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Impact of SARS-CoV-2 Infection on Erythropoietin Resistance Index in Hemodialysis Patients
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Pro-Inflammatory Gut Bacteria Are Elevated in Fecal Samples from Individuals Living with Alzheimer’s Dementia
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Effect of Protein Supplementation on Orthostatic Hypotension in Older Adult Patients with Heart Failure
Journal Description
Geriatrics
Geriatrics
is an international, peer-reviewed, scientific open access journal on geriatric medicine published bimonthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, ESCI (Web of Science), PubMed, PMC, and other databases.
- Journal Rank: CiteScore - Q2 (Health (Social Science))
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 23.9 days after submission; acceptance to publication is undertaken in 3.5 days (median values for papers published in this journal in the second half of 2024).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Testimonials: See what our editors and authors say about Geriatrics.
Impact Factor:
2.1 (2023);
5-Year Impact Factor:
2.4 (2023)
Latest Articles
Case Report: Multifactorial Intervention for Safe Aging in Place
Geriatrics 2025, 10(3), 68; https://doi.org/10.3390/geriatrics10030068 - 20 May 2025
Abstract
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
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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.
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(This article belongs to the Topic Exercise and Human Aging: Physiological and Psychological Functions)
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Open AccessArticle
Effect of a Six-Month Dance Intervention on Postural Control and Fall-Related Outcomes in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial
by
Ulrich Thiel, Nicole Halfpaap, Berit K. Labott, Fabian Herold, Corinna Langhans, Kristinn Heinrichs, Patrick Müller, Notger G. Müller and Anita Hökelmann
Geriatrics 2025, 10(3), 67; https://doi.org/10.3390/geriatrics10030067 - 17 May 2025
Abstract
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
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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-minute 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
(This article belongs to the Section Geriatric Public Health)
Open AccessArticle
Osteoporosis Is Associated with Cerebral Small Vessel Disease in Stroke-Free Individuals: A Retrospective Observational Study
by
Xueling Xiao, Luling Chen, Manxiang Deng, Jingqi Liu, Jiayan Cai and Chuhan Su
Geriatrics 2025, 10(3), 66; https://doi.org/10.3390/geriatrics10030066 - 9 May 2025
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Objectives: This study aimed to investigate the relationship between osteoporosis and cerebral small vessel disease (CSVD) burden in stroke-free individuals, as well as its specific imaging markers, including lacunes, enlarged perivascular spaces (EPVSs), white matter hyperintensities (WMHs), and brain atrophy (BA). Methods
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Objectives: This study aimed to investigate the relationship between osteoporosis and cerebral small vessel disease (CSVD) burden in stroke-free individuals, as well as its specific imaging markers, including lacunes, enlarged perivascular spaces (EPVSs), white matter hyperintensities (WMHs), and brain atrophy (BA). Methods: A total of 684 stroke-free patients who underwent both bone mineral density (BMD) assessments and brain MRI were included. Clinical data, CSVD burden scores, imaging markers of CSVD, and bone density parameters were collected. Logistic regression models were used to evaluate the relationship between BMD and CSVD burden and imaging markers. Results: Osteoporosis, including hip and vertebral osteoporosis, was independently associated with CSVD burden (OR = 2.332, 95%CI: [1.345, 4.039], p = 0.003; OR = 2.598, 95%CI: [1.540, 4.384], p < 0.001; OR = 1.515, 95%CI: [1.010, 2.272], p = 0.044). Increased BMD in the hip and spine correlated with reduced CSVD burden (OR = 0.929, 95%CI: [0.887, 0.972], p = 0.001; OR = 0.952, 95%CI: [0.917, 0.989], p = 0.012). Hip osteoporosis was a risk factor for lacunes (OR = 2.215, 95%CI: [1.197, 4.1], p = 0.011), multiple lacunes (OR = 2.274, 95%CI: [1.039, 4.980], p = 0.04), severe WMH (OR = 2.611, 95%CI: [1.171, 5.823], p = 0.019), and EPVS ≥ 2 (OR = 1.99, 95%CI: [1.133, 3.495], p = 0.017). No significant association was found between osteoporosis and BA (p = 0.928). In sex-stratified analyses, both hip and vertebral osteoporosis were independently associated with a higher CSVD burden in female patients (hip: OR = 2.529, 95%CI: [1.122, 5.703], p = 0.025; vertebral: OR = 3.129, 95%CI: [1.517, 6.455], p = 0.002; general osteoporosis: OR = 1.755, 95%CI: [1.057, 2.912], p = 0.03), whereas no significant association was observed in male patients (all p > 0.05). Conclusions: Osteoporosis was independently associated with an increased burden of CSVD, particularly evident in female patients. These findings suggest that bone health may be important in CSVD management, particularly for women.
