Search Results (2,014)

Black gay and bisexual older men face numerous barriers across the life course that can contribute to negative health and well-being as they age. Drawing on strengths-based social determinants discussed in the health literature and literature on intersectionality, justice, and critical consciousness, this study examines qualitative data from seventeen Black gay and bisexual older men about sources and strategies of resilience and thriving amidst intersecting systems of power and oppression that shape health inequities. The findings revealed an evolution of positive support networks across their life courses, including biological family and families of choice such as “houses” and support groups. Early and ongoing negative experiences relating to intersecting positionalities (e.g., race, gender, sexual orientation) also provided sources of strength and resilience. Participants identified three strategies for building resilience and thriving: naming external ignorance, acknowledging common struggles, and reconciling contradictions. These strategies reflected various levels of critical consciousness that helped them navigate complex and intersecting systems of power that they encountered as Black gay men across the life course. Overall, the findings underscore the importance of considering intersecting systems of power and critical consciousness when examining resilience and social determinants of health and contribute new insights on a vastly understudied population. Full article

Background/Objectives: Despite growing interest in oral frailty as a public health issue, no nationwide study has assessed regional differences in oral frailty awareness, and the factors associated with such differences remain unclear. This study investigated regional differences in oral frailty awareness among older adults in Japan and identified the associated individual- and municipal-level factors, focusing on local policy measures and community-based oral health programs. Methods: A cross-sectional analysis was conducted using data from the 2022 wave of the Japan Gerontological Evaluation Study. The analytical sample comprised 20,330 community-dwelling adults aged ≥65 years from 66 municipalities. Awareness of oral frailty was assessed via self-administered questionnaires. Individual- and municipal-level variables were analyzed using multilevel Poisson regression models to calculate prevalence ratios (PRs). Results: Awareness of oral frailty varied widely across municipalities, ranging from 15.3% to 47.1%. Multilevel analysis showed that being male (PR: 1.10), having ≤9 years (PR: 1.10) or 10 to 12 years of education (PR: 1.04), having oral frailty (PR: 1.04), and lacking civic participation (PR: 1.06) were significantly associated with lack of awareness. No significant associations were found with municipal-level variables such as dental health ordinances, volunteer training programs, or population density. Conclusions: The study found substantial regional variation in oral frailty awareness. However, this variation was explained primarily by individual-level characteristics. Public health strategies should focus on enhancing awareness among socially vulnerable groups—especially men, individuals with low educational attainment, and those not engaged in civic activities—through targeted interventions and community-based initiatives. Full article

Background/Objectives: Aging is associated with a gradual decline in physical capabilities, often leading to impaired balance and reduced functional status, which are major contributors to falls in older adults. Although many studies have assessed these variables independently, a limited amount of research has explored the direct relationship between balance and functional status in a healthy geriatric population. The aim of this study was to investigate the relationship between balance and functional capacity and to assess the influence of demographic factors such as age, comorbidities, smoking status, and history of falls. Methods: A sample of community-dwelling older adults (19 women, 16 men) (n = 35), aged 60 years and above (M = 78 years; SD = 9.23) from Sparta, Greece, took part in the present study. Participants were assessed using three validated tools: (a) the Five Times Sit-to-Stand test, (b) the Timed Up-and-Go test, and (c) the Berg Balance Scale. Spearman’s rank correlation coefficient was used for statistical analysis (α = 0.05). Results: Age was positively correlated with poorer performance in the Five Times Sit-to-Stand (r = 0.40; p < 0.01) and the Timed Up-and-Go test (r = 0.47; p < 0.01) and negatively correlated with Berg Balance Scale scores (r = −0.51; p < 0.01). Comorbidities and smoking were also associated with the Berg Balance Scale. A strong negative correlation was observed between balance and the other two functional tests (Five Times Sit-to-Stand: r = −0.51; Timed Up-and-Go: r = −0.66; both p < 0.01). Conclusions: The findings highlight the importance of evaluating both balance and functional capacity in older adults as interrelated factors that can significantly influence quality of life and fall risk. Future research with larger and more diverse populations is recommended to confirm the present findings and to use exercise programs to prevent falls in the geriatric population. Full article

