Search Results (130)

Sarcopenia is a progressive age-related musculoskeletal disorder characterized by loss of muscle mass, strength, and physical performance, contributing to functional decline and increased risk of disability. Emerging evidence suggests that vitamin D (Vit D) plays a pivotal role in skeletal muscle physiology beyond its classical functions in bone metabolism. This review aims to critically analyze the relationship between serum Vit D levels and sarcopenia in older adults, focusing on pathophysiological mechanisms, diagnostic criteria, clinical evidence, and preventive strategies. An integrative narrative review of observational studies, randomized controlled trials, and meta-analyses published in the last decade was conducted. The analysis incorporated international diagnostic criteria for sarcopenia (EWGSOP2, AWGS, FNIH, IWGS), current guidelines for Vit D sufficiency, and molecular mechanisms related to Vit D receptor (VDR) signaling in muscle tissue. Low serum 25-hydroxyvitamin D levels are consistently associated with decreased muscle strength, reduced physical performance, and increased prevalence of sarcopenia. Although interventional trials using Vit D supplementation report variable results, benefits are more evident in individuals with baseline deficiency and when combined with protein intake and resistance training. Mechanistically, Vit D influences muscle health via genomic and non-genomic pathways, regulating calcium homeostasis, mitochondrial function, oxidative stress, and inflammatory signaling. Vit D deficiency represents a modifiable risk factor for sarcopenia and functional impairment in older adults. While current evidence supports its role in muscular health, future high-quality trials are needed to establish optimal serum thresholds and dosing strategies for prevention and treatment. An individualized, multimodal approach involving supplementation, exercise, and nutritional optimization appears most promising. Full article

Background/Objectives: The incidence and prevalence of ischemic stroke, a leading cause of death and disability worldwide, are significantly higher in older adults than in younger individuals. Senescence induces a variety of biological changes that influence the pathogenesis of diseases such as ischemic stroke, thereby necessitating age-specific medical treatments. However, the molecular mechanisms underlying age-related differences in ischemic stroke progression remain poorly understood. Methods: We compared the histological and molecular features of ischemic stroke in a photothrombotic mouse model, focusing on 9-week-old (young) and 90-week-old (old) mice. Results: We found that microglial accumulation at the infarct region of the cerebral cortex was significantly lower in old mice than in young ones. This reduction in the microglial response was accompanied by a decrease in the morphological robustness of the astrocytes forming the glial scar. Furthermore, the mRNA expression of proinflammatory cytokines CXCL10, CCL2, and TNF-α, which were upregulated in the infarct region, was considerably higher in the old mice than in the young ones. Cytokine expression was well correlated with the mRNA levels of Toll-like receptor 4 (TLR4), a key regulator of neuroinflammation in old mice, but less correlated with them in young mice. Interestingly, Tlr4 mRNA expression in young mice was negatively correlated with the mRNA expression of the epigenetic regulator HDAC7, whereas this correlation was positive in old mice. Conclusions: These findings suggest that age-dependent changes in epigenetic regulation, such as the interaction between HDAC7 and TLR4, may contribute to the distinct pathological progression of ischemic stroke in older individuals. Full article

This study presents a systematic review regarding the use of augmented reality and virtual reality in exergaming by analyzing studies published during 2010–2025. This study focuses on providing an overview of the field and on examining and synthesizing the findings of related studies to identify the contexts, applications, and domains in which extended reality exergames are being used and the related implications, benefits, and challenges. Based on the results, augmented reality and virtual reality exergames offer immersive, enjoyable, engaging, and personalized experiences that support physical, cognitive, and emotional well-being, while enhancing physical performance, cognitive functioning, psychological outcomes, and mental health. They promote motivation, active lifestyles, and sustainable health behaviors across diverse populations, including older adults, individuals with disabilities, and neurological groups, as well as the general adult and youth populations. Although emphasis is placed on their use in physical and cognitive rehabilitation and treatment, they also show great potential to be effectively used in different domains, including education. Among the technologies examined, the significant majority of studies focused on virtual reality exergames, a limited number of studies involved augmented reality, and only a few studies examined mixed reality, extended reality, and the metaverse. Finally, nine main topics were identified through topic modeling, providing a clear representation of the core themes within the literature. Full article

