Geriatrics

36 pages, 7362 KiB

Open AccessReview

The Implementation of Infant Anoesis and Adult Autonoesis in the Retrogenesis and Staging System of the Neurocognitive Disorders: A Proposal for a Multidimensional Person-Centered Model

by Alessandro Pirani

Geriatrics 2025, 10(1), 20; https://doi.org/10.3390/geriatrics10010020 - 2 Feb 2025

Abstract

Background: Retrogenesis is the process by which the degenerative and vascular mechanisms of dementia reverse the order of acquisition in the normal development. Objective. The development of memory/knowledge after birth may help to know the biopsychosocial and functional characteristics (biosphere) of the retrogenesis. [...] Read more.

Background: Retrogenesis is the process by which the degenerative and vascular mechanisms of dementia reverse the order of acquisition in the normal development. Objective. The development of memory/knowledge after birth may help to know the biopsychosocial and functional characteristics (biosphere) of the retrogenesis. Methods. A literature review was performed in the PubMed, Google Scholar, and Scopus databases using 43 keywords related to retrogenesis: 234 eligible records were selected. Results. The infantile amnesia, characterized from anoesis, was described along the infant/child’s biosphere in which the limbic system progressively develops the acquisition of the body knowledge (Anoetic Body Consciousness, AnBC). Anoesis is the infant memory state characterized by the absence of long-term memories of the many stressful/painful experiences that accompany the acquisition under the long-life voluntary control of the long-term memories fundamental for the body growth and survival (mainly chewing/swallowing and walking). At the age of 3–4 years, usually, the AnBC evolves, as a continuum, into the adulthood autonoesis with the emergence, in the child/adolescent, of the consciousness of “self” trough the development of the Episodic Autobiographic Memory (EAM) and the Autonoetic Mind Consciousness (AuMC). The development of cognition and knowledge is due to the progressive maturation of the whole limbic system and not only of the hippocampus. In the biopsychosocial retrogenesis, the EAM/AuMC vanishes progressively along the mild, moderate, and severe stages of dementia when the infant AnBC resurfaces, losing progressively the basic activities of daily living in a retrogenetic order of acquisition where the last functions to disappear are chewing/swallowing. Conclusion. The transition from the adult EAM-AuMC to the infant AnBC, as a continuum in the individual biosphere, adds a contribution to the assessment of the retrogenesis in dementia from a multidimensional person-centered model. Full article

(This article belongs to the Topic Translational Advances in Neurodegenerative Dementias)

12 pages, 212 KiB

Open AccessArticle

Hindering Factors and Perceived Needs for the Decision Making of Advanced Directives Among People with Dementia and Their Families

by Hsiu-Ching Lin, Yu-Fang Lu, Ching-Hsueh Yeh, Jy-Jing Wang and Ya-Ping Yang

Geriatrics 2025, 10(1), 19; https://doi.org/10.3390/geriatrics10010019 - 1 Feb 2025

Abstract

Making advanced directives is challenging in Asia. The hindering factors and perceived needs for advanced directives for people with dementia and their families have not been fully explored in Taiwan. In this study, we aimed to identify the barriers and perceived needs of [...] Read more.

Making advanced directives is challenging in Asia. The hindering factors and perceived needs for advanced directives for people with dementia and their families have not been fully explored in Taiwan. In this study, we aimed to identify the barriers and perceived needs of people with mild dementia and the families of people with dementia within the cultural context of Taiwan for advanced directives. A qualitative descriptive design with purposive sampling and content analysis was used to collect and analyze the data. Thirteen people with mild dementia and thirty-two families of people with dementia were recruited. Our findings indicated that the hindering factors for people with mild dementia and the families of people with dementia to make advanced directives included “talking about death is a taboo”, “the timing is not right”, “cultural values of filial piety”, “male protagonist’s social status”, and “insufficient information on advanced directive”. The perceived needs for participants in making advanced directive decisions were “a wish to die without suffering”, “wanting to rely on others to make a decision”, and “an increased awareness of information”. This research offers valuable insights into the barriers and needs related to advanced directives for people with mild dementia and the families of people with dementia in Taiwan. These findings address the identified challenges and needs to develop effective solutions to help healthcare providers to better facilitate the decision-making process for advanced directives. Full article

18 pages, 615 KiB

Open AccessArticle

Identification of Barriers and Needs in the Discontinuation of Benzodiazepine Receptor Agonists in Elderly Patients of a Rural Community—A Qualitative Study

by Tiago de Barros Mendes, Marta Nazha, Ana Luísa Neves and Paula Broeiro-Gonçalves

Geriatrics 2025, 10(1), 18; https://doi.org/10.3390/geriatrics10010018 - 1 Feb 2025

Abstract

Background/Objectives: The predictors of successful discontinuation of benzodiazepine agonist receptors (BZRA) in elderly patients are not well known due to lack of research on the subject, and there is a need for further investigation, with more focus from the patients’ point of [...] Read more.

