Search Results (3,738)

Probiotics and microbiome-based therapeutics are increasingly used to prevent antibiotic-associated diarrhea (AAD) and support gut microbiota health across children, adults, and elderly populations. Evidence synthesized in this narrative review from randomized controlled trials and meta-analyses (>20,000 participants) suggests that early probiotic administration, particularly Lactobacillus rhamnosus GG, Bifidobacterium species, multistrain formulations, and Saccharomyces boulardii, is associated with a 30–40% relative reduction in AAD incidence across heterogeneous studies, with absolute risk reductions of approximately 5–12% depending on baseline risk, strain, dose, and timing. Probiotics are generally well tolerated, with mild gastrointestinal adverse effects reported in 3–5% of users and rare serious events mainly in immunocompromised individuals. However, heterogeneity in formulations, populations, and limited long-term real-world data underscores the need for further pharmacoepidemiological studies, microbiome surveillance, and evaluation of antimicrobial resistance implications. Full article

Background: Studies on the association between cognitive and physical fitness in older adults from particularly vulnerable settings are scarce. This study aims to analyse the relationship between different protocols for assessing physical fitness and the cognitive function of low-income older adults. Methods: A total of 312 adults aged 60–96 years (M age = 72.63, SD= 7.81) living in the urban area of Amazonas, Brazil, participated in the study. The following measures of physical fitness were assessed: body composition, handgrip strength, the Five Times Sit-to-Stand Test and Senior Fitness Tests. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Linear regression models were used to analyse the relationship between physical function measures and cognitive function. Results: For men, only the 30-chair stand test power (β = 0.33, p < 0.001) presented favourable association with cognitive function. For women, significant associations between MMSE score were observed for every fitness test, except for the chair sit-and-reach test. Conclusions: Physical fitness is differently associated with cognitive function among low-income older men and women from Amazonas. Muscular fitness particularly seems to be an important indicator of cognitive function. It should be considered for monitoring, promoting, and managing health-ageing of low-income elderly populations of both sexes. Full article

Alzheimer’s disease (AD) and related dementias (ADRD) are neurodegenerative conditions that cause gradual deterioration of cognition, memory and language in the elderly. AD has been declared as a health priority by the World Health Organization (WHO) considering its severity and unavailability of a permanent cure. Although the global AD/ADRD population is made up of many ethno-racial groups, the majority of AD studies have focused on the Caucasian population. The few AD studies conducted on minority populations in the US have found that significant AD health disparities exist, demonstrating that African Americans and Hispanics have a significantly higher prevalence of AD and related dementias, with their risk often approaching twice that of White individuals. For the past few years, epigenomic research has played an important role in understanding health disparities among diverse racial and ethnic groups. Unlike genetic studies, which focus on the DNA sequence that one is born with, epigenomics investigates how changes in gene expression due to extrinsic environmental exposures may impact disease pathophysiology. Recent epigenomic studies appear to be promising in not only understanding disease pathology but also in developing diagnostic and therapeutic tools for AD with population specificity. However, there is only a handful of studies and review articles available addressing the epigenomic applications in irradicating racial disparities in AD/ADRD. Therefore, the aim of this review is to discuss the recent findings of epigenomic studies in AD and related dementias, their contribution in irradicating racioethnic disparities and insights into the future direction of their application in precision medicine. Full article