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Open AccessSystematic Review
A Systematic Review on Subjective Cognitive Complaints: Main Neurocognitive Domains, Myriad Assessment Tools, and New Approaches for Early Detection
by
Felipe Webster-Cordero and Lydia Giménez-Llort
Geriatrics 2025, 10(3), 65; https://doi.org/10.3390/geriatrics10030065 - 9 May 2025
Abstract
Background/Objectives: Neuropsychological testing is key in defining cognitive profiles at early stages of dementia. More importantly, the detection of subtle cognitive changes, such as subjective cognitive complaints (SCCs), an understudied phenomenon, is critical for early detection and preventive interventions. Methods: This systematic review
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Background/Objectives: Neuropsychological testing is key in defining cognitive profiles at early stages of dementia. More importantly, the detection of subtle cognitive changes, such as subjective cognitive complaints (SCCs), an understudied phenomenon, is critical for early detection and preventive interventions. Methods: This systematic review analyzes the empirical data on the cognitive domains and neuropsychological tests used in studies addressing SCC in the last 15 years (2009–2024). Results: A selection of 15 papers with exploratory, cross-sectional, and prospective scope in this field was obtained from PubMed and Embase databases. They used screening tests (17%) and a broad spectrum of neurocognitive domains. Yet, we identified three main targeted cognitive domains: executive functions (28%), language (17%), and memory (17%). Myriad assessment tools were also applied, but the most commonly used was a set of eight tests: Mini-mental Scale Examination (MMSE), Trail Making Test (A-B), Stroop test, Digit span test (DST), Semantic and Phonological fluency test, Rey Auditory Verbal Learning Test (RAVLT), Weschler Memory Scale (WMS), and Boston Naming Test (BNT). New approaches involved including the Geriatric Depression Scale (GDS) and self/informant reports. Conclusions: Despite scarce agreement in the assessment protocols, the identification of early neurocognitive symptoms to objectivate the SCC phenomenon envisions a broad field of research.
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(This article belongs to the Special Issue Current Issues in Cognitive Testing of Older Adults)
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Open AccessSystematic Review
Overview of Systematic Reviews on Factors Related to the Structure and Functioning of Residential Long-Term Care Facilities for Older Adults
by
Aurélio Matos Andrade, Karine Rodrigues Afonseca, Tatiana de Almeida Jube, Suelen Meira Góes, Maíra Catharina Ramos and Flavia Tavares da Silva Elias
Geriatrics 2025, 10(3), 64; https://doi.org/10.3390/geriatrics10030064 - 3 May 2025
Abstract
Objective: To identify factors influencing the structure and functioning of long-term residential care facilities for older adults worldwide, in order to uncover practices and support evidence-based improvements in care delivery. Method: An overview of systematic reviews was performed according to the PRISMA protocol
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Objective: To identify factors influencing the structure and functioning of long-term residential care facilities for older adults worldwide, in order to uncover practices and support evidence-based improvements in care delivery. Method: An overview of systematic reviews was performed according to the PRISMA protocol and registered on the PROSPERO platform (no. CRD42023486204). Research was carried out on 21 September 2023, using the following databases: PubMed (via MedLine), EMBASE, Web of Science, Scopus, Virtual Health Library (VHL), and Epistemonikos. Results: The search yielded 12,040 articles, including 61 systematic reviews. Analyzing the primary outcomes, personnel structure, and risk management were the most-studied outcomes of the systematic reviews, followed by pharmaceuticals, food services, mobility/accessibility, and technological and physical structures. In terms of primary outcomes of the systematic reviews, the personnel structure was the most highlighted (in 39.34%), followed by risk management (in 32.79%), while the least highlighted was physical structure (in 9.84%). Conclusions: Personnel are critical to the safe and effective functioning of Long-Term Care Facility (LTCF) operations. Future research is needed to identify associations between models of care and structural concerns, including physical environment, as they relate to quality of care in LTCFs, particularly in low and middle-income countries (LMIC).
