Search Results (4,830)

Introduction: In recent years, electronic cigarettes, including disposable e-cigarettes and tobacco heating devices, have grown in popularity, especially among young people and young adults. Although e-cigarettes are touted as a “safer” alternative to traditional cigarettes, a growing body of evidence indicates that vaping can cause serious health problems, especially in the respiratory and cardiovascular systems. Aim of the Study: The aim of the study was to assess the prevalence of disposable e-cigarettes and other nicotine products among adolescents and young adults, as well as to examine the factors associated with regular smoking and nicotine dependence across individual nicotine-containing products. Material and Methods: The survey was conducted among residents of southern Poland. A total of 625 (100%) people were examined. Among them were: 350 women and 275 men. The subjects were aged between 14 and 29 years (Median and 25th–75th percentile: 19; 16–23). The study used an original questionnaire, the completion of which was anonymous and voluntary. The questions included in the survey concerned the smoking status of the respondents, the main sources of nicotine intake and general information such as age, gender, place of residence, employment or education, and financial stability of the family. The survey used the Fagerström test to examine the degree of nicotine dependence among the subjects. Results: A total of 34% (212; 33.92%) of the surveyed group of adolescents and young adults were smokers, most of whom used disposable e-cigarettes (69; 32.55%). In addition, 60% (368; 58.88%) of respondents reported having tried disposable e-cigarettes. Smokers, of both traditional cigarettes and e-cigarettes, accounted for 14% (88; 14.08%) of the study group. The results of the study showed a statistically significant effect of the age of the participants on the method of nicotine intake (p = 0.013). In the younger group, e-cigarettes were more often used, while in the older group, the use of heated tobacco products and traditional cigarettes dominated. Respondents’ median age at the first use of nicotine products was 16 years. Factors such as living in the city, lower financial stability, and having a parent who smoked during childhood were significantly associated with a higher likelihood of regular nicotine product use. Among the regular users, a high level of nicotine dependence was observed in 28.64% (n = 61) of individuals, with the largest proportion occurring among those using electronic cigarettes (39.37%; n = 50). Conclusions: 1. In the study group of adolescents and young adults, disposable e-cigarettes were the most used nicotine-containing product. 2. Parental smoking and male gender were positively associated with the likelihood of smoking, whereas primary education and financial stability were inversely associated with tobacco use. 3. Electronic cigarette users exhibited the highest average nicotine dependence scores. Multivariate analysis confirmed that male gender, the type of nicotine product used, and place of residence were independently associated with higher Fagerström test scores. Full article

Introduction: Community-based day center programs may support healthy ageing by promoting functional ability, mental well-being, and social participation among older adults, but real-world evidence from Latin America remains limited. Objective: We aimed to examine changes in functional status, mental health, and quality of life among older adults participating in the CEDIAM program in the Maule Region of Chile in 2022 and 2023. Methods: Pre–post observational study using routinely collected data from 15 CEDIAM centers. The 2022 and 2023 datasets were analyzed as independent cohorts. Functional status was assessed with the Barthel Index, the Lawton and Brody scale, and the Timed Up and Go test; mental health with the Mini-Mental State Examination and the 15-item Geriatric Depression Scale; and quality of life with the EuroQol-5D visual analogue scale. Paired comparisons, category-transition analyses, and multivariable logistic regression models of improvement were performed. Results: Baseline samples included 894 participants in 2022 and 897 in 2023. In 2022, all continuous outcomes improved significantly (all p ≤ 0.001). In 2023, the Barthel Index, the Timed Up and Go test, and the Geriatric Depression Scale improved (all p < 0.0001), and the EuroQol-5D visual analogue scale also improved (p < 0.01), whereas the Lawton and Brody scale (p = 0.204) and the Mini-Mental State Examination (p = 0.725) did not. Category-transition analyses showed significant improvements in basic activities of daily living and mobility in both cohorts (both p < 0.001), while significant categorical changes in instrumental activities of daily living, global cognition, depressive symptoms, and self-rated quality of life were observed only in 2022 (all p ≤ 0.01). Rural residence was associated with higher odds of improvement in basic activities of daily living (OR 1.62, 95% CI 1.17–2.25; p = 0.004), whereas age ≥75 years was associated with lower odds of improvement in depressive symptoms (OR 0.56, 95% CI 0.41–0.76; p < 0.001) and self-rated quality of life (OR 0.65, 95% CI 0.45–0.94; p = 0.023). Conclusions: Participation in CEDIAM was associated with favorable changes, particularly in basic functional status and mobility, although responses varied across outcomes and participant subgroups. Full article

