Aging Clinical and Experimental Research最新文献

Background

Reablement at home takes place in health and social care services globally to support older adults in achieving independent and meaningful daily living and reducing the need for long-term care. However, research into reablement at home is scarce and the results are partly conflicting.

Objective

To describe the characteristics of reablement participants and evaluate the effects of reablement on their physical functioning at six-month follow-up.

Design

A quasi-experimental one-group design was employed, with assessments of physical functioning conducted at baseline, post-intervention, and six-month follow-up within a primary healthcare setting in Finland.

Subjects

Home-dwelling older adults (n = 55) receiving interdisciplinary reablement care who met the inclusion criteria.

Methods

Primary outcomes are the Short Physical Performance Battery test and hand grip strength. Data collection was carried out during reablement visits by physiotherapists and occupational therapists. Results are described by mean, standard deviation and maximum and minimum values at baseline. Overall effects are estimated with linear mixed-effects model repeated measure analysis.

Results

The mean age of participants was 80.6 (SD 7.2) years. Physical functioning improved between baseline and post-test and between baseline and six-month follow-up. Improvement was shown especially in lower limb performance, in which the changes between baseline and post-test were statistically significant (p < 0.05).

Conclusion

The results indicate that reablement increases the physical functioning of home-dwelling older adults with functional decline at six-month follow-up. Reablement is therefore recommended for the corresponding target groups.

The accelerating ageing of populations worldwide presents profound challenges for public health, particularly within long-term care facilities (LTCFs). Older adults, often burdened by multimorbidity, frailty, and immunosenescence, are highly vulnerable to vaccine-preventable diseases such as influenza, pneumococcal pneumonia, COVID-19, respiratory syncytial virus (RSV), pertussis, and herpes zoster (HZ). Despite the availability of effective vaccines, immunization coverage in LTCFs remains inadequate, hindered by fragmented national policies, insufficient mandates, and systemic neglect of adult vaccination. In many settings, vaccination uptake is not even systematically monitored, leaving policymakers and clinicians without reliable data to identify gaps or measure progress. The COVID-19 pandemic underscored these vulnerabilities, temporarily spurring emergency vaccination efforts but failing to establish sustainable, life-course immunization frameworks. This consensus document, developed by the European Interdisciplinary Council on Ageing (EICA) following the San Servolo (Venice, Italy) 2025 meeting, synthesizes evidence on intrinsic and environmental infection risk factors in LTCFs, the health and economic burden of infections, and the persistent gaps in vaccine uptake among both residents and staff. We highlight the cost-effectiveness of preventive interventions, the critical role of non-pharmacological infection control measures, and the need to address antimicrobial resistance through integrated vaccination strategies. The Council emphasizes that routine adult vaccination must become a structural element of care planning for ageing populations, supported by digital registries, systematic assessments at LTC admission, co-administration strategies, and robust staff engagement. Stronger global and national policy leadership is urgently needed to align LTCF immunization with life-course approaches and primary healthcare integration. Protecting frail older adults from infectious diseases is not only a clinical necessity but also a societal obligation—central to safeguarding dignity, resilience, and healthy ageing in Europe and beyond.

Graphical Abstract

The fi gure was made FigureLabs.

Aims

The purpose of this study was to estimate the prevalence of geriatric syndrome (GS) in patients with type 2 diabetes(T2D) and analyse the factors associated with GS in T2D patients.

Methods

We conducted a cross-sectional study of 248 community-dwelling older adults with T2D. GS was assessed using the Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), Taiwan Geriatric Depression Scale (TGDS), handgrip strength, and 5-m walking speed. Multivariate logistic regression was applied to examine factors associated with each syndrome.

Results

The mean age of participants was 73.9 ± 5.9 years. The prevalence of functional dependence, depressive symptoms, cognitive impairment, and falls was 17.7%, 18.5%, 12.9%, and 19.4%, respectively. After adjusting for potential confounders, slower walking speed (< 0.7 m/s) was significantly associated with higher risks of functional dependence, depressive symptoms, and falls. In addition, each 1-kg increase in handgrip strength was associated with 13% lower odds of cognitive impairment.

