Geriatrics

10 pages, 344 KiB

Open AccessArticle

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

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

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

Abstract

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

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

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12 pages, 547 KiB

Open AccessArticle

Home Caregivers of Elderly People: Perceptions and Quality of Life

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

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

Abstract

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

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

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15 pages, 468 KiB

Open AccessArticle

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

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

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

Abstract

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

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

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20 pages, 480 KiB

Open AccessArticle

An Optimal Beneficiary Profile to Ensure Focused Interventions for Older Adults

by Dorina-Claudia Bălan, Rozeta Drăghici, Ioana Găiculescu, Alexandra Rusu, Andrada-Elena Stan and Polixenia Stan

Geriatrics 2025, 10(2), 59; https://doi.org/10.3390/geriatrics10020059 - 14 Apr 2025

Abstract

Background: Aging is a lifelong process, and many chronic diseases and geriatric syndromes are influenced by lifestyle factors. For active aging and maintaining functional capacity facilitate health, there are essential aspects in geriatric care. Our objective was to create a specific profile focusing [...] Read more.

Background: Aging is a lifelong process, and many chronic diseases and geriatric syndromes are influenced by lifestyle factors. For active aging and maintaining functional capacity facilitate health, there are essential aspects in geriatric care. Our objective was to create a specific profile focusing on the characteristics of a possible optimal beneficiary of a newly developed program that is meant to increase the social inclusion and participation in social life of older adults. Methods: The profile was built based on a mixed design, a quantitative and qualitative analysis that identified the typology of an optimal beneficiary of a newly developed yoga program. The quantitative analysis (50 subjects from NIGG “Ana Aslan” Bucharest) identified the main predictors impacting subjects’ willingness to participate in a yoga program based on their pathologies at a mental and/or physical level. The main materials used for this were the Clinical Assessment Scales for the Elderly (CASE-SF) and the Quality-of-Life Assessment Questionnaire (WHOQOL-BREF). The qualitative analysis consisted of four focus groups (10 subjects from NIGG “Ana Aslan” and 7 subjects from GNSPY), aiming to provide the in-depth reasons for participating in a yoga program. Results: The results showed that a diagnosed physical impairment was correlated with an increased willingness to participate in yoga classes, while a mental pathology was associated with a decreased willingness to participate in such a program. Five main themes emerged from the qualitative analysis. Conclusions: The profile provides answers related to the specifics of the beneficiary based on their motivation, limits, and personality traits. Full article

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18 pages, 474 KiB

Open AccessArticle

Culturally Tailored Community Brain Health Education for Chinese Americans Aged 50 or Above: A Mixed-Methods Open Pilot Study

by Kaipeng Wang, Fei Sun, Peiyuan Zhang, Carson M. De Fries, Xiaoyouxiang Li, Jie Zhu and My Ngoc To

Geriatrics 2025, 10(2), 58; https://doi.org/10.3390/geriatrics10020058 - 14 Apr 2025

Abstract

Background: Chinese Americans, the largest Asian American subgroup in the U.S., face linguistic, cultural, and socio-economic barriers to dementia prevention. To promote brain health in this population, a culturally tailored community approach is essential. This study evaluates a culturally tailored community brain health [...] Read more.

Background: Chinese Americans, the largest Asian American subgroup in the U.S., face linguistic, cultural, and socio-economic barriers to dementia prevention. To promote brain health in this population, a culturally tailored community approach is essential. This study evaluates a culturally tailored community brain health education program to enhance brain health knowledge and motivate lifestyle changes to prevent the risk of dementia among Chinese Americans aged 50 or older. Methods: The program was developed and evaluated in four phases. First, we assessed participants’ interests in brain health topics, availability, and preferred delivery modes. Next, experts on the identified topics developed educational content and outcome assessments. The third phase focused on implementing a six-session program covering general knowledge about Alzheimer’s disease and related dementias, diet, sleep, physical exercise, health checks, and mindfulness. Finally, we evaluated the program’s feasibility and effectiveness using pre–post surveys, feedback questionnaires, and focus groups. Results: Seventy-seven participants registered for the program, and sixty-nine (90%) attended at least four sessions. The quantitative results, based on paired t-tests, showed significant increases in brain health knowledge, sleep quality, and behavioral motivation for lifestyle changes, and a decrease in depressive symptoms, with two-tailed p-values lower than 0.05. The qualitative results further revealed promising feasibility and acceptability, as well as the perceived benefits of the program. Conclusions: The findings highlight the feasibility, acceptability, and potential effectiveness of a culturally tailored community education approach for promoting brain health and lifestyle changes. Sustained community outreach and education efforts among Chinese Americans are needed. Full article

