Search Results (1,406)

Prolonged hospitalization contributes to a decline in physical function and immobilization. This narrative review aims to explore physical rehabilitation approaches that address the specific characteristics of physical dysfunction in patients with schizophrenia. A literature review was conducted following an electronic search of PubMed for English-language articles published between January 2014 and January 2025. Based on the findings, a framework was constructed to categorize symptoms and physical challenges into three domains: (1) movement disorders and obesity induced by antipsychotic medications, which alter motor performance and lead to compensatory movements; (2) negative symptoms and cognitive impairments, which promote sedentary behavior and result in dysphagia, dynapenia, sarcopenia, and frailty; and (3) accelerated brain aging and disuse syndrome by schizophrenia, which impair neuromotor and cognitive function and increases the risk of physical dependency. These interconnected factors emphasize the need for targeted physical rehabilitation to maintain independence and reduce the risk of hospitalization. This review proposes a multidisciplinary approach involving psychiatrists, physical therapists, and occupational therapists, along with individualized nutritional support, as essential components of comprehensive rehabilitation strategies aimed at improving physical outcomes and reducing early mortality in this population. Full article

Background: A wide percentage (25–40%) of patients affected by head and neck squamous cell carcinoma (HNSCC) are over 70 years old, and they present with different characteristics if compared to younger patients. Elderly patients often receive less intensive, non-surgical, and non-multimodal treatments. Although age does not mean frailty, the elderly are at a higher risk of developing toxicity. In fact, several studies enrolling patients treated with cisplatin + radiotherapy (CISPLATIN + RT) or cetuximab + radiotherapy (Cet + RT) showed reduced efficacy over 65 years. Methods: We conducted a multicenter retrospective analysis in patients with Locally Advanced HNSCC aged over 65 years, who underwent Cet-RT, diagnosed in the period between 2017 and 2024. The primary endpoint was to describe Overall Survival (OS), the secondary endpoints were Progression Free Survival (PFS) and the percentage and type of Adverse Events (AEs). Patients received a geriatric assessment using the G8 questionnaire. Results: Data regarding Eighty-Two (82) patients were analyzed, median age was 74 years (range 65–84), most patients had oral cavity (26.8%) and laryngeal cancer (37.8%). Fifty-six point one (56.1%) of patients were smokers, and 17.1% reported alcohol consumption. All patients completed radiotherapy, and 80.5% of them developed AEs, which in 25.6% of cases were G3–4 toxicities. No relationship was found between G3–4 AEs and age (p = 0.596), G8score < 14 (p = 0.804), and smoking (p = 0.245)/drinking habits (p = 0.341). Median OS was 58 months, with a slightly non-significant positive trend in OS for patients who were non-smokers and those who did not develop G3–4 AEs (p = 0.786 and 0.799, respectively). Association between folliculitis and OS was statistically significant (p = 0.001). Conclusions: In elderly patients, Cet-RT represents a feasible, well-tolerated option, although further prospective studies are needed. Full article

Background: Frailty is a multidimensional syndrome characterized by reduced physiological reserve and resilience and has become a crucial predictor of outcomes in liver surgery. Unlike chronological age, frailty reflects broader vulnerabilities that significantly influence postoperative recovery. Aim: To review and synthesize current evidence on the relationship between frailty and postoperative outcomes following liver resection, with an emphasis on short-term complications, mortality, and long-term survival. Methods: A comprehensive literature review was performed, drawing on recent meta-analyses, large-scale cohort studies, and prospective observational data. Frailty was evaluated using a range of assessment tools, including the Modified Frailty Index (mFI), Clinical Frailty Scale (CFS), Kihon Checklist (KCL), and claims-based measures such as the Johns Hopkins Frailty Indicator. Results: Across studies, frailty has been consistently linked to a higher incidence of postoperative complications, such as post-hepatectomy liver failure (PHLF), infections, extended hospital stays, and increased mortality. In patients undergoing liver resection for cancer, frailty is also associated with poorer long-term survival. Importantly, frailty serves as an independent risk factor, even after adjusting for age, comorbid conditions, and tumor characteristics. Preoperative identification of frailty enhances risk stratification, informs surgical planning, potentially favoring parenchymal-sparing or minimally invasive approaches, and highlights patients who may benefit from prehabilitation. Conclusions: Frailty is a strong and independent predictor of poor outcomes after liver resection. Incorporating frailty assessment into routine preoperative evaluation can improve surgical decision-making, facilitate informed patient counseling, and optimize perioperative care strategies. Full article