Background/Objectives: The predictors of successful discontinuation of benzodiazepine agonist receptors (BZRA) in elderly patients are not well known due to lack of research on the subject, and there is a need for further investigation, with more focus from the patients’ point of view. No previous studies were identified that have been conducted in Portugal on this subject. We proposed to identify the barriers and facilitators in the discontinuation of BZRA from the perceptions of elderly patients under prolonged prescription of BZRA, belonging to the same rural community. The contributions for further research are intended to be the identification of potential intervention targets directed at patients to reduce the prevalence of elderly patients under prolonged prescription of BZRA. Methods: A set of 15 semi-structured interviews with patients under prolonged prescription of BZRA was conducted. Content analysis was done by the main researcher and a reviewer to identify original emerging themes for the two underlying domains. Results: Four themes were identified as barriers to the discontinuation of BZRA: (1) patient characteristics, (2) clinical factors, (3) medication-related factors, and (4) context and external factors. Seven themes were identified as facilitators to the discontinuation of BZRA: (1) motivation, (2) patients’ knowledge, (3) perception of BZRA insufficiency, (4) access to written information, (5) access to alternatives, (6) time for decision-making, and (7) attitudes of health professionals. Conclusions: The findings highlight the challenging nature of BZRA discontinuation and the range of barriers and facilitators that impact patients’ behaviour towards this purpose. We subdivided the elements identified in two areas, therefore aiming at producing significant knowledge to outline potential intervention targets. Full article

15 pages, 845 KiB

Open AccessSystematic Review

Nutritional Support in the Prevention and Treatment of Pressure Ulcers in Healthy Aging: A Systematic Review of Nursing Interventions in Community Care

by Giovanni Cangelosi, Francesco Sacchini, Federico Biondini, Stefano Mancin, Sara Morales Palomares, Gaetano Ferrara, Gabriele Caggianelli, Marco Sguanci and Fabio Petrelli

Geriatrics 2025, 10(1), 17; https://doi.org/10.3390/geriatrics10010017 - 22 Jan 2025

Abstract

Introduction: Pressure ulcers (PUs) represent a significant challenge in chronic care, particularly among the elderly with reduced mobility. They result in substantial socio-healthcare costs and negatively impact patients’ psychological well-being. Malnutrition is a key risk factor, hindering healing and increasing the risk of [...] Read more.

Introduction: Pressure ulcers (PUs) represent a significant challenge in chronic care, particularly among the elderly with reduced mobility. They result in substantial socio-healthcare costs and negatively impact patients’ psychological well-being. Malnutrition is a key risk factor, hindering healing and increasing the risk of complications. As such, appropriate nutritional interventions are crucial for managing PUs. However, these interventions are often underestimated in clinical practice, underscoring the need for a more comprehensive approach to elder care and healthy aging. Objectives: The primary objective of this study was to identify the best scientific evidence on nutritional interventions implemented by nurses in community settings to prevent complications related to PUs. Additionally, qualitative and quantitative outcomes reported in the included studies were analyzed. Method: This systematic review was conducted following PRISMA international guidelines. Searches were performed in PubMed, Scopus, Embase, and CINAHL databases. A predefined search strategy using Boolean operators was employed, and two researchers independently selected papers, with a third researcher resolving any discrepancies. Additional sources and manual reviews were conducted to minimize selection bias. Results: Out of 1003 records, 6 studies were included. Findings indicate that nurses play a fundamental role in managing PUs in community settings through specific nutritional intervention assistance processes. These healthcare professionals are pivotal in the prevention, care, and rehabilitation of vulnerable individuals with PUs. Conclusions: Nurses are strategic in the management of PUs within community care for frail populations. With nutritional support that plays a key role in both preventing and accelerating the healing of PUs. Policymakers are encouraged to invest in nursing roles to enhance assistance in community contexts, supporting healthy aging and lifestyle medicine approaches. Full article

(This article belongs to the Special Issue Healthy Ageing and Lifestyle Medicine: Current Knowledge and Future Direction)

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9 pages, 214 KiB

Open AccessArticle

A Retrospective Study of the Influence of Life Events and Social Support on Relapses and Recurrences in Older Patients with Bipolar Disorder

by Hanna Cusell and Rob Kok

Geriatrics 2025, 10(1), 16; https://doi.org/10.3390/geriatrics10010016 - 17 Jan 2025

Abstract

Background/Objectives: Life events and lack of social support are risk factors for a relapse or recurrence in patients with a bipolar disorder, yet studies focusing on older adults remain limited. Our aim was to investigate the influence of life events and social [...] Read more.

Background/Objectives: Life events and lack of social support are risk factors for a relapse or recurrence in patients with a bipolar disorder, yet studies focusing on older adults remain limited. Our aim was to investigate the influence of life events and social support on the course of bipolar disorder in older adults. Methods: A retrospective cohort study included patients aged 55 years and older in treatment for bipolar disorder and who used lithium. During a follow-up of maximum 5 years, relapses and recurrences, life events and six social support variables were constructed based on patients’ electronic medical files. Results: We included 100 older patients with a mean age of 68.1 (SD 8.6) years; 69% were female. At least one relapse or recurrence was observed within the 5 years of observation in 52% of our patients. Life events were noted in the medical files in 24 out of these 52 (46.2%) patients. Living alone, a lower quality of social support and having at least two children was significantly associated with the onset of a relapse or recurrence (p = 0.024, p < 0.001, p = 0.022, respectively). Conclusions: Older adults with bipolar disorder have a high rate of relapses or recurrences within 5 years of observation, and half of the relapses or recurrences were preceded by life events. Social factors may also play a significant role in the onset of relapses and recurrences. Our results underline the necessity for incorporating social and environmental factors into prevention of relapses or recurrences for older bipolar patients. Full article

