Search Results (1,377)

Background: Prehabilitation has become an essential component of perioperative care in colorectal surgery, aiming to improve postoperative outcomes through multimodal interventions. However, its real-world implementation remains heterogeneous. This study aimed to evaluate the degree of implementation and variability of prehabilitation programs across colorectal surgery units in Spain. Methods: A national multicenter cross-sectional survey (VAPPER Survey) was conducted among colorectal surgery units. The questionnaire included 83 items addressing organizational structure, nutritional assessment, frailty screening, and multidisciplinary collaboration. Data were analyzed descriptively and expressed as frequencies and percentages. Results: A total of 104 hospitals participated. Prehabilitation programs were present in 79% (n = 82) of centers, while 21% (n = 22) reported no program. Nutritional screening was not performed in 21% (n = 22) of hospitals. Among those performing screening, MUST was the most frequently used tool (68%, n = 56), although considerable variability existed. Systematic use of GLIM criteria was reported in only 24% (n = 20), whereas 35% (n = 28) did not use GLIM and 41% (n = 34) applied it selectively. Frailty screening in patients ≥70 years was absent in 54% (n = 44) of centers, and geriatric involvement was limited and non-standardized. Conclusions: Prehabilitation is widely implemented in Spain but remains highly heterogeneous across all dimensions. The most relevant deficits are concentrated in systematic nutritional assessment, malnutrition diagnosis using standardized criteria, geriatric integration, and psychological support. Standardization of protocols, strengthening of multidisciplinary teams, and enhanced training in perioperative nutrition are priorities for optimizing outcomes in colorectal surgery. Full article

Background: Older adults with cancer are at increased risk of severe treatment-related toxicity. CARG, CRASH, and CARG-BC were developed as toxicity-risk prediction models, whereas G8 was developed as a geriatric screening instrument but has also been evaluated as a predictor of treatment-related toxicity. This study aimed to assess, separately for each instrument, the accuracy with which these tools identify older adults who develop severe chemotherapy-related toxicity. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. Seven databases were searched through May 2026 for observational studies evaluating the predictive accuracy of the CARG, CRASH, CARG-BC and G8 tools in patients aged ≥65 years initiating chemotherapy. Pooled sensitivity and specificity with 95% confidence intervals (CIs) were calculated, and ROC curves were constructed. Risk of bias was assessed using QUADAS-2 and certainty of evidence was evaluated using GRADE. Results: Twenty-one studies were included, with an overall toxicity prevalence of 52.6%. CARG demonstrated a pooled sensitivity of 79.7% and specificity of 38.3% (AUC = 0.632). CRASH showed sensitivity of 86.9% and specificity of 68.2% (AUC = 0.866), but estimates were based on only four studies. CRASH hematological toxicity showed sensitivity of 75.9% and specificity of 53.1% (AUC = 0.694), with substantial heterogeneity. G8 yielded sensitivity of 69.5% and specificity of 41.5% (AUC = 0.666). CARG-BC showed sensitivity of 83.3% and specificity of 54.4% (AUC = 0.763), based on two breast cancer studies. Certainty of evidence ranged from low to very low. Conclusions: The instruments have distinct purposes and were not pooled against one another. CARG and G8 may be useful for initial risk screening, whereas CRASH showed a more balanced profile but remains supported by limited evidence. None should be used as a stand-alone basis to withhold or modify treatment. Full article

Background/Objectives: The cardiometabolic consequences of sarcopenic obesity (SO) remain poorly characterized in Latin America. We hypothesized that SO uniquely concentrates aortic stiffness, metabolic syndrome, and vitamin D deficiency in older Mexican adults, and that handgrip strength exhibits a dose–response relationship with cardiometabolic risk independent of adiposity. Methods: We conducted a cross-sectional analysis of 2087 adults ≥ 50 years from the Mexican Health and Aging Study (MHAS) 2012. Four phenotypes were defined using EWGSOP2 criteria: lean–fit, lean–sarcopenic, obese–non-sarcopenic, and obese–sarcopenic (BMI ≥ 30 kg/m²). Outcomes were pulse pressure (PP, aortic stiffness proxy), metabolic syndrome (modified IDF criteria), and serum 25(OH)D. Normality tests confirmed non-normal distribution (p < 0.001). Given heteroscedasticity (Breusch–Pagan p < 0.001), HC3 robust standard errors were used. Regression models were sex-adjusted and sex-stratified. Results: The sample showed high cardiometabolic burden: mean HbA1c 6.91% (35.3% ≥ 6.5%); metabolic syndrome 57.6%; mean PP 60.7 ± 17.9 mmHg; mean gait speed 0.708 m/s (70.4% slow). Phenotype distribution: lean–fit 12.3%; lean–sarcopenic 47.3%; obese–non-sarcopenic 8.7%; obese–sarcopenic 31.7%. In multivariable models, handgrip strength was an independent protective predictor of PP (beta = −0.09 per kg; 95% CI: −0.17 to −0.01; p = 0.033), with a sex-specific effect in women (beta = −0.13; p = 0.010). Conclusions: SO is highly prevalent in older Mexican adults and associates with an adverse cardiometabolic profile. Handgrip strength shows a protective dose–response association with cardiometabolic risk independent of adiposity, identifying muscle function as a candidate modifiable factor that warrants confirmation in longitudinal and interventional studies. The obese–non-sarcopenic phenotype exhibited the lowest PP, unveiling the sarcopenic obesity paradox: adiposity without muscle function loss does not promote arterial stiffening. Full article