Background/Objectives: Although peritoneal dialysis (PD) practices have improved over the past decades, limited evidence exists on all-cause mortality and cardiovascular death following PD-associated peritonitis. This study aimed to investigate the association between PD-associated peritonitis and the risk of all-cause mortality and cardiovascular death. Methods: This multicenter, retrospective cohort study included adult patients who newly initiated PD between 1 January 2006 and 31 December 2020, with follow-up through 30 September 2022. Patients were matched 1:1 by time from PD initiation to index date (the occurrence date of PD-associated peritonitis for the exposure group and the corresponding matched time on PD for the non-exposure group [individuals without any peritonitis event]), age, and sex. Multivariable Cox proportional hazards models with shared frailty correction and competing risk models were used to estimate hazard ratio (HR) and subdistribution hazard ratio (SHR), respectively. Subgroup analyses were conducted by age, sex, PD modality, and comorbid conditions. Results: The cohort included 1510 matched pairs (total sample, 3020; mean age [SD], 58.6 [14.2] years; 1618 males [53.6%]), with a median follow-up of 5.6 years. After adjusting for sociodemographic, PD, and clinical characteristics and laboratory profiles, patients with any PD-associated peritonitis episode had significantly higher risk of all-cause mortality (HR, 2.17 [1.78–2.66], p < 0.001; SHR, 2.00 [1.74–2.29], p < 0.001) and cardiovascular death (HR, 2.90 [2.05–4.59], p < 0.001; SHR, 2.25 [1.66–3.05], p < 0.001) compared to those without PD-associated peritonitis. Subgroup analyses revealed no significant interactions (all p values for interaction > 0.05). Conclusions: PD-associated peritonitis was independently associated with substantially increased risk of all-cause and cardiovascular mortality among patients undergoing PD. These findings support the need for targeted interventions and clinical strategies aimed at reducing adverse outcomes following PD-associated peritonitis. Full article

Background/Objectives: Mandibular advancement oral appliances (MAOAs) for obstructive sleep apnea syndrome treatment can be rendered more convenient by adopting a separate and movable design; however, concerns regarding possible weakening of effect have been raised. This study had the aim to clarify the factors associated with the longevity of separate and movable MAOAs. Methods: Information on 466 MAOAs from 230 patients was collected from medical records, including baseline information, apnea–hypopnea indexes, transcutaneous oxygen saturation, component connection method, and initial fabrication status (new fabrication or repair). MAOAs were evaluated in clinical practice, and breakage was considered a failure. Failures were classified into three types: Type A, breakage anywhere in MAOA; Type B, connector breakage (thermoplastic component breakage was censored); and Type C, thermoplastic component breakage (connector breakage was censored). Survival time of MAOA for all types was analyzed using a shared frailty model. Hazard ratios and 95% confidence intervals were determined, with the statistical significance at p < 0.05. Results: Type A failures were significantly linked to patient sex, age, and connection method; Type B failures were associated with sex and age; and no variables were linked to Type C failures. Younger male patients showed lower survival rate except for Type C, with no correlation between apnea symptom severity and survival status. Conclusions: MAOA connector strength was significantly associated with the MAOA survival rate. Connectors were more likely to break in younger patients, and this tendency was particularly pronounced in males. Therefore, age and sex should be considered when choosing the MAOA connection method. Full article

