Geriatrics

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

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

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

Background/Objectives: Frailty is a multifactorial condition influenced by physical and psychosocial factors. Understanding longitudinal changes in these domains may guide prevention strategies. This study examines the relationship between frailty status, physical fitness, and psychosocial conditions in community-dwelling older adults using five-year longitudinal data. Methods: Participants were 52 out of 89 older adults who completed both baseline and five-year follow-up assessments (follow-up rate: 58.4%). Data were collected using 10 physical fitness indicators, the fitness age score (FAS), geriatric depression scale (GDS), Lubben social network scale short form (LSNS-6), and relevant items in the six Kihon Checklist (KCL) domains. Due to low prevalence of frailty, individuals with pre-frailty and frailty were combined into the frailty-risk group. Repeated measures ANOVA with sex as a covariate was conducted to compare groups. Logistic regression was used to identify baseline predictors of frailty status at five years. Statistical significance was set at p < 0.05. Results: GDS, LSNS-6, and KCL scores remained stable over five years. However, physical fitness significantly declined in several measures, including grip strength, vertical jump height, knee extension strength, functional reach, and FAS. A significant interaction for the timed up and go test showed that the robust group maintained function, while the frailty-risk group declined. Logistic regression identified KCL oral function as a significant predictor (OR = 5.331, 95% CI = 1.593–17.839, p = 0.007). Conclusions: Maintaining both oral function and physical fitness is vital for preventing frailty, even among health-conscious older adults. Proactive strategies may support healthy aging. Full article

Background: Associations between high physical activity (PA) levels and incident atrial fibrillation (AF) is found in some earlier studies. We aim to study the association between levels of PA and AF in two cohorts. Methods: We used data from the Uppsala Longitudinal Study of Adult Men (ULSAM) study, initiated in 1970, included men aged 50 years, with 2202 included in the study. Examinations were reiterated three times, with follow-up after in median 33 years, with 3.8–6.0% on the highest PA level. We also used data from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS; with women 50%); mean age 70 years, baseline 2001–2004, median follow-up 15 years, with 961 included in the study, with 4.8% on the highest PA level. Cox regression analysis with hazard ratios (HRs) was used to study association between PA levels and incident AF, adjusted for CV risk factors: systolic blood pressure, LDL- and HDL-cholesterol, BMI, diabetes, and smoking. Results: Totally, in ULSAM 504 men during 59,958 person-years at risk, and in PIVUS 204 individuals during a follow-up of 11,293 person-years experienced an AF. Neither in ULSAM, PIVUS, nor in the meta-analysis of both cohorts, individuals with the highest PA level showed an increased AF risk, compared to individuals with lowest level of PA. Conclusions: The benefits of PA in community dwelling individuals for its benefits to mental, metabolic, and cardiovascular health should guide public recommendations, rather than a possible risk of AF. Lay Summary: We studied the risk of incident atrial fibrillation at various levels of physical activity in two cohorts and found no statistically significant increased risk after adjusting for cardiovascular risk factors (systolic blood pressure, LDL- and HDL-cholesterol, BMI, diabetes, and smoking). Full article

