Geriatrics最新文献

Alzheimer's disease (AD) is a growing public health issue disproportionately affecting adults 65 years and older. This growing trend is accompanied by rising economic, social, emotional, and physical costs, both for patients and their caregivers. As the U.S. population ages, understanding disparities in AD prevalence particularly by gender and age has become increasingly important, particularly in high-burden states like Illinois. This review focuses on gender and age disparities in AD, with a specific emphasis on Illinois. This review integrates national and global trends with state-specific projections and explores modifiable and non-modifiable risk factors that may contribute to these disparities. We analyzed projections from the Illinois Department of Public Health and the Alzheimer's Association to assess AD prevalence by gender and age across Illinois' 102 counties from 2020 to 2030, disaggregated by gender and age. Rates were compared with U.S. and global trends. Risk factors such as diabetes, education, access to care, and socioeconomic status were reviewed in the context of these disparities. Women consistently show higher AD prevalence across age groups and regions, with the greatest increase in cases is projected among adults aged 75 to 84 years, particularly in regions with higher women populations and social vulnerability. If unaddressed, risk factors like lower education, rural residency, and limited healthcare access may worsen these disparities. Addressing them requires focused public health efforts that combine early screening, caregiver support, and regional resource allocation. Illinois serves as a case study for targeted interventions applicable to broader national strategies.

Background: Although research has been conducted on older adults and social media, the relationship between social media use and social isolation remains unclear. This study aimed to explore the relationship between social isolation and the frequency of use of social media and group chats. Methods: We measured social isolation using the Japanese version of the Lubben Social Network Scale (LSNS-6) in 411 older adults people living in urban areas. We used a questionnaire to survey their use of social networking services (SNS) such as LINE, Facebook, X (formerly Twitter), and Instagram, and their use of group chats. A separate questionnaire surveyed frequency of and participation in group chats. We analyzed associations between variables with logistic regression and a chi-squared test. Results: The most used service was LINE, with 51.3% of users participating in group chat. The analysis did not show an association between frequency of social media use and social isolation. However, group chat use, especially in groups of friends and acquaintances, was significantly negatively associated with social isolation (OR = 0.30, p < 0.001). Conclusions: This study revealed that LINE group chats may ameliorate social isolation among older adults. It also suggests that research focusing on its content and usage is needed.

Background: Older adults are at elevated risk of falls, especially when prescribed AEDs (AEDs) for neuropathic pain. The sedative and neuropsychiatric effects of these agents contribute significantly to fall-related morbidity. However, existing studies often lack stratification by age and dose. Objective: To systematically evaluate the incidence and drug-specific risk of falls and fall-related adverse events (AEs) in older adults prescribed AEDs for neuropathic pain. Methods: A systematic search was performed across PubMed, Scopus, CINAHL, ScienceDirect, and Cochrane Library databases up to May 2025. Studies were selected using PICOS criteria and included RCTs and controlled cohort studies reporting on AED-related AEs among participants aged ≥60 years. The methodological quality was assessed using RoB 2, ROBINS-I, and GRADE frameworks. Meta-analyses were performed using logit event rates and fixed-effects modeling via Comprehensive Meta-Analysis v3.7. Publication bias was evaluated using Begg's and Egger's tests. Results: Twenty-three studies met the inclusion criteria. The pooled logit event rate for falls was -1.693 (95% CI: -1.993 to -1.393), corresponding to a 15.5% incidence. Gabapentin showed the lowest fall risk (~10%), while pregabalin and carbamazepine were associated with higher rates of dizziness (up to 21.6%), sedation (~15.5%), and ataxia (~17.8%). Heterogeneity was low (I² = 0-22.3%) across outcomes. Conclusions: AEDs carry a clinically significant fall risk in older adults, with dose-dependent patterns. Gabapentin may present a safer profile, while pregabalin and carbamazepine warrant cautious use and monitoring. These findings inform individualized prescribing and fall prevention strategies in geriatric neuropathic pain management.