Older people’s social participation is being shaped by the current context of “liquid modernity,” characterized by the erosion of traditional roles and identity, fragile social ties, individualism, economic precariousness, and uncertainty. The challenges entailed by these trends can be exacerbated when a circumstance, such as being the parent of an adult with a physical disability, is combined with old age. This study aimed to explore how this dual condition influences processes of aging and community participation. This work presents the findings of a phenomenological study conducted in 2025 through semi-structured interviews with a sample of 24 elderly people with children diagnosed with spina bifida. The results show that the children’s support needs, especially when they live with their parents, but also if they have become independent, impact the parents’ aging and social participation processes. Likewise, concern for the future is identified as a recurring aspect due to the children’s lack of support from a social network. It was concluded that public administrations and non-profit organizations should develop social intervention strategies aimed at promoting social participation, guaranteeing external assistance in the home, and providing coexistence resources. Full article

Hip fractures are among the most serious health events in older adults, frequently leading to disability, loss of independence, and elevated mortality. In 2019, an estimated 9.6 million new cases occurred globally among adults aged ≥ 55 years, with an incidence rate of 681 per 100,000. Despite improved surgical care, one-year mortality remains high (15–30%), and fewer than half of survivors regain their pre-fracture functional status. Traditionally regarded as mechanical injuries, hip fractures are now increasingly recognized as systemic events reflecting and accelerating biological vulnerability and frailty progression. We synthesize evidence across biological, clinical, and social domains to explore the systemic implications of hip fracture, from the acute catabolic response and immune dysfunction to long-term functional decline. The concept of intrinsic capacity, introduced by the World Health Organization, offers a resilience-based framework to assess the multidimensional impact of hip fracture on physical, cognitive, and psychological function. We highlight the importance of orthogeriatric co-management, early surgical intervention, and integrated rehabilitation strategies tailored to the individual’s functional reserves and personal goals. Innovations such as digital health tools, biological aging biomarkers, and personalized surgical approaches represent promising avenues to enhance recovery and autonomy. Ultimately, we advocate for a shift toward interdisciplinary, capacity-oriented models of care that align with the goals of healthy aging and enable recovery that transcends survival, focusing instead on restoring function and quality of life. Full article

Background/Objectives: Globally, one in eight people live with a mental disorder, with depression being a leading cause of disability. This study aimed to identify sociodemographic factors associated with public belief and perception of mental disorders among adults in Poland. Methods: A cross-sectional study with a self-prepared questionnaire (5-point Likert scale) was administered to a nationally representative quota sample of 1114 Polish adults (March 2025). The computer-assisted web interview (CAWI) method was applied. Results: A cross-sectional survey of 1114 adults found that 23.2% had visited psychiatrists, 15.9% psychotherapists, and 21.1% reported a family history of mental disorders. Most respondents (73.8%) believed employers are reluctant to hire individuals with mental disorders, and 53.8% perceived discrimination. Additionally, 19.4% thought mental health patients receive lower-quality care than those with physical illnesses like diabetes. Respondents from large cities (≥500,000 residents, aOR: 1.67; 95%CI: 1.11–2.51; p = 0.01), with higher education (aOR: 1.62; 95%CI: 1.26–2.07; p < 0.001), or a family history of mental disorders (p < 0.05) were more likely to hold this view. Higher education (aOR: 1.47; 95%CI: 1.11–1.94; p = 0.01), good economic status (aOR: 1.60; 1.06–2.40; p = 0.02), and personal psychiatric experience (aOR: 1.89; 95%CI: 1.24–2.87; p = 0.003) increased belief in treatment effectiveness. Males (aOR: 1.88; 95%CI: 1.36–2.61; p < 0.001) and medium-city residents (aOR: 1.82; 95%CI: 1.01–3.27; p = 0.04) more often perceived mental disorders as a sign of weakness, while women (aOR: 1.74; 95%CI: 1.36–2.22; p < 0.001) and those with affected relatives (p < 0.05) more frequently reported discrimination. Older respondents (p < 0.05), those with higher education (aOR: 1.65), and individuals with a family history of mental disorders (p < 0.05) were more likely to state that employers fear hiring people with psychiatric conditions. Conclusions: These findings underscore the need for public health interventions to reduce stigma, improve awareness, and address misconceptions about mental disorders in Poland. Full article