Background: Dementia is a syndrome with a high global prevalence that includes a number of progressive diseases of the brain affecting various cognitive domains such as memory and thinking and the performance of daily activities. It manifests as symptoms which often include significant mood and behaviour changes that are highly varied. Changed moods and behaviours due to dementia may reflect distress and may be stressful for both the person living with dementia and their informal and formal carers. To provide dementia care support specific to mood and behaviour changes, the Behaviours in Dementia Toolkit website (BiDT) was developed using human-centred design principles. The BiDT houses a user-friendly, digital library of over 300 free, practical, and evidence-informed resources to help all care partners better understand and compassionately respond to behaviours in dementia so they can support people with dementia to live well. Objective: (1) To characterize the users that visited the BiDT; and (2) to understand the platform’s early impact on these users. Methods: A multi-method, descriptive study was conducted in the early post-website launch period. Outcomes and measures examined included the following: (1) reach: unique visitors, region, unique visits, return visits, bounce rate; (2) engagement: engaged users, engaged sessions, session duration, pages viewed, engagement rate per webpage, search terms, resources accessed; (3) knowledge change; (4) behaviour change; and (5) website impact: relevance, feasibility, intention to use, improving access and use of dementia guidance, recommend to others. Data was collected using Google Analytics and an electronic survey of website users. Results: From 4 February to 31 March 2024, there were 76,890 unique visitors to the BiDT from 109 countries. Of 76,890 unique visitors to the BiDT during this period, 16,626 were engaged users as defined by Google Analytics (22%) from 80 countries. The highest number of unique engaged users were from Canada (n = 8124) with an engagement rate of 38%. From 5 March 2024 to 31 March 2024, 100 electronic surveys were completed by website users and included in the analysis. Website users indicated that the BiDT validated or increased their dementia care knowledge, beliefs, and activities (82%) and they reported that the website validated their current care approaches or increased their ability to provide care (78%). Further, 77% of respondents indicated that they intend to continue using the BiDT and 81.6% said that they would recommend it to others to review and adopt. Conclusions: The BiDT is a promising tool for sharing practical and evidence-informed information resources to support people experiencing dementia-related mood and behaviour changes. Early evaluation of the website has demonstrated significant reach and engagement with users in Canada and internationally. Survey data also demonstrated high ratings of website relevance, feasibility, intention to use, knowledge change, practice support, and its contribution to dementia guidance. Full article

Background: Falls in older adults are a major barrier to healthy longevity. Recent studies suggest that muscle quality is associated with fall risk. This study aimed to determine whether a functional muscle quality index (MQI) using the 5-repetition sit-to-stand test (5R-STS) reflects fall risk in community-dwelling older adults. Methods: This cross-sectional study included 137 community-dwelling older adults (≥65 years) in Japan. Lower limb skeletal muscle mass (SMM) was measured using the BIA method, and muscle function was assessed using the 5R-STS. The MQI was calculated as “(5R-STS (s)/SMM (kg)) × 10”. Fall history was collected using a self-administered questionnaire, and binary logistic regression analysis including gait speed and physical frailty was performed. Results: Participants were divided into fallers (n = 36; age = 78.2 ± 5.6) and non-fallers (n = 101; age = 76.9 ± 5.3). Significant differences were found between the groups in gait speed (p = 0.01), TUG (p < 0.01), 5R-STS (p < 0.01), and MQI (p < 0.01). Binary logistic regression identified MQI (OR = 1.28; p < 0.01) and gait speed (OR = 0.14; p = 0.02) as explanatory variables for fall history. The results of the evaluation using the receiver operating characteristic (ROC) curve showed that the cutoff value for MQI to distinguish fall history was 8.04 s/kg, and the cutoff value for gait speed was 1.21 s. Conclusions: The MQI using the 5R-STS shows promise as an indicator of fall risk in older adults. Further longitudinal studies are needed to clarify the causal relationship. Full article

Background/Objectives: Research suggests that attitudes toward aging significantly impact health and well-being outcomes in older adults and are influenced by various factors. Our study aims to identify gender differences in attitudes toward aging among aging individuals with disabilities while also examining the influence of demographic and psychological factors on these attitudes. Methods: For this cross-sectional study, we collected data from 393 middle-aged and older adults with disabilities via an online Qualtrics survey administered through the Prolific platform in the United States. Participants completed the Attitudes Towards Aging Questionnaire Short Form, Purpose in Life Test Short Form, Mindfulness Attention Awareness Scale, Acceptance of Chronic Health Conditions Scale, and Three-Item Loneliness Scale. Descriptive and correlation analyses, t-tests, and multiple regression analyses were performed. Results: The independent t-test findings reveal significant differences in physical change and psychological growth between men and women, with men scoring higher in physical change and women in psychological growth. In multiple regression analyses, purpose in life significantly predicted all three domains of attitudes toward aging in men, while both purpose in life and acceptance were predictors across all domains in women. Additionally, age, employment, and financial stability contributed to aging attitudes only among women. Conclusions: Attitudes toward aging, specifically physical change and psychological growth, were found to vary by gender, with purpose in life, acceptance, and loneliness influencing these attitudes among both groups, while certain demographic factors influenced aging attitudes only among women. These findings underscore the need for gender-specific interventions addressing these substantial factors. Full article

