Search Results (191)

Background/Objectives: Understanding the impact of dietary habits in terms of obesity, health outcomes, and functional decline is critical in Europe’s growing elderly population. This study analyzed trends in Mediterranean diet (MD) adherence, obesity prevalence, and grip strength among middle-aged and elderly Europeans using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Methods: Data from four SHARE waves (2015–2022) across 28 countries were analyzed. Dietary patterns were assessed through food frequency questionnaires classifying participants as MD-adherent or non-adherent where adherent implies daily consumption of fruits and vegetables and occasional (3–6 times/week) intake of eggs, beans, legumes, meat, fish, or poultry (an unvalidated definition of the MD pattern). Handgrip strength, a biomarker of functional capacity, was categorized into low, medium, and high groups. Body mass index (BMI), self-perceived health (SPHUS), chronic disease prevalence, and CASP-12 scores (control, autonomy, self-realization, and pleasure evaluated on the 12-item version) were also evaluated. Statistical analyses included descriptive methods, logistic regressions, and multiple imputations to address missing data. Results: A significant majority (74–77%) consumed fruits and vegetables daily, which is consistent with MD principles; however, the high daily intake of dairy products (>50%) indicates limited adherence to the MD, which advocates for moderate consumption of dairy products. Logistic regression indicated that individuals with two or more chronic diseases were more likely to follow the MD (odds ratio [OR] = 1.21, confidence interval [CI] = 1.11–1.32), as were those individuals who rated their SPHUS as very good/excellent ([OR] = 1.42, [CI] = 1.20–1.69). Medium and high maximal handgrip were also strongly and consistently associated with higher odds of MD adherence (Medium: [OR] = 1.44, [CI] = 1.18–1.74; High: [OR] = 1.27, [CI] = 1.10–1.48). Conclusions: The findings suggest that middle-aged and older adults are more likely to adhere to the MD dietary pattern if they have more than two chronic diseases, are physically active, and have a medium or high handgrip. Although an unvalidated definition of the MD dietary pattern was used, the results highlight the importance of implementing targeted dietary strategies for middle-aged and elderly adults. Full article

Background/Objectives: The rapid ageing of the European population presents growing challenges for mental health, highlighting the need to identify factors that can prevent or delay psychological decline and promote a higher quality of life in later life. This study aims to provide an updated and comprehensive overview of mental health among older adults in Europe by examining the prevalence of depressive symptoms and identifying key associated factors. Methods: We analysed data from individuals (n = 45,601) aged 65 years and older across 27 European countries and Israel who participated in Wave 9 of the Survey of Health, Ageing and Retirement in Europe (SHARE). This study assessed the prevalence of depressive symptoms, which were evaluated using the EURO-D scale (score range: 0–12), with a cut-off of ≥4 indicating clinically relevant symptoms. It also explored associations with sociodemographic characteristics, physical health, behavioural factors, social participation, internet skills and living conditions. Results: Our findings confirm that depressive symptoms remain highly prevalent among older adults in Europe, with 35.1% of women and 21.5% of men affected, reflecting persistent gender disparities in mental health. Depression in later life was significantly associated with poor physical health, loneliness and lower quality of life. Conversely, moderate involvement in grandchild care and in social participation emerged as potential protective factors. Conclusions: Late-life depression has substantial implications for both mental and physical well-being. Our findings suggest that social integration, gender related factors and physical health are closely associated with depressive symptoms in older adults. These associations highlight the importance of considering these domains when designing interventions and policies aimed at promoting mental health in ageing populations. Full article