Background: Herpes zoster (HZ), caused by the reactivation of varicella-zoster virus (VZV), primarily affects elderly populations worldwide. Although current recombinant HZ vaccines show strong immunogenicity, their high cost and potential side effects may limit their widespread use. Therefore, developing a cost-effective HZ vaccine with improved safety profiles would have significant clinical and public health implications. Methods: Building upon our previously optimized truncated gE (tgE350) from VZV, we developed the tgE350 + Fe nanoparticle vaccine using SpyTag/SpyCatcher covalent conjugation. The tgE350 protein (with a SpyTag tag) and the Fe protein (with a SpyCatcher tag) were expressed in HEK293F and E. coli BL21, respectively, enabling spontaneous nanoparticle assembly. Protein expression and nanoparticle formation were confirmed through SDS-PAGE and negative-stain electron microscopy. BALB/c mice were inoculated with either tgE350 + Fe or tgE350 combined with Al and CpG adjuvants. Immune responses were evaluated using ELISpot and flow cytometry for cellular immunity, along with ELISA, VZV microneutralization, and fluorescent antibody membrane antigen (FAMA) assays for antibody titers. Histopathological examination of major organs ensured vaccine safety. Results: Compared with the truncated vaccine tgE350, the nanoparticle vaccine tgE350 + Fe significantly enhanced VZV neutralizing antibodies and specific antibody responses in mice without causing significant changes in lymphocyte populations (no difference from the control group). Moreover, the tgE350 + Fe group had significantly more lymphocytes secreting IFN-γ, IL-2, and IL-4 than the tgE350 group. No apparent pathological damage was observed in the heart, liver, spleen, or lungs of mice in any experimental group. Conclusions: This experiment successfully developed the HZ nanoparticle vaccine tgE350 + Fe. It enhanced VZV-specific neutralizing antibodies, generated better cellular and humoral immune responses, and demonstrated good safety. Full article

The global population aged 65 and older is expected to double from 761 million in 2021 to 1.6 billion by 2050. Despite often being treated separately in clinical practice and policy, oral health and mental health are fundamentally interconnected in older adulthood, forming a bidirectional relationship that exacerbates disability, social inequity, and systemic healthcare challenges. This narrative review aims to summarize the two-way relationship between mental and oral health and emphasize their combined impact on systemic health, social engagement, and independence among ageing populations. The bidirectional relationship has profound clinical significance. Untreated oral diseases induce chronic pain and cause social embarrassment, aggravating pre-existing depression and anxiety. Periodontal disease can worsen systemic conditions such as diabetes, cardiovascular disease, and dementia via a shared inflammatory pathway. Conversely, mental health issues—including depression, anxiety, cognitive decline, and the use of psychotropic medications—reduce motivation for oral care, prompt dental neglect, and affect salivary function, deteriorating oral health. Despite clear connections, systemic gaps persist, including fragmented healthcare systems, financial barriers, stigma, lack of awareness, and caregiver burnout. To address these challenges, strategies such as developing integrated care models to unify dental and mental health services, reforming policies to prioritize oral and mental health parity, advocating anti-stigma campaigns to clear the misconceptions, and implementing community-based healthcare programmes to reach underserved older adults are essential. By recognizing oral health as a vital component of mental resilience, societies can transform ageing into an era of empowered well-being, where the mouth–mind connection promotes holistic health rather than functional decline. Full article

In the face of rapid aging, depression in later life has become a prominent issue in urban public health and environmental research. As potential places for social activities and emotional healing, the social stayability of shaded community spaces is an essential environmental factor influencing the mental well-being of the elderly. In order to overcome the challenge of depression relief in later life, it is important to investigate what attributes of social stayability in shaded spaces influence the mental well-being of the elderly, as well as their gap structures. This study innovatively develops a fuzzy multi-criteria decision-making method and builds an analytical framework combining Fuzzy-BWM and VIKOR to comprehensively evaluate three dimensions of physical accessibility, facilities, and spatial conditions, and environmental comfort and safety of shaded spaces. Using the Pioneer community in Panyu, Guangzhou, and the Yuehan community in Macau as empirical cases, this study integrates expert judgment and residents’ perception data to identify the key attributes and gap structure of shaded space stayability in mitigating depression-related psychological risk and promoting emotional restoration and psychological well-being among older adults. The results show that facilities and spatial conditions have the greatest impact on social stayability. The two attributes of sitting comfort and public service facilities are the dominant factors that affect stay intention and emotional recovery. Environmental comfort and safety have a secondary but stable supporting effect on psychological security. This study reveals the coupling relationship between functional configuration and perceptual experience and advocates for the transformation of urban renewal thinking from spatial optimization to psychological health promotion. This study’s results offer theoretical support and policy implications for building restorative, inclusive, and age-friendly cities. The findings provide a quantitative basis for decision making regarding sustainable community space governance and intervention prioritization. Full article