Background: Frailty is a state of increased vulnerability to psychosomatic dysfunction associated with aging, with sarcopenia being a major contributing factor. Metabolic-syndrome-related metabolic diseases are recognized as risk factors for sarcopenia. While previous studies have examined the relationship between metabolic disease history or elevated metabolic syndrome indicators and sarcopenia, limited evidence exists regarding the association between metabolic indicators within reference ranges and sarcopenia in the absence of metabolic disease. This study aimed to investigate the relationship between metabolic syndrome indicators within reference ranges and the presence or absence of possible sarcopenia, as well as changes in these indicators over a four-year period, in women aged ≥65 years. Methods: A total of 224 community-dwelling women aged ≥65 years from M City and O Town who participated in health check-ups were included (approval no. 20MH017, 1 October 2020). Data were collected on height, body weight, and metabolic indicators (triglycerides, HDL cholesterol, LDL cholesterol, systolic and diastolic blood pressure, and HbA1c) at baseline and after four years. Physical performance was assessed using calf circumference, grip strength, and the five-time sit-to-stand test. Possible sarcopenia was defined according to AWGS2019 criteria. Results: Higher baseline HDL cholesterol levels were found to be protective against possible sarcopenia. An increase in triglyceride levels over four years was also associated with a reduced likelihood of possible sarcopenia. Conclusions: Maintaining high HDL cholesterol levels and increasing or preserving triglyceride levels may contribute to the prevention of sarcopenia in older women with metabolic indicators within reference ranges. Full article

Background/Objectives: This study aims to explore how gender influences the role of informal caregivers aged 65 years, considering the increasing involvement of men in caregiving due to longer life expectancy and societal norms. Methods: A two-year cross-sectional study was conducted in the Valencian Community, Spain, involving informal caregivers of 65 years of age and older who provided home-based care for dependent individuals with chronic conditions. The participants were recruited through public health schools, carers’ associations, and clinical consultations. The caregivers completed a comprehensive semi-structured interview, which included items from the Zarit Brief Scale (seven items) to assess caregiver burden and questions about their caregiving responsibilities, training, and experience, as well as the self-perceived frequency of medication errors. Results: A sample of 80 caregivers over 65 years old was analyzed, including 23 men (28.8%) and 57 women (71.2%). Male caregivers were significantly less experienced (mean = 3.1 years, SD = 5.9) compared to female caregivers (mean = 10.1 years, SD = 13.0; p = 0.004). Men reported lower emotional and physical burdens than women (p-value = 0.003), as reflected in the Zarit scores. Caregiving performance, measured by self-reported errors, was comparable between genders. Conclusions: This study explores the growing role of older male caregivers, highlighting their lower experience and training compared to those of women but similar caregiving performance and lower burden. Additionally, trained caregivers demonstrated significantly lower odds of experiencing burden, underscoring the importance of training as a modifiable factor. The findings emphasize the need for gender-sensitive support and tailored training programs to address disparities, reduce caregiver burden, and enhance caregiving quality and equity. Full article