Background/Objective: The sequelae of COVID-19 on geriatric health is profound, yet its consequences on mental well-being remain insufficiently elucidated, particularly in older adults with musculoskeletal conditions. This study aimed to explore the interrelationships and magnitude of the effects of fear of COVID-19, fear of falls, physical activity, and social frailty on depressive symptoms in this population. Methods: Purposive sampling was applied to recruit 292 older adults with musculoskeletal conditions. Data were collected through structured interviews (face-to-face and telephone) using standard questionnaires. Path analysis with Satorra–Bentler correction examined the relationships in the proposed model of depressive symptoms. The model fit indices were evaluated using the chi-square (χ²); the goodness-of-fit test was assessed with standard criteria of the comparative fit index (CFI ≥ 0.95), the Tucker–Lewis index (TLI ≥ 0.95), the root mean squared error of approximation (RMSEA < 0.08), and the standardized root mean square residual (SRMR < 0.05). Results: Mean participant age was 70.30 ± 6.56 years, with 74.3% female. The path analysis model demonstrated an excellent fit indicating χ² = 0.007 (p = 0.933), CFI and TLI = 1.000, RMSEA = 0.000, SRMR = 0.001. Fear of COVID-19 negatively indirectly impacted depressive symptoms (β = −0.07, p = 0.017), while physical activity had a positive direct effect (β = 0.16, p = 0.004). Fear of COVID-19 directly influenced social frailty (β = 0.18, p = 0.003) but had a negative direct impact on physical activity (β = −0.37, p = 0.000). However, fear of falling did not show a significant relationship with the other study variables. Conclusions: Depressive symptoms entail physical and psychosocial consequences. Physical activity has a positive effect on depressive symptoms. Fear of COVID-19 increases social frailty, while increasing physical activity reduces this fear. Future research should evaluate longitudinal effects and investigate evidence-based public health interventions or tailored cognitive–behavioral interventions to reduce pandemic-related fear and prevent mental health sequelae. Full article

The gut microbiota greatly influences host physiology, including immune regulation, metabolic balance, and brain health. Aging is associated with alterations in the gut microbiome, including reduced microbial diversity and increased pro-inflammatory bacteria, which are linked to age-related decline and chronic diseases. This review examines the impact of the gut microbiota on key indicators of aging, including cellular senescence, mitochondrial dysfunction, alterations in gene expression, and immune system modifications. It also examines microbiome-related diseases associated with aging, including neurodegeneration, cardiovascular issues, metabolic syndrome, and frailty. Additionally, it highlights evidence-based methods to restore a youthful microbial profile. New findings suggest that certain microbial substances, including short-chain fatty acids, urolithins, and bile acids, play a role in regulating inflammation, maintaining barrier integrity, and influencing metabolism. Age-related diseases are often associated with molecular pathways driven by an imbalance in the gut microbiome. Various intervention strategies, from dietary changes and probiotics to personalized nutrition and fecal microbiota transplantation, have shown promise in reversing signs of microbial aging and improving health outcomes in both lab and human studies. Overall, the gut microbiome serves as both a marker and a regulator of healthy aging. Treatments that restore microbial balance offer hopeful ways to extend healthy living. Future studies should focus on developing long-term, multifaceted, and personalized methods to identify causal pathways and enhance microbiota-based strategies for various aging populations. Full article

Background and Objectives: Sarcopenic obesity, characterized by sarcopenia and obesity, is associated with adverse outcomes. The recent consensus from the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) proposed a diagnostic algorithm (screening, diagnosis, and staging) for sarcopenic obesity. However, the effectiveness of recommended screening tools for sarcopenic obesity remains unclear. This study aimed to assess the performance of SARC-F questionnaire (Strength, walking Assistance, Rise, Climb, and Falls), calf circumference (CC), and SARC-CalF (SARC-F combined with CC), combined with obesity indicators, as screening tools for sarcopenic obesity. Materials and Methods: This cross-sectional study analyzed 2020 community-dwelling older adults from the Korean Frailty and Aging Cohort Study. Sarcopenic obesity was defined according to ESPEN and EASO criteria. Screening tools included SARC-F, CC, and SARC-CalF in combination with high body mass index (BMI; ≥25 kg/m²) or high waist circumference (WC; men, ≥90 cm; women, ≥85 cm). The diagnostic performance was evaluated using sensitivity, specificity, and predictive value. Results: SARC-F (≥4) with high BMI or WC demonstrated low sensitivity (men, 5.68%; women, 17.82%) but high specificity (men, 99.03%; women, 94.35%) and negative predictive value (NPV) (men, 91.68%; women, 91.09%). Lowering the SARC-F cutoff improved sensitivity but reduced specificity. CC combined with a high BMI or WC showed modest sensitivity (men, 34.09%; women, 34.65%) but moderate specificity (men, 59.48%; women, 59.91%). SARC-CalF (≥11) combined with high BMI or WC showed slightly higher sensitivity (men, 13.64%; women, 19.80%) but lower specificity (men, 95.04%; women, 86.93%) than SARC-F. Conclusions: SARC-F combined with obesity indicators may serve as a case-finding tool with high specificity and NPV, supporting its usefulness in ruling out sarcopenic obesity in the clinical setting. Meanwhile, CC was not an effective screening tool, and SARC-CalF did not substantially improve sensitivity or accuracy compared with SARC-F. Full article

