Search Results (215)

For decades, transportation planning has relied on utilitarian principles, which aim to maximize cumulative benefit by meeting the needs of the “average user.” This approach ignores fundamental differences between population groups and produces uniform solutions that fail to address the diverse needs of women, children, the elderly, and other disadvantaged populations. In response, there are growing calls for a transportation justice paradigm that emphasizes individuals’ ability to access meaningful opportunities according to their characteristics, abilities, and life circumstances. Autonomous Mobility on Demand (AMoD) holds the potential to transform future transportation systems. However, without deliberate planning, they risk replicating existing patterns of inequality for populations whose mobility needs differ from those of the average user. This study applies transportation justice principles to examine how AMoD systems can be designed to meet diverse user needs. Using a combination of an Autoencoder for learning reduced representations and an HDBSCAN clustering algorithm, the analysis identifies distinct travel patterns across socioeconomic groups. These findings reveal significant gaps between population segments, particularly among children and older adults, and demonstrate how AMoD systems could expand access to after-school activities, reduce social isolation among elderly women, and reduce various transportation-related social gaps by improving their ability to reach a wider range of opportunities. Full article

Respiratory rate is one of the most important vital signs. It affects ventilation which relates to oxygen inhalation and carbon dioxide elimination. Currently, only a handful of prototypes are available for estimating the respiratory rate under the condition that users remain completely still. This research focuses on the development of a respiratory rate monitoring system that can detect human respiratory signals using force sensitive resistors (FSRs). The FSR sensors measure the forces from respiratory motion and then signal processing techniques are employed to minimize background noise and artifacts. Respiratory data are processed by a microcontroller and transmitted via Bluetooth to a mobile device for further processing and visualization. The system performance was evaluated in three stages. Firstly, for the proof by simulation, a mean absolute error (MAE), root mean square error (RMSE), and Pearson correlation coefficient (PCC) of 0.26, 0.37 breaths per minute (bpm), and 0.9998 are achieved, respectively, even when the noise level is very high, i.e., power signal-to-noise ratio is 0.25 or −6.02 decibel. Secondly, for the test on a robot, the MAEs are 0.25, 0.53, and 0.75 bpm; the RMSEs are 0.28, 0.64, and 0.92 bpm; the PCCs are approximately 1, 0.9993, and 0.9986, respectively, under sitting, walking, and jogging conditions. The system is further deployed on 14 human subjects yielding MAEs of 0.51, 1.24, and 1.92 bpm; RMSEs of 0.65, 1.63, and 2.22 bpm; and PCCs of 0.9893, 0.9831, and 0.9655, for human sitting, walking, and jogging, respectively. In the future, this respiratory rate monitoring system could be applied to patients, elderly individuals, or the general population who experience movement or locomotion during monitoring. Full article

The demographic shift towards an aging population necessitates innovative solutions for care and mobility support. While commercial quadruped robots like the Unitree Go1 offer dynamic stability, their native following modes often lack the safety margins and predictability required, and they do not consistently follow the user, at times deviating and navigating independently. This paper presents a robust, vision-based, person-following algorithm designed to address these limitations. Utilizing a ZED 2 stereo camera and Robot Operating System (ROS), the system employs a finite state machine to ensure deterministic target tracking. A velocity control strategy partitions the robot’s motion into distinct stability, proportional, and braking zones based on depth data to ensure fluid interaction. The framework was validated on a Unitree Go1 quadruped platform in an outdoor environment involving 90-degree turns to evaluate tracking robustness. By operating in a headless mode, the system achieved a mean processing latency of $66.5\pm 4.3$ ms. Experimental results demonstrated consistent operational stability, 0.0% intrusion into the intimate safety zone, and effective velocity synchronization between $0.47$ and $0.54$ m/s. While this study establishes a robust technical baseline using healthy subjects, it serves as a preliminary development platform; further iterative testing with elderly users in clinical settings is required to move toward deployment. Beyond the evaluated trials, the framework maintained reliable functional performance across various care facility workshops, successfully following the target in all deployment scenarios. These findings establish a stable technical foundation for the future development of robotic walking partners. Full article