Background: Gender differences in aging among people with HIV (PWH) remain poorly characterized. Women with HIV (WWH) may experience more complex aging trajectories, due to the interplay of biological, clinical, and psychosocial factors. In this context, we aimed to investigate gender-specific determinants of frailty among older people with HIV, with a particular focus on women, to better inform tailored clinical care. Methods: Cross-sectional analysis of the Over50 Cohort, including PWH aged ≥50 years from two tertiary hospitals in Spain. Participants underwent a comprehensive geriatric assessment across demographic, clinical, functional, cognitive, psychological, and social domains. Gender-stratified multivariable analyses examined frailty (by Fried criteria) and associated factors. Results: Among 588 participants, 139 (23.6%) were cisgender WWH. Despite younger age and better immune status, WWH showed higher prevalence of frailty (17% vs. 9%), musculoskeletal disease (47% vs. 28%), depressive symptoms (45% vs. 30%), sleep disturbances (10% vs. 5%), and cognitive complaints (23% vs. 11%). Men with HIV (MWH) more frequently had cardiovascular (48% vs. 35%) and renal disease (22% vs. 15%). In multivariable models, frailty in WWH was independently associated with musculoskeletal disease (OR 3.85), cognitive impairment (OR 3.21), depressive symptoms (OR 2.67), and malnutrition (OR 2.14). In MWH, frailty was associated with musculoskeletal disease, cognitive impairment, malnutrition, and older age. Conclusions: Frailty exhibits gender-specific patterns: a multidimensional phenotype in WWH versus age-driven in MWH, supporting tailored, gender-responsive care integrating geriatric, mental, and musculoskeletal health. Full article

Globally, the growth of ageing populations is significant, with more people requiring supported living environments, including residential aged care (RAC). Given the influence of the environment on health outcomes, it is important to consider approaches to evaluate aged care design, including both the built environment and products and technology. With the overarching aim to identify the scope of RAC-built environment and assistive technology design interventions and the way this data is captured methodologically, this review (i) identified methods and measures used to evaluate RAC-built environment and assistive technology design, and examined populations these methods and measures were used with, and (ii) mapped identified approaches to the International Classification of Functioning, Disability and Health (ICF). An a priori review protocol was developed, and a scoping review was then conducted. Eight databases were searched for publications between January 2000 and February 2023, resulting in 81 included studies, which were then mapped to ICF activity, participation and environment domains. Twenty methods and 16 methodologies were identified. Sixty-one articles collected data directly from resident populations, primarily including older adults (n = 52). Forty-nine publications reported on the evaluation of built design, 23 reported on products and technology, and nine reported on both, but with limited inclusion of valued participation as a goal or outcome. While some participatory methods were identified, 25% of the studies did not include consumer perspectives. Analyzing aged care design can identify ways to facilitate, or remove barriers to, healthier spaces and lives in RAC. Use of internationally recognized terminology and an integrative lens on the relationship between technology and environmental design is recommended. Full article

Background/Objectives: Cerebrovascular disease (CVD) is the fifth leading cause of death in the U.S. and poses marked health ramifications. Improvements in CVD-related mortality rates have been observed since the 1970s, but incidence remains high. It is imperative to analyze demographic disparities and trends in CVD-related mortality to inform better efforts to reduce the burden of CVD. This study aimed to examine demographic disparities in CVD-related mortality across age groups, biological sex, race/ethnicity, and regions from 1999 to 2024. Methods: This was a retrospective population-based study using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER). The CDC WONDER was used to extract crude and age-adjusted mortality rates (AAMRs) for CVD-related deaths in the US. Adults aged 25 years and older were included in the study. Joinpoint analysis software was used to calculate the annual percent change (APC) and the average annual percent change (AAPC) for mortality trends. Results: There was a total of 6,541,598 CVD-related deaths from 1999 to 2024 in adults aged 25 years and older. The trend in overall CVD-AAMR steadily declined until 2014, then gradually increased, accelerated, and eventually peaked in 2021 during the COVID-19 pandemic. Male individuals experienced a higher mortality rate and comprised 43% of crude deaths vs. 57% of female individuals across the study period. When stratified by race/ethnicity, non-Hispanic (NH) Black individuals had an AAMR that was nearly 1.5 times that of the next-highest group at 148.37 (146.89 to 149.85) per 100,000 people in 2024. The South had the highest AAMR and experienced 39.4% of deaths out of the four regions. All demographics experienced an increase in mortality during the pandemic, but the Northeast region experienced an earlier peak in 2020 as opposed to all other groups, which saw a peak in 2021. Conclusions: CVD-related mortality declined significantly in adults from 1999 to 2024. Differences across demographic and regional subgroups have narrowed; however, significant disparities persist. These disparities will require comprehensive, concerted efforts to improve cerebrovascular health, outcomes, and equity among the young and middle-aged populations in the US. Full article