Conclusion

Slower walking speed was associated with functional dependence, depressive symptoms, and falls in older adults withT2D. Greater handgrip strength was inversely associated with cognitive impairment. Assessing these simple measures may help identify individuals at risk for multidimensional decline at an early stage.

Background

Life-space mobility (LSM) is a critical health indicator in older adults, the mechanisms underlying the relationship between subjective cognitive decline (SCD) and LSM remain unclear.

Aims

This study examined depression as a mediator between SCD and LSM, and assessed whether perceived social support (PSS) moderates the relationship between SCD and depression among Chinese community-dwelling older adults.

Methods

We seek to elucidate psychosocial mechanisms of the SCD-LSM link and inform targeted intervention strategies. Drawing on a face-to-face interview sample of 287 community-dwelling aged, this cross-sectional study utilised a moderated mediation analysis. Key constructs were evaluated by the Subjective Cognitive Decline Questionnaire-9, 15-item geriatric depression scale, Perceived Social Support Scale, the Life Space Assessment, respectively.

Results

The results showed that SCD was negatively associated with LSM (β = -0.213, p < 0.001). Mediation analysis indicated an indirect association between SCD and LSM through depression (indirect effect = -1.868, 95% CI [-2.825, -1.029]), accounting for 41.6% of the total association. Furthermore, PSS was identified as a significant moderator in the relationship between SCD and depression (β = -0.088, p < 0.05), with a stronger association observed among older adults with lower PSS levels. The interaction term contributed a unique incremental variance of ΔR² = 0.0086 to the model.

Discussion

Establishing a social support system holds promise for improving life-space mobility and alleviating depression among community-dwelling older adults with subjective cognitive decline, thereby enhancing their well-being.

Conclusion

A negative association between SCD and LSM was observed, with depression partially mediating this relationship. Importantly, PSS demonstrated a statistically significant moderating effect on the relationship between SCD and depression, although the effect size was small.

This study examines the relationship between depression and clinical functioning among cognitively normal (CN) and mildly cognitively impaired (MCI) older adults, with a specific focus on cross-ethnic comparisons between Hispanic and White non-Hispanic (WNH) populations. Despite a significant body of research linking depression to cognitive decline, limited studies have explored how this relationship differs across ethnic groups. Using data from the 1Florida Alzheimer's Disease Research Center (1Florida ADRC), multiple ordinal logistic regression models were applied separately for Hispanic and WNH samples to assess the impact of cognitive status, depression severity, and age on clinical functioning, as measured by the modified Clinical Dementia Rating (mCDR) scale. Results indicated that among Hispanics, higher depression levels were significantly associated with greater clinical impairment, whereas this association was not significant among WNHs. Given the cross-sectional nature of this study, future longitudinal research should examine whether clinical impairment leads to increased depressive symptoms over time. These findings underscore the need for culturally informed interventions targeting depression in aging Hispanic populations.

Background

Hospital readmissions are common among older multimorbid patients, and hospitalisation is associated with functional decline and reduced quality of life. Identifying patient characteristics and risk factors for repeated hospital visits following an emergency department (ED) encounter is important for guiding targeted interventions to prevent future revisits.

Aim

To characterise multimorbid older patients with frequent unplanned hospital visits following an emergency department (ED) visit, compare them to those with fewer revisits, and identify risk factors for frequent unplanned hospital revisits.

Methods

A retrospective analysis of 25 436 multimorbid patients aged ≥ 75 years who visited 8 EDs in Sweden in 2017 was performed. Patients with ≥ 3 ED visits or unplanned hospital admissions in the following year were classified as frequent hospital visitors. Their characteristics were compared to those of infrequent visitors, and binomial logistic regression was used to identify factors predictive of frequent hospital visits.