(This article belongs to the Topic Psychopathology and Developmental Trajectories)

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Graphical abstract

22 pages, 2308 KiB

Open AccessArticle

Short- and Long-Term Effects on Physical Fitness in Older Adults: Results from an 8-Week Exercise Program Repeated in Two Consecutive Years

by Manne Godhe, Johnny Nilsson and Eva A. Andersson

Geriatrics 2025, 10(1), 15; https://doi.org/10.3390/geriatrics10010015 - 16 Jan 2025

Abstract

Introduction: Information on the long-term maintenance of short-term exercise fitness gains measured by field-based tests is scarce in older adults. This study aimed to investigate short- and long-term changes in various physical fitness parameters after an 8-week exercise program. Methods: In [...] Read more.

Introduction: Information on the long-term maintenance of short-term exercise fitness gains measured by field-based tests is scarce in older adults. This study aimed to investigate short- and long-term changes in various physical fitness parameters after an 8-week exercise program. Methods: In this longitudinal study, a total of 265 participants (62% women; mean age 71.4 ± 4.7 years) completed a field-based test battery of 12 fitness tests (22 parameters) at 2 pre-tests and 1 post-test following an 8-week exercise program (2 sessions/week, combining aerobic and strength activities) in 2 consecutive years. The tests assessed muscle endurance, muscle strength, cardiorespiratory fitness, and motor fitness. Results: Significant short-term improvements were observed, e.g., in isometric trunk flexion and extension endurance (21–37%) for both sexes in both years. Lower-body muscular endurance improved in the first year (9–12%) for both sexes, while cardiorespiratory fitness (6-min walk test) improved only for men in both years (3%). No changes were seen in submaximal cycle test heart rates or any balance tests in any year. Most fitness parameters did not significantly decrease during the 9-month inter-intervention period, with a few exceptions in trunk strength and walking distance. Conclusions: This study demonstrates physical fitness improvements in older adults following short-term exercise interventions and that some of these improvements were maintained long term, whereas a few of these physical fitness test improvements decreased significantly over 9 months in older adults. Full article

(This article belongs to the Section Geriatric Public Health)

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13 pages, 446 KiB

Open AccessArticle

Genetic Predisposition to Hippocampal Atrophy and Risk of Amnestic Mild Cognitive Impairment and Alzheimer’s Dementia

by Ioannis Liampas, Vasileios Siokas, Niki Mourtzi, Sokratis Charisis, Stefanos N. Sampatakakis, Ioannis Foukarakis, Alex Hatzimanolis, Alfredo Ramirez, Jean-Charles Lambert, Mary Yannakoulia, Mary H. Kosmidis, Efthimios Dardiotis, Georgios M. Hadjigeorgiou, Paraskevi Sakka, Konstantinos Rouskas and Nikolaos Scarmeas

Geriatrics 2025, 10(1), 14; https://doi.org/10.3390/geriatrics10010014 - 16 Jan 2025

Abstract

Background: There is a paucity of evidence on the association between genetic propensity for hippocampal atrophy with cognitive outcomes. Therefore, we examined the relationship of the polygenic risk score for hippocampal atrophy (PRShp) with the incidence of amnestic mild cognitive impairment (aMCI) and [...] Read more.

Background: There is a paucity of evidence on the association between genetic propensity for hippocampal atrophy with cognitive outcomes. Therefore, we examined the relationship of the polygenic risk score for hippocampal atrophy (PRShp) with the incidence of amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD) as well as the rates of cognitive decline. Methods: Participants were drawn from the population-based HELIAD cohort. Comprehensive neuropsychological assessments were performed at baseline and at follow-up. PRShp was derived from the summary statistics of a large genome-wide association study for hippocampal volume. Cox proportional hazards models as well as generalized estimating equations (GEEs) were used to evaluate the association of PRShp with the combined incidence of aMCI/AD and cognitive changes over time, respectively. All models were adjusted for age, sex, education, and apolipoprotein E (APOE) genotype. Results: Our analysis included 618 older adults, among whom 73 developed aMCI/AD after an average follow-up of 2.96 ± 0.8 years. Each additional SD of PRShp elevated the relative hazard for incident aMCI/AD by 46%. Participants at the top quartile of PRShp had an almost three times higher risk of converting to aMCI/AD compared to the lowest quartile group. Higher PRShp scores were also linked to steeper global cognitive and memory decline. The impact of PRShp was greater among women and younger adults. Conclusions: Our findings support the association of PRShp with aMCI/AD incidence and with global cognitive and memory decline over time. The PRS association was sex- and age-dependent, suggesting that these factors should be considered in genetic modelling for AD. Full article

(This article belongs to the Section Geriatric Neurology)

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13 pages, 1172 KiB

Open AccessArticle

Healthcare Workers’ Attitudes Toward Older Adults’ Nutrition: A Descriptive Cross-Sectional Study in Italian Nursing Homes

by Milko Zanini, Gianluca Catania, Marco Di Nitto, Lara Delbene, Stefania Ripamonti, Maria Emma Musio and Annamaria Bagnasco

Geriatrics 2025, 10(1), 13; https://doi.org/10.3390/geriatrics10010013 - 16 Jan 2025

Abstract

Background: Malnutrition is a widespread issue among older people, significantly impacting health outcomes. Nutritional interventions can improve health, but their success often depends on the attitudes and knowledge of healthcare workers. Aim: This study assesses healthcare workers’ attitudes toward older people’s nutrition using [...] Read more.