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(This article belongs to the Special Issue Healthy Ageing and Lifestyle Medicine: Current Knowledge and Future Direction)
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Open AccessArticle
What Combination of Generic Bedside Screening Tools Is Optimal to Capture Patients with Penetration/Aspiration Due to Dysphagia? Comparing Single Bedside Tools Versus Combinations of Tools for Sensitivity and Specificity
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Albert Westergren, David Smithard, Johannes Riis, Christina Emborg, Anne Lund Krarup and Dorte Melgaard
Geriatrics 2025, 10(3), 63; https://doi.org/10.3390/geriatrics10030063 - 30 Apr 2025
Abstract
Background/Objectives: This study aimed to explore the validity of various generic bedside screening tools, and combinations of these, for capturing dysphagia as compared to aspiration/penetration found through the Flexible Endoscopic Evaluation of Swallowing (FEES). Methods: In this cross-sectional study, participants diagnosed
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Background/Objectives: This study aimed to explore the validity of various generic bedside screening tools, and combinations of these, for capturing dysphagia as compared to aspiration/penetration found through the Flexible Endoscopic Evaluation of Swallowing (FEES). Methods: In this cross-sectional study, participants diagnosed with chronic pulmonary disease (n = 25), Parkinson’s disease (n = 26), multiple sclerosis (n = 24), or stroke (n = 25) participated. Patient-reported outcomes and clinical-rated assessments included: the four-question test (4QT), the Minimal Eating Observation Form—II, the Volume–Viscosity Swallow Test (V-VST), the Penetration–Aspiration Scale, and the FEES. Activities in daily living were assessed with the Barthel Index. The sensitivity, specificity, negative predictive value (NPV), positive predictive value, and accuracy were calculated. Results: The 100 participants’ median age was 72 years, and 42 were women. In total, 78 patients had eating difficulties (MEOF-II). According to the 4QT, 69 patients had dysphagia while 62 had it according to the V-VST. Furthermore, 29 patients had penetration/aspiration according to the FEES. All generic bedside tools performed better when combined with another tool, when compared to the identification of penetration/aspiration according to the FEES. The combination of the MEOF-II and 4QT as well as the combination of the MEOF-II and V-VST proved to have very high sensitivity (96.1–96.3%) and NPVs (92.3% in both instances). Combining the three tools, the MEOF-II, 4QT, and V-VST, did not improve the sensitivity or NPV. Conclusions: A combination of the MEOF-II and 4QT or the MEOF-II and V-VST bedside tools is recommended for identifying patients at risk of penetration/aspiration and in need of further in-depth clinical assessment.
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(This article belongs to the Section Dysphagia)
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Open AccessArticle
Validity and Reliability of the Self-Administered Timed Up and Go Test in Assessing Fall Risk in Community-Dwelling Older Adults
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Magda Reis, Maria Teixeira, Carlota Carvão and Anabela Correia Martins
Geriatrics 2025, 10(3), 62; https://doi.org/10.3390/geriatrics10030062 - 29 Apr 2025
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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
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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.
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Open AccessArticle
Home Caregivers of Elderly People: Perceptions and Quality of Life
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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 - 29 Apr 2025
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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
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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.
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Open AccessArticle
Recognition of Serious Infections in the Elderly Visiting the Emergency Department: The Development of a Diagnostic Prediction Model (ROSIE)
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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
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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
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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.
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Open AccessArticle
An Optimal Beneficiary Profile to Ensure Focused Interventions for Older Adults
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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
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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
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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.
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Open AccessArticle
Culturally Tailored Community Brain Health Education for Chinese Americans Aged 50 or Above: A Mixed-Methods Open Pilot Study
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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
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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.
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(This article belongs to the Section Healthy Aging)
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Open AccessArticle
The Influence of Frailty on Pharmacotherapy Adherence and Adverse Drug Reactions in Older Psychiatric Patients
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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
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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.
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(This article belongs to the Section Geriatric Psychiatry and Psychology)
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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
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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.
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(This article belongs to the Section Geriatric Oncology)
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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
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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.
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(This article belongs to the Special Issue Healthy Ageing and Lifestyle Medicine: Current Knowledge and Future Direction)
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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
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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
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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.
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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
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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.
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(This article belongs to the Section Dysphagia)
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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
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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.
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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
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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.
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(This article belongs to the Collection Frailty in Older Adults)
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Rhinitis in the Geriatric Population: Epidemiological and Cytological Aspects
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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
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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
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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.
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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
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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
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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.
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