Background/Objectives: Depression accompanying hypertension increases the burden of illness and negatively affects patients' lives. However, depression among elderly with cardiovascular diseases in general and hypertension in specific has not been paid proper attention, especially in the context of Vietnam. Therefore, we expected to examine the prevalence, characteristics, and related factors of depression on elderly patients with hypertension. Methods: A cross-sectional study at the Department of Geriatrics, Can Tho Central General Hospital (from April 2020 to February 2022), involving 414 patients aged ≥60 years with hypertension. Depression was assessed using ICD-10 diagnostic criteria; related factors were evaluated using the Pittsburgh Sleep Quality Index (PSQI), KATZ12 index, and UCLA-LS3-J11 scale. Results: 31.4% of participants were found to have depression (mild 17.7%, moderate 9.7%, severe 4.0%). Common characteristics of depression included sleep disturbances, decreased energy, and low mood. Poor sleep quality, being female, lower socioeconomic status, higher hypertension grade, and increased loneliness were found to be significantly associated with depression. Conclusions: The high prevalence of depression among elderly hypertensive patients highlights the need for effective screening and intervention strategies. Addressing factors such as sleep quality, gender, socioeconomic challenges, and social isolation may help mitigate the burden of depression in this vulnerable population. This research should be expanded to elderly patients with hypertension in society, outpatients, and individuals with other chronic diseases. Developing a predictive model for depression in elderly patients, particularly those with chronic diseases, can improve early detection, treatment effectiveness, and overall care quality.

Background/Objectives: Home healthcare assistants (HHCAs) play a vital role in supporting older adults to remain in their homes. Yet, this work is often performed under conditions of emotional strain, limited resources, and systemic undervaluation. This study answers the question, how do HHCAs cope with work-related stress? Methods: Undertaken during the COVID-19 pandemic, a period of heightened stress and mandated social distancing, online interviews were conducted with HHCAs (n = 10). Data were inductively analyzed and themes were identified. Results: It was found that amid experiences of fear, caregiver stress, grief, and exhaustion, HHCAs coped with resource, communication, and care challenges by relying on informal peer-managed communication systems with colleagues. Leveraging existing peer-support coping strategies, HHCAs negotiated caring for others while taking care of themselves alongside a care ecosystem under unprecedented strain. Conclusions: HHCAs are increasingly vital to front-line home health care amid global aging and a shift toward community-based services. Urgent organizational reform is needed to support their well-being, prevent stress, and avoid burnout. Research-informed sector-wide planning must ensure adequate resources to maintain high-quality home care in the face of rising demand and anticipated future health crises.

Background: This 2-year longitudinal study was undertaken to investigate the relationship between incidence of knee pain and ground reaction force (GRF) in stepping motion in older adults. Methods: In all, 29 older participants, aged 50 and over (11 males and 18 females; 63.0 ± 6.2 years), presented without knee pain at baseline. The participants performed a 10 s stepping motion at optimal speed on a force plate, and 14 mechanical and temporal parameters of vertical GRF were obtained. Knee pain was evaluated based on subjective complaint during daily activities. The participants were classified into a no pain (NP) group or a knee pain (KP) group. Results: Of the 29 participants (11 males, 18 females), 9 (all female) developed knee pain, representing 31.0% of the total participants and comprising the KP group at the follow-up. We compared the amount of change in the evaluated parameters between the two groups and found moderate effect sizes for the mechanical parameters, ΔMshaped (p = 0.07, d = 0.77) and ΔF2 (p = 0.08, d = 0.72), as well as a flatter change in the bimodal waveform of the GRF in the KP group. Conclusions: It was thus suggested that a flattening of the vertical GRF waveform during stepping motion may indicate early biomechanical changes associated with incident knee pain and that waveform changes in GRF may be useful for early detection of functional decline.

Background/objectives: Aging is associated with a decline in physiological and cognitive functions. Periodontitis, a disease affecting the periodontal tissues, increases in prevalence with age. Bacteria and inflammatory mediators resulting from periodontitis can trigger neuroinflammation and potentially accelerate the progression of neurodegenerative diseases. This study aimed to evaluate the association between periodontal status, salivary flow rate, salivary cortisol levels, and cytokine levels with cognitive status in elderly Indonesian subjects. Methods: This cross-sectional study involved 70 participants aged ≥ 60 years from several social institutions in Jakarta and the Dental Hospital, Faculty of Dentistry, Universitas Indonesia. All participants provided written informed consent before the examination. Periodontal parameters, including plaque score, calculus index, bleeding on probing, number of remaining teeth, and functional tooth units, were assessed. Unstimulated salivary flow was collected over five minutes, and salivary cortisol levels were measured. Gingival crevicular fluid samples from the deepest periodontal pockets were collected to measure cytokine levels (TNF-α and IL-1β). Both cortisol and cytokine levels were analyzed using ELISA. Cognitive function was evaluated using the Hopkins Verbal Learning Test. Results: Plaque score, calculus index, and bleeding on probing were moderately associated with cognitive scores (p < 0.05). In contrast, the number of remaining teeth, functional tooth units, periodontitis severity, salivary flow rate, salivary cortisol, and cytokine levels were not significantly associated with cognitive scores (p > 0.05). Conclusions: These findings suggest that elderly individuals with cognitive impairment tend to have poorer periodontal health than those with normal cognitive function.