Background/Objective: Sarcopenia is a predictor of poor surgical outcomes in older adults. The Psoas Muscle Index (PMI), calculated from routine preoperative CT scans, has been proposed as an imaging-based marker of physiological reserve, but its diagnostic utility in vascular surgery remains unclear. We aimed to assess the predictive value of PMI for early complications following elective abdominal aortic aneurysm (AAA) repair in two European centers. Methods: We retrospectively analyzed 245 patients who underwent open or endovascular AAA repair between 2018 and 2022 in Poland and The Netherlands. PMI was measured at the level of third lumbar vertebrae (L3) level, normalized to height, and stratified into center-specific tertiles. Early complications were compared across tertiles, procedures, and centers. Multivariate logistic regression was used to adjust for age, comorbidities, and procedure type. Results: Low PMI was significantly associated with early complications in EVAR patients at the Polish center (p = 0.004). No associations were found in open repair or at the Dutch center. Mean PMI values did not differ significantly between centers. Conclusions: PMI may serve as a context-dependent imaging biomarker for early risk stratification following AAA repair, particularly in endovascular cases. Its predictive value is influenced by institutional and procedural factors, highlighting the need for prospective validation and standardization before clinical adoption. Full article

Background/Objectives: The use of artificial sweeteners (AS) is increasing globally despite growing evidence suggesting potential health risks. This study investigates the sociodemographic and health-related factors associated with AS use in the Hungarian population. Methods: We conducted a cross-sectional analysis using data from the 2019 European Health Interview Survey (EHIS), comprising 5603 participants. AS users were identified based on self-reported use of AS. Logistic regression models were used to examine associations between regular AS use and demographic, socioeconomic, and health variables. Interaction terms were included to explore potential effect modification. Results: AS use was reported by 20.1% of participants. Older adults, individuals with overweight or obesity, and those reporting poorer self-perceived health were more likely to use AS. AS use was also higher among individuals in lower and middle-income quintiles. Interaction analyses revealed that overweight and obese individuals with the lowest income, as well as older adults in poor health, were particularly likely to use AS. Conclusions: The findings highlight disparities in AS use across age, income, BMI, and health status, raising concerns about the public’s perception of AS as a healthier alternative. Public health strategies should focus on increasing awareness of the potential risks and encourage evidence-based dietary choices. Full article

The ultimate goal of developed societies is to age with quality of life, but this concept is broad, and few studies have addressed which variables specifically affect its dimensions. This study aims to test a model for predicting the impact of frailty, pain, and loneliness on the four dimensions of quality of life (control, autonomy, pleasure, and self-realization). Data were drawn from a sample of 61,355 Europeans from the Wave 7 of the SHARE project, aged 60 or older (M = 71.87, SD = 8.22), from which 55.9% were females. Statistical analyses included a fully Bayesian structural equation model that evidences the significant effect of loneliness, frailty, and pain on the four dimensions of quality of life. The variables have an unequal impact on the different dimensions’ loneliness was the main predictor for the dimensions control, autonomy, and pleasure, while frailty was the main predictor to self-realization. This study supports the need to address these variables to intervene on the different aspects of quality of life in old age. Full article