Background: Malnutrition is a widespread issue among older people, significantly impacting health outcomes. Nutritional interventions can improve health, but their success often depends on the attitudes and knowledge of healthcare workers. Aim: This study assesses healthcare workers’ attitudes toward older people’s nutrition using the validated Italian version of the Staff Attitudes to Nutritional Nursing Geriatric care scale (SANN-G), focusing on staff in nursing homes in Northern Italy. Methods: A cross-sectional study was conducted with 1789 healthcare workers from 41 facilities. The SANN-G questionnaire measured attitudes across five dimensions: nutritional norms, habits, assessment, intervention, and individualization. Data were collected online and on paper, with descriptive and inferential statistical analyses (chi-square and ANOVA) performed using R software (R-4.4.2 for Windows). Results: Most healthcare workers were female (68.59%) and aged 41–50 (33.31%), with nursing assistants comprising 35.83%. Only 23.48% scored positively on the SANN-G scale, with most exhibiting neutral or negative attitudes. Healthcare workers who attended a malnutrition course were more likely to exhibit positive attitudes toward nutrition, particularly in the dimension of norms, assessment, intervention, and individualization. Younger healthcare workers, with the role of nurses and who attended a course on malnutrition, were more likely to have positive attitudes, while older healthcare workers and with the role of physicians tended to show neutral or negative attitudes. Conclusions: Education on malnutrition improves healthcare workers’ attitudes toward older adults’ nutrition, especially among younger nurses. The low percentage of positive attitudes (23.48%) underscores the need for broader education programs to enhance nutritional care quality. Full article

(This article belongs to the Section Geriatric Nutrition)

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21 pages, 697 KiB

Open AccessSystematic Review

Effects of Aquatic Exercise in Older People with Osteoarthritis: Systematic Review of Randomized Controlled Trials

by Carlos Ayán-Pérez, Daniel González-Devesa, Beatriz Montero-García and Silvia Varela

Geriatrics 2025, 10(1), 12; https://doi.org/10.3390/geriatrics10010012 - 13 Jan 2025

Abstract

Objective: In this study, the objective is to analyze the efficacy of different aquatic physical exercise programs in the treatment of osteoarthritis in older people. Material and Methods: The systematic review was conducted until April 2024 and updated in November 2024 in five [...] Read more.

Objective: In this study, the objective is to analyze the efficacy of different aquatic physical exercise programs in the treatment of osteoarthritis in older people. Material and Methods: The systematic review was conducted until April 2024 and updated in November 2024 in five electronic databases. Randomized controlled studies in people over 60 years of age with a diagnosis of osteoarthritis were included. Water-based exercise interventions were assessed for their impact on osteoarthritis symptoms, walking ability, muscle strength, depressive symptoms, range of motion, body composition, fear of falling, fall risk, quality of life, range of motion, and dual task function. The methodological quality of included studies was assessed using the Physiotherapy Evidence Database. Results: A total of 12 studies were included, with sample sizes ranging from 35 to 312 participants. The presence of osteoarthritis in the sample was manifested in different joints. The methodological quality of the included studies varied from fair to good. Based on the results of this review, aquatic exercise significantly improved balance, stiffness, pain, and walking ability compared to non-exercise controls (p < 0.05). Compared with land-based exercise groups, only one study found significant differences between the two groups. Conclusions: Water-based exercise programs do not provide significantly superior benefits compared to other exercise modalities and appear to have limited effectiveness in the management of OA. However, the feasibility and high adherence make these programs a recommendable option for older people with OA. Future studies should investigate the impact of exercise intensity on the short- and long-term efficacy of aquatic therapy. Full article

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13 pages, 598 KiB

Open AccessArticle

Participation as a Pillar of Active Ageing: The Role of Eudaimonic Psychological and Health Factors

by Teresa Paniagua-Granados, Virginia Fernández-Fernández and María Ángeles Molina-Martínez

Geriatrics 2025, 10(1), 11; https://doi.org/10.3390/geriatrics10010011 - 13 Jan 2025

Abstract

Background/Objectives: With ageing population projections, promoting positive ageing trajectories is critical. While health is often emphasised, eudaimonic psychological factors remain underexamined. A qualitative study presented throughout the main text highlighted the importance of psychological factors like purpose in life and resilience in fostering [...] Read more.

