Search Results (298)

The increasing prevalence of chronic metabolic diseases poses a significant challenge in the modern world, impacting healthcare systems and individual life expectancy. The World Health Organization (WHO) recommends that older adults (65+ years) engage in 150–300 min of moderate-intensity or 75–150 min of vigorous-intensity physical activity, alongside muscle-strengthening and balance-training exercises at least twice a week. However, nearly one-third of the adult population (31%) is physically inactive, which increases the risk of developing obesity, type 2 diabetes, cardiovascular diseases, hypertension, and psychological issues. Physical activity in the form of aerobic exercise, resistance training, or a combination of both is effective in preventing and managing these metabolic diseases. In this review, we explored the effects of exercise training, especially on respiratory and pulmonary factors, including oxygen consumption, pulmonary ventilation, and blood gas analyses among adults. During exercise, oxygen consumption can increase up to 15-fold (from a resting rate of ~250 mL/min) to meet heightened metabolic demands, enhancing tidal volume and pulmonary efficiency. During exercise, the increased energy demand of skeletal muscle leads to increases in tidal volume and pulmonary function, while blood gases play a key role in maintaining the pH of the blood. In this review, we explored the influence of age, body composition (BMI and obesity), lifestyle factors (smoking and alcohol use), and comorbidities (diabetes, hypertension, neurodegenerative disorders) in the modulation of these physiological responses. We underscored exercise as a potent non-pharmacological intervention for improving cardiopulmonary health and mitigating the progression of metabolic diseases in aging populations. Full article

Understanding the utilization patterns of nuclear medicine (NM) services is essential for optimizing resource allocation and service provision. This study aimed to address the regional evidence gap by reporting the demand for NM services by sex and age at a public hospital in Jamaica. This was a non-experimental, retrospective study of NM scans that were completed at the University Hospital of the West Indies from 1 June 2022 to 31 May 2024. While all scans were reported in the descriptive totals, for patients with multiple scans during the study period, only the data from the first visit was used in the inferential statistical analysis. This was performed with the IBM SPSS (version 29.0) software and involved the use of chi-square goodness of fit and multinomial logistic regression. A total of 1135 NM scans for 1098 patients were completed (37 patients had more than one scan); 596 (54.3%) were female and 502 (45.7%) were male, with the ages ranging from 3 days to 94 years old. Among the female patients, there was a greater demand in the ≥60 years age group for cardiac amyloid scans (χ² = 6.40, p < 0.05), while females 18–59 years had a greater demand for thyroid scans (χ² = 7.714, p < 0.05) and bone scans (χ² = 3.904, p < 0.05). On the other hand, significantly more males in the ≥60 age group presented for cardiac amyloid (χ² = 4.167; p < 0.05) and bone scans (χ² = 145.79, p < 0.01). Males were significantly less likely to undergo a thyroid scan than females (p < 0.01, OR = 0.072, 95% CI: 0.021, 0.243) while individuals aged 18–59 years were more likely to undergo this scan than patients aged 60 or older (p = 0.02, OR = 3.565, 95% CI: 1.258, 10.104). Males were more likely to do a cardiac amyloid scan (p < 0.05, OR = 2.237, 95% CI: 1.023, 4.891) but less likely to undergo a cardiac rest/stress test than females (p = 0.02, OR = 0.307, 95% CI: 0.114, 0.828). Prolonged life expectancy and an aging population have the potential to impact NM utilization, thus requiring planning for infrastructure, equipment, work force, and supplies. Cancer-related and cardiovascular indications are a top priority at this facility; hence, age- and sex-specific analysis are useful in establishing models for policy makers with regard to the allocation of economic and human resources for the sustainability of this specialized service. Full article