Background/Objectives: Nursing home residents were among the most vulnerable populations during the COVID-19 pandemic, facing strict restrictive measures, limited access to medical services, and significant psychological consequences derived from institutional confinement. Despite the magnitude of these impacts, the perspective of residents themselves remain underrepresented in the qualitative literature, particularly in the Spanish context. The aim of this study was to analyze and describe the perspectives of residents in a nursing home regarding the restrictive measures adopted by the facility and their access to medical services during the COVID-19. Methods: An exploratory qualitative study was conducted with 24 residents of a nursing home in Cáceres, Spain. Data were collected through in-depth interviews and field notes, and analyze using inductive thematic analysis following Braun and Clarke’s framework. Results: Two main themes were identified: Necessary to feel safe, but unpleasant: accepting the restrictive measures (Accepting the measures; and Better safe, even if unpleasant) and Barriers to healthcare: abandonment, fear, and age-based exclusion (Neglect and abandonment by healthcare system; The residence as a “bubble” and fear of hospital transfer; and Not treated because of our age). Conclusions: The findings highlight the complexity of the experiences of older adults in residential care during the COVID-19 pandemic and underscore the urgent need to balance health protection with psychological well-being, dignity, and the rights of older people in future emergency responses. Full article

The growing aging population is a primary driver of chronic, long-term health conditions. The rising prevalence of cognitive decline in older populations is a pressing public health issue due to its impact on health and social care and its emotional toll on family members. A lesser-known condition is sarcopenia—the age-related debilitating loss of skeletal muscle mass and function which leads to weakness and loss of mobility, quality of life and social independence. Neither health condition has a clear pharmacological treatment pathway. Diet and nutrition have therefore received the most attention for disease prevention. This review evaluates the research on the association between sarcopenia and cognitive decline and how both conditions may be linked to protein intake. While findings can be inconclusive or contradictory, a higher consumption of protein may protect against declines in physical and cognitive health, either acting separately or synergistically with exercise. The evidence supports the recommendation for a daily intake of protein higher than the current guideline of 0.8 g/kg/d for older people. Evidence suggests that healthy dietary patterns such as the Mediterranean diet appear to positively influence cognitive health in older people. Furthermore, the impact of specific high-protein foods, including egg, soy and dairy foods, on cognitive health has been reviewed, again with a suggestion that their consumption may mitigate against cognitive decline. Functional foods aimed at the aging population who wish to increase their protein intake and avert or delay the onset of these health conditions could play an important role in preventive nutrition, especially if they are formulated around the protein-rich foods which appear to positively impact cognitive health. Full article