Toxoplasmosis is a parasitic disease associated with significant morbidity and mortality. This cross-sectional study aimed to determine the prevalence, associated risk factors, and ocular health outcomes related to Toxoplasma gondii seropositivity in 161 residents from four Quilombolas communities in the northern region of Tocantins, Brazilian Legal Amazon. Peripheral blood samples were collected and tested by Enzyme-Linked Immunosorbent Assay (ELISA) for Immunoglobulin G (IgG) and/or Immunoglobulin M (IgM) and Polymerase Chain Reaction (PCR), while a standardized form was used to collect sociodemographic, health, and behavioral data. Statistical analysis, conducted using Epi-Info 3.3.2, considered T. gondii seropositivity as the primary outcome, with a significance level less than 5% (p ≤ 0.05). An overall seroprevalence of 62.11% (100/161) was observed. Key risk factors significantly, as measured by the Odds Ratio (OR), associated with T. gondii seropositivity included being elderly (OR: 4.07, CI: 2.05–8.06, p < 0.01), having cats (OR: 5.56, CI: 2.74–22.27, p < 0.01), a low parental education level (OR: 2.97, CI: 1.46–6.02, p < 0.01), children playing on the ground (OR: 2.50, CI: 1.30–4.82, p < 0.01), and having a home vegetable garden (OR: 3.80, CI: 1.94–7.47, p < 0.01). Regarding ocular health, no conclusive direct association was established between T. gondii seropositivity and specific ocular manifestations when analyzed for children and the elderly separately. Observed ocular problems in the grouped population were primarily linked to age-related comorbidities rather than parasitic infection. High rates of T. gondii seropositivity, driven by specific environmental and socioeconomic factors, highlight the vulnerability of these communities, emphasizing the need for targeted preventive strategies. Full article

Urban and population densification have resulted in deteriorating living conditions for populations and the loss of UGSs. The COVID-19 pandemic has exposed the social, economic and environmental vulnerabilities of our societies, but it has also demonstrated the importance of UGSs as intrinsic elements for maintaining the quality of life of the population and making urban spaces sustainable. Due to its considerable area of UGS, the district of Benfica in Lisbon, Portugal, is the object of study. The study focuses on understanding how the proximity of UGS influences the practice of leisure activities for different publics, and how they are reflected in the populations’ lives, exploring the context during the COVID-19 pandemic. It develops a methodology with a mixed-methods approach: (1) literature review, policies, and urban planning; (2) observation methods, mapping and spatial analysis of UGS types; and (3) surveys. The empirical results indicate the importance of proximity to improve the frequency, namely for the elderly and children. The results also demonstrate that the quality (infrastructure and equipment) of UGS, despite having less walking proximity, is an important element to attract people to use the UGS. A general conclusion is that the proximity and accessibility (walking or public transport) are interlinked in both profiles of UGS, demonstrating a relationship between the place of residence, easy access and frequency of UGS in the practice of activities and the self-assessed physical and mental health benefits. Full article

In urban design, public open spaces (POS) are essential for enhancing health and well-being across the lifetime. High-quality public open spaces facilitate the maintenance of optimal physical and mental health in older individuals by encouraging activities like physical exercise and social engagement. Preserving the physical and mental well-being of elderly individuals is a fundamental concern for aging policy. Nevertheless, urbanization presents considerable problems with the provision of public open spaces for activities aimed at the elderly. South Korea has more significant issues than other nations globally. This study, based on data from 477 valid questionnaires collected in and around Tapgol Park in Jung-gu, Seoul, employed a decision tree approach to identify key factors and paths that influence overall satisfaction. The goal was to identify decision paths that improve satisfaction while ensuring interpretability, thereby providing a scientific basis for urban space design and renovation. The results show that: (1) The decision tree of this study presents a hierarchical logic of quietness first, then accessibility and cleanliness, and finally price and vitality, which is consistent with the high frequency of use of Tapgol Park by the elderly and the diverse facilities in the surrounding area. (2) The key to improving the management and satisfaction of Tapgol Park in Seoul is the quietness of the site. (3) When the park is not quiet, users are most sensitive to bottom-line factors, such as commercial supply, evacuation safety, transportation accessibility, price perception, barrier-free, and anti-slips. (4) When the park is quiet, basic comfort factors such as smooth walking, all-day opening, sunlight, and no odor constitute the minimum condition set for entering the comfort zone. (5) Water experience, waterfront accessibility, proximity to cultural resources, and moderate business and community-oriented leisure facilities are key plus points. Methodologically, this study is among the first to apply a decision tree approach to low-income elderly using a small public open space in a historic city center, clarifying the nonlinear and hierarchical relationships among environmental factors within these low-income elderly groups. This provides empirical support and reference for the aging-friendly urban space in world heritage cities and other historical and cultural cities. Full article