Background and objectives: Life expectancies have increased globally, including in Romania, leading to an aging population and thus increasing the burden of chronic diseases. Over 80% of individuals over 65 have more than three chronic conditions, with many exceeding ten and often requiring multiple medications and supplements. This widespread polypharmacy raises concerns about drug interactions, side effects, and inappropriate prescribing. This review examines the impact of polypharmacy in older adult patients, focusing on the physiological changes affecting drug metabolism and the potential risks associated with excessive medication use. Special attention is given to proton pump inhibitors (PPIs), a commonly prescribed drug class with significant benefits but also risks when misused. The aging process alters drug absorption and metabolism, necessitating careful prescription evaluation. Methods: We conducted literature research on polypharmacy and PPIs usage in the older adult population and the risk associated with this practice, synthesizing 217 articles within this narrative review. Results: The overuse of medications, including PPIs, may lead to adverse effects and increased health risks. Clinical tools such as the Beers criteria, the STOPP/START Criteria, and the FORTA list offer structured guidance for optimizing pharmacological treatments while minimizing harm. Despite PPIs’ well-documented safety and efficacy, inappropriate long-term use has raised concerns in the medical community. Efforts are being made internationally to regulate their consumption and reduce the associated risks. Conclusions: Physicians across all specialties must assess the risk–benefit balance when prescribing medications to older adult patients. A personalized treatment approach, supported by evidence-based prescribing tools, is essential to ensure safe and effective pharmacotherapy. Addressing inappropriate PPI use is a priority to prevent potential health complications. Full article

Background: Pleural empyema remains a serious clinical condition with high morbidity and mortality, especially in elderly patients. As life expectancy increases, a growing number of older individuals require surgical treatment. This retrospective single-center study investigated age-related differences in clinical presentation, perioperative features, and postoperative outcomes in patients undergoing surgery for pleural empyema. Methods: We conducted this retrospective study at Helios University Hospital Wuppertal, Witten Herdecke University in Germany, from December 2019 to May 2024. We stratified the patients into two age groups: <65 and ≥65 years. We compared baseline characteristics, American Society of Anesthesiologists (ASA) physical status classification, empyema stage, hospital stay, drainage duration, complication rates, and in-hospital mortality. Results: A total of 103 patients were included, of whom 43 (41.7%) were aged ≥ 65 years. Older patients had significantly higher ASA scores and presented with more advanced empyema stages. Hospital stay was significantly longer in this group. However, complication rates (60.0% vs. 44.9%; p = 0.25), drainage duration, ICU admissions (91.4% vs. 83.7%; p = 0.48), and in-hospital mortality (0% in both groups) did not differ significantly. Conclusions: Although older patients had higher perioperative risks, their surgical outcomes were similar to those of younger patients. Chronological age alone should not be a limiting factor for surgical treatment of pleural empyema. Surgical decisions should be based on clinical condition rather than chronological age. Full article

Achieving health equity for people with disabilities requires addressing the barriers that they face when accessing healthcare. Older adults with disabilities may experience compounded disparities, yet little research has explored their satisfaction with health facility personnel, including non-healthcare staff. This study examines differences in satisfaction with health facility personnel between younger (18–59 years) and older (60+) adults with disabilities in Chile. Data from the 2024 Disability and Citizenship (DISCA) survey were analysed using chi-square tests to examine differences between younger and older people with disabilities with regard to their satisfaction with health facility personnel. Ordered logistic regressions were employed to predict high satisfaction, given socioeconomic and health-related variables. Findings indicated that a higher percentage of older adults with disabilities reported high satisfaction with health facility personnel compared to younger adults. Ordered logistic regressions confirmed that older adults had greater odds of reporting high satisfaction with doctors (OR: 3.83), other health professionals (OR: 4.66), paramedical technicians (OR: 4.31), and administrative staff (OR: 3.13). These results suggest that age influences satisfaction levels among people with disabilities, potentially due to varying expectations, experiences, or interactions with health facility personnel. Understanding the underlying reasons for these age-related differences is essential to inform policies and practices that ensure equitable, person-centred care for people with disabilities across the life course. Full article