(This article belongs to the Section Healthy Aging)

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11 pages, 365 KiB

Open AccessArticle

The Influence of Frailty on Pharmacotherapy Adherence and Adverse Drug Reactions in Older Psychiatric Patients

by Tuan Anh Phan and Rob Kok

Geriatrics 2025, 10(2), 57; https://doi.org/10.3390/geriatrics10020057 - 7 Apr 2025

Abstract

Aim/Objectives: To investigate whether frailty predicts adherence to psychotropic drug treatment or adverse drug reactions, within 6 months after treatment initiation. Methods: A prospective cohort study including 77 patients over the age of 65, treated in one large psychiatric institute in [...] Read more.

Aim/Objectives: To investigate whether frailty predicts adherence to psychotropic drug treatment or adverse drug reactions, within 6 months after treatment initiation. Methods: A prospective cohort study including 77 patients over the age of 65, treated in one large psychiatric institute in the Netherlands. Patients were assessed at baseline for their frailty status, using different operationalizations of the Fried frailty criteria. Data on duration of psychotropic drug treatment and number of reported adverse drug reactions were retrieved from electronic patient files. Regression analyses were adjusted for age, sex, patient setting, and polypharmacy as potential confounders. Results: Frail patients were not significantly more likely to discontinue psychotropic treatment than non-frail patients (OR = 1.4; 95% CI 0.6–3.7, p = 0.468). Time to treatment discontinuation was also not statistically different between both study groups (HR = 0.8; 95% CI 0.4–1.6, p = 0.498), and neither was the number of adverse drug reactions (OR = 1.6, 95% CI 0.6–4.1, p = 0.345). Conclusions: We could not demonstrate a statistically significant effect of frailty as predictor of discontinuing psychotropic treatment or adverse drug reactions, but a lack of power may also explain our results. A more comprehensive frailty assessment may be needed to predict treatment adherence or adverse drug reactions in psychiatric patients. Full article

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

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16 pages, 1377 KiB

Open AccessArticle

Impact of Rehabilitation Intervention for Cancer Patients with Spinal Bone Metastasis: Psychosocial and Clinical Outcomes

by Noémi Németh, Lavinia Davidescu, Liviu Lazăr, Florica Voiță-Mekeres, Mariana Racoviță and Călin Tudor Hozan

Geriatrics 2025, 10(2), 56; https://doi.org/10.3390/geriatrics10020056 - 7 Apr 2025

Abstract

Background/Objectives: Cancer remains a significant global health issue in the 21st century, accounting for 16.8% of all deaths and 22.8% of noncommunicable disease (NCD) deaths globally. This study investigated the impact of a novel integrated rehabilitation intervention on clinical and psychosocial outcomes in [...] Read more.

Background/Objectives: Cancer remains a significant global health issue in the 21st century, accounting for 16.8% of all deaths and 22.8% of noncommunicable disease (NCD) deaths globally. This study investigated the impact of a novel integrated rehabilitation intervention on clinical and psychosocial outcomes in cancer patients with vertebral metastasis. Methods: The three-year study included newly diagnosed oncological patients or those undergoing treatment, aged 18 years or older, with vertebral metastasis and spinal pain. The intervention was tailored to each patient based on mental and functional reserves, risk of vertebral fractures, physical reserves, fatigue, and ongoing oncological therapy. Results: The control and experimental groups were compared in terms of baseline characteristics, physical activity, tumor characteristics, pain, sphincter disorders, complications, survival, functional scores, and coping mechanisms. The experimental group demonstrated significantly better outcomes, including longer mean survival time (3.5 vs. 2.8 years, p < 0.001), higher Barthel Total Score (60.7 vs. 40.8, p = 0.002), and lower prevalence of fractures (20.0% vs. 55.4%, p < 0.001), osteoporosis (17.0% vs. 37.0%, p = 0.001), anemia (22.2% vs. 57.4%, p < 0.001), and vomiting (6.1% vs. 54.5%, p < 0.001). The experimental group also exhibited a lower reliance on avoidant coping strategies (29.0 vs. 31.3, p < 0.001). Conclusions: The study provides robust evidence that a personalized rehabilitation intervention significantly improves survival, functional independence, and coping strategies in cancer patients with spinal bone metastasis. Full article

(This article belongs to the Section Geriatric Oncology)

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25 pages, 1432 KiB

Open AccessArticle

Development of an Adult Daycare Center Service Model for the Elderly Through Community Participation: An Action Research Approach

by Benjayamas Pilayon, Kanin Chueaduangpui, Juthaluck Saentho, Ruchakron Kongmant and Niruwan Turnbull

Geriatrics 2025, 10(2), 55; https://doi.org/10.3390/geriatrics10020055 - 4 Apr 2025

Abstract

Introduction: This study aimed to develop a service model for daycare centers for the elderly through community participation using participatory action research methods. The objectives were threefold: (1) to investigate the current situation of the elderly in the community and their needs [...] Read more.