Background and Objectives: Sarcopenia and lower urinary tract symptoms (LUTSs) are both prevalent among older adults and may share underlying pathophysiological mechanisms. However, their association has not been systematically quantified. This systematic review and meta-analysis aimed to evaluate the association between sarcopenia and LUTSs, including the pooled estimates of prevalence and odds ratios (ORs), and to explore the influence of diagnostic definitions and study-level factors. Materials and Methods: A comprehensive literature search was conducted using PubMed and Embase for studies published between 1 January 2000 and 26 April 2025. This study adhered to PRISMA and MOOSE guidelines and was registered in PROSPERO (CRD420251037459). Eligible observational studies reported LUTS prevalence or ORs in individuals with sarcopenia, low muscle strength (LMS), low lean mass (LLM), low gait speed (LGS), or sarcopenia risk identified by SARC-F (score ≥4). Pooled ORs and prevalence rates were calculated using a random-effects model. Subgroup analyses were performed based on sarcopenia definitions—Asian Working Group for Sarcopenia (AWGS) and European Working Group on Sarcopenia in Older People (EWGSOP)—as well as LUTS subtypes and diagnostic components. Univariate meta-regression assessed associations with age, BMI, sex distribution, WHO region, and risk of bias. Results: Twenty-five studies comprising 84,484 participants were included. Sarcopenia was significantly associated with LUTSs (pooled OR = 1.78; 95% CI: 1.29–2.45; p < 0.001), with a pooled LUTS prevalence of 43.2% (95% CI: 26.9–61.0%). Stronger associations were observed in studies using AWGS diagnostic criteria (OR = 2.24; 95% CI: 1.41–3.56; p = 0.001), in those evaluating severe sarcopenia (OR = 1.66; 95% CI: 1.03–2.68; p = 0.038), and in institutionalized populations (OR = 3.68; 95% CI: 2.18–6.24; p < 0.001) compared to community-dwelling populations (OR = 1.43; 95% CI: 1.06–1.92; p = 0.018). Sarcopenia risk identified by SARC-F (score ≥4) showed the strongest association with LUTSs (OR = 3.20; 95% CI: 1.92–5.33; p < 0.001). Significant associations were also found for LLM (OR = 1.52; 95% CI: 1.19–1.95; p = 0.001) and LGS (OR = 1.37; 95% CI: 1.06–1.76; p = 0.015), but not for LMS (OR = 0.94; 95% CI: 0.47–1.89; p = 0.871). Exploratory analyses comparing LLM diagnostic modalities—including standardized criteria (ASMI, ASM/BMI), imaging-based methods (SMI, PMA), and surrogate measures (calf circumference)—revealed no significant differences (all p > 0.05). Heterogeneity was high (I² > 90%). Egger’s test indicated no evidence of publication bias (p = 0.838), and trim-and-fill analysis did not affect the pooled estimates. Conclusions: Sarcopenia—particularly in its severe forms—is significantly associated with LUTSs. Additionally, individuals who screened positive for sarcopenia using the SARC-F tool demonstrated a heightened risk of LUTSs. Subgroup analyses revealed a stronger association in institutionalized populations, suggesting that care setting may modify risk. These findings underscore the importance of assessing muscle health in older adults with urinary symptoms. Standardization of diagnostic criteria and longitudinal studies are needed to clarify causality and guide targeted interventions. Full article

Background: Sarcopenia (loss of muscle mass) and dynapenia (loss of strength) are prevalent in older adults aged 70 years and over. Both have an impact on their functional ability and quality of life, with type II muscle fibres being particularly affected. Although traditional resistance training (TRT) is effective, it presents technical difficulties and an increased risk of injury among this vulnerable population. Isometric strength training (IST) is a potentially safer, more accessible and more effective alternative. Objective: To describe the protocol of a single-arm, pre-post intervention trial designed to evaluate the efficacy and applicability of a 16-week IST programme on muscle strength, skeletal muscle mass, quality of life and applicability (safety, acceptability, perceived difficulty) in 18 older adults aged 70 years and above with a diagnosis of sarcopenia and dynapenia. The influence of genetic and environmental factors on the variability of response to IST will also be explored. Methodology: The participants, who have all been diagnosed with sarcopenia according to EWGSOP2 (European Working Group on Sarcopenia in Older People 2) criteria, will perform two IST sessions per week for 16 weeks. Each 30-min session will consist of one progressive set (total duration 45 s to 90 s) for each of the eight major muscle groups. This series will include phases at 20% and 40% of individual Maximal Voluntary Isometric Contraction (MVIC), culminating in 100% Maximal Effort (ME), using the CIEX SYSTEM machine with visual feedback. The primary outcome variables will be: change in knee extensor MVIC and change in Appendicular Skeletal Muscle Mass Index (ASMMI). Secondary variables will be measured (other components of sarcopenia, quality of life by EQ-5D-5L, use of Likert scales, posture and physiological variables), and saliva samples will be collected for exploratory genetic analyses. The main statistical analyses will be performed with t-tests for related samples or their non-parametric analogues. Discussion: This protocol details a specific IST intervention and a comprehensive evaluation plan. The results are expected to provide evidence on the feasibility and effects of IST among older adults with sarcopenia and dynapenia. Understanding individual variability in response, including genetic influence, could inform the design of more personalised and effective exercise strategies for this population in the future. Full article