Background: With the vast and fast-growing number of mHealth applications supporting health, disease management and self-care for older people, the usability of these applications has become a critical factor determining their acceptance and usage. In order to develop mHealth applications suitable for the aging population, it is important to investigate the relationship between older people’s experience with mobile technology in the past, their perception of the usability of mHealth applications and their subsequent use of these applications. Objective: This study investigated the impact of the length of mobile usage on the perceived mHealth application usability of older adults, and the impact of mHealth application usability on the mHealth application user satisfaction and frequency of use of older adults. Methods: This study is based on a cross-sectional survey among older individuals in Al-Ahsa, Saudi Arabia. The measurement model consisted of five distinct constructs with fifteen corresponding indicators including efficiency, learnability, memorability, error handling, and user satisfaction. In terms of analysis, this study included reliability and descriptive statistics as well as correlation and regression analysis, as well as simple and bootstrapped mediation analysis, and, finally, confirmatory factor analysis (CFA) and structural equation modeling (SEM). Based on discriminant validity, the findings suggest that four first-order dimensions, efficiency, learnability, memorability, and error handling, constitute second-order usability dimensions. Results: A total of 271 older adults were included in the final analysis. All constructs demonstrated satisfactory reliability and convergent validity, with Cronbach’s alpha values ranging from 0.797 to 0.862, Composite Reliability values ranging from 0.798 to 0.860, and Average Variance Extracted values ranging from 0.568 to 0.673. Structural equation modeling revealed that mobile usage duration significantly influenced usability (β = 0.616, p < 0.001), usability significantly influenced user satisfaction (β = 0.953, p < 0.001), and user satisfaction significantly influenced use frequency (β = 0.193, p = 0.002). The second-order structural model demonstrated excellent fit to the data (χ²/df = 1.824, CFI = 0.972, TLI = 0.966, GFI = 0.940, AGFI = 0.928, RMSEA = 0.055). Conclusions: Usability plays a central role in explaining the satisfaction of older people with mHealth services and their continuous use of applications. Older people’s experience with their smartphones is associated with their perceptions of the usability of mHealth applications. Higher perceived usability of mHealth applications is positively associated with greater user satisfaction and more frequent use of these applications among older adults. The findings are in line with a usability-centered technology acceptance model. Design of mHealth services should be based on user-centered design principles. In addition to other design principles, efficiency, learnability, memorability, error handling and other usability principles should be particularly addressed in order to increase acceptance of mHealth services by older people. Full article

Background: In older adults, multimorbidity and polypharmacy complicate medication regimens and often lead to poor adherence. Mobile health (mHealth) has been suggested as a solution to enhance medication adherence in chronic conditions. Despite the increase in smartphone usage among people aged 65 and over, there is still a lack of evidence of mHealth in this age group. Objectives: To evaluate the impact of mHealth interventions on medication adherence in older adults (≥65 years) with chronic diseases, compared with standard care or other interventions. Methods: The review was conducted in accordance with PRISMA 2020 guidelines and the Cochrane Handbook for Systematic Reviews. Randomized controlled trials published from 2000 onwards were considered with no linguistic or geographical restrictions. The databases searched included PubMed, Scopus, Cochrane Library, and CINAHL. Methodological quality was assessed using the Revised Cochrane Risk of Bias Tool for Randomized Trials. Results: 551 records were initially identified, from which 8 randomized controlled trials published between 2014 and 2025 were included. Six of eight studies showed that medication adherence in mHealth groups was significantly higher than in controls. However, one study found benefits only in specific drug classes rather than a general improvement. Conclusions: The results of this review suggest that mHealth has the potential to improve medication adherence among older adults with chronic diseases, especially when interventions go beyond simple reminders and incorporate educational and relational components. Nevertheless, higher quality studies with larger samples and longer follow-up are needed to clarify mHealth’s role in the care of this population. Full article

Background/Objectives: Norway’s ageing population includes many older adults living alone who receive home care and are at increased risk of loneliness. Loneliness is the subjective sense of unmet or imbalanced social needs, shaped by culture and living conditions, and can be social (lack of contact) or emotional (absence of close, trusting relationships). In older people, it often follows partner or role loss or reduced mobility or participation and is associated with emotional pain, lowered self-worth and poorer health and quality of life. This study aimed to explore patients’ experiences of loneliness while living alone and receiving home care. Methods: Twelve older patients (aged 74–98 years) participated in in-depth interviews, which were analysed using phenomenological-hermeneutical analysis in line with Lindseth and Norberg’s recommendations. Results: The results are presented under the following themes: (I) An overwhelming and painful feeling, (II) A presence without connection, and (III) Experiencing a sense of alienation. Conclusions: This study describes complex feelings of loneliness for the majority of participants, often worsened by poor mobility and shrinking social networks. From the patient perspective, good home care goes beyond practical and medical tasks: patients need to be treated as whole persons, with respect and understanding, to alleviate loneliness. Staffing stability, predictable visiting times, time for conversation, and small acts of kindness are central to well-being and the prevention of loneliness. Municipal healthcare should prioritize relationship-building, communication skills, and organizational solutions that enable continuity and flexibility. Focusing on the patient perspective in planning and evaluation will create better targeted interventions and support dignified ageing. Full article

