, involving age-related changes in gastrointestinal motility, neural regulation, comorbidities, and polypharmacy. However, this condition has traditionally been regarded as a localized gastrointestinal disorder, which may not fully reflect its systemic clinical significance in older populations. While prior narrative reviews have described multifactorial contributors to constipation, none have formally applied a geriatric syndrome framework to integrate these dimensions. This review proposes a three-criterion operational definition—multifactorial pathogenesis, association with functional decline and frailty, and contribution to adverse systemic outcomes—to characterize constipation in older adults as a “systemic geriatric syndrome,” and evaluates available evidence against each criterion. Methods: A narrative literature search was conducted using PubMed to identify relevant studies published between 1 January 2023, and 31 December 2025. MeSH terms included “Constipation” [Major Topic] and “Aged” [MeSH Terms]. Eligible articles included English-language original studies, systematic reviews, and clinical or epidemiological studies involving individuals aged ≥65 years. Results: Diagnosis in older adults is often complicated by secondary causes, including medications and neurological disorders, as well as atypical symptom presentations in individuals with cognitive impairment. Key pathophysiological mechanisms include reductions in interstitial cells of Cajal, impaired smooth muscle contractility, dysfunction of the enteric and autonomic nervous systems, and gut microbiota dysbiosis, which may promote chronic low-grade inflammation. Major contributing factors include physical inactivity, sarcopenia, dehydration, inappropriate defecation posture, and polypharmacy, particularly opioids and anticholinergic agents. Importantly, these factors interact through the brain–gut–microbiota axis, contributing not only to gastrointestinal dysfunction but also to systemic outcomes such as frailty, cognitive decline, and increased healthcare burden, thereby supporting a multidimensional disease framework. Conclusions: The available evidence collectively supports the plausibility of framing constipation in older adults as a systemic geriatric syndrome, though formal validation of this classification requires further longitudinal and mechanistic research. Comprehensive and individualized management strategies, extending beyond simple laxative use, are essential to reduce complications and preserve functional health in aging populations. Further studies are required to validate this framework. Full article

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11 pages, 347 KB

Open AccessArticle

Clinical Utility of Gait Speed Indices for Identifying Sarcopenia in Older Adults with Type 2 Diabetes

by Kensaku Kashima, Rie Nishimura, Hisashi Sugano and Shimpei Fujimoto

Geriatrics 2026, 11(2), 46; https://doi.org/10.3390/geriatrics11020046 - 14 Apr 2026

Abstract

Background/Objectives: This study aimed to compare the diagnostic performance of usual gait speed (UGS), maximal gait speed (MGS), and gait speed reserve (GSR) for identifying sarcopenia in older adults with type 2 diabetes (T2D), and to examine whether combining gait indices improves [...] Read more.

Background/Objectives: This study aimed to compare the diagnostic performance of usual gait speed (UGS), maximal gait speed (MGS), and gait speed reserve (GSR) for identifying sarcopenia in older adults with type 2 diabetes (T2D), and to examine whether combining gait indices improves diagnostic performance. Methods: This cross-sectional study included 117 older adults with T2D hospitalized for glycemic control. UGS and MGS were measured in the central 10-m section of a 16-m course, which included 3-m acceleration and deceleration zones on either side. GSR was calculated as the difference between MGS and UGS. Sarcopenia was diagnosed according to the AWGS 2025 criteria. Multivariable logistic regression was used to examine the associations between each gait index and sarcopenia. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis, and the usefulness of a combined criterion based on UGS and GSR was also assessed. Results: Sarcopenia was identified in 32 participants (27.4%). UGS, MGS, and GSR were each associated with sarcopenia independently of clinical factors. UGS showed the highest sensitivity (90.6%), suggesting its potential usefulness as a screening measure, whereas GSR showed the highest specificity (83.5%), suggesting its potential usefulness in reducing false positives when identifying sarcopenia. In the ROC analysis of the three gait-related indices, the area under the curve (AUC) for MGS was the highest (0.79), but it was not significantly different from the AUC for UGS. The combined criterion of UGS < 1.07 m/s and GSR < 0.21 m/s improved specificity and yielded a high positive likelihood ratio (PLR = 6.5). Conclusions: UGS, MGS, and GSR each exhibit distinct diagnostic characteristics for sarcopenia. UGS may be useful for screening, whereas GSR may help improve specificity. In particular, combining UGS and GSR may provide complementary diagnostic information for identifying sarcopenia in older adults with T2D. Full article

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29 pages, 4117 KB

Open AccessReview

Cognitive Testing in Spanish Older Adults: A Scoping Review

by Lucía Sáez-González, Luis A. Martínez, Gema Blázquez-Abellán, José Antonio Carbajal de Lara, Rosa M. Martinez-Garcia and Lucía Castro-Vázquez

Geriatrics 2026, 11(2), 45; https://doi.org/10.3390/geriatrics11020045 - 10 Apr 2026

Abstract

Background/Objectives: Cognitive impairment is a major concern in aging populations. Early detection through validated neuropsychological tests is essential for dementia risk stratification and preventive interventions. This scoping review (PRISMA-ScR, 2013–2023, registration protocol: 10.17605/OSF.IO/8NHJF) evaluated cognitive testing trends in aging research and identified the [...] Read more.

Background/Objectives: Cognitive impairment is a major concern in aging populations. Early detection through validated neuropsychological tests is essential for dementia risk stratification and preventive interventions. This scoping review (PRISMA-ScR, 2013–2023, registration protocol: 10.17605/OSF.IO/8NHJF) evaluated cognitive testing trends in aging research and identified the most frequently used neuropsychological screening tests in Spanish populations. Methods: Searches in PubMed and Web of Science (March 2024) yielded 730 records; 156 were reviewed in full, and 15 met inclusion criteria for Spanish adults ≥65 years. Results: The Mini-Mental State Examination was the most-used test, followed by verbal fluency and Trail Making Test. No test covered all six DSM-5 cognitive domains, and social cognition was never assessed in any of the studies. The Montreal Cognitive Assessment was underused despite its superior sensitivity. Conclusions: Findings support developing a tailored, multidomain battery combining global and domain-specific tests. Social cognition assessments should be included to ensure a complete cognitive domain coverage. Full article

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

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