Background/Objectives: Old age and cognitive impairment/dementia are risk factors for falling and fall-related injuries. We have, in a previous study in persons with cognitive impairment, shown that falls were associated with frailty, reduced physical fitness, and cognitive reduction. Falls were independent of the disorders causing the impaired functions. Because most falls are innocent, knowledge of predictors of fall-related injuries seems more clinically relevant than the predictors of falls. Predictors of falls and fall-related injuries are not necessarily identical. The aim of this follow-up study to our previous one in the same population was to explore predictors of fall-related injuries in fallers and compare these predictors with those of falls. Methods: This study and our previous study used data from the “The Norwegian Registry of Persons Assessed for Cognitive Symptoms” (NorCog), a Norwegian research and quality registry with a biobank. The registry included consecutive home-dwelling persons referred to Norwegian specialist healthcare units for assessment of cognitive decline. This study included 3774 persons from our previous study who experienced falls last year and compared persons with and without a fall-related injury. A fall-related injury was defined as admittance to a hospital for the injury. Results: The annual incidence of fall-related injuries in the fallers was 884/3774 (23.4%). Female sex, older age, lower BMI, in need of public health service and walking assistance, and low Hb and Ca were independent predictors of fall-related injuries, indicating reduced physical fitness and state of health and a high burden of comorbidity. Injuries were not associated with the degree of cognitive impairment or the dementia diagnosis. Conclusions: In home-dwelling persons with impaired cognitive functions and falls, fall-related injuries were associated with reduced physical fitness and state of health. In contrast to predictors of falls, neither the degree of cognitive impairment nor the dementia diagnosis was associated with fall-related injuries. The difference is comprehensible. Persons with cognitive impairment or dementia might have reduced power of judgment and be inattentive, unconcerned and careless, which increases the fall incidence but not the risk of injury once falling. Prevention of fall-related injuries should focus on relieving comorbidities, improving physical fitness and general health rather than on cognitive improvement. Full article

This paper draws on stories of receiving the diagnosis of Parkinson’s disease, which emerged from a broader narrative study exploring beliefs about exercise and challenges facing people with Parkinson’s disease. Background/Objectives: By interviewing people with Parkinson’s disease (PwPD) and their family members, this paper aimed to gain insights into PwPD’s experiences with diagnosis, its influence on exercise engagement, and access to services in Ireland. Methods: This study employed a qualitative research design, using purposeful and maximum variation sampling. PwPD (varying in age, sex, geographical setting, and disease severity) were recruited from urban physiotherapy services. Semi-structured interviews with 12 PwPD and a group interview with four family members were conducted between November 2022 and January 2023. The interviews were recorded, transcribed, and analysed using thematic analysis. Results: Four themes emerged: (1) firstly, there was disempowerment and emotional shock at diagnosis: PwPD expressed frustration with delays in diagnosis and with how language and empathy affected their ability to cope initially. (2) There was a lack of signposting and services access: a strong need exists for clear information on services and resources to prevent social disengagement. (3) In terms of exercise education and self-management support, PwPD lacked early exercise education and guidance, relying on self-education. (4) With regard to the emotional burden on family caregivers, family members manage care logistics and face emotional burdens, which they try to conceal. Conclusions: The delivery of a Parkinson’s diagnosis could be improved by recognising its psychosocial impact on PwPD and families. Providing clear information on services within weeks of diagnosis was considered crucial. Limited exercise education affected PwPD’s ability to self-manage. Early physiotherapy access is strongly recommended to help delay functional decline and encourage an active lifestyle. Full article

Background: Periodontal health is closely related to systemic health and crucial for healthy aging. Periodontal disease is prevalent among older adults due to declined systemic conditions, medication side effects, and reduced dexterity and cognition. Effective preventive care is essential to maintain periodontal health and promote oral and general health. Objective: The aim of this narrative review is to examine preventive periodontal care tailored for older individuals, with a focus on strategies to reduce the incidence of periodontal disease, maintain periodontal health, and improve the overall well-being of older adults. Findings: Preventive periodontal care includes mechanical plaque control, use of chemotherapeutic agents, lifestyle modifications, and regular professional periodontal care. Mechanical plaque control through regular toothbrushing and interdental cleaning remains the cornerstone of prevention. The use of adaptive aids and caregiver support is essential for maintaining the oral hygiene of older adults with physical limitations. Chemotherapeutic agents, such as chlorhexidine mouth rinses, can be used as adjunctive agents for plaque control. Lifestyle modifications, like smoking cessation and dietary adjustments, are crucial components of risk factor control. Professional periodontal care, including periodontal evaluation, risk factor control, tailored oral hygiene instruction, and professional mechanical plaque removal, are essential for the prevention and early detection and management of periodontal disease in older adults. Conclusions: This review underscores the importance of a multidisciplinary approach involving oral healthcare professionals, primary care providers, and caregivers to ensure patient-centered, integrated and comprehensive geriatric care to improve periodontal outcomes and overall well-being of older adults. Full article