Background/Objectives: Chronic kidney disease (CKD) is a major global public health issue, affecting over 690 million individuals worldwide. The prevalence, diagnosis, and treatment of kidney disease vary considerably across different geographical regions. However, comprehensive and in-depth research on CKD remains limited due to its diverse etiologies. Methods: This study provides a detailed assessment of the disease burden of CKD, considering its etiological basis and utilizing the latest data reflecting changing trends. This research synthesizes findings from previous studies, with the necessary literature sourced from online platforms such as Google Scholar, EMBASE, and PubMed/MEDLINE databases, as well as Global Burden of Disease (GBD), to compare visualizations of the world’s CKD levels and trends from 1990 to 2021. Results: The study results demonstrated that eating patterns are affected by historical and industrial factors, which likely contribute to the high prevalence of CKD in Western countries. The data also indicated that the global number of new CKD cases increased from just over 7.8 million in 1990 to nearly 19 million after 30 years. Additionally, the results showed that age and sex together accounted for the observed prevalence and disease-attributable disability-adjusted life year (DALY) rates in CKD, with the highest rates seen in older age groups, except for CKD attributed to type 1 diabetes, where the incidence was higher in children, and the burden was greater in middle-aged adults. Conclusions: Overall, these findings are a valuable addition to the existing literature and provide evidence that CKD studies over a similar time frame reveal notable global trends and regional differences in highlighting this increasing burden. Full article

Background: Depressive symptoms and cognitive decline are common in older adults. The aims of this study were (i) to assess the frequency of depressive symptoms and cognitive impairment in users of municipal home care services and (ii) to explore factors that may pertain to seeking in-depth neuropsychiatric diagnostic workup, if recommended. Methods: The study was mainly conducted in low-resource areas of south-western Greece. The Geriatric Depression Scale (GDS-15), the Mini-Mental State Examination (MMSE) and the Clock Drawing Test (CDT) were employed. The study included the tracking of whether participants sought medical consultation within 12 months after receiving the recommendation for further neuropsychiatric diagnostic workup. Results: The study encompassed 406 individuals. Cognitive deficits were detected in 312 (76.84%) study participants, of whom only 82 (26.28%) had received the diagnosis of a mental or neurological disorder. Depressive symptoms were detected in 236 (58.27%) individuals, of whom only 18 (4%) had received the diagnosis of a mental or neurological disorder. Only just over a third of individuals consulted physicians. Reluctance towards in-depth neuropsychiatric workup mainly derived from a lack of insight and fears related to COVID-19. Previously diagnosed neuropsychiatric disorders slightly correlated with the decision to consult a physician. Conclusions: Developing pragmatic cognitive and mental healthcare services to address the needs of older people with disabling chronic disorders who live in low-resource settings is urgently needed. Full article

Background/Objectives: Research suggests that attitudes toward aging significantly impact health and well-being outcomes in older adults and are influenced by various factors. Our study aims to identify gender differences in attitudes toward aging among aging individuals with disabilities while also examining the influence of demographic and psychological factors on these attitudes. Methods: For this cross-sectional study, we collected data from 393 middle-aged and older adults with disabilities via an online Qualtrics survey administered through the Prolific platform in the United States. Participants completed the Attitudes Towards Aging Questionnaire Short Form, Purpose in Life Test Short Form, Mindfulness Attention Awareness Scale, Acceptance of Chronic Health Conditions Scale, and Three-Item Loneliness Scale. Descriptive and correlation analyses, t-tests, and multiple regression analyses were performed. Results: The independent t-test findings reveal significant differences in physical change and psychological growth between men and women, with men scoring higher in physical change and women in psychological growth. In multiple regression analyses, purpose in life significantly predicted all three domains of attitudes toward aging in men, while both purpose in life and acceptance were predictors across all domains in women. Additionally, age, employment, and financial stability contributed to aging attitudes only among women. Conclusions: Attitudes toward aging, specifically physical change and psychological growth, were found to vary by gender, with purpose in life, acceptance, and loneliness influencing these attitudes among both groups, while certain demographic factors influenced aging attitudes only among women. These findings underscore the need for gender-specific interventions addressing these substantial factors. Full article