Background/Objectives: With ageing population projections, promoting positive ageing trajectories is critical. While health is often emphasised, eudaimonic psychological factors remain underexamined. A qualitative study presented throughout the main text highlighted the importance of psychological factors like purpose in life and resilience in fostering participation and subjective well-being, even amidst declining health. This model bridges the most recent updates from governmental organisations—the International Longevity Center, Brazil and the World Health Organization. Building on this model, the current research seeks to empirically assess the impact of health and eudaimonic psychological factors on the frequency and satisfaction of participation among older adults. Methods: This study involved 289 participants (56.74% women) aged 65+ in Madrid. Data on participation, self-perceived health, and eudaimonic factors were collected through an online survey. Hierarchical regression and cluster analyses explored the predictors and profiles of participation. Results: Resilience, positive relationships, and autonomy explained 8.8% of variance in participation frequency. Satisfaction was influenced by health, meaning in life, and autonomy, accounting for 11% of variance. Profiles showed the highest participation and satisfaction in individuals with high eudaimonic scores, despite moderate health. Conclusions: Eudaimonic factors significantly influence participation and mitigate health limitations, reinforcing the qualitative study model mentioned. By uniting updates from governmental organisations proposals, this model underscores the role of psychological well-being in active ageing. Future research should explore hedonic well-being as a key outcome of active ageing. Full article

(This article belongs to the Section Healthy Aging)

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14 pages, 464 KiB

Open AccessArticle

SPING Block Analgesia in Non-Operative Management of Proximal Femur Fractures in Older Adults Living with Frailty: A Retrospective Cohort Study

by Miriam W. A. van der Velden, Thamar Kroes, Nick J. G. Visschers, Frank P. J. F. de Loos, Pleun Janssens, Bart Spaetgens, Miriam C. Faes, Marieke H. J. van den Beuken-van Everdingen and Arnela Suman

Geriatrics 2025, 10(1), 10; https://doi.org/10.3390/geriatrics10010010 - 10 Jan 2025

Abstract

Background/Objectives: Spinal Phenol IN Glycerol (SPING) block is a novel palliative pain treatment for the non-operative management of proximal femur fractures (PFFs) in older adults living with frailty. Effective pain management that aligns with patient preferences and minimizes opioid use is critical [...] Read more.

Background/Objectives: Spinal Phenol IN Glycerol (SPING) block is a novel palliative pain treatment for the non-operative management of proximal femur fractures (PFFs) in older adults living with frailty. Effective pain management that aligns with patient preferences and minimizes opioid use is critical in this setting. This study evaluated the patient, safety, and process outcomes of SPING block in this population. Methods: A retrospective cohort study was conducted in a suburban teaching hospital from March 2021 to June 2024, which included sixty-eight older adults living with frailty that suffered from a PFF and received SPING block. Data were collected from the Electronic Patient Records. The patient living situation was visualized with a Sankey diagram. Changes in pain scores and opioid use were assessed using the Wilcoxon Signed Rank test. Results: The median patient age was 89 years (Interquartile range (IQR) 83–92). Most were severely or terminally ill (American Society of Anesthesiologists (ASA) ≥ 4, 72%) and had cognitive impairment or dementia (68%). SPING block was effective in 93% of patients, significantly reducing median pain scores (4 [IQR 3–5] to 0 [IQR 0–1], p < 0.001) and opioid use (15 mg/day [IQR 4–30] to 0 mg/day [IQR 0–0], p < 0.001). Within 24 h, 84% could sit upright and 44% could transfer between their bed and chair. The median time to discharge was one day (IQR 0–3), with a median survival of 13 days (IQR 7–44). Conclusions: This study supports SPING block as a viable option for older adults living with frailty suffering from a PFF who opt for non-operative management in a palliative setting. SPING block for PFFs in a palliative setting offers effective pain relief, reduces opioid use, and enables mobility for older adults living with frailty. Follow-up is essential to monitor efficacy and safety. Prospective studies are needed to confirm these findings. Full article

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15 pages, 440 KiB

Open AccessArticle

Comparing the PRISMA-7 and a Modified Version (PRISMA-6) for Frailty Screening: Addressing Sex Bias in Community-Dwelling Older Adults

by Dietmar Ausserhofer, Angelika Mahlknecht, Verena Barbieri, Adolf Engl, Giuliano Piccoliori and Christian J. Wiedermann

Geriatrics 2025, 10(1), 9; https://doi.org/10.3390/geriatrics10010009 - 7 Jan 2025

Abstract

Background/Objectives: Frailty screening facilitates the identification of older adults at risk of adverse health outcomes. The Program of Research to Integrate Services for the Maintenance of Autonomy 7 (PRISMA-7) is a widely utilised frailty tool; however, concerns regarding its potential sex bias persist [...] Read more.