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder that affects millions globally, particularly those in the elderly population. Several occupational exposures typical of maritime environments are recognized or suspected risk factors for PD, warranting attention within occupational health frameworks. The disease is characterized by motor symptoms such as tremor, rigidity, and bradykinesia, as well as non-motor impairments including speech abnormalities. Objective: Early diagnosis is crucial for effective disease management but remains challenging due to symptoms overlapping with normal aging and other neurological conditions. This study presents a machine learning (ML)-based approach for the early diagnosis of PD using speech signal analysis. Methods: We employed six supervised ML classifiers to differentiate between PD patients and healthy controls based on vocal features. The experimental dataset, MDVR-KCL, consists of speech recordings from both reading tasks and spontaneous dialogs, collected via mobile devices. From these recordings, we extracted Mel-Frequency Cepstral Coefficients (MFCCs), Gammatone Frequency Cepstral Coefficients (GTCCs), and acoustic features such as jitter, shimmer, and harmonic-to-noise ratio. These features capture a broad range of prosodic, spectral, and articulatory characteristics associated with PD-related speech impairments. Speaker diarization was applied in spontaneous dialog recordings to separate participant speech. Hyperparameter tuning was performed using GridSearchCV with 10-fold cross-validation, while final model evaluation was conducted using Leave-One-Subject-Out Cross-Validation (LOSOCV) to ensure subject-independent performance assessment. Results: In the read-text task, the SVM model performed exceptionally, yielding 95.45% accuracy, 94.62% sensitivity, 95.97% specificity, an F1-score of 94.12%, and an AUC of 0.98 with an MCC value of 0.90, for GTCCs with the acoustic features. In the spontaneous dialog task, the XGB model demonstrated the highest overall performance across all metrics, with a test accuracy of 83.7%, a sensitivity of 76.3.9%, a specificity of 88.9%, an F1-score of 79.5%, an AUC value of 0.88, and an MCC value of 0.66. Conclusions: Comparable results were obtained on both spontaneous dialog and reading speech subsets, demonstrating the robustness of the approach across different speaking contexts. These results demonstrate the effectiveness of integrating cepstral and acoustic features with machine learning models for non-invasive PD classification. The findings support the use of speech-based digital biomarkers in early PD detection and highlight the potential for developing scalable tools. This work highlights the potential of speech-based digital diagnostics to support clinical decision-making and improve patient outcomes. Full article

The Timed Up and Go (TUG) test is a clinical gold standard for assessing elderly mobility, yet its automated deployment in home-monitoring and resource-limited areas is hindered by high hardware costs and expert calibration requirements. This study introduces a Physics–Data Hybrid framework specifically designed for uncalibrated consumer-grade CMOS cameras, enabling a “plug-and-play” solution for early Parkinson’s disease (PD) risk screening. The proposed pipeline integrates learning-based pose perception with a self-evolving physics model to recover absolute metric-scale motion without manual checkerboard calibration. A noise-adaptive fusion strategy is implemented to reconcile 2D pixel dynamics with 3D kinematic consistency, overcoming the inherent scale ambiguity of monocular vision. Crucially, this framework enables the extraction of high-dimensional spatiotemporal parameters—such as stride length coefficient of variation and mean gait velocity—which provide a finer diagnostic resolution for capturing subtle motor fluctuations than conventional timing-only systems. Results from our pilot study with a cohort of 10 subjects demonstrate that these extracted metric features serve as decisive markers for risk staging simulated by dual-task-induced cognitive-motor-interference, achieving 98% screening accuracy and an overall classification accuracy of 87.32%. This framework provides a robust, low-cost tool for ubiquitous telehealth, potentially supporting early PD risk assessment in underserved populations. Full article

With the increasing global elderly population and, naturally, mobility limitations, the number of people requiring walking aids is increasing. Research on robotic walking aids tends to focus on walkers, while robotic canes are usually designed for hospital or clinical use. Research into compact, low-cost robotic canes intended for use outside clinical environments remains limited. This work aims at designing a robotic cane with a deformable wheel and exploring its dynamics in a variety of terrains and small obstacles. A flexible wheel fabricated from thermoplastic polyurethane (TPU) material allows it to adapt to different surface profiles. The motion is controlled via a LQR controller. The prototype was tested in several real-world scenarios, with users without walking difficulties, and in rehabilitation scenarios, with users with mild locomotion difficulties. The flexible wheel proved capable of adapting to terrains with some irregularities while still providing support to the users. Furthermore, expert opinions suggest benefits in terms of musculoskeletal efforts. Full article

