Geriatrics & Gerontology International最新文献

Aim: Standardized quality indicators for long-term care (QIs-LTC) were previously developed to ensure high-quality holistic nursing care for older adults. This research aimed to assess the feasibility and reliability of unfavorable health outcomes measured by the QIs-LTC and proposed strategies for improvement.

Methods: Thirty-nine pairs of home care nurses assessed 53 clients. We evaluated 20 of the 21 items of feasibility to calculate scores for the "I do not know" answer and test the interrater reliability using bias-adjusted and prevalence-adjusted kappa (PABAK). We then conducted interviews with 16 home care nurses to collect feedback on the implementation of QIs-LTC. Based on this feedback, we developed the QIs-LTC assessment manual and reassessed the QIs-LTC when used with the manual.

Results: The mean for the "I do not know" answer was 13.8%, and the mean PABAK was 0.75 (±0.28). Overall, the reliability was good for physical assessment but inadequate for social aspects. Using the assessment manual, the mean for the "I do not know" answers decreased to 10.4%. The mean PABAK was 0.77 (±0.32) and increased for 12 unfavorable health outcomes.

Conclusions: The feasibility and reliability of most unfavorable health outcomes were ensured by using the newly developed assessment manual. Challenges in education and practice of social aspects were identified. QIs-LTC support individual and agency evaluations, nursing interventions and quality evaluations, which are a priority for long-term care in Japan. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: This study aimed to reestimate the prevalence of hearing loss based on the updated World Health Organization hearing loss classification and investigate whether existing hearing screening criteria could efficiently screen for frailty or cognitive deficit.

Methods: Data collected from community dwellers aged 40-91 years included 2325 samples. Health checkup hearing screening used were as follows: (A) 30 dB both at 1 and 4 kHz and (B) 30 dB at 1 kHz and 40 dB at 4 kHz were used. For participants aged ≥60 years, frailty according to the modified Cardiovascular Health Study criteria and cognitive deficit defined by a Mini-Mental State Examination score <28 were assessed. Logistic regression was performed to obtain odds ratios for frailty and cognitive deficit.

Results: The rates of hearing loss using the updated World Health Organization classification in men were 8.6, 24.1, 54.2, 79.0 and 96.0% in their 40s, 50s, 60s, 70s and 80s and 3.7, 12.7, 36.4, 72.1 and 90.4% in women, respectively. Failing hearing screening using criterion A was associated with an increased risk of frailty, a sex-adjusted odds ratio of 4.136 (95% confidence interval, 2.182-7.838) and an increased risk of cognitive deficit: 1.753 (95% confidence interval, 1.346-2.283). After adjusting for age and sex, the effects on frailty and cognitive deficit were no longer significant. The results were similar when criterion B was used.

Conclusion: Because of the high prevalence of hearing loss and the ability to utilize existing devices and methodologies, hearing screening for the elderly should be reviewed. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: Fatigue is a common health problem in older adults. Chronic pain is associated with fatigue. However, the longitudinal association between chronic pain and the incidence of subjective fatigue among community-dwelling older adults remains unclear. Therefore, this study aimed to investigate the association between chronic pain and subjective fatigue using prospective data.

Methods: The study included 2060 community-dwelling older adults (age 70.5 ± 6.4 years; male: n = 944) without subjective fatigue at baseline. Chronic pain and other data were assessed at baseline. Subjective fatigue incidence was investigated at the follow-up examination 2.5 years from baseline.

Results: In total, 389 (18.9%) reported chronic low back pain, 322 (15.6%) reported chronic knee pain at baseline, and 342 (16.6%) reported subjective fatigue at follow-up examination. A logistic regression analysis showed that the odds ratio for the incidence of subjective fatigue in participants with chronic low back pain had a higher odds ratio for the incidence of subjective fatigue compared to participants without chronic low back pain (odds ratio = 1.71, 95% confidence interval = 1.29-2.26). Chronic knee pain had a higher odds ratio for the incidence of subjective fatigue compared to participants without chronic knee pain (odds ratio = 1.63, 95% confidence interval = 1.21-2.20).

Conclusions: These results suggest that chronic low back pain and knee pain increase the risk of subjective fatigue incidence. These findings emphasize the contribution of chronic pain to fatigue among older adults. Therefore, intervention studies are required to prevent subjective fatigue in participants with chronic pain. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: The study aimed to determine the sleep and life quality of elderly individuals living in a nursing home using pet therapy, a complementary and supportive therapy.

Methods: The study was conducted with elderly individuals in a nursing home in Tokat province in Turkey. The study sample consisted of 59 elderly individuals, with 30 in the intervention group and 29 in the control group, who met the inclusion criteria. Pet therapy was applied to elderly individuals twice a week for 6 weeks for a total of 12 sessions as a randomized controlled trial to determine the effect of pet therapy on sleep and life quality. While pet therapy was applied to the individuals in the intervention group, the control group was no pet theraphy.

Results: It was determined that the sleep and life quality of the individuals in the intervention group increased statistically and significantly. There was no statistically significant difference in the change in sleep and life quality of individuals in the control group. A statistically significant difference was determined between the intervention and control groups regarding sleep and life quality.

Conclusion: Pet therapy was determined to significantly improve the sleep and life quality of elderly individuals living in a nursing home. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: The Hemoglobin, Albumin, Lymphocyte and Platelet (HALP) score, calculated as hemoglobin × albumin × lymphocytes / platelets, serves as a novel biomarker that can provide insights into a patient's nutritional status, anemia status and inflammatory processes. This study aimed to investigate the predictive value of the HALP score for mortality among geriatric patients presenting to the emergency department.