Introduction: This study aimed to develop a service model for daycare centers for the elderly through community participation using participatory action research methods. The objectives were threefold: (1) to investigate the current situation of the elderly in the community and their needs for daycare center services, (2) to develop a daycare center for the elderly with active community involvement, and (3) to evaluate the effectiveness of the service delivery at the daycare center for the elderly. Methods: The study was conducted in Ban Kho Subdistrict, Phon Sawan District, Nakhon Phanom Province. Research participants included 210 elderly individuals surveyed to assess their situation, and 15 key informants, including elderly club leaders, subdistrict health promotion hospital staff, volunteers, subdistrict administrative organization officers, and village health volunteers, were specifically selected for in-depth insights. The research process was structured into three phases: Phase 1 focused on studying the situation of the elderly in the community and their service needs; Phase 2 was dedicated to developing the daycare center with community participation; and Phase 3 involved evaluating the service delivery of the daycare center. Results: The results indicated that the development process of the daycare center service model for the elderly, through community participation, involved four key mechanisms: elderly clubs, subdistrict health promotion hospitals, volunteer teachers or technicians, and village volunteers. Additionally, the supporting mechanisms included academic institutions, hospitals, temples, village heads, the Non-Formal Education Center, foundations, and the subdistrict administrative organization. The comprehensive service model encompassed five components: health, social, psychological, economic, and environmental aspects. Conclusions: The study successfully developed a daycare center service model for the elderly through community participation, which can be expanded and adapted to other semi-urban and semi-rural contexts. This model demonstrates the importance of community involvement in providing holistic care for the elderly, addressing various aspects of their well-being. Full article

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

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14 pages, 439 KiB

Open AccessArticle

Factors Associated with Mortality and Short-Term Patient Outcomes for Hip Fracture Repair in the Elderly Based on Preoperative Anticoagulation Status

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

Geriatrics 2025, 10(2), 54; https://doi.org/10.3390/geriatrics10020054 - 4 Apr 2025

Abstract

Background: The one-year mortality risk for elderly patients undergoing proximal femur fracture repair surgery is three to four times higher compared to the general population. Other than time to surgery, risk factors for postoperative morbidity and mortality following surgery are poorly understood in [...] Read more.

Background: The one-year mortality risk for elderly patients undergoing proximal femur fracture repair surgery is three to four times higher compared to the general population. Other than time to surgery, risk factors for postoperative morbidity and mortality following surgery are poorly understood in the elderly. We sought to identify risk factors associated with morbidity and mortality in geriatric patients by anticoagulation status undergoing hip fracture repair. Methods: Patients aged ≥65 years undergoing surgery for hip fracture repair were included (2009–2019) from a US-based hip fracture registry. Factors associated with 90-day mortality were determined using multivariable logistic regression and stratified by antithrombotic agent medication use prior to surgery. Direct oral anticoagulation (DOAC) medications were the largest group, and all antithrombotic agents were included in the delineation. Results: A total of 35,463 patients were identified, and 87.1% (N = 30,902) were DOAC-naïve. Risk factors for 90-day mortality in DOAC-naïve patients were an American Society of Anesthesiologist’s (ASA) classification ≥3 (odds ratio [OR] = 2.56, 95% confidence interval [CI] = 2.24–2.93), preoperative myocardial infarction (OR = 1.87, 95% CI = 1.33–2.64), male gender (OR = 1.73, 95% CI = 1.59–1.88), congestive heart failure (CHF) (OR = 1.64, 95% CI = 1.50–1.80), psychoses (OR = 1.27, 95% CI = 1.15–1.42), renal failure (OR = 1.29, 95% CI = 1.19–1.40), smoking history (OR = 1.19, 95% CI = 1.09–1.29), chronic pulmonary disease (OR = 1.14, 95% CI = 1.05–1.25), increasing age (OR = 1.07, 95% CI = 1.06–1.07), and decreasing body mass index (BMI) (OR = 1.06, 95% CI = 1.05–1.08). Identified factors for mortality in the DOAC group also included ASA classification ≥3 (OR = 2.15, 95% CI = 1.44–3.20), male gender (OR = 1.68, 95% CI = 1.41–2.01), CHF (OR = 1.45, 95% CI = 1.22–1.73), chronic pulmonary disease (OR = 1.34, 95% CI = 1.12–1.61), decreasing BMI (OR = 1.04, 95% CI = 1.02–1.06), and increasing age (OR = 1.02, 95% CI = 1.01–1.03). Conclusions: Regardless of preoperative DOAC status, ASA classification, gender, CHF, chronic pulmonary disease, lower BMI, and higher age are associated with an increased risk of mortality. Some of these comorbidities can be utilized for risk stratification prior to surgery. Full article