Functional decline in older adults represents a major challenge in geriatric rehabilitation, and machine learning (ML) clustering techniques may help identify functional recovery profiles and support personalized rehabilitation strategies. This study characterizes functional recovery profiles in older adults admitted for rehabilitation using unsupervised clustering techniques. A retrospective longitudinal study was conducted including 957 older adults admitted to a geriatric rehabilitation unit between 2019 and 2025. Clinical and functional variables, including the Modified Barthel Index (MBI), Daniels and Worthingham’s Muscle Testing, and Functional Ambulation Category, were collected from medical records. Considering the baseline functional status and the temporal changes in MBI scores, a clustering of the functional trajectories has been performed using a k-means algorithm based on the silhouette score. The robustness of the resulting segmentation has been evaluated by comparing alternative partitions obtained from bootstrap-sampling, hierarchical clustering, and the centroids of Gaussian Mixture Models. Four distinct functional recovery profiles were identified, showing different trajectories of independence, ambulation, and muscle strength during rehabilitation. Two clusters demonstrated favorable recovery and higher functional resilience, whereas the remaining profiles were characterized by chronic impairment or severe damage with limited recovery. These findings support the usefulness of unsupervised ML clustering techniques for identifying clinically meaningful recovery profiles and may facilitate patient stratification and individualized intervention planning in geriatric rehabilitation. Full article

Background: Elderly and frail patients undergoing surgery for urological cancer have increased vulnerability to postoperative complications, delayed recovery, and functional decline. The da Vinci Single-Port (SP) platform may reduce surgical stress by enabling regionalized extraperitoneal, retroperitoneal, or transvesical access through a single incision. Objective: The objective was to provide a narrative review of the comparative evidence on da Vinci SP versus conventional multi-port (MP) robotic surgery in elderly or frail urological cancer patients. Methods: A structured search was performed to identify comparative studies reporting outcomes in patients defined as elderly by chronological age (≥65 years) or as frail by a validated frailty index. Findings are reported separately according to the vulnerability construct that was actually measured. Because of procedural and methodological heterogeneity, a narrative synthesis was performed, and the risk of bias was appraised qualitatively along the domains of the ROBINS-I tool. Results: Only three retrospective comparative studies are currently available: two on robot-assisted radical prostatectomy (one in patients aged ≥65 years and one in patients stratified by the 5-item modified frailty index) and one on robot-assisted partial nephrectomy in patients aged ≥65 years. Across these studies, SP surgery was associated with fewer early postoperative complications, shorter length of stay, and more favourable recovery-related endpoints, and in the frailty-stratified study the apparent protective effect increased with frailty burden. All estimates are those published by the original authors, are reported descriptively, and were not pooled. Importantly, in none of the three studies was the SP platform compared with MP surgery performed through the same access route: SP procedures were predominantly extraperitoneal or retroperitoneal and MP procedures were predominantly transperitoneal, so the effect of the platform cannot be separated from that of the access route. Conclusions: The available data are compatible with a reduction in early perioperative morbidity after SP robotic surgery in selected elderly or frail urological cancer patients, particularly when the platform enables extraperitoneal or retroperitoneal access. Because this evidence rests on three retrospective studies at serious risk of bias, the findings are preliminary and hypothesis-generating rather than confirmatory. Prospective studies incorporating geriatric screening, validated frailty metrics, patient-reported recovery, cost-effectiveness, and long-term oncological outcomes are needed. Full article