Background: The global rise in life expectancy and the resulting shift toward ageing populations pose significant public health and socioeconomic challenges. As healthy ageing becomes a priority, understanding the factors that support well-being in older age is essential. Oral health is increasingly recognised as a critical determinant of overall health and has been linked to chronic conditions. Objectives: To conduct a systematic review of longitudinal studies examining the relationship between oral health and healthy ageing. Materials and Methods: Two independent reviewers conducted searches in three databases (MEDLINE, EMBASE, and LILACS) up to April 2025, following a defined search strategy. Grey literature was explored using Open Grey and Google Scholar. The quality and the risk of bias of the included studies were evaluated using the Newcastle Ottawa Quality Assessment Scale (NOS) for longitudinal studies. The review protocol was registered with the International Prospective Register of Systematic Reviews (CRD420251029090). Results: Four longitudinal studies reporting the association between oral health and healthy ageing were recognised and included. All selected studies were considered of good quality according to the NOS. The studies varied in defining and measuring healthy ageing, the follow-up period, the sample size, and the measure of oral health; therefore, it was not possible to perform a meta-analysis. The studies included in the review demonstrated a positive relationship between the number of natural teeth and healthy ageing. Discussion: Despite variations in the definition of healthy ageing and the application of different oral health indicators, the review identified significant associations between the number of natural teeth and trajectories of healthy ageing. Conclusions: This review recognised significant longitudinal associations between oral health measures (number of teeth) and trajectories of healthy ageing. The findings emphasise the need to incorporate oral health into research and policy related to healthy ageing. Full article

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

The COVID-19 pandemic has had a profound impact on society, including on physical and mental health. This study investigated changes in mental health parameters among a Swedish sample during and after the pandemic. Using a longitudinal study, we investigated the relationships among life dissatisfaction, psychological distress, and worries, with factors such as age, sex, education, severe illness, and job loss due to the pandemic among 588 men (mean age 54.9 years), and 653 women (mean age 52.9 years). The results reveal sex differences in life dissatisfaction and psychological distress; in addition, younger individuals reported more life dissatisfaction, and psychological distress compared with older groups. Women were 4.5 times more likely than men to report worries in 2021 and 2.3 times more likely in 2022, even after adjusting for age, education, severe illness, and job loss. This study shows how societal expectations and sex roles may exacerbate these differences in mental well-being during a time of crisis. The conclusions emphasize the importance of considering factors such as sex, age, education, and employment status when developing interventions and support systems during a global crisis. The COVID-19 pandemic will continue to affect society for a long time, indicating a need for ongoing research into population-level consequences. Full article

Osteoarthritis (OA) is a multifactorial, degenerative joint disease that significantly impairs mobility and quality of life, especially among older adults. The growing aging population and increasing obesity rates are expected to increase the incidence and prevalence of OA. In the absence of Disease-Modifying Antirheumatic Drugs (DMARDs) for OA, current treatment strategies largely focus on symptom relief rather than disease modification. These symptomatic treatments often fail to account for the substantial inter-individual variability in drug response. Pharmacogenomics (PGx), the study of how genetic variation influences drug response, offers a promising approach to personalize OA therapy. This review explores the clinical and pharmacogenomic considerations of commonly used OA medications—acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), duloxetine, and tramadol—focusing on gene–drug interactions that influence efficacy, safety, and metabolism. Evidence-based recommendations from the Clinical Pharmacogenetics Implementation Consortium guidelines are discussed, where applicable, to highlight actionable genetic variants in very important pharmacogenes such as CYP2D6, CYP2C9, and other important drug-metabolizing encoding genes such as CYP2E1 and UGT1A6. While PGx data are not currently embedded in OA clinical treatment guidelines, their integration into clinical practice may enhance therapeutic outcomes and minimize adverse drug events. This review underscores the potential of PGx as a clinical tool in OA pain management, paving the way toward truly personalized medicine. Full article