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15 pages, 470 KiB

Open AccessReview

Implementation of Instrumental Assessment to Assess Dysphagia in Older Adults Receiving Long-Term Care Services: A Scoping Review

by Alvis Ki-Fung Kan, Elaine Kwong, Michael Siu-Wai Chan and Phoebe Tsz-Ching Shek

Geriatrics 2025, 10(2), 53; https://doi.org/10.3390/geriatrics10020053 - 3 Apr 2025

Abstract

Background/Objectives: Dysphagia, a prevalent condition among older adults, poses significant health risks if not accurately assessed and managed. Instrumental assessments (IAs) like videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES) allow detailed examinations of swallowing physiology but are underutilized in [...] Read more.

Background/Objectives: Dysphagia, a prevalent condition among older adults, poses significant health risks if not accurately assessed and managed. Instrumental assessments (IAs) like videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES) allow detailed examinations of swallowing physiology but are underutilized in long-term care settings due to logistical challenges. This study aims to explore the current practice patterns, stakeholder perspectives, and barriers to and facilitators of IA implementation in these settings. Methods: A scoping review was conducted following the PRISMA-ScR guidelines, analyzing the literature from databases including CINAHL Complete, EMBASE, MEDLINE, and SCOPUS. A total of 1339 articles were identified. After the removal of 332 duplications, 1007 articles were screened, with four meeting the inclusion criteria for describing IA implementation or stakeholder perspectives in community-based long-term care settings for older adults. Results: This review identified significant underutilization of IA in long-term care settings, primarily due to logistical barriers and transportation issues. Stakeholders, particularly speech–language pathologists (SLPs), acknowledged the benefits of IA in improving dysphagia management but encountered challenges in accessing these assessments. Mobile FEES (mFEES) emerged as a promising solution, offering on-site assessments that could enhance the accuracy and timeliness of dysphagia care. Conclusions: While IA is crucial for effective dysphagia management in older adults, its implementation in long-term care settings is hindered by various barriers. mFEES presents a viable solution to improve IA accessibility and representativeness. Further research is warranted to develop context-specific implementation strategies and to explore the perspectives of all stakeholders involved in dysphagia care. Full article

(This article belongs to the Section Dysphagia)

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16 pages, 262 KiB

Open AccessArticle

The Role of Inflammatory Sarcopenia in Increasing Fall Risk in Older Adults: Exploring the Impact on Mobility-Impaired and Immunocompromised Patients

by Marc-Dan Blajovan, Simona-Alina Abu-Awwad, Mirela-Cleopatra Tomescu, Cristina Tudoran, Daniela Gurgus, Anca Dinu and Ahmed Abu-Awwad

Geriatrics 2025, 10(2), 52; https://doi.org/10.3390/geriatrics10020052 - 1 Apr 2025

Cited by 1

Abstract

Background/Objectives: Inflammatory sarcopenia, characterized by muscle weakness exacerbated by chronic systemic inflammation, has emerged as a critical factor in fall risk among older adults. While previous studies have examined sarcopenia and inflammation independently, few have investigated their combined impact on mobility impairments [...] Read more.