Aim: With the intensification of population aging, the public health challenges posed by multimorbidity have become increasingly severe. This study employs bibliometric analysis to elucidate research hotspots and trends in the field of multimorbidity against the backdrop of global aging. The immediate aim is to systematically map the intellectual landscape and evolving patterns in multimorbidity research. The ultimate long-term aim is to provide a scientific basis for optimizing chronic disease prevention systems and guiding future research directions. Methods: The study adopted the descriptive research method and employed a bibliometric approach, analyzing 8129 publications related to multimorbidity from the Web of Science Core Collection. Using CiteSpace, we constructed and visualized several knowledge structures, including collaboration networks, keyword co-occurrence networks, burst detection maps, and co-citation networks within the multimorbidity research domain. Results: The analysis included 8129 articles from 2004 to 2024, published across 1042 journals, with contributions from 740 countries/regions, 33,931 institutions, and 40,788 authors. The five most frequently occurring keywords were prevalence, health, older adult, mortality, and risk. The top five contributing countries globally were the United States, the United Kingdom, Germany, China, and Spain. Five pivotal research trajectories delineate the intellectual architecture of this field: ① Evolution of Disease Cluster Management: Initial investigations (2013–2014) prioritized disease cluster coordination within general practice settings, particularly cardiovascular comorbidity management through primary care protocols and self-management strategies. ② Paradigm Shifts in Health Impact Assessment: Multimorbidity outcome research demonstrated sequential transitions—from physical disability evaluation (2013) to mental health consequences like depression (2016), culminating in current emphasis on holistic health indicators including frailty syndromes (2015–2019). ③ Expansion of Risk Factor Exploration: Analytical frameworks evolved from singular physical activity metrics (2014) toward comprehensive lifestyle-related determinants encompassing behavioral and environmental dimensions (2021). ④ Emergence of Polypharmacy Scholarship: Medication optimization studies emerged as a distinct research stream since 2016, addressing therapeutic complexities in multimorbidity management. ⑤ Frontier Investigations: Cutting-edge directions (2019–2021) feature cardiometabolic multimorbidity patterns and their dementia correlations, signaling novel interdisciplinary interfaces. Conclusions: The prevalence of multimorbidity is on the rise globally, particularly in older populations. Therefore, it is essential to prioritize the prevention of cardiometabolic conditions in older adults and to provide them with appropriate and effective health services, including disease risk monitoring and community-based chronic disease care. Full article

Background: Access to and use of health services represent crucial issues/challenges for older people experiencing frailty with functional limitations and chronic diseases, especially when they age in place alone. Both access to and use of health services are also characterised by gender differences. The present study analysed these factors in three Italian regions (Lombardy, North; Marche, Centre; and Calabria, South), where in 2019, the “Inclusive Ageing in Place” (IN-AGE) project was carried out, involving 120 senior people aged 65 years and of both genders. Methods: In this mixed-methods study, both qualitative (predominant section) and some quantitative data (e.g., socio-demographic aspects and functional limitations) were collected through semi-structured interviews. In addition to basic quantitative analyses, content analysis and the quantification of statements were performed to process the qualitative data. The results for both men and women are presented. Possible barriers to accessing health services were also considered. Results: Women reported more cases of chronic diseases than men, especially arthritis/osteoporosis, and a greater use of drugs than men. Both genders used services provided by the general practitioner (GP) and medical specialist (MS), the latter being mostly private. More women than men used rehabilitation, especially in the private sector, and reported the issue of cost for private healthcare and the travel distance to reach medical units as barriers to access. The long waiting lists/times were complained about by both males and females. Conclusions: This study, despite its simple/descriptive qualitative approach with a limited sample, could provide, however, some insights for policymakers and healthcare professionals to plan prevention policies and deliver appropriate and timely health services to older people experiencing frailty and ageing in place alone, devoting attention to gender-related issues in the design and provision of such services. Full article