Walking recovery is a central goal of geriatric rehabilitation, but it is shaped by multiple interacting factors rather than by muscle impairment alone. This mini-review examines whether sarcopenia-related weakness, low muscle quality, and reduced physical reserve identify a clinically important vulnerability phenotype relevant to delayed gait recovery in older adults after hospitalization, hip fracture, surgery, or cardiac procedures. We summarize current consensus definitions of sarcopenia, explain why muscle strength and physical performance are often more clinically informative than muscle mass alone, and review the mechanistic pathways that may connect sarcopenia with impaired walking, including anabolic resistance, inflammation, disuse, neuromuscular remodeling, trunk weakness, and cognitive–emotional modifiers. Across community, orthogeriatric, post-acute, and cardiac rehabilitation settings, sarcopenia markers are generally associated with slower gait or poorer attained mobility; however, findings for change in mobility are inconsistent, and most available studies are observational, heterogeneous, or indirect. Sarcopenia should therefore be interpreted as one potential marker of reduced reserve and mobility risk rather than as a determinant of walking recovery or evidence that sarcopenia-aware rehabilitation improves outcomes. Future work should use more consistent diagnostic frameworks and test whether a sarcopenia-aware rehabilitation integrating early strength assessment, individualized nutrition care, and multicomponent gait rehabilitation improve walking outcomes in medically complex older adults beyond current standards of care. Full article

Background: Dietary diversity has been proposed as a modifiable determinant of healthy ageing, but its association with objectively assessed frailty in geriatric outpatients remains poorly characterised. We examined the cross-sectional association between a four-item Dietary Diversity Score (DDS) and frailty severity, and whether nutritional status statistically mediates this association. Methods: Cross-sectional study of 317 older adults (median age 82 years, 73.8% female) attending a geriatric outpatient unit in Northern Italy. Consumption of four food groups (dairy, legumes/eggs, meat/fish/poultry, fruits/vegetables) was summed into a DDS (0–4). Frailty was measured with the Edmonton Frail Scale (EFS). Mediation by the Mini Nutritional Assessment (MNA) was tested with bootstrapping; individual food-group associations across eight outcomes were corrected for multiple testing (Benjamini–Hochberg). Results: Each additional food group was associated with a 0.61-point-lower EFS score after adjusting for age, sex and BMI (β = −0.608; p = 0.001; adjusted R² ≈ 0.04–0.07) and 36% lower odds of higher frailty severity (OR = 0.64; p < 0.001). MNA statistically explained 86.2% of the DDS-EFS association (bootstrap 95%CI excluding zero), and the significant mediation paths remained robust after FDR correction (q ≤ 0.0015). Legumes/eggs showed the strongest food-specific association with EFS and MNA after correction (q ≤ 0.002); fruit/vegetable associations with inflammatory and nutritional biomarkers did not survive correction and are exploratory. Conclusions: Dietary diversity is associated with lower frailty severity in geriatric outpatients, largely explained by nutritional status; the modest explanatory power reflects frailty’s multifactorial aetiology, and prospective studies are needed to test causality. Full article

Background and Objectives: Sarcopenia is highly prevalent among older adults with chronic kidney disease (CKD) and is associated with adverse clinical outcomes. The finger-ring (Yubi-wakka) test is a simple anthropometric screening tool based on calf circumference; however, its performance in older adults with CKD remains unclear. This study aimed to investigate the association of the finger-ring test with low muscle mass, sarcopenia, and comprehensive geriatric assessment parameters and to evaluate its diagnostic performance for identifying low muscle mass in older adults with CKD. Materials and Methods: This cross-sectional study included 115 patients aged ≥65 years with CKD who were evaluated in geriatric and nephrology inpatient services. After excluding two participants with missing finger-ring measurements, 113 individuals were analyzed. Muscle mass was assessed using bioelectrical impedance analysis and low muscle mass was defined according to EWGSOP2-based Turkish cut-off values. Demographic characteristics, anthropometric measurements, laboratory findings, and comprehensive geriatric assessment parameters were recorded. Correlation analyses, logistic regression models, receiver operating characteristic (ROC) analyses, and likelihood-ratio tests were performed. Results: Among 113 participants, 62 were classified as finger-ring positive (FR = 0) and 51 as finger-ring negative (FR = 1). Low muscle mass was significantly more frequent in the FR = 0 group than in the FR = 1 group (51.6% vs. 24.0%, p = 0.005). Finger-ring test results showed strong correlations with calf circumference (rho = 0.689, p < 0.001) and body mass index (BMI) (rho = 0.631, p < 0.001), whereas the correlation with muscle mass was modest (rho = 0.250, p = 0.008). For detecting low muscle mass, the finger-ring test demonstrated an area under the curve (AUC) of 0.643 (95% CI 0.554–0.732), sensitivity of 72.7%, specificity of 55.9%, positive predictive value of 51.6%, and negative predictive value of 76.0%. In multivariable analyses, BMI remained the strongest independent determinant of finger-ring test results, whereas the association with muscle mass lost statistical significance after BMI adjustment. Adding age and sex significantly improved discrimination, while the contribution of nutritional status was limited. Conclusions: The finger-ring test is associated with low muscle mass in older adults with CKD; however, its diagnostic performance is modest and appears to be substantially influenced by body size and calf circumference. Therefore, the finger-ring test should be considered a simple adjunctive screening tool rather than a stand-alone method for identifying low muscle mass in this population. Full article