Introduction: Sarcopenia is a systemic condition linked to increased morbidity and mortality in older adults. Point-of-Care Ultrasound (POCUS) offers a rapid, bedside method to assess muscle mass. This study evaluates the diagnostic accuracy of POCUS compared to Dual-energy X-ray Absorptiometry (DXA), the gold standard method, and explores its prognostic value in old patients undergoing surgery for hip fractures. Patients and Methods: In this prospective, single-center study, 126 patients aged ≥ 70 years and hospitalized with hip fractures were included. Sarcopenia was defined according to the revised 2018 EWGSOP2 criteria. Muscle mass was assessed by the Appendicular Skeletal Muscle Mass Index (ASMI) using DXA and by the thickness of the rectus femoris (RF) muscle using POCUS. Results: Of the 126 included patients, 52 had both DXA and POCUS assessments, and 43% of them met the diagnostic criteria for sarcopenia or severe sarcopenia. RF muscle thickness measured by POCUS was significantly associated with ASMI (R² = 0.30; p < 0.001). POCUS showed a fair diagnostic accuracy in women (AUC 0.652) and an excellent accuracy in men (AUC 0.905). Optimal diagnostic thresholds according to Youden’s index were 5.7 mm for women and 9.3 mm for men. Neither RF thickness, ASMI, nor sarcopenia status predicted mortality or major postoperative complications. Conclusions: POCUS is a promising, accessible tool for diagnosing sarcopenia in old adults with hip fractures. Nonetheless, its prognostic utility remains uncertain and should be further evaluated in long-term studies. Full article

Background: Non-communicable diseases (NCDs) are a leading cause of mortality globally, contributing significantly to the burden on healthcare systems. Understanding the spatiotemporal patterns of NCD mortality is crucial for identifying vulnerable populations and regions at high risk. Objectives: Here, we evaluated the spatiotemporal patterns of NCD mortality in the Metropolitan Area of the Valley of Mexico (MAVM) from 2000 to 2019 for five International Classification of Diseases chapters (4, 5, 6, 9, and 10) at two spatial scales: the municipal level and metropolitan region. Methods: Mortality rates were calculated for the total population and stratified by sex and age groups at both spatial scales. In addition, the relative risk (RR) of mortality was estimated to identify vulnerable population groups and regions with a high risk of mortality, using women and the 25–34 age group as reference categories for population-level analysis, and the overall MAVM mortality rate as the reference for municipal-level analysis. Results: Mortality trends showed that circulatory-system diseases (Chapter 9) are emerging as a concerning health issue, with 45 municipalities showing increasing mortality trends, especially among older adults. Respiratory-system diseases (Chapter 10), mental and behavioral disorders (Chapter 5) and nervous-system diseases (Chapter 6) predominantly did not exhibit a consistent general mortality trend. However, upon disaggregating by sex and age groups, specific negative or positive trends emerged at the municipal level for some of these chapters or subgroups. Endocrine, nutritional, and metabolic diseases (Chapter 4) showed a complex pattern, with some age groups presenting increasing mortality trends, and 52 municipalities showing increasing trends overall. The RR showed men and older age groups (≥35 years) exhibiting higher mortality risks. The temporal trend of RR allowed us to identify spatial mortality hotspots mainly in chapters related to circulatory, endocrine, and respiratory diseases, forming four geographical clusters in Mexico City that show persistent high risk of mortality. Conclusions: The spatiotemporal analysis highlights municipalities and vulnerable populations with a consistently elevated mortality risk. These findings emphasize the need for monitoring NCD mortality patterns at both the municipal and metropolitan levels to address disparities and guide the implementation of health policies aimed at reducing mortality risk in vulnerable populations. Full article

Background/Objectives: Accurately assessing the independence level of older adults using useful assessment tools is an important step toward providing them with the necessary care while preserving their dignity. These tools allow older adults to receive effective, personalized home care, which improves their quality of life. This study aimed to clarify the current prevalence of severe and complete functional dependence and associated factors among Kazakhstan’s older adults aged >60 years. Methods: This cross-sectional study was conducted in several polyclinics and geriatric service care centers in two cities of Kazakhstan from March to May 2024. Functional status was assessed by the Barthel Index. We combined the selection into two categories: total dependency and severe dependency in the category “dependent”, and moderate dependency, slight dependency, and total independence in the category “active patients”. Results: Among the 642 older people in this study, 43.3% were dependent patients, and 56.7% were active patients. The odds of severe and total functional dependence are significantly higher for frail participants (adjusted odds ratio (AOR) = 2.96, 95% confidence interval (CI) [1.70, 5.16], p < 0.001) compared to those that are not frail; eleven times higher for those at home (AOR =11.90, 95% CI [5.77, 24.55], p < 0.001) than those in nursing homes; two times higher for participants with sarcopenia (AOR =2.61, 95% CI [1.49, 4.55], p < 0.001) compared to those with no sarcopenia; and three times higher for participants with high risk of fracture (AOR =3.30, 95% CI [1.94, 5.61], p < 0.001) compared to those with low risk. The odds of having severe and total functional dependence are significantly higher for participants with low dynamometry (AOR =1.05, 95% CI [1.03, 1.07], p < 0.001) compared to those with normal dynamometry. Conclusions: Old age, low dynamometry (for men ≤ 29 kg, for women ≤ 17 kg), frailty, being at home, high risk of fracture and osteoporosis, and sarcopenia were associated with increased risk of severe and total functional dependence. Full article