Culture encompasses, among other things, the ways of living, feeling, and thinking of a social group and is transmitted from one generation to the next. In part, this transmission is accomplished by older adults. Generative cultural demand refers to the perception that older adults have of what society and their families expect them to contribute to the benefit of younger generations and the communities in which they live. This phenomenological study explores generative cultural demand. Semi-structured interviews were conducted with 20 older adults between the ages of 61 and 89 from urban and rural areas in Mexico. The interviews were transcribed and analyzed through content analysis using the MAXQDA program. The results show that the main category of cultural demand was wisdom, conceived as the transmission of experiences, knowledge, behavior, traditions, and values, which varied by sex and by type of urban or rural area. In rural areas, women emphasized the transmission of experiences about daily life, while men focused on matters of labor; in urban areas, both men and women highlighted the transmission of personal experiences. Participants considered themselves to be appreciated, still capable of contributing to society, and as a reservoir of knowledge, traditions, values, and principles useful to future generations. Full article

Background/Objectives: This study aims to explore how gender influences the role of informal caregivers aged 65 years, considering the increasing involvement of men in caregiving due to longer life expectancy and societal norms. Methods: A two-year cross-sectional study was conducted in the Valencian Community, Spain, involving informal caregivers of 65 years of age and older who provided home-based care for dependent individuals with chronic conditions. The participants were recruited through public health schools, carers’ associations, and clinical consultations. The caregivers completed a comprehensive semi-structured interview, which included items from the Zarit Brief Scale (seven items) to assess caregiver burden and questions about their caregiving responsibilities, training, and experience, as well as the self-perceived frequency of medication errors. Results: A sample of 80 caregivers over 65 years old was analyzed, including 23 men (28.8%) and 57 women (71.2%). Male caregivers were significantly less experienced (mean = 3.1 years, SD = 5.9) compared to female caregivers (mean = 10.1 years, SD = 13.0; p = 0.004). Men reported lower emotional and physical burdens than women (p-value = 0.003), as reflected in the Zarit scores. Caregiving performance, measured by self-reported errors, was comparable between genders. Conclusions: This study explores the growing role of older male caregivers, highlighting their lower experience and training compared to those of women but similar caregiving performance and lower burden. Additionally, trained caregivers demonstrated significantly lower odds of experiencing burden, underscoring the importance of training as a modifiable factor. The findings emphasize the need for gender-sensitive support and tailored training programs to address disparities, reduce caregiver burden, and enhance caregiving quality and equity. Full article

Objectives: Previous studies have confirmed that biological age (BA) acceleration is associated with single cardio-renal–metabolic diseases (CRMDs), typically including type 2 diabetes mellitus, cardiovascular disease, and chronic kidney disease. However, its association with progression to cardio-renal–metabolic multimorbidity (CRMM, coexistence of ≥2 CRMDs) and subsequent mortality remains unexplored. Methods: Using the multi-state model, we analyzed 278,927 UK Biobank participants free of CRMDs at baseline to investigate the association between BA acceleration—measured by phenotypic age (PhenoAge) and Klemera–Doubal method age (KDMAge)—and CRMM progression trajectory, from health to the first CRMD and then to CRMM and death. BA acceleration was the residual from regressing BA on chronological age; positive values indicated a biologically older individual. Results: PhenoAge acceleration showed stronger associations than KDMAge acceleration. Per the 1-SD increase in PhenoAge acceleration; HRs (95% CIs) were observed at 1.18 (1.17–1.19) for baseline to first CRMD; 1.24 (1.22–1.26) for first CRMD to CRMM; 1.25 (1.22–1.27) for baseline to death; 1.13 (1.11–1.15) for first CRMD to death; and 1.09 (1.06–1.12) for CRMM to death. Biologically older individuals by PhenoAge acceleration showed greater reductions in CRMD-free and total life expectancy than those by KDMAge acceleration. Age, socioeconomic status, education, smoking status, alcohol consumption, physical activity, and diet-modified risks for specific transitions. Conclusions: BA acceleration, particularly PhenoAge acceleration, relates to higher CRMM progression risk and shorter life expectancy. Combining BA acceleration with sociodemographic or lifestyle factors improves risk identification for specific transitions. BA acceleration offers the potential to guide CRMM prevention across its entire progression. Full article