Background/Objectives: Individualized nursing care is a fundamental component of high-quality healthcare, particularly in geriatric populations. However, its consistent implementation remains challenging, a situation further exacerbated by the COVID-19 pandemic due to increased workloads and resource constraints. This study aimed to assess nurses’ perceptions of individualized care for older adults in Spain and to examine the influence of the workplace ethical climate on these perceptions. Methods: A cross-sectional observational study was conducted using two validated instruments: the Individualized Care Scale–Nurse version (ICS-Nurse) and the Hospital Ethical Climate Survey (HECS). Descriptive and inferential analyses were performed to assess individualized care, ethical workplace climate, and the associations between both constructs. Results: A total of 96 nursing professionals participated in the study. Participants reported an overall favorable perception of individualized care. The highest scores were observed in the clinical situation dimension, whereas lower scores were reported for aspects related to hygiene organization and the incorporation of patients’ preferences. A moderate, positive, and statistically significant association was observed between ethical workplace climate and individualized care, particularly in dimensions related to patients and physicians. Participants working in hospital settings reported higher recent-experience individualized care scores than those working in nursing homes. Conclusions: These results highlight the critical role of an ethical workplace climate in supporting nurses’ capacity to deliver individualized care. They also underscore the need for targeted strategies to strengthen organizational support, enhance interprofessional collaboration—particularly with physicians—and promote training in individualized care practices. Addressing these factors may facilitate more consistent and comprehensive individualized care, especially in long-term care settings where structural challenges persist. Full article

Background and Objectives: Vitamin D deficiency has been implicated in muscle weakness and functional decline among older adults. However, its association with sarcopenia-related impairment, particularly when evaluated using readily available nutritional and functional indicators in routine clinical practice, remains incompletely understood. Materials and Methods: This retrospective cross-sectional study included 148 adults aged ≥65 years who attended a Physical Medicine and Rehabilitation outpatient clinic. Sarcopenia-related risk was classified using an EWGSOP2-informed operational framework based on handgrip strength together with nutritional and functional indicators available in the retrospective dataset. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured using a chemiluminescent microparticle immunoassay. Group comparisons, correlation analyses, and multivariable logistic regression analyses were performed. Results: The prevalence of probable sarcopenia and probable sarcopenia with nutritional/functional risk indicators was significantly higher among participants with vitamin D deficiency. Serum 25(OH)D levels differed significantly across the three study groups (p < 0.001). Post-hoc Tukey analysis demonstrated significantly lower serum 25(OH)D concentrations in the probable sarcopenia with nutritional/functional risk indicators group than in both the no sarcopenia and probable sarcopenia groups (both p < 0.001). Serum 25(OH)D levels were moderately and inversely correlated with sarcopenia-related risk severity (r = −0.48, p < 0.001). Lower vitamin D levels were also associated with reduced serum albumin levels and a higher prevalence of falls and assistive walking device use. In multivariable logistic regression analysis, vitamin D deficiency remained independently associated with sarcopenia-related risk after adjustment for age and sex. Conclusions: Vitamin D deficiency was significantly associated with greater sarcopenia-related risk severity and poorer functional status in older adults. Assessment of vitamin D status may therefore represent a simple, inexpensive, and readily available tool for identifying individuals at increased risk of sarcopenia-related impairment in routine geriatric practice. Prospective studies incorporating direct measures of muscle quantity and standardized physical performance assessments are needed to confirm these findings. Full article