Background: Aortic stenosis (AS) has long been considered a degenerative disease and is typically diagnosed in older men at an advanced stage. However, accumulating evidence has highlighted the similarities between AS and atherosclerosis, particularly regarding shared risk factors and overlapping pathophysiological mechanisms. This connection has led to a paradigm shift, suggesting that AS may be preventable in its early stages. Methods: This narrative review synthesizes the existing literature exploring the parallels between AS and atherosclerosis, focusing on common risk factors, pathogenic pathways, and evolving therapeutic strategies. Clinical trials and translational studies were examined to assess the effectiveness of atherosclerosis-based treatments for AS. Results: Multiple studies have confirmed the shared inflammatory, lipid-mediated, and calcific mechanisms of AS and atherosclerosis. Despite these similarities, therapeutic strategies effective in atherosclerosis, such as statin therapy, have not consistently shown benefits in AS. New medical approaches aim to delay aortic valve replacement and reduce the associated morbidity. The partially overlapping pathogenesis continues to guide future research. Conclusions: While AS and atherosclerosis share several pathogenic features, their clinical courses and treatment responses diverge. Understanding the limits and potential of their overlap may inform future preventive and therapeutic strategies. Earlier detection and targeted intervention in AS remain key goals, drawing on insights from cardiovascular disease management. Full article

Background: Prostate cancer (PCa) trends have evolved due to changing screening practices. This study assessed long-term trends in PCa incidence and survival according to Gleason score (GS) in Friuli Venezia Giulia, northeastern Italy. Methods: A population-based study was conducted, encompassing 21,571 PCa cases from the regional Cancer Registry, diagnosed between 2000 and 2020. Age-standardized incidence rates and 5-year overall (OS) and net survival (NS) were assessed by GS (2–6, 7, 8–10) and age group (<65, 65–74, ≥75). Trends were analyzed using Joinpoint regression. Results: PCa incidence increased from 2000 to 2007 (Annual Percent Change, APC = +1.8%), then declined sharply until 2010 (APC = −7.6%) and remained stable thereafter. Incidence of low-grade cancers (GS 2–6) decreased across all age groups, especially in men aged ≥ 75 years (APC = −8.1%). The incidence of GS 7 rose until 2007 and then stabilized. High-grade cancers (GS 8–10) showed a stable incidence, but their proportion increased from 20% to 29%, mainly in older men. Survival improved across all GS groups. For GS 2–6, OS increased from 81.4% to 88.2%; for GS 7, from 78.1% to 88.1%. GS 8–10 had smaller gains, but NS reached 82% in recent years. Among men aged ≥ 75 years, OS for GS 7 rose from 51.9% to 78.1%, and for GS 8–10, from 43.9% to 54.4%. NS remained high for GS ≤ 7. Conclusions: While overall outcomes improved, the increasing proportion of high-grade PCa, despite a stable incidence, raises concerns, particularly in older men, and calls for tailored clinical strategies. Full article