Background/Objectives: Overnutrition, leading to overweight and obesity, is a growing concern among the elderly, contributing to non-communicable diseases. This study examines socio-demographic, dietary, and lifestyle factors associated with overnutrition in Hungarian adults aged 65 and older. Methods: A cross-sectional analysis was conducted using 2019 European Health Interview Survey data, including 1628 elderly participants. Body mass index (BMI ≥ 25 kg/m²) defined overnutrition. Socio-demographic (gender, income, urbanization, partner status), dietary (fruit, vegetable, water, sweetener, salt intake), and lifestyle (alcohol, smoking, physical activity) factors were analyzed. Chi-square tests and multivariate logistic regression identified associations, with odds ratios (ORs) and 95% confidence intervals (CIs) calculated. Results: Overnutrition prevalence was 72.7%, higher in males (77.8%) than females (69.1%). Urbanization, income, and partner status showed associations. Significant predictors included lower water intake (OR = 0.47, 95% CI: 0.33–0.65 for 1–1.5 L), artificial sweetener use (OR = 1.54, 95% CI: 1.13–2.11), moderate/high salt intake (OR = 1.45, 95% CI: 1.06–1.99), former/never smoking (OR = 2.56, 95% CI: 1.73–3.77), and heavy alcohol use (OR = 4.00, 95% CI: 1.33–12.50). Conclusions: Artificial sweetener use, high salt intake, smoking history, and heavy alcohol consumption are key modifiable predictors of overnutrition, informing targeted interventions for elderly Hungarians. Full article

Background/Objectives: Vaccination rates in South Tyrol, Northern Italy, remain among the lowest in the country. This study investigated whether health literacy is associated with vaccine uptake in this multilingual region. Methods: A representative cross-sectional survey (n = 2090) was conducted using the validated European Health Literacy Survey Questionnaire (HLS-EU-Q16) to assess health literacy. Vaccine uptake was evaluated on a 4-point Likert scale and analysed by age group (18–54 years; ≥55 years). Associations were explored using ANCOVA and multivariate logistic regression models. Results: Among younger adults (18–54 years), higher health literacy was significantly associated with greater vaccine uptake, particularly when compared with individuals with missing health literacy data. Health literacy was not a significant predictor for vaccine uptake in the older age group (≥55 years). Instead, vaccine uptake correlated with trust in healthcare providers, the presence of chronic diseases, and educational level. Differences in health literacy were notable across language groups, but these did not interact with vaccination behaviour. Conclusions: Building trust and targeting individuals with lower educational attainment are key strategies for improving vaccination rates across language groups. Although health literacy plays a secondary role, efforts to enhance it, especially among the German-speaking population, are still warranted. Younger individuals with missing health literacy scores, often with a migration background and low trust in healthcare, should be prioritised in vaccination and health literacy campaigns. Full article

Background/Objectives: Quality of life (QoL) is negatively affected in people with all-over pain. Widespread pain has a negative impact on physical function, cognitive function, mental health and mood. Physical activity (PA) may help to improve the QoL in these people. This study aimed to assess the relationships between PA frequency (PAF) and QoL in middle-aged and older European people with all-over pain, in addition to developing and analyzing the performance of a classification and regression tree model (CRT) to predict QoL in this population. Methods: A cross-sectional study of 1025 middle-aged and older European individuals with all-over pain. Relationships between moderate and vigorous PAF and QoL were assessed. A predictive algorithm for QoL was developed using CRT analysis. A cross-validation study was conducted to assess the performance of the model. In addition, a multivariate linear regression model was developed to predict QoL and compare its performance with the CRT model. Results: Higher PAF and higher QoL were found to be related (p < 0.001). Specifically, the CRT found that depression, poor perceived health, and moderate physical activity once a week, rarely or never were the combinations of variables that predicted lower quality of life scores. Conversely, not having depression and performing moderate physical activity more than once a week predicted higher quality of life scores. The linear regression model performed better than the CRT model (R² = 38% vs. R² = 30%), and both identified depression, SPH, moderate PAF and education level as main predictors of QoL. Conclusions: PA on a regular basis could improve the QoL of people with all-over pain. Depressive symptoms, self-perceived health, PAF and educational level are predictors of QoL in this population. Our findings provide useful information for assessing QoL in people with all-over pain, offering an easy-to-interpret visual model with similar accuracy to traditional models. Full article