Introduction: Sarcopenia, the progressive age-related decline in skeletal muscle mass, strength, and function, represents a major contributor to morbidity, frailty, and reduced quality of life in older adults. Oxidative stress and chronic low-grade inflammation are increasingly recognized as central mechanisms driving its onset and progression, through pathways involving mitochondrial dysfunction, impaired satellite cell activity, and dysregulated protein turnover. Objective: The purpose of the following manuscript is to summarize current research on the molecular and cellular interactions between oxidative stress and inflammation in sarcopenia, as well as to assess Aronia melanocarpa’s potential as a nutritional intervention. Methods: A narrative review was conducted by searching PubMed, Scopus, and Web of Science for peer-reviewed literature published between 2000 and 2024. Keywords included “sarcopenia”, “oxidative stress”, “inflammation”, “Aronia melanocarpa”, “polyphenols”, and even “functional foods”. Eligible publications provided mechanistic, preclinical, or clinical findings on skeletal muscle biology and A. melanocarpa bioactivity. Results: This narrative review examines the relationship between oxidative stress and inflammation in sarcopenia, focusing on NF-κB-mediated inflammatory signaling, Nrf-2-dependent antioxidant defenses, myokines like myostatin and irisin, and macrophage polarization in muscle homeostasis. Aronia melanocarpa (black chokeberry) is highlighted as a polyphenol-rich fruit with a distinct profile of anthocyanins and proanthocyanidins that have strong antioxidant and anti-inflammatory properties. According to preclinical, clinical, and nutritional studies, A. melanocarpa bioactives modulate redox balance, suppress pro-inflammatory cytokine production, increase antioxidant enzyme activity, and regulate metabolic and regenerative signaling pathways important for skeletal muscle health. Conclusions: Overall, the data suggest A. melanocarpa’s potential as a functional food and nutraceutical candidate for the prevention and treatment of sarcopenia. However, further translational and clinical research is needed to determine the appropriate intake, bioavailability, and long-term efficacy in human populations. Full article

Respiratory syncytial virus (RSV) is a major cause of respiratory illness, particularly in children, yet its burden in adults—especially in older adults—remains under-recognized. We analyzed RSV-related hospitalizations in Switzerland from 2017 to 2023 using national data from the Federal Statistical Office, including cases with RSV coded as either a primary or secondary diagnosis. Over 35,000 RSV-related hospitalizations were recorded. The highest incidence occurred in children under 10 years (390 per 100,000/year), with a second peak in adults ≥ 80 years (151 per 100,000/year). Older adults (≥60 years) accounted for more than 9700 hospitalizations overall, with an average of over 16,600 total hospital days per year. Average length of stay (LOS) was shortest in young children (4.6 days) and highest in adolescents (13.9 days), while in adults, it increased from 6.8 days (age 20–29) to 12.3 (age ≥ 80). Mechanical ventilation rates peaked at 12.6% in 60–69 year olds, and in-hospital mortality at 7.1% in those ≥80 years. In adults, RSV was more often recorded as a secondary diagnosis and commonly associated with chronic comorbidities, including chronic obstructive pulmonary disease, heart failure, kidney disease, and diabetes. Frailty-related diagnoses—such as cognitive or motor impairment, delirium, and need for nursing care—were also frequent. These findings highlight the importance of improved adult RSV surveillance and targeted prevention strategies in high-risk populations. Full article

Background and Objectives: Active pulmonary tuberculosis (aPTB) in the Older Adults (≥75 years) is frequently under-recognized in non-pulmonology settings due to atypical symptoms and multiple comorbidities. This study aimed to develop and validate a TRIPOD-compliant clinical prediction model for early identification of atypical aPTB in this vulnerable population. Materials and Methods: We retrospectively analyzed 5651 patients aged ≥75 years with culture-confirmed aPTB and World Health Organization (WHO) symptom scores < 5. Patients were stratified into Group a (Ga, Patients with aPTB not initially suspected by non-pulmonologists (atypical presentation, WHO/CDC 7-point score < 5, n = 1155) and Group b (Gb, Patients without aPTB within the first 24 h (non-TB comparators), n = 4496). Multivariate logistic regression identified independent predictors of delayed diagnosis. A weighted scoring system was derived from β-coefficients and validated in independent derivation (2000–2020) and temporal validation (2021–2023) cohorts. Model discrimination, calibration, and decision curve analysis (DCA) were assessed following TRIPOD standards. Results: Five independent predictors—age > 85 years (OR = 6.31, 95% CI = 5.31–8.72), hypoalbuminemia (OR = 4.10, 95% CI = 3.92–7.26), cardiovascular disease (OR = 3.32, 95% CI = 1.23–5.27), diabetes mellitus (OR = 2.03, 95% CI = 1.32–4.07), and predominant lower-lung field involvement (OR = 1.25,95% CI = 1.03–2.44)—were incorporated into the scoring model. Using a cutoff ≥ 7, the model achieved excellent performance across all cohorts (AUC 0.95–0.96; sensitivity 91–94%; specificity 97–99%). Calibration plots and DCA confirmed strong agreement and high net clinical benefit. Nearly 70% of atypical cases had symptom scores ≤ 1, lacking typical signs such as fever or cough. Conclusions: Oldest-old (>85 years) emerged as the strongest independent predictor of atypical TB, surpassing conventional frailty indicators such as sarcopenia or osteoporosis. The proposed score provides a simple, accurate, and validated tool for early detection of aPTB in non-pulmonology settings. Its integration into electronic medical records may reduce diagnostic delays and improve outcomes in this high-risk, late-elderly population. Full article