Background/Objectives: Frailty screening facilitates the identification of older adults at risk of adverse health outcomes. The Program of Research to Integrate Services for the Maintenance of Autonomy 7 (PRISMA-7) is a widely utilised frailty tool; however, concerns regarding its potential sex bias persist due to item 2, which assigns a frailty point for male sex. This study compared the PRISMA-7 with a modified version, the PRISMA-6 (excluding item 2), to assess their suitability for frailty screening in South Tyrol, Italy. Objectives included evaluating the impact of item 2 on frailty classification and exploring the feasibility of the PRISMA-6 as a more equitable alternative. Methods: A cross-sectional survey of 1695 community-dwelling older adults aged ≥75 years was conducted in South Tyrol. Frailty was assessed using both the PRISMA-7 and PRISMA-6. Sociodemographic, health, and lifestyle data were collected to examine associations with frailty classifications. Logistic regression was applied to identify predictors of frailty for each tool. Agreement between the PRISMA-7 and PRISMA-6 was assessed, and internal consistency was evaluated using Cronbach’s alpha. Results: Frailty prevalence was 33.9% with the PRISMA-7 and 27.0% with the PRISMA-6. The PRISMA-7 classified men as frail more frequently than women (34.7% vs. 33.0%), while the PRISMA-6 reversed this trend (men, 21.4%; women, 33.0%). Excluding item 2 improved internal consistency (Cronbach’s alpha: PRISMA-7, 0.64; PRISMA-6, 0.75) and aligned frailty classifications with predictors such as age, health status, and physical activity. Logistic regression revealed significant sex differences with the PRISMA-7 but not with the PRISMA-6. Conclusions: The PRISMA-7 introduces sex bias by overestimating frailty in men, whereas the PRISMA-6 provides a more equitable and consistent alternative. The findings highlight the PRISMA-6’s potential as a reliable tool for unbiased frailty screening. Future research should validate the PRISMA-6 against established frailty tools to support its integration into primary care settings. Full article

(This article belongs to the Collection Frailty in Older Adults)

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20 pages, 600 KiB

Open AccessArticle

Exploring Context Allows Us to Better Understand Physical Activity in People with and Without Parkinson’s Who Have Fallen: A Mixed Methods Study

by Katherine Baker, Julia Das, Lynn Rochester, Silvia Del Din and Jenni Naisby

Geriatrics 2025, 10(1), 8; https://doi.org/10.3390/geriatrics10010008 - 7 Jan 2025

Abstract

Background: Falls are a frequent and serious problem for older adults, especially for those living with Parkinson’s. The relationship between falls and physical activity is complex, and people often restrict activity following a fall. Exercise is an important aspect of reducing further risk [...] Read more.

Background: Falls are a frequent and serious problem for older adults, especially for those living with Parkinson’s. The relationship between falls and physical activity is complex, and people often restrict activity following a fall. Exercise is an important aspect of reducing further risk of a fall and a key component of the management of Parkinson’s. The aim of this study was to understand the types of activity they are engaged in, the environments in which they take place, and the experience of people with and without Parkinson’s who have fallen. Method: Seventeen people with Parkinson’s and thirteen older adults who had experienced at least one fall in the previous year were recruited to this mixed methods study. Activity levels were captured over one week using accelerometers and body-worn cameras, allowing the type and location of activity to be recorded and analysed. This information informed an interview. Results: Findings showed that although both groups often achieved up to 10,000 steps per day, this was in very short bouts of activity. Sedentary activity, such as watching television, dominated the findings. Participants were aware of the benefits of being active but described many barriers to achieving the level of activity they would like to. Full article

(This article belongs to the Special Issue Physical Activity and Exercise in Older Adults)

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11 pages, 957 KiB

Open AccessArticle

Effect of Early Postoperative Gait Parameters After Total Hip Arthroplasty on Forgotten Joint Score-12 at 2-Year Follow-Up

by Kazuya Okazawa, Satoshi Hamai, Tsutomu Fujita, Shinya Kawahara, Daisuke Hara, Yasuharu Nakashima and Hiroshi Katoh

Geriatrics 2025, 10(1), 7; https://doi.org/10.3390/geriatrics10010007 - 6 Jan 2025

Abstract

Purpose: This study aimed to elucidate the relationship between early postoperative gait parameters after total hip arthroplasty (THA) and the Forgotten Joint Score-12 (FJS-12) score at the 2-year follow-up after surgery. In addition, the cutoff gait parameter values for predicting discomfort using specific [...] Read more.

Purpose: This study aimed to elucidate the relationship between early postoperative gait parameters after total hip arthroplasty (THA) and the Forgotten Joint Score-12 (FJS-12) score at the 2-year follow-up after surgery. In addition, the cutoff gait parameter values for predicting discomfort using specific FJS-12 subitems were evaluated. Methods: Among 313 patients who underwent THA between April and December 2019, 44 (14.0%) who responded to the FJS-12 questionnaire at 2 years postoperatively were included in this study. Gait parameters, including walking speed, stride length, and their coefficients of variation (CVs), were measured at 13.8 ± 3.6 (mean ± standard deviation) days postoperatively. The FJS-12 was used to evaluate patients at 2 years after surgery. The correlation between the FJS-12 score and gait parameters was analyzed using Spearman’s rank correlation coefficient. To determine the significant predictors of the FJS-12 score, multiple regression analysis was performed after adjusting for age as a covariate. Furthermore, receiver operating characteristic curves were used to determine the cutoff gait parameter values for predicting discomfort using specific FJS-12 subitems. Results: The FJS-12 score was significantly positively correlated with walking speed (r_s = 0.38, p < 0.05) and stride length (r_s = 0.51, p < 0.01). Meanwhile, the FJS-12 score was significantly negatively correlated with the CVs of walking speed (r_s = −0.34, p < 0.05) and stride length (r_s = −0.35, p < 0.05). Based on multiple regression analysis, stride length was a significant predictor of discomfort assessed using the FJS-12 score (β = 0.48, p < 0.01). According to the receiver operating characteristic curves, the cutoff stride length values for predicting discomfort using the FJS-12 subitems 9, 10, 11, and 12 showed moderate accuracy (area under the curve > 0.7). Conclusions: Improved walking ability of patients who underwent THA through early rehabilitation is linked to joint discomfort and patient satisfaction in daily life 2 years postoperatively. Full article