Background/Objective: Stroke is one of the leading causes of death and disability worldwide, with older survivors (aged > 65 years) bearing significant health and economic impacts, particularly in industrialized countries. While gait rehabilitation is a cornerstone in post-stroke recovery and robotic technologies offer promising tools to enhance its effectiveness, the existing literature has largely overlooked elderly populations. Most studies on robot-assisted gait training (RAGT)—which uses exoskeleton or end-effector devices to support and guide movement—either exclude older adults or do not analyze their outcomes separately. This review aims to critically evaluate the current evidence on RAGT in elderly post-stroke patients, addressing a significant gap in the literature and providing novel insights into the effectiveness and adaptability of RAGT for this specific population. Methods: The search included databases such as PubMed, Scopus, Embase, Web of Science, and ClinicalTrials. The inclusion criteria covered studies published up to March 2025, focusing on post-stroke individuals aged >65 years, who underwent RAGT. Results: 25 studies were included in the review, 21 involving exoskeleton and 4 end-effector devices. The primary focus was on motor outcomes, such as gait independence, gait parameters, and balance control. Only a few studies examined non-motor aspects, including cognitive and emotional functions, fatigue, pain, and neuroplasticity. Moreover, data on the long-term effects on the elderly population remain scarce. Conclusions: RAGT is an effective strategy for promoting motor recovery and improving functional outcomes, from independence in daily activities to quality of life, in the post-stroke elderly population. Early and high-intensity interventions are particularly useful with positive effects on neuronal plasticity, cognitive function, and well-being. Full article

Food insecurity is not only shaped by behavioral, socioeconomic, and demographic factors but is also determined by an individual’s ability to access food in their community. Analyzing new survey data from a large city located in the southwest USA, this research adds to current dialogues on food insecurity among older adults and individuals with disabilities in economically disadvantaged communities. Using logistic regression, the findings provide nuanced evidence to distinguish between two crucial determinants of food insecurity related to transportation access—the lack of service availability and transportation unaffordability. One-third of respondents missed grocery trips due to a lack of affordable transportation. For individuals who cannot drive or do not own vehicles, access to ride services is critical to overcome exacerbated risks owing to food insecurity compared with those who own personal vehicles. Those relying on community-based ride services are more likely to miss grocery trips due to inadequate services. Our research further provides evidence that inadequate services result in greater food insecurity for specific vulnerable subgroups, such as those with poor health, renters, and those with lower incomes. Our findings highlight the importance of understanding behavioral travel constraints and call for equity-focused improvements in transportation systems to mitigate food access barriers. Full article

Accessible housing plays a vital role in promoting independent living and quality of life for people with disabilities. However, the existing design standards often fail to address the specific needs of diverse disability groups. This study aims to establish architectural and habitability criteria for housing adapted to various disabilities, including wheelchair users, individuals with achondroplasia (little people), Autism Spectrum Disorder (ASD) and Down syndrome, individuals with visual and hearing impairments, and older adults, by integrating international frameworks and prior research. The Analytic Hierarchy Process (AHP) was used to prioritize key factors in the housing design. The factors analyzed included autonomy, independence, safety, comfort, communication, and mobility. Findings reveal that autonomy consistently emerged as the most relevant criterion across groups, particularly for older adults (61.8%), wheelchair users (83%) and little people (64%). Secondary priorities varied: mobility was emphasized by wheelchair users (77%), communication by visually impaired individuals (64%), and comfort by deaf and hard of hearing participants (43%). The results underscore the need for housing solutions that reflect the priorities of each disability group. This study contributes by validating user-centered design criteria and offering a framework to guide inclusive housing policies and practices. By highlighting needs, it bridges the gap between generic accessibility standards and design. These findings support policy development and enrich the literature by incorporating unique resident-centered perspectives and overlooked indicators of housing accessibility and inclusive residential design. Full article