Results

An increasing number of hospital visits in the prior 12 months (odds ratio (OR) 1.25 95% confidence interval (95% CI) 1.21–1.29) and an increasing number of comorbidities (OR 1.11 95% CI 1.09–1.13) were the most impactful risk factors for multiple unplanned hospital revisits. Female sex (OR 0.81 95% CI 0.75–0.88) was the most important protective factor.

Conclusion

A history of frequent hospital visits was the strongest risk factor for future unplanned hospital visits. Several other factors were also identified, suggesting the potential for predictive models to identify at-risk patients before frequent visits occur.

Background

The global rise in dementia prevalence, a major neurocognitive disorder, poses a significant challenge to aging populations. This study aimed to determine the prevalence of dementia and its associated risk factors among community-dwelling elderly in selected provinces of Iran.

Methods

A cross-sectional study was conducted from October 2022 to March 2024, enrolling 58,228 individuals aged 60–75 years from two provinces (Qazvin and Yazd) selected via multi-stage, stratified random sampling. A multi-stage diagnostic protocol was employed, using validated Persian versions of the Geriatric Depression Scale (GDS), Abbreviated Mental Test Score (AMTS), Mini-Mental State Examination (MMSE), Functional Assessment Staging (FAST), and Montreal Cognitive Assessment (MoCA) with standardized cut-offs. Multivariable logistic regression was used to identify factors associated with dementia.

Results

After exclusions, the final analytical sample was 56,456 participants. The overall prevalence of dementia was 10.1%. Prevalence was significantly higher in women (13.2%) than in men (7.0%). In the adjusted model, female gender (aOR: 2.04, 95% CI: 1.92–2.15), older age (70–79 years vs. 60–64 years, aOR: 1.70, 95% CI: 1.59–1.82), widowhood (aOR: 1.50, 95% CI: 1.05–2.16), and lower educational attainment (illiterate vs. academic, aOR: 6.55, 95% CI: 5.43–7.91) were significantly associated with higher odds of dementia.

Conclusions

This large-scale study reveals a substantial burden of dementia in the studied Iranian provinces. The identified risk factors, including female sex, advanced age, widowhood, and low education, highlight vulnerable subgroups and underscore the urgent need for targeted public health strategies focused on early detection, risk reduction, and support systems for the elderly in Iran.

Background

Sarcopenia is a progressive skeletal muscle disorder characterized by declining muscle mass and function in older adults. This study aimed to develop and validate a four-year predictive model for sarcopenia using data from the China Health and Retirement Longitudinal Study (CHARLS) to facilitate early identification and targeted interventions.

Methods

We analyzed data from 2,173 participants enrolled in the 2011 CHARLS baseline survey after applying exclusion criteria. Predictors including anthropometric measurements, laboratory biomarkers, and cognitive function were assessed. Data were split 7:3 for training and testing, with oversampling applied to address class imbalance in the training set. LASSO regression with 10-fold cross-validation was used for feature selection, followed by multivariable logistic regression to identify significant predictors. Model performance was evaluated using ROC curves, calibration curves, and decision curve analysis (DCA).

Results

Among 2,173 participants, 160 (7.36%) developed sarcopenia over four years. Univariate analyses showed area under the curve (AUC) values ranging from 0.461 to 0.818. Ten significant predictors were identified: age, body mass index (BMI), cognition, waist circumference, mean corpuscular volume (MCV), platelet count, glucose, creatinine, high-density lipoprotein cholesterol (HDL), and hematocrit. Advancing age and higher MCV were positively associated with sarcopenia, whereas higher BMI, larger waist circumference, and better cognitive function were protective. The model showed excellent discrimination with AUCs of 0.859 (training) and 0.842 (testing), good calibration, and favorable clinical utility across a range of thresholds. An online nomogram was developed for clinical application.

Conclusion

This study developed and validated a four-year predictive model for sarcopenia in older adults, integrating key risk factors into a user-friendly nomogram. The model enables early identification of high-risk individuals, supporting targeted interventions and enhancing sarcopenia management strategies. External validation is recommended to confirm generalizability.