(This article belongs to the Section Geriatric Rehabilitation)

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19 pages, 2377 KiB

Open AccessArticle

Predicting Hospitalization in Older Adults Using Machine Learning

by Raymundo Buenrostro-Mariscal, Osval A. Montesinos-López and Cesar Gonzalez-Gonzalez

Geriatrics 2025, 10(1), 6; https://doi.org/10.3390/geriatrics10010006 - 4 Jan 2025

Abstract

Background/Objectives: Hospitalization among older adults is a growing challenge in Mexico due to the high prevalence of chronic diseases and limited public healthcare resources. This study aims to develop a predictive model for hospitalization using longitudinal data from the Mexican Health and [...] Read more.

Background/Objectives: Hospitalization among older adults is a growing challenge in Mexico due to the high prevalence of chronic diseases and limited public healthcare resources. This study aims to develop a predictive model for hospitalization using longitudinal data from the Mexican Health and Aging Study (MHAS) using the random forest (RF) algorithm. Methods: An RF-based machine learning model was designed and evaluated under different data partition strategies (ST) with and without variable interaction. Variable importance was assessed based on the mean decrease in impurity and permutation importance, enhancing our understanding of predictors of hospitalization. The model’s robustness was ensured through modified nested cross-validation, with evaluation metrics including sensitivity, specificity, and the kappa coefficient. Results: The model with ST2, incorporating interaction and a 20% test proportion, achieved the best balance between sensitivity (0.7215, standard error ± 0.0038), and specificity (0.4935, standard error ± 0.0039). Variable importance analysis revealed that functional limitations (e.g., abvd3, 31.1% importance), age (12.75%), and history of cerebrovascular accidents (12.4%) were the strongest predictors. Socioeconomic factors, including education level (12.08%), also emerged as critical predictors, highlighting the model’s ability to capture complex interactions between health and socioeconomic variables. Conclusions: The integration of variable importance analysis enhances the interpretability of the RF model, providing novel insights into the predictors of hospitalization in older adults. These findings underscore the potential for clinical applications, including anticipating hospital demand and optimizing resource allocation. Future research will focus on integrating subgroup analyses for comorbidities and advanced techniques for handling missing data to further improve predictive accuracy. Full article

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24 pages, 823 KiB

Open AccessArticle

COVID-19 and Mental Distress and Well-Being Among Older People: A Gender Analysis in the First and Last Year of the Pandemic and in the Post-Pandemic Period

by M. Pilar Matud

Geriatrics 2025, 10(1), 5; https://doi.org/10.3390/geriatrics10010005 - 3 Jan 2025

Abstract

The Coronavirus disease 2019 (COVID-19) pandemic seriously threatened the health and well-being of the population. This study aims to investigate the relevance of the COVID-19 pandemic on the stress, mental distress, and well-being of older people in Spain. The design was quantitative repeated [...] Read more.

The Coronavirus disease 2019 (COVID-19) pandemic seriously threatened the health and well-being of the population. This study aims to investigate the relevance of the COVID-19 pandemic on the stress, mental distress, and well-being of older people in Spain. The design was quantitative repeated cross-sectional. The sample was non-probability and consisted of 1436 persons from the general population divided into two groups: (1) the study group, composed of 718 women (61.3%) and men aged 60 to 89; (2) the comparison group, composed of the same number of women and men aged 30 to 45. All were assessed in three phases of the COVID-19 pandemic: the first pandemic year, the last pandemic year, and the post-pandemic period. The results showed that during the first year of the pandemic, the prevalence of mental distress was higher in older women (50%) than in older men (37.2%), while the rates in the comparison group were 57.2% for women and 53.2% for men. In the post-pandemic period, the rates of mental distress were 30.2% for older women and 29.8% for older men while in the comparison group, the rates were 48.5% for women and 26.5% for men. No significant differences in well-being were found between the groups or between the different phases of the pandemic. The most common stressors reported by older people were illness and death of family and/or loved ones, followed by personal illness. In the post-pandemic period, more stressful events and lower stress resilience were found to predict mental distress in older women and men. Greater perceived vulnerability to infection was another important predictor for women. Low self-esteem and younger age were also predictors of mental distress for men. High self-esteem, high social support, greater stress resilience and fewer stressful events were predictors of well-being for both genders. The results of this study are relevant for the design of policies, programs, and strategies to improve the health and well-being of older people. Full article

(This article belongs to the Section Geriatric Psychiatry and Psychology)

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10 pages, 749 KiB

Open AccessArticle

Improving Sleep Quality and Well-Being in Institutionalized Older Adults: The Potential of NESA Non-Invasive Neuromodulation Treatment

by Aníbal Báez-Suárez, Virginia Báez-Suárez, Laissa Saldanha, Martín Vílchez-Barrera, Andrea Hernández-Pérez and Raquel Medina-Ramírez

Geriatrics 2025, 10(1), 4; https://doi.org/10.3390/geriatrics10010004 - 3 Jan 2025

Abstract

Background/Objectives: Ageing is associated with several cognitive, physical, and emotional changes, including a decrease in sleep quality and mental health issues. This study studies NESA (Spanish acronym for Neuromodulación Superficial Aplicada) non-invasive neuromodulation using microcurrents as something that may provide a potential [...] Read more.