Background: Frailty is a common syndrome amongst older individuals characterized by a progressive long-term loss of physical and or cognitive resilience. Given the high prevalence and chronic conditions and the lack of literature on frailty among rural older individuals in South Africa, the present study aimed to investigate the prevalence of frailty and its associated factors in older individuals residing in Limpopo province. Methods: This was a cross-sectional study, comprising 546 participants (48.4% males and 51.6% females) using Africa Wits-INDEPTH Partnership for Genomic Research (AWI-Gen) phase 2 data. Convenient sampling was used to select the participants. Frailty was measured using the five criteria proposed by Fried. Data was analyzed using Statistical Package for the Social Sciences (SPSS) 27. Results: The mean age (SD) of the participants was 66.78 ± 5.72. The proportion of individuals living with frailty was 26.4%. Individuals living with frailty were significantly older than both pre-frail and non-frail individuals. Current smokers significantly had higher proportion of frailty compared to both pre-frail and non-frail. The proportion of frailty reduced as the level of education increased. The present study found no association between biological sex and frailty. The likelihood of having frailty increased with age. On the unadjusted model, there was a significant association between frailty and 66 and above age group (OR: 1.61; 95% CI: 1.00–2.60). On the fully adjusted model the same age group was 1.75 more likely to be frail with a p value of 0.001. The present study found no significant association between marital status, smoking, alcohol status, current smoker, hypertension, diabetes, and obesity with frailty. Centrally obese participants were 0.48 and 0.37 times less likely to have frailty on unadjusted and adjusted models, respectively. Participants with dyslipidemia indicated by high total cholesterol (TC) were 2.25 times more likely to be associated with frailty. Conclusions: The prevalence of frailty was 26.4% and it was associated with age, educational status and dyslipidemia. Based on the findings of the present study, the authors recommend implementation of screening programs, for frailty in healthcare settings, especially targeting older adults with comorbidities. Full article

Background/Objectives: As the aging population is growing globally, oral health has become integral to ensuring healthy aging and quality of life. This study assessed the oral health status of older adults in a Malaysian long-term care facility and explored caregiver-reported challenges in providing oral care. Methods: A convergent mixed-methods design was applied, involving 115 residents aged ≥60 years and 16 caregivers in a public facility. The residents’ oral health was assessed using interviewer-assisted questionnaires (demography, dependency level, Oral Frailty Five-item Checklist), clinical examinations (dental caries status, number of remaining teeth, oral and denture hygiene), and the Decayed, Missing, and Filled Teeth (DMFT) index. Focus group discussions with caregivers were conducted, transcribed, and thematically analyzed. Quantitative data were descriptively analyzed using SPSS version 29.0. Results: Over one-third of the residents (39%) were moderately to highly dependent on caregivers. All had experienced dental caries, with most having fewer than 20 teeth (92.9%) and requiring dentures (81.7%). Overall, both oral and denture hygiene were poor. Assessment of oral frailty indicated that the majority of residents (94.8%) were at risk of impaired oral function. A thematic analysis identified four key themes influencing oral health: (1) health and oral health conditions of residents; (2) variety in oral care practices; (3) older adults’ attitudes and behaviors; and (4) system factors. These themes were mapped in a conceptual framework demonstrating multilevel influences on oral care. Conclusions: Despite the single-center design, these findings provide actionable insights for improving geriatric oral health policies in Malaysia. Practical recommendations include integrating oral health into aged-care standards, expanding mobile dental services, and establishing oral care champions within facilities. Addressing these challenges is critical to improving quality of life and aligning long-term care practices with the WHO’s healthy aging priorities. Full article