Methods: This retrospective study was carried out at the emergency department of a tertiary hospital. Patients aged ≥65 years who presented to the emergency department between 1 January 2018 and 1 January 2024 were included in the study. A total of 62 262 patients who visited our emergency department were enrolled. Patient data, including hemoglobin, albumin, lymphocyte and platelet values; age; sex, the reason for hospital presentation; and outcome (mortality or discharge) were obtained from electronic medical records. HALP scores were calculated for the patients, and statistical analyses were carried out.

Results: Of the patients, 32 410 were men, and the mean age was 73 years. Within this cohort, in-hospital mortality occurred in 3093 of the patients. The HALP score was significantly lower in patients who died compared with those who were discharged (P < 0.001).

Conclusion: Due to its cost-effectiveness and ease of calculation, the HALP score appears to be more feasible in predicting mortality in the emergency department compared with other scoring systems. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: Septic older adults represent a vulnerable population with high mortality rates. Base excess (BE), an indicator of acid-base status, may serve as a prognostic marker in sepsis. This study aimed to investigate the association between BE and mortality in septic older adults.

Methods: A retrospective analysis included septic older adults (age ≥ 65 years) from the Medical Information Mart for Intensive Care (MIMIC)-IV database. The primary outcome was 30-day mortality. Multivariate Cox regression models and Kaplan-Meier analysis were used to assess the association between BE and 30-day mortality. A two-segment linear regression model with smooth curve fitting was employed to examine threshold effects of BE on clinical outcomes.

Results: The study comprised 7379 participants, with a 21.8% 30-day mortality rate and an 18.6% in-hospital mortality rate. A nonlinear, U-shaped relationship (P < 0.001) was observed between BE and 30-day mortality in septic older adults, indicating increased risk with higher or lower BE levels. Various BE groups showed different hazard ratios for mortality: 2.7 (2.26-3.22), 1.86 (1.65-2.09), 1.41 (1.19-1.67), and 1.9 (1.4-2.58), respectively, compared with the reference group (-3 mEq/L ≤ BE < 3 mEq/L). The inflection point was calculated as 0.5 mEq/L.

Conclusions: Our findings suggest a U-shaped relationship between BE and mortality in septic older adults, emphasizing the importance of monitoring acid-base status in sepsis management for this population. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: Patients with Parkinson's disease (PD) present with both motor and non-motor symptoms, and understanding the interplay between these symptoms is crucial for individualized patient care. This study aims to investigate the relationship between motor features and non-motor symptoms in patients with de novo PD.

Methods: A total of 105 patients were analyzed, focusing on motor subtypes or subscores and their impact on cognition, depression, anxiety, fatigue, and dysautonomia. We utilized the Unified Parkinson's Disease Rating Scale-part III (UPDRS-III) for motor assessment, and various validated scales for non-motor symptoms.

Results: Compared with tremor-dominant (TD) patients, non-TD patients showed severe scores in fatigue and dysautonomia, but no difference in other non-motor symptoms, including global cognition, depression, and anxiety. Linear regression analysis revealed that the total motor score of UPDRS-III was negatively related to global cognition (β = -0.4454, P = 0.0121). As a post-hoc analysis, partial correlation analysis showed that rigidity and bradykinesia subscores were associated with global cognition (r = -0.3527, P = 0.0004; r = -0.2206, P = 0.0299, respectively), whereas the postural instability/gait difficulty subscore was associated with depression, anxiety, fatigue, and dysautonomia (r = 0.2181, P = 0.0319; r = 0.2371, P = 0.0194; r = 0.3659, P = 0.0002; r = 0.3968, P = 0.0001, respectively) but not with global cognition.

Conclusions: These results suggest that motor features in the early stages of PD can serve as important indicators of non-motor symptoms, potentially guiding more personalized therapeutic approaches. Geriatr Gerontol Int 2025; ••: ••-••.

Objectives: To promote standardization and feasible measurements of gait speed across the field, we developed a device that used light detection and ranging (LiDAR) technology to measure gait speed from a standing-start testing procedure conducted on a 4-m total walkway. We compared this automated (LiDAR-based) standing-start 4-m gait speed test (AS-4MG) with automated and manual (stopwatch-based) dynamic-start 4-m gait speed tests (AD-4MG and MD-4MG, respectively) on between-method agreement, measurement repeatability, and predictive validity with functional outcomes.

Methods: A sample of 48 community-dwelling adults (mean [SD], 69 [9] years) participated in this method comparison study. Participants completed a survey and a physical function assessment, from which self-reported stair difficulty, handgrip strength, sit-to-stand performance, and gait speed (AS-, AD-, and MD-4MG) were measured.

Results: Mean AS-4MG, AD-4MG, and MD-4MG were 1.12, 1.13, and 1.14 m/s, respectively, with a strong correlation (r = 0.94) and no systematic bias observed between AS-4MG and the referent AD-4MG. In the analyses of repeated gait measurements, coefficients of repeatability were <0.20 m/s for the automated tests (0.16 and 0.18 m/s for AS-4MG and AD-4MG, respectively) but not for MD-4MG (0.22 m/s). Correlations between gait speed and functional measures ranged between 0.44 and 0.68 (Ps < 0.01). Correlations for the automated tests were comparable, while AS-4MG correlations tended to exceed MD-4MG correlations.

Conclusions: In community-dwelling adults, the AS-4MG test was unbiased when compared with the AD-4MG, encompassing a 9-m walkway, with both tests showing equivalence of measurement repeatability and predictive validity. The AS-4MG potentially allows gait measurements in confined spaces (e.g., doctor's office) where the gait speed test was previously unfeasible. Geriatr Gerontol Int 2025; ••: ••-••.