Background/Objectives: Respiratory Syncytial Virus (RSV) is a leading cause of Lower Respiratory Tract Infections (LRTIs), posing a serious threat to vulnerable populations. Although growing evidence highlights its significant impact on older adults, RSV surveillance and data collection remain largely focused on children, underestimating the burden in older and high-risk adults. This review aims to synthesize current evidence on the epidemiological and clinical impact of RSV in older adults in Europe, assess existing surveillance strategies, and identify gaps to guide targeted public health responses. Methods: A two-phase research strategy was adopted. First, a comprehensive review of studies published between 2015–2025 was conducted via PubMed, focusing on the RSV burden in high-risk and elderly populations in Europe. Second, a structured web screening was performed to assess the status of existing RSV surveillance systems, focusing on eight selected European countries. Results: The review reported RSV prevalence rates ranging from 1% to 64.7% among older adults, with a high prevalence of comorbidities that exacerbate disease severity. Hospitalization rates varied between 12.6–55.9%, while mortality ranged from 2.15% to 13%, reaching up to 36% in intensive care settings. Surveillance systems for adult RSV infections across Europe remain limited and fragmented, with only 37.5% (3/8) of analyzed countries having dedicated surveillance for adults. Conclusions: RSV represents a substantial and underrecognized threat to older adults, with significant clinical and healthcare implications. Strengthening surveillance, standardizing data collection, and ensuring equitable access to newly available preventive measures are urgent priorities to reduce the disease burden, protect vulnerable populations, and support resilient health systems against future health challenges. Full article

Background/Objectives: This study compares dietary and physical activity (PA) habits between Spanish adults with and without diabetes and analyzes the association between PA, sociodemographic variables, and adherence to nutritional recommendations among individuals with diabetes. Methods: A cross-sectional case–control study was conducted using data from the 2020 European Health Survey for Spain (EESE). Diabetes and PA levels were self-reported. Each participant with diabetes was matched with a control without diabetes by age, gender, and region of residence. Food intake was assessed using a food frequency questionnaire, and adherence to nutritional guidelines was evaluated based on the recommendations of the Spanish Agency for Food Safety and Nutrition. The PA levels were classified as “sedentary/low” or “moderate/high”. Results: A total of 2053 matched pairs were analyzed. The participants with diabetes adhered to significantly more nutritional recommendations than those without diabetes (6.19 vs. 5.30; p < 0.001). However, 88.6% of the individuals with diabetes reported sedentary or low PA levels. Among those with diabetes, women showed better adherence to nutritional recommendations, while men reported higher PA levels. Moderate/high PA was associated with greater adherence to nutritional recommendations (OR 1.991; 95% CI: 1.201–3.146). Older age was also positively associated with adherence. Conclusions: Although individuals with diabetes demonstrated better adherence to nutritional recommendations than controls, most reported low PA levels. Higher PA levels, female gender, and older age were linked to greater adherence to nutritional recommendations among people with diabetes. However, the use of self-reported data made it impossible to judge whether the participants under- or over-reported their PA levels and diabetes status. Public health strategies should aim to promote both PA and healthy eating habits in this population. Full article