Background/Objectives: Displaced femoral neck fractures in older adults are associated with substantial morbidity, loss of functional independence, and reduced quality of life. Although total hip arthroplasty (THA) and hemiarthroplasty (HA) are widely used surgical options and have been extensively compared, differences in postoperative functional recovery in routine clinical practice continue to be investigated. This study aimed to compare postoperative functional outcomes between THA and HA in elderly patients with femoral neck fractures during postoperative follow-up. Methods: This prospective cohort study included 100 patients aged 70–85 years treated surgically for displaced femoral neck fractures from 1 May to 1 December 2024. Patients underwent THA (n = 57) or HA (n = 43). Functional recovery was evaluated using the Barthel Index (BI) and modified Harris Hip Score (mHHS) at 3 weeks, 3 months, and 6 months postoperatively. Changes in functional outcomes during follow-up were analyzed using repeated-measures general linear models adjusted for age, body mass index (BMI), and educational level. Exploratory binary postoperative outcomes were analyzed using logistic regression. Results: Patients treated with THA demonstrated significantly better postoperative functional outcomes compared with HA throughout follow-up. In both unadjusted and adjusted analyses, THA patients achieved consistently higher BI and mHHS scores across repeated postoperative assessments, including at 6 months postoperatively. Independent outdoor walking at 3 months postoperatively differed significantly between groups in the unadjusted analysis, although this association did not remain statistically significant after adjustment. In adjusted analyses, patients in the HA group demonstrated significantly higher odds of movement-related hip pain at 6 months postoperatively. Conclusions: THA was associated with significantly better postoperative functional outcomes compared with HA in elderly patients with femoral neck fractures. These findings highlight the importance of considering functional recovery outcomes, in addition to traditional surgical outcomes, when selecting arthroplasty strategies in geriatric hip fracture management. Given the observational study design, these findings should be interpreted as associations rather than evidence of a causal treatment effect. Full article

Background/Objectives: Older women with breast cancer carry a high burden of frailty, depressive symptoms and cognitive complaints, yet how these domains relate to one another in routine clinical practice remains incompletely understood. We examined the prevalence of positive frailty screening and its association with patient-reported cognitive function and asked whether depressive symptoms account for the apparent link between the two. Methods: We analyzed 314 women aged 65 years or older with stage IIB–IIIC breast cancer who underwent a standardized geriatric assessment. Measures included the G8 screening tool, Vulnerable Elders Survey-13 (VES-13), Geriatric Depression Scale (GDS), Instrumental Activities of Daily Living (IADL), cognition and quality of life (FACT-Cog, FACT-G, and EORTC QLQ-C30). Associations were examined using correlation analyses, group comparisons, and multivariable linear regression. Results: Mean age was 72.9 years. A positive frailty screen (G8 ≤ 14) was present in 295 patients (93.9%), and 102 patients (32.5%) screened positive for depressive symptoms (GDS ≥ 5). G8 screening score correlated strongly with patient-reported cognitive function (Pearson r = 0.80, p < 0.001), and patients with a positive frailty screen reported lower FACT-Cog scores than those with a negative screen (113.0 vs. 129.0, p < 0.001). In multivariable analysis adjusted for age and G8 score, depressive symptoms emerged as the strongest independent correlate of FACT-Cog (β = −0.89, p < 0.001; model R² = 0.90), whereas G8 screening score was no longer independently associated (p = 0.16). Patients with depressive symptoms had more than double the VES-13 vulnerability score of those without (7.8 vs. 3.6, p < 0.001). Overall geriatric assessment profiles were generally comparable across the three exploratory treatment-era cohorts. Conclusions: In this cross-sectional analysis of older women with locally advanced breast cancer, depressive symptoms were the strongest independent correlate of patient-reported cognitive function. Incorporating a brief depression screen into routine geriatric assessment may represent a clinically actionable target that deserves further evaluation. Full article