Background/objective: Maxillofacial fractures continue to represent a significant public health issue, with incidence patterns shaped by regional and demographic variables. This study aimed to deliver a comprehensive 15-year epidemiological analysis of maxillofacial trauma cases in southern Hungary. Methods: The study included patients who received treatment for maxillofacial trauma at the University of Pécs from 2009 to 2023. Data collected encompassed demographic characteristics, injury etiology, fracture location and complexity, date of injury, presence of alcohol involvement, therapeutic interventions, postoperative complications and reasons, and number of fixation plates removed. Descriptive statistics and odds ratios were calculated, with statistical significance defined as p < 0.05. Results: Among 1948 patients (69.9% male), a total of 2826 fractures were reported, averaging 1.45 fractures per patient. The most frequently affected age group was 21–30 years; however, a notable increase in cases among the elderly was observed for recent years. Falls accounted for the highest proportion of injuries (44.4%), followed by assaults (28.3%) and traffic accidents (16.8%). Injuries predominantly occurred on weekends, with Saturdays being particularly common. Alcohol consumption was documented in 14.7% of cases. The condyle (27.9%), body (25.7%), and angle (25.0%) were the most common sites of mandibular fracture. The maxillary sinus and zygomatic body were the leading sites of maxillofacial fractures. Conservative treatment was implemented in 54.6% of all cases, whereas surgical intervention was more frequently required for mandibular injuries (76.7%). Plate removal was performed in 15.3% of patients. Conclusions: During the study period, the incidence of maxillofacial trauma demonstrated a consistent increase, accompanied by demographic changes indicative of an aging population and a reduction in assault-related cases. Falls—especially among older adults—became the leading cause of injury. These results emphasize the necessity for targeted prevention efforts, geriatric-specific trauma management, and the implementation of health policies tailored to regional needs. Full article

Background: Diabetes is associated with sub-optimal vascular function. Current evidence suggested purified anthocyanins (ACNs) could improve cardio-metabolic health, but the dose–response effects on arterial stiffness have not been verified. Objectives: To assess the dose-responsiveness of purified ACNs on vascular stiffness and cardiovascular risk among Chinese middle-aged and elderly patients with either prediabetes or early diabetes. Methods: This was a secondary analysis based on a 12-week double-blind, randomized and placebo-controlled trial. Eligible participants were randomly assigned to placebo, 160, 320 and 640 mg/d ACNs groups (n = 46/group). Information on dietary intakes and lifestyle habits and blood samples were collected at baseline and at week 12. Arterial stiffness and vascular function were measured by brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and four-limb blood pressures. Composite cardiovascular indices were estimated based on lipids and anthropometric data. Results: Total 184 eligible participants were recruited and 19 withdrew during the intervention. Baseline characteristics were generally comparable among groups. No significant effects or dose–response relationships were observed by ACNs supplementation on arterial stiffness and cardiovascular risk factors. Conclusions: The 12-week randomized controlled trial among Chinese middle-aged and elderly adults with dysglycemia showed multiple dosages of anthocyanins had no significant impacts on arterial stiffness and cardiovascular risk. Full article

Background/Objectives: Socially assistive robots effectively support elderly care when they incorporate personalization, person-centered principles, rich interactions, and careful role setting with psychosocial alignment. Hyodol, a socially assistive robot designed for elderly people, embodies a grandchild’s persona, emulating the grandparent–grandchild relationship. Based on the behavioral activation principles and a human-centered approach, this robot continuously supports users’ emotional well-being, health management, and daily routines. Methods: The current study evaluated Hyodol’s impact on depressive symptoms and other quality of life factors among older adults living in medically underserved areas. A total of 278 participants were assessed for depressive symptoms, loneliness, medication adherence, and user acceptance. Results: After six months of use, participants showed significant reductions in overall depressive symptoms, with a 45% decrease in the proportion of individuals at high risk of depression. Significant improvements were also observed in loneliness and medication adherence. Participants reported high levels of user acceptance and satisfaction, exceeding 70% of the total score. Participants who engaged more frequently in free chat with Hyodol showed greater improvements in depressive symptoms. Conclusions: These results highlight Hyodol’s potential as a promising tool for enhancing mental healthcare and overall well-being in this population. This at-home mental-healthcare framework can complement primary care and, if its effects are confirmed in controlled trials, could contribute to reducing healthcare burden and preventing the onset and escalation of depressive symptoms. Full article