Background and Objectives: Knee joint injuries incur substantial healthcare and socioeconomic burdens worldwide. The connection between various demographic and clinical factors and meniscal injury patterns in patients undergoing surgery for meniscal rupture remains underexplored, especially in Eastern European cohorts. This study aimed to determine the influence of age, sex, and history of previous meniscal rupture on the patterns and types of knee joint injuries in adults aged 35 years and older undergoing surgery. Materials and Methods: A single-site exploratory retrospective analysis was conducted on 420 Romanian patients. The age of 35 years was selected as a cut-off for recruiting patients, as it marks the typical age at which early degenerative changes in the musculoskeletal system begin to emerge. Nonparametric/frequency analysis was applied to datasets stratified based on injury type—medial meniscal damage (MMD), lateral meniscal damage (LMD), and any patellar damage (APD). Logistic regression was used to determine influential predictors, including age, sex, and history of meniscal rupture. Results: Surgery was performed at a significantly younger age in patients with previous meniscus rupture (p < 0.001), but at a significantly older age in patients with co-occurring patellar lesions (p = 0.048). Men tended to be younger at the time of first surgery or any reoperations (p = 0.054) and displayed LMD significantly more often than MMD (p = 0.023). Significant differences existed in the distribution of different tear types in LMD (p < 0.001) and MMD (p < 0.001), with bucket handle tears and parrot beak tears being the most common. Male sex was associated with significantly higher odds of LMD (p = 0.046). Patients with previous meniscal rupture had a significantly and approximately threefold higher likelihood of presenting with MMD (p = 0.003). Conclusions: Age, sex, and history of meniscal rupture significantly influence the patterns and prevalence of knee injuries in adults aged 35 years and older. These findings reveal a dynamic interplay between demographic factors and knee joint pathologies, providing a foundation for targeted prevention and treatment strategies. Future studies should expand to larger, diverse populations to refine these insights. Full article

Background/Objectives: Depression, as one of the leading causes of disease burden, frequently co-occurs with other diseases. Cancer seems to be strongly associated with depression more than any other disease. As an outcome of physical fitness, muscular strength seems to have a protective effect on depression. This study aimed to analyze how muscular strength moderates the relationship between cancer and depressive symptomatology among older European adults. Methods: Cross-sectional data from wave 8 (2019/2020), including 41,666 participants (17,986 males) of the population-based Survey of Health, Aging, and Retirement in Europe, were analyzed. Grip strength, used as the moderator, was measured twice on each hand using a dynamometer. The EURO-D 12-item scale was used to measure depressive symptomatology. Results: Grip strength had a significant effect as a moderator in the association between cancer and depressive symptoms (male: B = −0.025, 95% CI = −0.04, −0.01; female: B = −0.02, 95% CI = −0.04, 0.00). Also, the grip strength moderation values are below 55.3 kg for males and 39.4 kg for females. Conclusions: Muscular strength, as measured by grip strength, moderated the relationship between cancer and depressive symptomatology. This supports the theory that recovery programs could include physical activity, namely muscle-strengthening exercises, to prevent depression. Full article

Secondary sexual traits, such as specific body parts or colouration, play an important role in mating interactions. It has been proposed that they function as quality indicators driven by sexual selection. In birds, much attention has been paid to the study of feather pigmentation, especially in diurnal passerines. However, recent research demonstrates that structural achromatic colours are likely to be of similar importance for communication, especially for species inhabiting poorly lit environments and that are active at night. Using 15 years of capture–recapture data from a long-term study on adult European Nightjars (Caprimulgus europaeus), we investigated the role of males’ white tail and wing markings as secondary sexual traits. We show that the inter-individual variation in marking size exceeds that of the other morphometric variables, suggesting that wing and tail markings could be subject to sexual selection. Older males, individuals with a higher body condition index, and long-term territory holders had larger markings, while these effects were particularly pronounced in terminal tail feather markings. The importance of markings for signalling is likely related to their observed use in social displays. Pronounced site differences in tail marking sizes and annual variation suggest environmental factors acting on the ornaments that remain to be further examined. Full article