Background/Objectives: Dementia poses a major public health challenge in South Korea, where population ageing has accelerated rapidly. We aimed to describe national 2016–2025 dementia prevalence trends and to generate a one-year 2026 forecast using NHIS-linked administrative data. Methods: We performed a retrospective longitudinal analysis of de-identified aggregate administrative data from the Ministry of Health and Welfare Municipal and District Dementia Status Report (2016–2025) and NHIS age–sex pivot table records. This was a purely descriptive and forecasting analysis; no inferential statistical tests were applied. Descriptive statistics were computed for national, sex-stratified, regional, and age-stratified outcomes. For the 2026 forecast, we used a prespecified demographic-offset time-series approach: the population aged 65 years or older and the estimated prevalence rate were modelled separately using damped-trend Holt exponential smoothing, then recombined to estimate patient count. Residual bootstrap resampling (20,000 iterations) was used to derive a 95% prediction interval for the patient count. A sensitivity analysis using ARIMA(1,1,0). Results: 602,633 (8.89%) in 2016 to 955,585 (9.09%) in 2025, a 58.6% increase. Females consistently showed higher prevalence than males (2025: 9.55% vs. 8.52%), and regional analysis identified South Jeolla Province (10.17%) as the highest-prevalence region and Ulsan Metropolitan City (8.10%) as the lowest. The female-to-male cumulative rate ratio reached 2.49 in the ≥85-year group. The primary 2026 forecast estimated 1,003,407 dementia patients among adults aged 65 years or older, with an estimated prevalence of 9.19% and a 95% prediction interval of 983,838–1,022,158. Conclusions: South Korea’s rising dementia burden is primarily driven by population ageing rather than a sharp increase in age-specific prevalence. The 2026 forecast supports urgent planning for a national dementia care population of approximately one million people. Full article

Background/Objectives: Traffic accidents are a significant public health issue. Pedestrians are considered the most vulnerable victims, showing the highest mortality rates. Thus, mortality rate indicators reflect the effectiveness of policies and safety measures applied to urban mobility. Therefore, the study objective is to identify trends in pedestrian mortality to foster an understanding of the local reality and to propose effective interventions for the safety and mobility of this population. Methods: This ecological time-series study used secondary data from the Unified Health System Information System (DATASUS) on all traffic accident-related deaths in Espírito Santo, Brazil, from 2009 to 2020. Data were classified according to the 10th Revision of the International Classification of Diseases (ICD-10). Variables included sex (male; female), age group (in years: 0 to 80+), and victim type (pedestrian). Mortality rates were logarithmically transformed (base 10), and the Prais–Winsten regression model was employed using STATA 13.0. Results: A total of 1969 traffic accident-related deaths were recorded. Males accounted for 75% of deaths, individuals of mixed race (pardo) represented 57%, and 72% were unmarried. A significant reduction in mortality rates was observed across age groups, especially among individuals aged 0–24 years. Mortality trends remained stationary only among individuals aged 80 years and older. Overall, the mortality rate decreased throughout the study period, from 5.51 to 1.69 deaths per 100,000 inhabitants. Conclusion: Pedestrian mortality rates from traffic accidents in Espírito Santo showed a decreasing trend, particularly among children and young people, while remaining stable among the elderly. Full article

Background/Objectives: Sarcopenia significantly increases the risk of hospitalization and mortality in older adults. However, the prevalence by sex varies across populations and according to the criteria used by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Hence, in the current study, we aim to characterize the prevalence of sarcopenia by jointly evaluating all three diagnostic domains in a Mexican cohort of older adults subscribed to a health insurance plan. Methods: We performed binomial and multinomial regression models, ordinal logistic regression, and multiple linear regression from the data corresponding to muscle mass (ASMI), muscle strength (handgrip dynamometry), and physical performance (SPPB) from 556 Mexican older adults (62.2% female; 72.27 ± 6.35 y.o.) categorized by sarcopenia severity according to the EWGSOP2. Results: Men exhibited significantly higher absolute muscle mass and strength across all categories (p < 0.001). Additionally, our statistical analyses demonstrate that age, but not sex, is involved in sarcopenia severity in this population. Moreover, when analyzing the disaggregated EWGSOP2 domains, the results demonstrate that sex is significantly associated with muscle mass (ASMI) and muscle strength (Handgrip strength). Conclusions: These results suggest that sex only influences both muscle mass (ASMI) and muscle strength (handgrip strength) while sarcopenia severity only depends on age. Full article

