Journal of Gerontology and Geriatrics

Evidence regarding endoscopic retrograde cholangiopancreatography (ERCP) in adults in their 90s and 100s remains limited, and chronological age may not adequately reflect procedural vulnerability. We compared ERCP strategy and short-term outcomes across advanced age strata and included a contemporary younger reference cohort. This retrospective cohort included 48 patients aged ≥80 years undergoing ERCP for choledocholithiasis or stone-related acute cholangitis between 2023 and 2025: 80–89 years (n = 20), 90–99 years (n = 21), and ≥100 years (n = 7). A reference group of 15 consecutive patients aged <80 years treated during the same period under the same eligibility criteria was added. Only the first eligible ERCP per patient during the study period was analyzed as the index procedure; subsequent ERCPs were outcomes rather than additional observations. Clinical Frailty Scale (CFS), stone burden, treatment strategy, drainage, adverse events, intensive care use, and 30-day mortality were analyzed using nonparametric and Fisher–Freeman–Halton methods. Frailty–outcome analyses were restricted to the ≥80-year primary cohort and were exploratory and unadjusted. Median CFS was 4.0, 4.5, 6.0, and 8.0 in the <80, 80–89, 90–99, and ≥100-year groups, respectively (p < 0.001). Complete index stone clearance was 93.3%, 90.0%, 76.2%, and 71.4% (p = 0.358), while stenting was used in 6.7%, 10.0%, 33.3%, and 42.9% (p = 0.055). Successful biliary drainage remained 100%, 95.0%, 95.2%, and 100% (p = 1.000). Repeat ERCP occurred in 0%, 0%, 14.3%, and 28.6% (p = 0.027), and median length of stay increased from 3 to 4, 5, and 6 days (p < 0.001). Within the ≥80-year cohort, higher CFS remained associated with failed index clearance, stenting, post-procedure ICU requirement, and 30-day mortality in exploratory analyses. ERCP achieved high biliary drainage rates across age strata, including centenarians. The small younger reference cohort provided clinical context, while the ≥80-year analyses continued to show increasing frailty and more frequent staged management in the oldest groups. The retrospective design, small reference cohort, sparse events, and strong age–frailty correlation preclude causal or independent prognostic claims.

With limited bed availability at Malta’s state-run rehabilitation hospital, efficient and accurate assessment of frail older adults is essential for appropriate inpatient geriatric rehabilitation (GR) admissions. This study aimed to identify key predictors influencing admission decisions for inpatient GR programmes in Malta. Prospective data were collected from 250 patients aged 60 and over. In total, 83 predictors, including demographic details, clinical history, functional levels and social factors, were analysed against admission outcomes. Logistic regression analysis, mainly univariate analysis, followed by multivariate analysis with backward stepwise elimination, was used to determine significant predictors. Seven key predictors were identified, which shed light on the decision-making processes of the assessing specialists, highlighting the importance of embracing the ICF model rather than relying solely on medical criteria. These predictors reflect the WHO ICF and CGA frameworks, supporting a holistic, patient-centred approach. They informed the development of a digital tool, incorporating a future predictive model to guide GR admission decisions in Malta, aiming to facilitate the delivery of stratified and personalised care by enabling clinicians to select a care pathway based on the patient’s potential health trajectory in response to rehabilitation interventions.

Older adults may have both someone to consult and opportunities to be consulted by family or friends. This cross-sectional secondary analysis examined their mutually adjusted associations with happiness and self-rated health using a nationwide survey of 2084 Japanese adults aged 60–104 years. Happiness on a 0–10 scale was the primary outcome. Linear and logistic regression models adjusted for demographic, socioeconomic, family, behavioral and functional covariates, using study-specific broader and basic functional scores. Complete-case samples were 1806 and 1817 for happiness and 1802 and 1813 for self-rated health. Mean age was 73.0 years, and 52.2% were women. Having someone to consult was associated with higher happiness in both models (unstandardized B = 1.14 and 1.15). Being consulted by family or friends was also associated with higher happiness (B = 0.49, 95% CI 0.22–0.76; B = 0.58, 95% CI 0.33–0.84), as was social contribution activity. Being consulted was associated with good self-rated health in the basic-function model (OR = 1.37, 95% CI 1.01–1.86), but not clearly in the broader-function model. Five-category ordinal analyses showed a similar pattern. These findings support examining consultation access and being consulted as distinct indicators of older adults’ social relationships. They do not establish causal effects or reciprocity between the same people.