Background/Objectives: Inflammatory sarcopenia, characterized by muscle weakness exacerbated by chronic systemic inflammation, has emerged as a critical factor in fall risk among older adults. While previous studies have examined sarcopenia and inflammation independently, few have investigated their combined impact on mobility impairments and fall susceptibility, particularly in immunocompromised individuals. This study aimed to assess the role of inflammatory sarcopenia in increasing fall risk by comparing functional performance, muscle strength, and inflammatory biomarkers across three groups: healthy older adults, individuals with non-inflammatory sarcopenia, and those with inflammatory sarcopenia. A secondary objective was to evaluate fall incidence in immunocompromised versus non-immunocompromised individuals. Methods: A prospective observational study was conducted on 250 adults aged ≥65 years, categorized based on inflammatory status and muscle health. Functional assessments included handgrip strength, the Timed Up and Go (TUG) test, and fall frequency analysis. Inflammatory status was determined by measuring C-reactive protein (CRP) and interleukin-6 (IL-6) levels. Multivariate regression models were used to identify predictors of fall risk. Results: Participants with inflammatory sarcopenia exhibited significantly higher CRP and IL-6 levels, greater muscle weakness, poorer mobility performance, and a fourfold increase in fall incidence compared to controls (p < 0.001). Immunocompromised individuals had nearly double the fall risk of their non-immunocompromised counterparts (p < 0.001). TUG test performance was the strongest fall predictor. Conclusions: Our findings highlight the importance of integrating fall prevention strategies that not only focus on muscle-strengthening programs but also include regular screening for inflammatory markers. Given the strong association between systemic inflammation, muscle weakness, and fall risk, identifying and managing chronic inflammation may play a crucial role in reducing mobility impairments and improving outcomes in older adults. Full article

16 pages, 1322 KiB

Open AccessArticle

Implications of Intra-Individual Variability in Motor Performance on Functional Mobility in Stroke Survivors

by Neha Lodha, Prakruti Patel, Evangelos A. Christou, Anjali Tiwari and Manfred Diehl

Geriatrics 2025, 10(2), 51; https://doi.org/10.3390/geriatrics10020051 - 24 Mar 2025

Abstract

Background: Motor impairments following stroke contribute to deficits in functional mobility. Traditionally, these impairments are quantified by mean-level motor performance. However, this mean-level approach neglects the well-established fact that motor performance becomes highly variable in aging and disease. Increased intra-individual variability (IIV) in [...] Read more.

Background: Motor impairments following stroke contribute to deficits in functional mobility. Traditionally, these impairments are quantified by mean-level motor performance. However, this mean-level approach neglects the well-established fact that motor performance becomes highly variable in aging and disease. Increased intra-individual variability (IIV) in behavior predicts functional decline in neurological disorders. Despite this, the impact of stroke on IIV in motor performance and its influence on functional mobility has not been investigated. This study aimed to (1) quantify the impact of stroke on IIV in motor performance, and (2) determine the contribution of IIV and mean motor performance to functional mobility. Methods: Twenty stroke survivors and 20 age-matched controls performed a goal-directed ankle movement task over 30 trials. We measured average accuracy (mean endpoint error) and IIV (within-person SD of endpoint error). Functional mobility was assessed with postural control (sway area during quiet standing) and braking response time in a driving simulator. Results: Stroke participants showed a higher mean (p = 0.04) and greater IIV (p = 0.016) in endpoint error than controls. Sway area did not differ between groups (p = 0.24), but stroke survivors had increased braking response time (p = 0.016). In stroke survivors, IIV significantly predicted sway area (R² = 0.33, p = 0.008) and braking response time (R² = 0.27, p = 0.02), and mean error did not account for any additional variance. Conclusions: Stroke reduces the trial-to-trial consistency of executing motor tasks with precision. IIV in motor performance predicts postural balance and braking response time and can potentially serve as an indicator of increased vulnerability and an important target for stroke rehabilitation. Full article

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

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11 pages, 1168 KiB

Open AccessReview

Rhinitis in the Geriatric Population: Epidemiological and Cytological Aspects

by Matteo Gelardi, Rossana Giancaspro, Elisa Boni, Mario Di Gioacchino, Giulia Cintoli, Michele Cassano and Maria Teresa Ventura

Geriatrics 2025, 10(2), 50; https://doi.org/10.3390/geriatrics10020050 - 20 Mar 2025

Abstract

Allergic rhinitis (AR), traditionally considered as a childhood condition, is increasingly recognized among older adults, driven by rising life expectancy and environmental factors. Although allergic sensitization declines with age, AR prevalence in the elderly is underestimated, with 3–12% of geriatric patients affected. Diagnosis [...] Read more.