Background: The increase in life expectancy has led to a higher prevalence of chronic conditions, including widespread pain (WP), which often compromises functional independence and quality of life in older adults. WP is strongly associated with limitations in Basic and Instrumental Activities of Daily Living (BADLs and IADLs). While physical activity (PA) and muscle strength (handgrip) are known to enhance general health, their specific role in preserving functional capacity in individuals with WP remains underexplored. Methods: This cross-sectional study analyzed data from 1154 adults aged 50-80 reporting WP, drawn from the Ninth Wave of The Survey of Health, Ageing and Retirement in Europe (SHARE). Associations between moderate and vigorous PA (MPA and VPA), handgrip strength (HGS), and limitations in BADLs and IADLs were examined using multivariate logistic regression, adjusting for demographic and health-related variables. Results: Lower MPA was significantly associated with greater odds of all BADL and most IADL limitations, while VPA had no significant associations. Higher relative HGS was significantly associated with lower odds of limitations in BADLs and IADLs. Conclusions: Among older adults with WP, MPA and muscular strength appear to reduce the risk of functional limitations. These findings highlight the relevance of promoting sustainable strategies to support independence in aging populations.

Background/Objectives: Frailty in older adults limits social participation. We aimed to predict social participation in older individuals undergoing frailty health checkups using three machine learning (ML) models and identify key predictive factors through deep neural network (DNN) analysis. Methods: Overall, 301 older individuals were enrolled; 295 were included in the final analysis. The survey measured 18 attributes, including demographic, physical, cognitive, and social factors. Logistic regression (LR), nonlinear support vector machine (NLSVM), and DNN were used for prediction, with precision, accuracy, sensitivity, specificity, F1 score, and area under the curve (AUC) calculated as evaluation metrics. Results: Among 295 participants, 236 (80%) engaged in social activities, whereas 59 (20%) did not. The three models demonstrated complementary strengths: DNN provided the most balanced performance with superior sensitivity for detecting social participants; NLSVM showed the best overall discriminative ability but with higher false positive rates; and LR achieved the highest precision for correctly identifying participants but missed detecting social participants. AUC values ranged from 0.776 to 0.795 across models, indicating moderate discriminative performance. Contribution analysis revealed information-collection ability as the strongest predictor of social participation, followed by walking speed and number of cohabitants. Conclusions: ML models achieved moderate discriminative performance for predicting social participation among frailty-screened older adults. The DNN provided the most balanced performance. Each model exhibited distinct characteristics suitable for different screening purposes, with information-collection ability emerging as a key factor. The findings suggest that models must be carefully selected based on specific community health screening objectives.

Background/objectives: As individuals age, they experience declines in multiple physiological domains, which increases their vulnerability to health challenges and frailty. While adherence to healthy dietary patterns has been shown to protect against frailty, consuming ultra-processed foods (UPFs)-which are high in added sugars and saturated fat-may contribute to frailty risk. This study investigates the association between UPF consumption and frailty progression among 938 participants aged 65 years and older who were in the InCHIANTI study, Italy.

Methods: The patients' dietary intakes over the past year were assessed using a validated food frequency questionnaire, with items categorized into food groups based on the Nova classification. Frailty was operationalized using a 42-item frailty index (FI). Multivariable linear regression was used to examine the association between the baseline UPF consumption frequency and baseline frailty status, while linear mixed-effects models were used to examine the frailty progression over time.

Results: Overall, the participants with the lowest UPF consumption frequency were younger, had more years of education, and had a lower baseline FI. Higher UPF consumption was significantly associated with a greater baseline FI after adjustments for the sociodemographic and health characteristics (β = 0.026, 95% CI = 0.010-0.041, p = 0.001), and this difference persisted over a 16.1-year follow-up period (β = 0.022, 95% CI = 0.006-0.037, p = 0.006).

Conclusions: These findings underscore the potential negative health impacts of UPF on frailty prevalence and progression in older adults.