Background: Nursing homes are congregate settings for elderly individuals where infectious diseases can easily spread. The elderly are at high risk of contracting and dying from influenza, and the most effective way to prevent this is to receive the influenza vaccine. Methods: This study conducted a cross-sectional survey of elderly people in nursing homes to investigate the occurrence of influenza symptoms during the 2024–2025 flu season, as well as vaccination status and reasons for receiving or not receiving the vaccine. Bivariate logistic regression was used to determine the factors influencing the vaccination rate. Results: Of the 1024 elderly people who participated in the survey, 25.39% reported experiencing flu-related symptoms in the previous flu season. While 16.21% of the elderly expressed willingness to receive vaccination, only 5.57% actually received it. Influenza vaccination was positively correlated with educational attainment (aOR 3.800, 95% CI 1.480–9.758 for middle school; aOR 5.138, 95% CI 1.738–15.191 for high school), monthly household income (aOR 0.216, 95% CI 0.072–0.644 for >8000), ability for self-care (aOR 0.269, 95% CI 0.123–0.591), and the scale of the nursing home (aOR 9.033, 95% CI 1.531–53.305 for 151–299; aOR 2.629, 95% CI 1.359–5.084 for ≥300). Willingness to receive the influenza vaccination was positively correlated with an unhealthy health status (aOR 0.398, 95% CI 0.204–0.779), symptoms of influenza (aOR 2.730, 95% CI 1.861–4.007), nursing home location (aOR 1.537, 95% CI 1.099–2.941 for outer suburbs), and the scale of the nursing home (aOR 1.991, 95% CI 1.154–3.435 for 151–299; aOR 2.158, 95% CI 1.374–3.390 for ≥300). Most elderly people who received the vaccine believed that vaccination could effectively prevent flu and that it could reduce the risk of complications, the rest were not vaccinated due to concerns about adverse reactions, mobility issues, or the distance to vaccination sites. Conclusions: Low awareness of flu vaccines and physical inability to travel to vaccination sites may be potential barriers to receiving the flu vaccine. It is worrying that the influenza vaccination rate is low among the elderly in nursing homes in Shanghai. As a result, it is crucial to prioritize targeted monitoring and intervention strategies for vulnerable populations living in collective institutions. Full article

Background and Objectives: Acetabular fractures in elderly patients are increasing in incidence and are frequently associated with osteoporotic bone, fracture comminution, marginal impaction, and pre-existing joint degeneration. Open reduction and internal fixation (ORIF) alone in this population is associated with high rates of fixation failure, post-traumatic osteoarthritis, and secondary conversion to total hip arthroplasty (THA). Acute THA, with or without concomitant internal fixation, has emerged as an alternative strategy aimed at enabling early mobilization and reducing reoperation rates. Materials and Methods: We retrospectively reviewed a series of elderly patients who sustained an acetabular fracture and were treated with acute THA, either as a standalone procedure or combined with internal fixation. Demographic data, fracture patterns, surgical technique, implant choice, complications, and short-term clinical and radiographic outcomes were analyzed. Results: Acute THA allowed immediate or early weight bearing in all patients. Implant stability was achieved using a highly porous, multi-hole acetabular component with supplemental screw fixation and selective use of internal fixation to restore columnar stability when required. Complications were comparable to those reported in the contemporary literature for acute THA in acetabular fractures. Conclusions: In carefully selected elderly patients with acetabular fractures at high risk of failure after ORIF, acute THA with or without internal fixation represents a viable definitive treatment strategy, enabling early mobilization and avoiding the morbidity associated with delayed salvage arthroplasty. Full article