Background/Objectives: Ageing is associated with several cognitive, physical, and emotional changes, including a decrease in sleep quality and mental health issues. This study studies NESA (Spanish acronym for Neuromodulación Superficial Aplicada) non-invasive neuromodulation using microcurrents as something that may provide a potential improvement in the quality of sleep and general health of older adults and residents in a healthcare institution. Methods: This observational study recruited 24 people who were residents at a long-term care facility. Participants were divided into two groups: one intervention group, who underwent NESA therapy twice a week for a total of 20 sessions, and a control group, who did not receive this treatment. The outcomes measured include sleep quality (Pittsburgh Sleep Quality Index), diary of sleep, symptoms of depressed mood (Yesavage Geriatric Depression Scale), and quality of life with the World Health Organization Quality of Life-Old (WHOQOL-OLD). Scores were collected at baseline, after 10 and 20 sessions, and 3 months after finishing the treatment. Results: The intervention group exhibited a notable improvement in sleep quality (p = 0.05). Additionally, there were fewer nocturnal awakenings. The quality of life also showed better scores, especially in relation to social relations and physical and mental health, which matches the slight decrease in scores and clinical improvement regarding depressive symptoms. In contrast, the control group demonstrated no improvement in symptoms, and in some cases, there was a worsening of symptoms. Conclusions: Our findings indicate that NESA non-invasive neuromodulation therapy is likely to enhance sleep quality and health-related measures in institutionalized older adults. Despite the limitations of the current study, the results support the potential of NESA microcurrents to enhance the well-being of this population. Full article

(This article belongs to the Section Healthy Aging)

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12 pages, 191 KiB

Open AccessArticle

“We Work in an Industry Where We’re Here to Care for Others, and Often Forget to Take Care of Ourselves”: Aged-Care Staff Views on Self-Care

by Anna P. Lane and Jennifer Tieman

Geriatrics 2025, 10(1), 3; https://doi.org/10.3390/geriatrics10010003 - 2 Jan 2025

Abstract

Objective: This study aimed to explore self-care understanding and behaviours among aged-care workers in Australia. It was conducted as part of a project to co-produce a self-care resource for the Australian aged-care workforce. Methods: Semi-structured interviews with eleven aged-care staff and [...] Read more.

Objective: This study aimed to explore self-care understanding and behaviours among aged-care workers in Australia. It was conducted as part of a project to co-produce a self-care resource for the Australian aged-care workforce. Methods: Semi-structured interviews with eleven aged-care staff and a focus group with four staff at an aged-care facility were undertaken to understand how staff understand and practice self-care and how death and dying affect workers. Thematic analysis was performed using software to generate a data coding tree. Results: Aged-care workers view self-care as taking care of oneself and as being a way to manage and maintain wellbeing so that they can continue to care. As practiced in daily life, self-care is highly individualised, with actions at work and at home having significant impact on a person’s wellbeing. Supportive organisational cultures and collegial teams were found to be particularly relevant in helping staff to deal with death and dying. Conclusions: Aged-care workers may benefit from an online self-care resource tailored to their specific needs and based on their first-hand experiences of working in aged-care. Organisations can support aged-care workers by creating space and time for self-care. Full article

12 pages, 458 KiB

Open AccessArticle

The Classification and Language Description of Patients with Primary Progressive Aphasia Using the Mini Linguistic State Examination Test

by Elena Herrera, Claudia Acevedo and María González-Nosti

Geriatrics 2025, 10(1), 2; https://doi.org/10.3390/geriatrics10010002 - 26 Dec 2024

Abstract

Introduction. Primary progressive aphasia (PPA) is a clinical syndrome characterized by a progressive deterioration in language and speech. It is classified into three variants based on symptom patterns: logopenic, semantic, and non-fluent. Due to the lack of fully reliable and valid screening tests [...] Read more.

Introduction. Primary progressive aphasia (PPA) is a clinical syndrome characterized by a progressive deterioration in language and speech. It is classified into three variants based on symptom patterns: logopenic, semantic, and non-fluent. Due to the lack of fully reliable and valid screening tests for diagnosing PPA and its variants, a Spanish version of the Mini Linguistic State Examination (MLSE) has recently been introduced. Materials and methods. This study aimed to describe the language impairments in a small sample of six patients with PPA and classify them into the three variants using the decision tree and syndrome guide proposed by the MLSE authors. Results. The findings demonstrate the test’s utility in classifying some PPA variants through a qualitative analysis of patient performance and error types. The study revealed a 50% accuracy rate for the decision tree and an 83.33% accuracy rate when using the syndrome guide. Discussion. This discrepancy arises because the decision tree often classified cases as logopenic variant PPA (lvPPA) when working memory was significantly impaired. Specifically, it tended to misclassify patients with semantic, motor, or speech impairments as having lvPPA due to its reliance on the sentence repetition task for assessing working memory. Full article

(This article belongs to the Section Geriatric Psychiatry and Psychology)

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