Allergic rhinitis (AR), traditionally considered as a childhood condition, is increasingly recognized among older adults, driven by rising life expectancy and environmental factors. Although allergic sensitization declines with age, AR prevalence in the elderly is underestimated, with 3–12% of geriatric patients affected. Diagnosis is challenging due to nonspecific symptoms and overlapping conditions, leading to underdiagnosis and inadequate treatment. AR significantly impacts the quality of life (QoL), often exacerbating respiratory comorbidities like asthma and COPD. Presbynasalis, encompassing age-related sinonasal changes, includes reduced allergic responses, increased chronic rhinosinusitis, altered nasal structure, and impaired mucociliary clearance. Non-allergic rhinitis, atrophic rhinitis, and overlapping rhinitis further complicate AR diagnosis in the elderly. Effective management involves personalized pharmacotherapy, allergen-specific immunotherapy (AIT), and addressing comorbidities and polypharmacy risks. Despite safety concerns, recent studies demonstrate AIT efficacy in elderly patients, reducing symptoms and medication use. Given AR’s impact on cognitive and respiratory health, accurate diagnosis and treatment can enhance QoL and mitigate health decline. Greater awareness and further research are essential to understand AR prevalence and improve outcomes for geriatric patients. Full article

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13 pages, 1559 KiB

Open AccessArticle

Evaluation of Convolutional Neural Network-Based Posture Identification Model of Older Adults: From Silhouette of Sagittal Photographs

by Naoki Sugiyama, Yoshihiro Kai, Hitoshi Koda, Toru Morihara and Noriyuki Kida

Geriatrics 2025, 10(2), 49; https://doi.org/10.3390/geriatrics10020049 - 19 Mar 2025

Abstract

Background/Objectives: Posture is a significant indicator of health status in older adults. This study aimed to develop an automatic posture assessment tool based on sagittal photographs by validating recognition models using convolutional neural networks. Methods: A total of 9140 images were [...] Read more.

Background/Objectives: Posture is a significant indicator of health status in older adults. This study aimed to develop an automatic posture assessment tool based on sagittal photographs by validating recognition models using convolutional neural networks. Methods: A total of 9140 images were collected with data augmentation, and each image was labeled as either Ideal or Non-Ideal posture by physical therapists. The hidden and output layers of the models remained unchanged, while the loss function and optimizer were varied to construct four different model configurations: mean squared error and Adam (MSE & Adam), mean squared error and stochastic gradient descent (MSE & SGD), binary cross-entropy and Adam (BCE & Adam), and binary cross-entropy and stochastic gradient descent (BCE & SGD). Results: All four models demonstrated an improved accuracy in both the training and validation phases. However, the two BCE models exhibited divergence in validation loss, suggesting overfitting. Conversely, the two MSE models showed stability during learning. Therefore, we focused on the MSE models and evaluated their reliability using sensitivity, specificity, and Prevalence-Adjusted Bias-Adjusted Kappa (PABAK) based on the model’s output and correct label. Sensitivity and specificity were 85% and 84% for MSE & Adam and 67% and 77% for MSE & SGD, respectively. Moreover, PABAK values for agreement with the correct label were 0.69 and 0.43 for MSE & Adam and MSE & SGD, respectively. Conclusions: Our findings indicate that the MSE & Adam model, in particular, can serve as a useful tool for screening inspections. Full article

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17 pages, 793 KiB

Open AccessReview

Comprehensive Geriatric Health Assessment Core Competencies and Skills for Primary Care Nurses: A Scoping Review

by Ioanna Dimitriadou, Eloranta Sini, Jekaterina Šteinmiller, Maria Saridi, Anna Lundberg, Magdalena Häger, Ingibjorg Hjaltadottir, Sigrun S. Skuladottir, Nina Korsström, Susanna Mört, Hannele Tuori and Evangelos C. Fradelos

Geriatrics 2025, 10(2), 48; https://doi.org/10.3390/geriatrics10020048 - 18 Mar 2025

Abstract

Objective: This scoping review aims to explore and synthesize the core competencies and skills required for primary care nurses conducting comprehensive geriatric assessments. Comprehensive geriatric assessments have become integral to providing holistic, patient-centered care for older adults with complex health needs, but the [...] Read more.

Objective: This scoping review aims to explore and synthesize the core competencies and skills required for primary care nurses conducting comprehensive geriatric assessments. Comprehensive geriatric assessments have become integral to providing holistic, patient-centered care for older adults with complex health needs, but the specific competencies required in primary care remain underresearched. Design: The review followed Arksey and O’Malley’s five-stage scoping review framework, incorporating studies from PubMed, CINAHL, EMBASE, and the Cochrane Library. A comprehensive search was conducted from May 2014 to May 2024, and a population–concept–context (PCC) framework was used to identify relevant studies. Results: Nineteen studies met the inclusion criteria, revealing six key competency domains for nurses involved in comprehensive geriatric assessments: Clinical Assessment and Diagnostic Competencies, Care Planning and Coordination, Professional and Interpersonal Competencies, Environmental and Systemic Competencies, Technical and Procedural Competencies, and Quality Improvement and Evidence-Based Practice. These competencies are essential for providing high-quality care to older adults and supporting integrated, multidisciplinary approaches to geriatric care. Conclusions: The identified competency domains provide a structured framework that can enhance primary care nurses’ ability to deliver more effective, individualized, and coordinated care to older adults. However, the standardization of these competencies remains crucial for ensuring consistency in practice. Full article