Background/Objectives: Dysphagia may adversely affect nutritional status in patients with Multiple Sclerosis (MS). This study aimed to investigate the associations between dysphagia severity and (i) nutritional status, assessed by the Malnutrition Universal Screening Tool (MUST) and Global Leadership Initiative on Malnutrition (GLIM) criteria, and (ii) secondary sarcopenia indicators according to the European Working Group on Sarcopenia in Older People-2 (EWGSOP2) framework. Materials and Methods: This cross-sectional study enrolled 32 consecutive adult outpatients with confirmed MS and self-reported dysphagia (DYMUS ≥ 1). Dysphagia severity was evaluated using the Dysphagia in Multiple Sclerosis (DYMUS) questionnaire, the Eating Assessment Tool-10 (EAT-10), and the Yale Swallow Protocol. Nutritional assessment included MUST screening and GLIM-based malnutrition diagnosis. Muscle function was evaluated via handgrip strength, calf circumference, and 4-metre gait speed. Results: GLIM-defined malnutrition was identified in 12 (37.5%) patients. Dysphagia severity was significantly associated with MUST score (ρ = 0.596, p < 0.001) and the presence of GLIM-defined malnutrition (median DYMUS 6.5 vs. 4.0; p = 0.012). In exploratory logistic regression, higher DYMUS scores were associated with GLIM-defined malnutrition. Conversely, no significant associations were found between dysphagia severity and handgrip strength, calf circumference, or sarcopenia classification (p > 0.30 for all). The categorical severe-sarcopenia rate was not considered reliably interpretable because of a pronounced gait speed floor effect. Conclusions: In ambulatory MS patients with dysphagia, dysphagia severity was associated with nutritional risk indicators and GLIM-defined malnutrition, but not with the primary muscle strength and mass indicators evaluated. Because MUST and GLIM reflect composite nutritional risk rather than confirmed protein–energy deficiency, these findings should be regarded as exploratory and hypothesis-generating. The present data did not permit a reliable estimate of sarcopenia prevalence because of a pronounced gait speed floor effect and the absence of body composition measurement. As a preliminary practical consideration, these findings may support combined dysphagia and nutritional screening in multidisciplinary MS outpatient care, pending confirmation in larger prospective cohorts. Full article

Background/Objectives: Age-related hearing loss (ARHL) is a common sensory impairment in the elderly, and its early prediction and intervention are crucial for improving the quality of life in older adults. This study aims to develop and validate an interpretable machine learning model based on routine blood biomarkers to predict the risk of ARHL occurrence. Methods: A total of 542 participants were selected from the National Health and Nutrition Examination Survey (NHANES) database, including 271 ARHL patients and 271 healthy controls. The samples were randomly divided into a training set (50%) and two independent internal validation sets (25% each). Through systematic comparison of 113 machine learning algorithm combinations, the optimal predictive model (glmBoost+Stepglm[forward]) was constructed, and the SHAP method was employed for feature interpretation. To evaluate the model’s generalization ability, external validation was further performed using a cohort of 92 cases from Chongqing People’s Hospital. Additionally, an openly accessible interactive prediction web page was developed based on the R Shiny framework, supporting real-time clinical risk assessment and visual interpretation. Results: The model achieved an AUC of 0.948 in the training set, with AUCs of 0.893 and 0.945 in two internal validation sets, respectively, and an overall accuracy rate of 86.3%. In the external validation cohort (albeit with a limited sample size of 92 from a single center), the model maintained good performance with an AUC of 0.839 (95% CI: 0.750–0.918) and an accuracy of 77.2%. The model identified nine key predictive features, with the top three being glycated hemoglobin (HbA1c), mean corpuscular volume (MCV), and blood glucose according to SHAP interpretability analysis. Conclusions: This study successfully developed and validated an interpretable machine learning model based on routine blood biomarkers for community-based risk stratification of age-related hearing loss. The model demonstrated robust performance in internal and external validations, including an age-matched elderly subgroup. An interactive web tool was developed to facilitate real-time risk assessment. While the model is intended as a prescreening tool for large-scale populations rather than a diagnostic test for age-matched individuals, it provides a novel approach for early identification of individuals at higher risk of ARHL and offers insights into its systemic pathogenesis. Full article