Nowadays, longitudinal data are common—typically high-dimensional, large, complex, and collected using various methods, with repeated outcomes. For example, the growing elderly population experiences health deterioration, including limitations in Instrumental Activities of Daily Living (IADLs), thereby increasing demand for long-term care. Understanding the risk of repeated IADLs and estimating the trajectory risk by identifying significant predictors will support effective care planning. Such data analysis requires a complex modeling framework. We illustrated a regressive modeling framework employing statistical and machine learning (ML) models on the Health and Retirement Study data to predict the trajectory of IADL risk as a function of predictors. Based on the accuracy measure, the regressive logistic regression (RLR) and the Decision Tree (DT) models showed the highest prediction accuracy: 0.90 to 0.93 for follow-ups 1–6; and 0.89 and 0.90 for follow-up 7, respectively. The Area Under the Curve and Receiver Operating Characteristics curve also showed similar findings. Depression scores, mobility score, large muscle score, and Difficulties of Activities of Daily Living (ADLs) score showed a significant positive association with IADLs (p < 0.05). The proposed modeling framework simplifies the analysis and risk prediction of repeated outcomes from complex datasets and could be automated by leveraging Artificial Intelligence (AI). Full article

Background/Objectives: Mitochondrial dysfunction, often reflected by a decline in mitochondrial DNA copy number (mtDNA-CN) in peripheral blood cells (PMBCs), is a key hallmark of biological aging and is linked to numerous adverse health outcomes, including frailty and cardiovascular disease. Furthermore, emerging evidence suggests that vitamin D may influence mitochondrial dysfunction. This cross-sectional study aims to investigate the associations of mtDNA-CN with muscular strength, self-rated health, and serum 25-hydroxyvitamin D₃ (25(OH)D₃) levels in a community-dwelling elderly population. Methods: A total of 149 elderly outpatients (≥65 years) from Soria, Spain, were included in this cross-sectional study. Muscular strength was assessed using the hand grip strength (HGS) test, and self-rated health-related quality of life (QoL) was measured using the EuroQoL five-dimension questionnaire (EQ-5D). Genomic DNA was extracted from peripheral blood, and mtDNA-CN was quantified using quantitative real-time PCR (qPCR). Serum 25(OH)D₃, intact parathyroid hormone (iPTH), phosphorus, calcium, albumin and other mineral metabolism markers were measured. Statistical analyses, including Spearman correlations and multivariate logistic regression, were performed to assess associations, with stratification by sex. Results: In the total population, a marginally significant positive correlation was observed between mtDNA copy number (mtDNA-CN) and serum 25(OH)D₃ levels (r = 0.210; p = 0.010), which did not remain significant after Bonferroni correction. Among women, lower mtDNA-CN was significantly linked to muscle weakness (p = 0.005), mobility problems (p = 0.009), and a trend toward self-care difficulties (p = 0.016). Multivariate analysis confirmed an independent association with increased mobility impairment risk (adjusted OR = 0.983; 95% CI: 0.97–1.00; p = 0.009). No significant associations were observed between mtDNA-CN and dynapenia or QoL components in the male group. Conclusions: This study identified a marginally significant positive correlation between serum 25(OH)D₃ levels and mtDNA-CN in the total population (r = 0.210; p = 0.010), which did not persist after Bonferroni correction, suggesting an exploratory link between vitamin D status and mitochondrial homeostasis in older adults. In addition, these results highlight sex-specific differences in mtDNA-CN as a potential biomarker of functional decline, particularly of mobility, in women. These findings support the idea that mtDNA-CN could serve as an integrated biomarker and that sex-specific nutrition could be used to promote healthy aging. Full article