(This article belongs to the Section Geriatric Public Health)

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9 pages, 212 KiB

Open AccessArticle

Establishment of a Mandarin Chinese Version of the Oral Frailty Index-8 and Exploration of the Association Between Oral Frailty and Sarcopenia

by Chen-Cheng Yang, Hsiang-Tai Chen, Katsuya Iijima, Tomoki Tanaka, Chia-Yen Dai, Sang-Ju Yu and Hung-Yi Chuang

Geriatrics 2025, 10(2), 47; https://doi.org/10.3390/geriatrics10020047 - 17 Mar 2025

Abstract

Objective: The aim of our study was to introduce a Mandarin Chinese version of the oral frailty assessment and explore the relationship between oral frailty and sarcopenia. A total of 409 elders (171 male, 238 female) participated in surveys using the Mandarin Chinese [...] Read more.

Objective: The aim of our study was to introduce a Mandarin Chinese version of the oral frailty assessment and explore the relationship between oral frailty and sarcopenia. A total of 409 elders (171 male, 238 female) participated in surveys using the Mandarin Chinese version of the Oral Frailty Index-8 (OFI-8) in Kaohsiung, Taiwan. Method: The translation of the Mandarin Chinese version of OFI-8 adhered to the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) reporting guidelines. The eight-item questionnaire assessed tooth status, oral function, and other subjective measures. Additionally, sarcopenia was evaluated using the SARC-F questionnaire. Result: Among the participants, 195 participants were classified as non-oral frailty and 214 participants were oral frailty. Significant differences were observed in age, gender, body mass index (BMI), education level, and scores on the SARC-F questionnaire between the non-oral frailty and oral frailty populations. In logistic regression model, oral frailty showed a significant and positive association with the SARC-F score (adjusted odds ratio 2.130, 95% confidence interval 1.580–2.872, p-value < 0.001), even after adjusting for age, gender, BMI, and education level. Conclusion: This study has developed a valuable Mandarin Chinese version of the oral frailty screening questionnaire, the OFI-8. Oral frailty is significantly and positively associated with a higher risk of sarcopenia, particularly among the elderly, males, and those with lower education levels. This measure proves to be practical for assessing oral health status in the Chinese community, promoting oral frailty research within the Mandarin Chinese population, and addressing the challenges associated with defining oral frailty in future studies. Full article

(This article belongs to the Topic One Health Approach in Global Health and Clinical Medicine)

12 pages, 582 KiB

Open AccessArticle

Impact of an Interprofessional Collaboration Between Physicians and Pharmacists on Fall-Risk-Increasing Drugs in Older Patients with Trauma in the Emergency Department

by Benjamin J. Hellinger, André Gries, Thilo Bertsche and Yvonne Remane

Geriatrics 2025, 10(2), 46; https://doi.org/10.3390/geriatrics10020046 - 17 Mar 2025

Abstract

Background/Objectives: In older patients, falls constitute a significant public health concern and a major cause of hospital admission. Fall-risk-increasing drugs (FRIDs) represent a key risk factor for falls. Therefore, modifying these drugs represents an important strategy for preventing recurrent falls and further [...] Read more.

Background/Objectives: In older patients, falls constitute a significant public health concern and a major cause of hospital admission. Fall-risk-increasing drugs (FRIDs) represent a key risk factor for falls. Therefore, modifying these drugs represents an important strategy for preventing recurrent falls and further patient harm. The objective of this study was to evaluate a structured interprofessional collaboration between physicians and pharmacists on managing FRIDs in older patients who present to the emergency department (ED) after a fall. Methods: This study was performed in the ED of a tertiary care hospital. Patients who were >65 years old and presented to the ED after a fall were included. A routine care group was included between 1 March 2020 and 31 May 2020. A pharmaceutical care group was included between 1 September 2023 and 30 November 2023. In the pharmaceutical care group, a clinical pharmacist supported the physicians in identifying and managing FRIDs. Possible solutions for improving FRID prescription were discussed interprofessionally. The number of FRIDs at ED admission and discharge, as well as the number of FRID modifications, were evaluated. Results: A total of 107 patients were enrolled in each group. There were 85 patients in the routine care group and 89 patients in the pharmaceutical care group, with at least 1 FRID prescribed at ED admission (p = 0.483). At ED discharge, there were 85 patients in the routine care group and 68 patients in the pharmaceutical care group, with at least 1 FRID prescribed at (p = 0.010). There were seven FRID modifications in the routine care group compared to 125 FRID modifications in the pharmaceutical care group. Conclusions: In this study, the interprofessional collaboration between physicians and pharmacists led to a reduced number of FRIDs being prescribed and more FRID modifications in older patients at ED discharge. Further research is required to ascertain the feasibility of integrating this single intervention into a multifactorial fall prevention program. Full article