Background/Objectives: The rapid ageing of the European population presents growing challenges for mental health, highlighting the need to identify factors that can prevent or delay psychological decline and promote a higher quality of life in later life. This study aims to provide an updated and comprehensive overview of mental health among older adults in Europe by examining the prevalence of depressive symptoms and identifying key associated factors. Methods: We analysed data from individuals (n = 45,601) aged 65 years and older across 27 European countries and Israel who participated in Wave 9 of the Survey of Health, Ageing and Retirement in Europe (SHARE). This study assessed the prevalence of depressive symptoms, which were evaluated using the EURO-D scale (score range: 0–12), with a cut-off of ≥4 indicating clinically relevant symptoms. It also explored associations with sociodemographic characteristics, physical health, behavioural factors, social participation, internet skills and living conditions. Results: Our findings confirm that depressive symptoms remain highly prevalent among older adults in Europe, with 35.1% of women and 21.5% of men affected, reflecting persistent gender disparities in mental health. Depression in later life was significantly associated with poor physical health, loneliness and lower quality of life. Conversely, moderate involvement in grandchild care and in social participation emerged as potential protective factors. Conclusions: Late-life depression has substantial implications for both mental and physical well-being. Our findings suggest that social integration, gender related factors and physical health are closely associated with depressive symptoms in older adults. These associations highlight the importance of considering these domains when designing interventions and policies aimed at promoting mental health in ageing populations. Full article

Dietary protein is an essential macronutrient derived from both plant and animal sources required for muscle building, immune function, and wound healing. However, in the United States, protein consumption worsens as individuals age, with 30% of men and 50% of women over 71 consuming inadequate dietary protein due to a variety of factors, including changes in gut function, loss of appetite, tooth loss, financial concerns, and social isolation. The aim of this review is to underscore the need for increased protein requirements in aging populations, highlight potential barriers, synthesize these protein requirements, and also recommend strategies to meet these increased protein needs. Achieving adequate protein status, especially when facing chronic or acute health concerns, is essential to promote muscle and bone strength (because aging is associated with significant decreases in postprandial muscle protein synthesis), to support immune health (due to immunosenescence), and to maintain a good quality of life. For older adults, the literature suggests that a dietary protein intake of at least 1.0–1.2 g/kg/day is required in healthy, aging populations, and intakes of 1.2–1.5 g/kg/day are necessary for those with chronic or acute conditions. These protein intake recommendations can increase to 2.0 g/kg/day in more severe cases of illness, malnutrition, and chronic conditions. The reviewed literature also suggests that evenly balanced protein distributions of 25–30 g of dietary protein (0.4 g/kg) per meal from animal and plant protein sources alike are sufficient to maximize muscle protein synthesis (MPS) rates in older populations. Additionally, pre-sleep protein feeds of 40 g/night may be another strategy to improve daily MPS and amino acid utilization. Full article

Background: Comprehensive Geriatric Assessment (CGA) is essential for evaluating older cancer patients, but significant gaps persist in both research and clinical practice. This study aimed (I) to identify the CGA elements that most influence anti-cancer treatment decisions in older patients and (II) to explore the predictive value of CGA components for mortality. Methods: This observational study included older patients with newly diagnosed, histologically confirmed solid or hematological cancers, recruited consecutively from 2003 to 2023. Participants were followed for four years. The data collected included CGA measures of functional (Activities of Daily Living-ADL), cognitive (Mini-Mental State Examination-MMSE), and emotional (Geriatric Depression Scale-GDS) domains. Patients were categorized into frail, vulnerable, or fit groups based on Balducci’s criteria. Statistical analyses included decision tree modeling and Cox regression to identify predictors of mortality. Results: A total of 7022 patients (3222 females) were included, with a mean age of 78.3 ± 12.9 years. The key CGA factors influencing treatment decisions were ADL (first step), cohabitation status (second step), and age (last step). After four years, 21.9% patients had died. Higher GDS scores (OR 1.04, 95% CI 1.01–1.07, p = 0.04) were independently associated with survival in men and living with family members (OR 1.67, 95% CI 1.35–2.07, p < 0.001) in women. Younger patients (<77 years) showed both MMSE and GDS as significant risk factors for mortality. Conclusions: Functional capacity, cohabitation status, and GDS scores are crucial for guiding treatment decisions and predicting mortality in older cancer patients, emphasizing the need for a multidimensional geriatric assessment. Full article

The Gahai wetland in Gansu, China, is a key wetland for nationally and globally threatened bird species. This research aims to quantify the economic value of wetland birds by the method of contingent valuation questionnaire, thereby providing a foundation for conservation of avian species. The result indicated that residents were willing to pay between 208 and 230 CNY (29–32 USD $) annually for bird protection, a total annual value of wetland birds in Luqu County ranging from 7.9 M to 8.8 M CNY (1.1–1.3 M USD $). Men, locals, and older individuals were more inclined to contribute and offered higher payments, albeit non-significant correlation between education level and annual income with the willingness to pay. While the depth of understanding of wetland pressures did not significantly influence the willingness to pay, it did show a positive correlation; those with more profound understanding tended to be more generous in their payments. Tibetan male residents were more likely to prioritize ecological and environmental protection due to their religious beliefs and cultural customs, which emphasize the reverence for and compassion towards birds. This research not only complemented and validated the applicability of the contingent valuation method in China but also underscores the considerations that should be taken into account when employing this method. Full article