Objectives: This study aimed to investigate the prevalence of and risk factors for sarcopenia in community-dwelling older adults. Methods: This cross-sectional study was conducted in Riyadh between February and May 2024. Sarcopenia was diagnosed using the Asian Working Group on Sarcopenia (AWGS) criteria, which include muscle mass, grip strength, and gait speed. Polypharmacy was defined as taking 5 medications or more. Depressive symptoms were examined using the Arabic version of the Geriatric Depression Scale-15 with a cutoff score of >5. Multivariable logistic regression analyses were used to assess the possible risk factors for sarcopenia. Results: A total of 182 participants were enrolled and analyzed in the current study. Approximately 11% (n = 20) of participants were identified as having sarcopenia based on the AWGS criteria. Individuals with sarcopenia were older, with a mean age of 68.6 years, and a higher percentage were female (75.0% vs. 41.4% in the non-sarcopenia group; p = 0.004). Compared with the non-sarcopenia group, the sarcopenia group showed a higher prevalence of polypharmacy (≥5 medications) (55% vs. 16%; p < 0.001) and depressive symptoms (55% vs. 13.6%; p < 0.001). Conclusions: This study identified an increased prevalence of sarcopenia among the geriatric population in the Kingdom of Saudi Arabia using the AWGS criteria. The associated risk factors for sarcopenia included older age, polypharmacy, and depressive symptoms. These associations underscore the complex systemic interplay between physical health, mental well-being, and therapeutic management in geriatric care. Routine assessment for sarcopenia should be implemented into primary healthcare protocols for the older population, along with medication review and depressive symptom screening. Full article

Background: Mortality risk in patients with hip fractures is influenced by multiple factors, including age, pre-existing medical conditions, and frailty. This study aims to compare the predictive ability of 6-month mortality between traditional risk models—the American Society of Anesthesiologists (ASA) classification, the Hip Fracture Estimator of Mortality of Amsterdam (HEMA), and the Nottingham Hip Fracture Score (NHFS)—and frailty assessment. Methods: This retrospective study included patients who were admitted to the Orthopedics and Traumatology Clinic with intracapsular femoral neck fractures treated with hemiarthroplasty and with extracapsular intertrochanteric fractures treated with intramedullary nailing between 1 January 2023 and 31 December 2023. Demographic and clinical data were retrieved from medical records, and survival status at 6 months post-admission was determined using the Turkish Death Registry System. The frailty status was determined retrospectively from electronic medical records using the Clinical Frailty Scale (CFS) by a trained specialist. Results: A total of 164 patients were analyzed, with a mean age of 78.2 ± 8.9 years, and 64.6% (n = 106) were female. The 6-month mortality rate was 31.1% (n = 51). Frailty, as measured by CFS, was significantly associated with increased mortality risk [hazard ratio: 4.465, 95% confidence interval (CI): 2.588–7.703, p < 0.001]. Receiver Operating Characteristic (ROC) analysis demonstrated that all risk models were predictive of 6-month mortality, with CFS exhibiting the highest area under the curve (AUC) (CFS: AUC = 0.879 (95% CI: 0.824–0.934, p < 0.001). Conclusions: In this cohort, several perioperative risk scores were associated with mortality; however, frailty measured by the CFS provided stronger discrimination for medium-term prognosis after hip fracture surgery. Incorporating frailty assessment alongside perioperative risk evaluation may improve risk stratification and support orthogeriatric care planning and postoperative management in this high-risk population. Full article

Background and Objectives: Xerostomia is common among institutionalized older adults, but the relative contributions of comorbidity burden and medication-class burden remain incompletely clarified. This study evaluated their associations with Xerostomia Inventory (XI) severity and explored related salivary dysfunction and clinical oral health findings. Materials and Methods: We conducted a cross-sectional study of 90 institutionalized older adults in Bucharest, Romania. Xerostomia Inventory (XI) scores, a binary dry-mouth question, chairside salivary assessments, comorbidity categories, medication classes, oral mucosal findings, and complete denture retention and stability were recorded. Primary analyses used hierarchical regression and bootstrap statistical decomposition; secondary and exploratory analyses evaluated salivary concordance, medication classes, denture-related findings, and oral mucosal conditions. Results: Medication-class count remained associated with XI severity after adjustment for comorbidity burden (partial r = 0.445, p < 0.001), whereas the association between comorbidity burden and XI was no longer significant after adjustment for medication-class count (partial r = −0.063, p = 0.557). Inclusion of medication-class count increased the explained variance in XI scores (ΔR² = 0.253, p < 0.001). Bootstrap decomposition yielded similar findings, with a significant indirect estimate and a non-significant direct estimate. Among complete denture wearers, XI severity was associated with maxillary denture instability (ρ = −0.687, n = 44). Conclusions: In this cohort, medication-class burden showed the strongest association with xerostomia severity, whereas comorbidity burden was not independently associated after adjustment. Given the cross-sectional design, these findings should be interpreted as exploratory associations and support future prospective studies integrating medication review with geriatric-prosthodontic assessment. Full article