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25 pages, 2639 KiB

Open AccessArticle

by Yusuke Shizuka, Shin Murata, Akio Goda, Shun Sawai, Shoya Fujikawa, Ryosuke Yamamoto, Takayuki Maru, Kotaro Nakagawa and Hideki Nakano

Geriatrics 2025, 10(2), 45; https://doi.org/10.3390/geriatrics10020045 - 17 Mar 2025

Abstract

Background/Objectives: The steady increase in the global older adult population highlights critical challenges, including the development of preventive strategies to extend healthy life expectancy and support independence in activities of daily living. Although there is an aging-related reduction in manual dexterity, the difference [...] Read more.

Background/Objectives: The steady increase in the global older adult population highlights critical challenges, including the development of preventive strategies to extend healthy life expectancy and support independence in activities of daily living. Although there is an aging-related reduction in manual dexterity, the difference in bimanual coordination performance between young and older adults remains unclear. We aimed to elucidate the characteristics of bimanual coordination among young, young-old, and old-old adult participants. Methods: The participants performed in-phase (tapping the thumb and index finger together as fast as possible) and anti-phase (alternating movement between the left and right fingers) bimanual coordination tasks, and intergroup comparison of the task parameters was performed. The receiver operating characteristic curve was also conducted to calculate age cut-off points for bimanual coordination. Results: The number and frequency of taps significantly decreased sequentially in young, young-old, and old-old adults, whereas the average of tap interval significantly increased in this order (p < 0.05). There was no significant difference between the young-old and old-old groups in the average local maximum distance (p > 0.05). These findings indicate that bimanual coordination task performance varies depending on specific parameters. Furthermore, the age cut-off points for bimanual coordination were determined as 68.5 years for the right-hand number of taps (AUC = 0.73) in the anti-phase task, 73.5 years for the right-hand average of tapping interval (AUC = 0.72) in the anti-phase task, and 65.5 years for the left-hand frequency of taps (AUC = 0.72) of the anti-phase task. Conclusions: the number of taps, average of tapping interval, and frequency of taps are potential indicators of aging-related changes in bimanual coordination. Full article

(This article belongs to the Section Healthy Aging)

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13 pages, 298 KiB

Open AccessArticle

Prevalence of Poor Diet Quality and Associated Factors Among Older Adults from the Bagé Cohort Study of Ageing, Brazil (SIGa-Bagé)

by Tainã Dutra Valério, Rosália Garcia Neves, Elaine Thumé, Karla Pereira Machado and Elaine Tomasi

Geriatrics 2025, 10(2), 44; https://doi.org/10.3390/geriatrics10020044 - 17 Mar 2025

Abstract

(1) Background: The accelerated aging of the population raises concerns about the diet of older adults due to its relationship with health and quality of life. This study aimed to investigate the prevalence of poor diet quality and its association with sociodemographic factors [...] Read more.

(1) Background: The accelerated aging of the population raises concerns about the diet of older adults due to its relationship with health and quality of life. This study aimed to investigate the prevalence of poor diet quality and its association with sociodemographic factors and health status among older adults residing in the city of Bagé, located in southern Brazil; (2) Methods: A cross-sectional analysis was conducted using data from the 2016/2017 follow-up of the Bagé Aging Cohort Study (SIGa-Bagé). Diet quality was assessed using the Elderly Diet Quality Index. Descriptive analysis and Poisson regression with robust variance adjustment, based on hierarchical levels, were used to calculate crude and adjusted prevalence ratios with their respective 95% confidence intervals; (3) Results: The sample included 728 older adults (65.7% female; mean age: 77.2 years). Poor diet quality was observed in 41.5% of participants. After adjustment, male sex, black or brown skin color, absence of multimorbidity, and presence of depressive symptoms were significantly associated with poor diet quality; (4) Conclusions: The findings highlight the most vulnerable groups and the need for investments in strategies to promote mental health and healthy eating habits among the older adults, particularly among men and racial minority groups. Full article

(This article belongs to the Special Issue Nutrition Care and Support in Geriatrics)

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