Background: Thumb carpometacarpal (CMC) arthritis affects up to 25% of women and 8% of men over 70 years of age, significantly compromising their activities of daily living. With the rapid growth of the elderly population globally and their specific clinical needs, understanding optimal surgical treatment for this age group is crucial. This systematic review compares trapeziectomy with ligament reconstruction and tendon interposition (LRTI) versus dual-mobility prosthesis for treating thumb CMC arthritis in elderly patients over 70 years old. Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library for studies published up to August 2025. Studies that directly compared both techniques were included, with subgroup analyses performed for elderly patients over 70 years of age when data were available. Primary outcomes included pain relief, functional improvement, grip and pinch strength, complications, and patient satisfaction. Results: Five studies met the inclusion criteria for direct comparison of both techniques, encompassing 313 patients (324 thumbs). While none exclusively focused on patients over 70, elderly patients represented 25–41% of study populations. Due to the absence of age-stratified data in the original studies, our analysis encompasses all age groups with specific considerations for elderly patients where identifiable. Dual-mobility prostheses demonstrated faster pain relief and earlier functional improvement, particularly within the first 3–6 months postoperatively. Prostheses consistently provided superior grip and pinch strength outcomes throughout follow-up periods. Both procedures effectively preserved thumb function, but prostheses better maintained thumb length and metacarpophalangeal stability. While complication rates were comparable, LRTI complications were typically minor and self-limiting, whereas prosthesis complications, though rare, could potentially require revision surgery. Longer-term follow-up data (>3 years) remain limited, particularly regarding implant degradation and adverse local tissue reactions. Conclusions: Both procedures effectively treat thumb CMC arthritis in elderly patients, with distinct advantages. Dual-mobility prostheses offer faster recovery, enhanced strength, and better thumb length preservation, making them potentially advantageous for elderly patients prioritizing rapid functional recovery. Trapeziectomy with LRTI provides reliable long-term pain relief with fewer serious complications, making it suitable for patients with poor bone quality or significant comorbidities. Treatment selection should be individualized based on patient characteristics, functional demands, and surgeon expertise. Future research specifically focusing on elderly populations with longer follow-up periods (>5 years) is critically needed to provide stronger evidence for this growing demographic and to better understand long-term implant performance. Full article

Postsocialist peri-urban spaces are characterized by a chaotic development as a result of the transition from communism to capitalism. Recent research has highlighted that liveability in peri-urban spaces encounters challenges of adaptation to the peri-urban areas. The aim of the present study is to identify and analyze patterns and contrasts that occur between age groups and gender in relation to the level of liveability as well as to better understand the daily mobility practices and commuting dependencies and how mobility shapes key contrasts and emerging tensions within Timișoara’s postsocialist peri-urban spaces. As liveability relates to local development, commuting, and accessibility to service facilities in the residential environment, the identification of patterns and differences is imperative when considering the perception of local residents on potential (un)sustainable liveability in peri-urban areas. This study utilizes a quantitative analysis, informed by a survey of considerable size (N = 954) conducted in peri-urban settlements of Timisoara, Romania, with a view to elucidating the distinctions and commonalities in the perceptions held by the local populace. The findings indicate that the elderly population exhibits a greater reluctance to adapt to the emerging peri-urban environment. In contrast, the younger and more educated demographic demonstrates a higher degree of adaptability to the contemporary challenges posed by peri-urban expansion and hazardous development. Daily mobility, including commuting, is directly influenced by the effects of dispersed and chaotic development (e.g., more than 79% of respondents rely on private cars for commuting), as well as the lack of facilities and services (e.g., 2.21 level of satisfaction regarding cultural events). This highlights Timisoara’s dependence on external services, as well as the significant role of personal vehicles in providing access to the city center and its neighborhoods. Therefore, we can observe the peri-urban area undergoing a transitional phase as it navigates the initial stages of sustainable urban development and pursues an enhanced quality of life. Finally, we propose several policy recommendations for local authorities, offering solutions for enhancing liveability in peri-urban areas. Full article

Population aging is driving the need for unobtrusive, continuous monitoring solutions in residential care environments. Radio-frequency (RF)-based technologies such as Ultra-Wideband (UWB) and millimeter-wave (mmWave) radar are particularly attractive for providing detailed information on presence and movement while preserving privacy. Building on a UWB–mmWave localization system deployed in a senior living residence, this paper focuses on the data-processing methodology for extracting quantitative mobility indicators from long-term indoor monitoring data. The system combines a device-free mmWave radar setup in bedrooms and bathrooms with a tag-based UWB positioning system in common areas. For mmWave data, an adaptive short-term average/long-term average (STA/LTA) detector operating on an aggregated, normalized radar energy signal is used to classify micro- and macromovements into bedroom occupancy and non-sedentary activity episodes. For UWB data, a partially constrained Kalman filter with a nearly constant velocity dynamics model and floor-plan information yields smoothed trajectories, from which daily gait- and mobility-related metrics are derived. The approach is illustrated using one-day samples from three users as a proof of concept. The proposed methodology provides individualized indicators of bedroom occupancy, sedentary behavior, and mobility in shared spaces, supporting the feasibility of combined UWB and mmWave radar sensing for longitudinal routine analysis in real-world elderly care environments. Full article