Background: The association between high-sensitivity C-reactive protein (hsCRP) and activities of daily living (ADL) disability remains unclear. Our study aimed to comprehensively explore the relationship between hsCRP concentrations and the risk of ADL disability, while also identifying potential modifiers of this association in middle-aged and older adults. Methods: We conducted a prospective study involving 16,342 participants aged 50 years and older (mean age: 64 ± 10 years) from the Health and Retirement Study. To investigate the longitudinal association between hsCRP and the risk of ADL disability, we employed Cox proportional hazard regression models, adjusting for a wide range of potential confounders. Subgroups analyses were further conducted to examine interactions across factors such as gender, age, body mass index, smoking status, and drinking status. Results: This study involved a follow-up of 125,858 person-years (median of 8 years; interquartile range: 4–12 years), revealing a total of 4579 incidents of ADL disability. The highest hsCRP concentration was significantly associated with ADL disability after adjustment for covariates (hazard ratio [HR] = 1.25; confidence interval [CI] = 1.14–1.36). The associations between hsCRP and the risk of ADL disability seemed to be somewhat stronger among individuals aged < 65 years and with a BMI ≥ 30 kg/m² (both p for interaction < 0.05). Conclusions: Our findings indicated that elevated hsCRP concentrations are associated with an increased risk of ADL disability in middle-aged and older adults. HsCRP appears to serve as a biomarker for ADL disability, particularly among individuals with obesity and middle-aged adults. Full article

Background and Objective: Aging in place (AIP) refers to the ability to remain in one’s home and community as one ages. While AIP is widely regarded as beneficial, disparities in housing stability, accessibility, and affordability create inequitable barriers. Current clinical AIP interventions focus on individual-level solutions, often overlooking broader socio-economic and structural determinants.This study examines how community-based interventions, particularly those from Rebuilding Together Richmond (RT-R), address these gaps through home modifications and critical repairs. Methods: Using the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework, demographic and service data from home modifications from a community-based organization, RT-R was analyzed. Descriptive statistics assessed the characteristics of homeowners served, the types of repairs performed, and their potential impact on AIP. Repairs were categorized as structural or occupational to evaluate their contributions to home safety and accessibility. Results: RT-R provided repairs for 33 homes, benefiting 47 individuals all of whom were Black or African American living in a ZIP code with high eviction rates. The majority (63.8%) were female, and 51% were older adults and/or had a disability. Structural repairs were more frequent than occupational modifications reflecting both homeowner needs, service availability, and community organizational goals. Conclusions: Housing stability is a critical yet overlooked factor in AIP. Integrating clinical AIP interventions with community-based solutions can more effectively address health disparities, reduce institutionalization risks, and improve long-term livability. Partnerships between healthcare practitioners and organizations like Rebuilding Together are essential to advancing equity in AIP. Access to housing is not accessible housing, and to remove barriers, practitioners and community-based organizations should expand their appreciation of obstacles to include historical, contemporary, economic, and environmental factors to work toward equity in aging in place for all. Full article

Human–machine interface (HMI) systems are increasingly utilized to develop assistive technologies for individuals with disabilities and older adults. This study proposes two HMI systems using piezoelectric sensors to detect facial muscle activations from eye and tongue movements, and accelerometers to monitor head movements. This system enables hands-free wheelchair control for those with physical disabilities and speech impairments. A prototype wearable sensing device was also designed and implemented. Four commands can be generated using each sensor to steer the wheelchair. We conducted tests in offline and real-time scenarios to assess efficiency and usability among older volunteers. The head–machine interface achieved greater efficiency than the face–machine interface. The simulated wheelchair control tests showed that the head–machine interface typically required twice the time of joystick control, whereas the face–machine interface took approximately four times longer. Participants noted that the head-mounted wearable device was flexible and comfortable. Both modalities can be used for wheelchair control, especially the head–machine interface for patients retaining head movement. In severe cases, the face–machine interface can be used. Moreover, hybrid control can be employed to satisfy specific requirements. Compared to current commercial devices, the proposed HMIs provide lower costs, easier fabrication, and greater adaptability for real-world applications. We will further verify and improve the proposed devices for controlling a powered wheelchair, ensuring practical usability for people with paralysis and speech impairments. Full article