Introduction: Vertebral Compression Fractures (VCF) are the most common vertebral fractures, usually osteoporotic, with rising incidence. The natural history of VCFs-related pain remains unclear, and treatment protocols are still being evaluated, ranging from conservative to surgical. Patient-reported measures have been proven inaccurate and carry significant biases. This study examines maximal tenderness location (MTL) to palpation and percussion on physical examination during VCF healing and the postoperative period. Methods: A prospective study included 40 patients treated for VCFs per the NICE guidelines (2013) from 2019 to 2021. Treatment was either conservative (n = 12) or surgical (n − 28), Balloon Kyphoplasty (BKP). All patients’ MTL were recorded in EMR (Electronic Medical Record) on every visit. BKP was offered for severe ongoing pain after a recent, unhealed vertebral fracture despite optimal pain management, progressive fracture collapse, or lack of union. Follow-up was six months. Pain evolution was analyzed using Kaplan–Meier survival curves, Log-Rank tests, Mann–Whitney U tests, t-tests, and logistic regression models. A p-value < 0.05 was considered statistically significant. Results: 12 patients were treated conservatively, and 28 underwent BKP for T12-L2 VCFs, accounting for 75% of fractures, mostly single-level fractures. All initially suffered MTL over the VCF; BKP patients showed local VCF pain resolution after 3.5 weeks following surgery while lasting seven weeks under conservative treatment. Lumbosacral pain was more prevalent following BKP (OR = 4, p = 0.05) and developed earlier. Conclusions: This study is novel in relating physical examination findings to fracture age and treatment provided, suggesting that VCFs-related pain is a time-related shift from local fracture pain to lumbosacral pain. Patient-reported pain scales may not reliably distinguish between these varying pain patterns. These findings suggest that only local VCF pain should be considered for surgical treatment. Future studies evaluating VCF outcomes should address physical examination and not rely solely on patient-reported metrics. Full article

Background: Experiencing agitation can be particularly distressing for people with dementia and their caregivers. Using technologies to detect agitation can help monitor and intervene when agitation occurs, potentially reducing overall care and support needs. This systematic review aims to explore the implementation outcomes related to the use of agitation detection technologies in people with dementia. By adopting a taxonomy of implementation outcomes, this review seeks to provide insights valuable for the real-world adoption of such technologies for people with dementia. Methods: Searches were conducted in the following databases: SCOPUS, PubMed, PsychINFO, IEEEXplore, and CINAHL Plus. Included studies were required to have implemented, evaluated, or validated technology with the intention to detect agitation in people with dementia in real-time. Results: On 14 May 2024, 1697 records were identified, and 19 were included in the review. The median sample size was 10, and around two-thirds of the records (n = 12, 63%) used ‘multimodal’ technologies for detecting agitation. Over half of the records (n = 10, 53%) were reporting from two studies. Across technologies, there was evidence of acceptability and feasibility, though there was a general absence of primary data related to implementation outcomes. There were, however, a number of technical issues and limitations that affected the fidelity and appropriateness of the technology, albeit not unique to people with dementia. Conclusions: There is a need for more empirical data on this topic to maximise uptake and adoption. Future research needs to ensure that the voice of the person with dementia is integrated within the evaluation process. Full article

Background/Objectives: Carbapenem-resistant Enterobacterales (CRE) infections are widespread, and the risk factors for carbapenemase-producing CRE (CP-CRE) infections are known. Non-CP-CRE (NCP-CRE) infections occur frequently; however, the associated risk factors remain elusive. Therefore, we investigated the risk factors for NCP-CRE infections, especially those caused by Enterobacter and Citrobacter species. Methods: We conducted a retrospective cohort study of patients aged ≥ 18 years with Enterobacter or Citrobacter infections who were admitted to the Department of General Medicine of a tertiary care hospital in Japan from October 2014 to September 2020. We used the data at first detection and performed univariate and multivariate logistic regression analyses to assess the associations between NCP-CRE infections and risk factors such as patient characteristics and antibiotics. Results: In total, 1416 participants were evaluated. The mean age of the patients was 74 ± 17 (range: 18–107) years, of whom 746 (53%) were men. Past use of antibiotics (≥4 days before specimen collection) was not significantly associated with NCP-CRE infections (133 [84%] vs. 1034 [82%], p = 0.5); however, recent use (≤3 days before sample collection) was significantly associated with NCP-CRE infections (42 [27%] vs. 245 [19%], p = 0.036). In the multivariate logistic model, recent use of antibiotics (odds ratio: 1.50, 95% confidence interval: 1.03–2.18) was an independent risk factor for NCP-CRE infections. Conclusions: NCP-CRE infection may be associated with recent antibiotic exposure, but not with the host’s immune status. Therefore, alternative risk factors for NCP-CRE infection may exist. Full article