Background/Objectives: Specific pharmacological osteoporosis therapy (SPOT) is regarded as a key intervention to reduce fracture risk and improve musculoskeletal function. Real-life data, particularly regarding functional muscular outcomes and pain trajectories, remain limited. This study aimed to longitudinally analyze bone mineral density, laboratory parameters, handgrip strength, functional performance, and pain symptoms under guideline-based SPOT. Methods: In this monocentric prospective real-life observational study, 178 patients (80.9% women; median age 82 years) with confirmed osteoporosis were followed for a median of four years. All patients received guideline-recommended antiresorptive or osteoanabolic therapy. Analyses included T-scores, 25(OH)D, calcium, handgrip strength, Chair Rise Test (CRT), tandem stance (TS), pain parameters, alkaline phosphatase (AP), HbA1c, fractures, comorbidities, and body mass index (BMI). Time-dependent changes were evaluated using linear mixed-effects models. Results: Bone mineral density improved highly significantly (ΔT-score ≈ +0.45 SD; p < 0.001), with no differences between therapy groups (antiresorptive vs. osteoanabolic) or BMI categories. Serum 25(OH)D levels increased markedly (Δ ≈ +20 nmol/L; p < 0.001), while calcium levels showed a small but highly significant decrease (Δ ≈ −0.047 mmol/L; p < 0.001), particularly under antiresorptive treatment. Dominant (Δ ≈ −1.95 kg; p < 0.001) and non-dominant handgrip strength (Δ ≈ −0.83 kg; p = 0.046) decreased significantly. In contrast, functional performance improved significantly: CRT time decreased by ~1 s (p = 0.004), and TS time increased by ~1 s (p = 0.007). Back pain decreased highly significantly (Δ ≈ −1.5 NRS; p < 0.001), while pain-free walking time (Δ ≈ +38 min; p = 0.031) and pain-free standing time (Δ ≈ +31 min; p = 0.038) both increased significantly. AP levels decreased significantly (p = 0.003), particularly among normal-weight patients. HbA1c changes were not significant. Overall, 73% of patients had at least one major osteoporotic fracture. Conclusions: In this real-life cohort, guideline-based specific pharmacological osteoporosis therapy was associated with significant improvements in bone mineral density, vitamin D status, functional performance, and pain-related outcomes. Despite a moderate decline in handgrip strength, balance- and mobility-related functional parameters improved, suggesting preserved or even enhanced functional capacity in daily life. These findings provide real-world evidence on the associations between SPOT, laboratory parameters, functional performance, and pain outcomes in a very elderly and multimorbid population. Full article

Objective: Cardiovascular diseases have a high prevalence among the elderly, together with frailty syndrome, and both conditions negatively affect quality of life and limit patient autonomy. This study aimed to explore potential relationships between cardiovascular and metabolic parameters, renal function, and frailty domains to identify potential intervention targets. Methods: A cross-sectional study was conducted between January 2024 and April 2025 at the National Institute of Gerontology and Geriatrics “Ana Aslan”, including 359 patients aged over 40 years. Demographic, anthropometric, and clinical data were collected through interviews, medical records, and standardized assessments of frailty components (weakness, exhaustion, slow gait, balance impairment, reduced activity, cognitive decline, and weight loss), as well as cardiovascular diseases and comorbidities. Results: Most participants were aged 65–79 years. ROC curve identified triglycerides as a good indicator of both alcohol consumption (AUC = 0.631, p = 0.042) and smoking status (AUC = 0.676, p = 0.004), while HDL cholesterol showed an inverse association with smoking status (AUC = 0.356, p = 0.019). Reduced renal function was significantly associated with smoking status, balance, gait impairment, and reduced functional mobility. The Up and Go Test indicated a good discriminatory ability for renal function decline (AUC = 0.656, p < 0.001). Muscle strength, MMSE, and Tinetti scores showed inverse associations with renal function. Conclusions: Renal impairment appears to be a reliable indicator across multiple frailty domains, acting as an accelerator of frailty progression. Triglycerides reflect lifestyle-related factors, while the Up and Go Test may serve as a practical screening tool for renal dysfunction in frail older adults. These findings suggest the need to adapt traditional cardiovascular risk management to the frail geriatric population. Full article