Background/Objectives: High-density lipoprotein cholesterol (HDL-C) regulates muscle energy metabolism and function, enhancing glucose uptake and promoting glycogen synthesis. However, studies on the association between HDL-C levels and sarcopenia remain controversial. We therefore investigated the association between HDL-C levels and sarcopenia in elderly Koreans. Methods: This cross-sectional study was based on previously collected, anonymous health checkup data. Participants included 3776 individuals aged 65 years and older who underwent body composition analysis using a bioelectrical impedance meter during a health checkup in 2024. Sarcopenia was defined as an appendicular skeletal muscle index of <7.0 kg/m² for males and <5.7 kg/m² for females. Logistic regression analyses were performed for each variable, including HDL-C levels, to identify sarcopenia association expressed as odds ratios (ORs). Participants were further divided into four quartiles according to HDL-C levels, and comparative multivariable analyses were performed, with the quartile with the lowest HDL-C level serving as the reference. Results: Of the 3776 Koreans with a mean age of 70.5 years, sarcopenia was diagnosed in 23.1% (n = 872) of participants. Sarcopenia prevalence showed a steadily increasing trend from the lowest quartile group (Q1, n = 977) with HDL-C levels ≤48 mg/dL to the highest quartile group (Q4, n = 974) at ≥67 mg/dL (p < 0.001). After adjusting for sarcopenia-associated risk factors, a significant association was found between the condition and HDL-C levels (OR 1.01, 95% CI 1.00–1.02; p = 0.008). Q4 showed a consistent sarcopenia association compared with Q1, even after adjusting for all variables (OR 1.36, 95% CI 1.05–1.75; p = 0.018). Conclusions: In Koreans aged 65 years and older, we found an association between high HDL-C levels and sarcopenia. Full article

Background and Objectives: Japan’s aging population faces growing challenges related to oral frailty, a condition characterized by the decline of oral function associated with physical and nutritional deterioration. Impaired oral function contributes to reduced chewing, swallowing, and saliva secretion, leading to poor appetite and frailty progression. Ninjin’yoeito (NYT), a traditional Kampo formula, has been clinically used to improve systemic weakness and oral symptoms. This study aimed to evaluate the efficacy and safety of NYT in improving oral health among elderly individuals with impaired oral function. Materials and Methods: In this open-label prospective study, patients received NYT daily for 12 weeks. Assessments included oral symptom scores, mucosal moisture, repetitive saliva swallowing tests (RSST), gustatory function by visual analogue scale (VAS), an 11-item oral questionnaire, and immune profiling by flow cytometry. Safety was assessed through hematological and biochemical tests. Results: Symptom scores decreased from 8.27 at baseline to 3.64 at 12 weeks (p = 0.006), while oral condition scores improved from 5.09 to 1.36 (p = 0.006). Mucosal moisture increased (25.1 to 28.1, p = 0.03), and RSST frequency improved (2.18 to 4.55, p = 0.046). Questionnaire scores declined from 5.1 to 2.0 (p < 0.001). VAS-taste was unchanged overall (p = 0.21) but improved in low baseline patients. Laboratory findings showed no adverse changes, with favorable lipid trends. Immune analysis revealed a decline in NKG2D expression (p = 0.02), whereas other activating and inhibitory markers remained stable. Conclusions: NYT was well tolerated and associated with gradual improvements in oral and physical symptoms among elderly individuals with impaired oral function. These findings provide preliminary evidence supporting the feasibility of Kampo-based approaches for maintaining oral health in aging populations and warrant further validation in larger controlled trials. Full article