Background: Type 2 diabetes (T2D) is a major global health concern influenced by sociodemographic and lifestyle factors. This study compared T2D risk scores between commerce and industry sectors and assessed the associations of age, sex, education, physical activity, diet, and smoking with elevated risk. Methods: This cross-sectional study included 56,856 men and 12,872 women employed in the commerce (n = 27,448) and industry (n = 42,280) sectors across Spain. Anthropometric, clinical, and biochemical data were collected. Four validated T2D risk scores (QDscore, Finrisk, Canrisk, and TRAQ-D) were calculated. Multinomial logistic regression models estimated adjusted odds ratios (ORs) for high-risk categories by sociodemographic and lifestyle characteristics. Results: Women in the industrial sector had significantly higher age, BMI, waist circumference, and lipid levels than those in commerce; differences among men were less marked. Across all participants, higher T2D risk scores were independently associated with physical inactivity (OR up to 12.49), poor Mediterranean diet adherence (OR up to 6.62), industrial employment (OR up to 1.98), and older age. Male sex was strongly associated with high Canrisk scores (OR = 6.31; 95% CI: 5.12–7.51). Conclusions: Employment in the industrial sector, combined with sedentary behavior and poor dietary habits, is independently associated with higher predicted T2D risk. Workplace prevention strategies should prioritize multicomponent interventions targeting modifiable risk factors, especially in high-risk subgroups such as older, less-educated, and inactive workers. Full article

Background: Hearing loss is increasingly prevalent and poses a significant public health concern. While both aging and occupational noise exposure are recognized contributors, their interactive effects and gender-specific patterns remain underexplored. Methods: This cross-sectional study analyzed data from 135,251 employees in Jiangsu Province, China. Demographic information, noise exposure metrics, and hearing thresholds were obtained through field measurements, questionnaires, and audiometric testing. Multivariate logistic regression, restricted cubic spline modeling, and interaction analyses were conducted. Machine learning models were employed to assess feature importance. Results: A nonlinear relationship between age and high-frequency hearing loss (HFHL) was identified, with a critical inflection point at 37.8 years. Noise exposure significantly amplified HFHL risk, particularly in older adults (OR = 2.564; 95% CI: 2.456–2.677, p < 0.001), with consistent findings across genders. Men exhibited greater susceptibility at high frequencies, even after adjusting for age and co-exposures. Aging and noise exposure have a joint association with hearing loss (OR = 2.564; 95% CI: 2.456–2.677, p < 0.001) and an interactive association (additive interaction: RERI = 2.075, AP = 0.502, SI = 2.967; multiplicative interaction: OR = 1.265; 95% CI: 1.176–1.36, p < 0.001). And machine learning also confirmed age, gender, and noise exposure as key predictors. Conclusions: Aging and occupational noise exert synergistic effects on auditory decline, with distinct gender disparities. These findings highlight the need for integrated, demographically tailored occupational health strategies. Machine learning approaches further validate key risk factors and support targeted screening for hearing loss prevention. Full article

When people overextend their step length, it leads to an increase in vertical movement and braking force. The overextension elevates landing impacts, which may increase pain in the knees or lower back. The objective of this study was to examine the effects of soft-landing walking techniques in a 90 min, instructor-led group class for older adults. To evaluate a landing impact, an accelerometer measurement system (Descente LTD., Tokyo, Japan) was used to measure a participant 10 meter (m) of walking. Assessment outcomes included the average number of steps, step length, upward acceleration which reflects the landing impact, and survey questions. A total of 223 older adults (31 men, 192 women, mean age 74.4 ± 5.7 years) completed the walking lesson. Following the lesson, participants decreased their step lengths and reduced upward acceleration, along with an increased step count. The number of steps increased, and a positive correlation (r = 0.73, p < 0.01) was observed between the rate of change in step length and upward acceleration. Over 95% of participants gave high marks for practicality and understanding the accelerometer measurements. The information derived from this study will provide valuable insight into the effectiveness of soft-landing techniques as a promotion of a healthy walking program for older adults. Full article