Background/Objectives: Falls are a leading cause of morbidity in older adults, particularly those with multiple comorbidities. A multidisciplinary approach addressing physical, psychological, and environmental factors is essential for reducing fall risk and supporting aging in place. This report evaluates the effectiveness of a multidisciplinary, multifactorial approach in managing high fall risk in an older adult with diabetes, hypertension, and osteoporosis. Methods: A 72-year-old woman with a recurrent history of falls participated in an 8-week intervention as part of the American Physical Therapy Association (APTA) balance and falls prevention credential program. This study was conducted in Virginia Beach, USA, at the participant’s residence. A single-subject design investigation was conducted, measuring outcomes including the Balance Evaluation Systems Test (BESTest), gait speed, Timed Up and Go (TUG), fear of falling, and balance confidence at baseline and post-intervention. Results: The participant had impaired baseline values across various variables and was classified as a recurrent high-risk faller. After 8 weeks of intervention, clinically meaningful improvements with large effect sizes were observed: self-selected gait speed improved by 25%, BESTest scores improved by 50%, Falls Efficacy—International (FES I) scores improved by 26%, and Activity Balance Confidence (ABC) scores improved by 26%. No falls or adverse events occurred during the intervention period, and the patient reported enhanced mobility and safety at home. Conclusions: A tailored multidisciplinary approach effectively addressed the physical, psychological, and environmental factors contributing to high fall risk. This highlights the importance of patient-centered interventions in managing fall risk and promoting safe aging in place. Continued education, environmental adaptations, and regular follow-up are essential for long-term fall prevention. Full article

Background/Objectives: Older adults with mild cognitive impairment often exhibit reduced postural control and increased fall risk. As fall-related injuries consume substantial healthcare resources, the development of fall-preventive interventions is of public health relevance. This study aims to investigate the effects of a six-month dance intervention on postural control and fall-related measures in older adults with mild cognitive impairment. Methods: In this randomized controlled trial, 55 participants were allocated to either an intervention group or a control group. The intervention group performed two 90-min dance training sessions per week for six months, while the control group maintained their usual activities of daily living. Postural control was operationalized via balance performance, which was measured with the Sensory Organization Test and the Limits of Stability Test. Neuromuscular function of the lower extremities was assessed via muscle contraction velocity using tensiomyography. Fear of falling was quantified with the Falls Efficacy Scale, and participants reported fall history over the past year. It was hypothesized that older adults with mild cognitive impairment participating in the six-month dance training would show significantly greater improvements in postural control and fall-related outcomes than those in the control group. Results: A mixed analysis of variance (time × group) revealed no significant improvements in balance performance or neuromuscular function following the dance intervention (p > 0.05). However, several main effects for time were observed in the Sensory Organization Test, Limits of Stability Test, and muscle contraction velocity. Scores on the Falls Efficacy Scale improved significantly in the intervention group, reflecting reduced fear of falling, although only shown by a paired-samples t-test (t(23)= 2.276, p = 0.032, d = 0.465). Conclusions: This study did not provide evidence that a six-month dance intervention improves postural or neuromuscular functions. However, it cannot be ruled out that such null findings are related to confounding factors, such as insufficient training specificity or duration. Nonetheless, the fear of falling was significantly reduced in the intervention group, suggesting potential benefits for perceived fall risk in older adults with mild cognitive impairment. Full article