This study aims to evaluate the effects of a Walking Football (WF) programme on physical fitness, body composition, health-related quality of life (QoL), and happiness in men and women over 60 years. WF is proposed as a safe and accessible activity to counteract physical inactivity and chronic conditions in ageing populations. A randomized controlled trial will be conducted with 120 participants (both sexes), assigned to either an experimental group (WF intervention) or a wait-list control group. The six-month intervention includes bi-weekly sessions with skills training, match simulations, and fitness exercises. Assessments will be performed at baseline, 3 months, and 6 months. Primary outcome measures will be: body composition (weight, BMI, fat and lean mass), muscular strength, aerobic endurance, agility, range of motion, and subjective well-being (QoL and happiness scales). Linear mixed-effects models and ANCOVA will be used to analyse the data. It is expected that WF will lead to improvements in physical and mental health, contributing to active ageing. This study may also support WF as a tool for social inclusion and well-being in older adults. Full article

The aging of the global population over recent decades has resulted in an increased prevalence of hypertension in older adults. Hypertension develops with increasing age primarily due to a disastrous feedback loop of increased arterial stiffness and maladaptive hemodynamics; this is compounded by age-related changes in physiology. The risk of adverse hypertension-related outcomes concurrently increases with age, and optimal blood pressure (BP) control in older adults thus becomes increasingly important each year. The results of several randomized clinical trials (RCTs) evaluating antihypertension strategies in older adults have concluded that the potential benefits of intensive BP management outweigh the risks of harm. However, the exclusion of frail, multimorbid, and institutionalized individuals limits the generalizability of such findings to the broader population of older patients with hypertension. Secondary analyses and external studies have continued to support intensive BP control strategies in older adults with frailty or sarcopenia. Therefore, based on available evidence, clinicians should continue practicing intensive BP control strategies in the older population, yet careful consideration of functional status, life expectancy, medication side effects, polypharmacy, and multimorbidity must take place to avoid unnecessary harm. Strategies must then be tailored to accommodate modifiers such as frailty and sarcopenia in older adults with hypertension. Knowledge gaps underscore the need for future studies evaluating BP management in older adults that incorporate greater proportions of multimorbid and institutionalized individuals with frailty, assess personalization of treatment, and identify subgroups in which optimal BP levels exist or the permissibility of higher BP levels is safer than BP reduction. Full article

This study specifically examines the post-reproductive lifespan and ovarian activation in honeybee workers (Apis mellifera) with differing life expectancies. Drawing on the “grandmother hypothesis”, which postulates that older females enhance the survival and reproductive success of their descendants, we aimed to determine if similar patterns exist in eusocial insects. We conducted an experiment with newly emerged honeybee workers, dividing them into two groups: an untreated control group and an injured group with shortened lifespans due to thorax puncturing. The workers were monitored in an experimental apiary, and observations regarding ovarian development and hypopharyngeal gland size were recorded at various age intervals. Our results demonstrated a significant difference in lifespan between the control and injured bees, with injured individuals living notably shorter lives. The size of the hypopharyngeal gland, crucial for brood food production, varied significantly with respect to age and treatment, suggesting that physical injuries adversely affected physiological development. More intriguingly, our findings indicated that older honeybee workers displayed reduced ovarian activation, implying a potential reproductive cessation. This phenomenon can be interpreted as a form of menopause, which represents a strategic shift in energy investment from personal reproduction toward contributing to the colony as older individuals age. Full article