Pub Date : 2025-11-07DOI: 10.1016/j.archger.2025.106081
Liang-Kung Chen
{"title":"Reframing sarcopenia: the AWGS 2025 paradigm shift from disease to muscle health","authors":"Liang-Kung Chen","doi":"10.1016/j.archger.2025.106081","DOIUrl":"10.1016/j.archger.2025.106081","url":null,"abstract":"","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106081"},"PeriodicalIF":3.8,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-06DOI: 10.1016/j.archger.2025.106079
Camille Ouvrard , Ivane Koumetio Jiatsa , Antoine Gbessemehlan , Yvanna Simon , Luc Letenneur , Jean-François Dartigues , Melissa K Andrew , Hélène Amieva , Karine Pérès
Background and objectives
Social vulnerability (SV) is a multidimensional construct associated with adverse health outcomes, including mortality. However, little is known about how SV differentially affects older men and women.
Research design and methods
We analyzed data from 3695 community-dwelling older adults from the Paquid cohort, followed for 15 years. SV was assessed using a 26-item SV Index (SVI), categorized into low, moderate, and high levels. Delayed-entry Cox models stratified by gender were used to estimate mortality risk, adjusting for disability, history of ischemic heart disease, dyspnea, diabetes, and cognitive impairment. Associations between SV subdimensions and mortality were also examined separately by gender.
Results
Women accumulated more social deficits than men (40 % vs. 21 % with high SV). High SV was associated with a 21–25 % increased mortality risk in both genders. However, moderate SV is significantly associated with an increased mortality risk only in men (adjusted Hazard Ratio = 1.25, 95 % CI: 1.09–1.44 vs. aHR = 0.96, 95 % CI: 0.81–1.13 in women). Among subdimensions, low socioeconomic status and poor leisure activity engagement were the strongest mortality predictors in men–even at moderate levels (result marginally significant for leisure activities, p = 0.073). In women, poor engagement in leisure activities and negative psychological experience were the main predictors of mortality; low socioeconomic status (SES) showed a trend-level association (p = 0.045).
Discussion and implications
Despite greater SV, women seem to withstand moderate social deficits better than men. These findings highlight the need for further studies to explain gender differences and develop gender-sensitive public health interventions.
{"title":"Social vulnerability increases the risk of death differently in men and women: longitudinal analysis over 15 years in the Paquid Study","authors":"Camille Ouvrard , Ivane Koumetio Jiatsa , Antoine Gbessemehlan , Yvanna Simon , Luc Letenneur , Jean-François Dartigues , Melissa K Andrew , Hélène Amieva , Karine Pérès","doi":"10.1016/j.archger.2025.106079","DOIUrl":"10.1016/j.archger.2025.106079","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Social vulnerability (SV) is a multidimensional construct associated with adverse health outcomes, including mortality. However, little is known about how SV differentially affects older men and women.</div></div><div><h3>Research design and methods</h3><div>We analyzed data from 3695 community-dwelling older adults from the Paquid cohort, followed for 15 years. SV was assessed using a 26-item SV Index (SVI), categorized into low, moderate, and high levels. Delayed-entry Cox models stratified by gender were used to estimate mortality risk, adjusting for disability, history of ischemic heart disease, dyspnea, diabetes, and cognitive impairment. Associations between SV subdimensions and mortality were also examined separately by gender.</div></div><div><h3>Results</h3><div>Women accumulated more social deficits than men (40 % vs. 21 % with high SV). High SV was associated with a 21–25 % increased mortality risk in both genders. However, moderate SV is significantly associated with an increased mortality risk only in men (adjusted Hazard Ratio = 1.25, 95 % CI: 1.09–1.44 vs. aHR = 0.96, 95 % CI: 0.81–1.13 in women). Among subdimensions, low socioeconomic status and poor leisure activity engagement were the strongest mortality predictors in men–even at moderate levels (result marginally significant for leisure activities, <em>p</em> = 0.073). In women, poor engagement in leisure activities and negative psychological experience were the main predictors of mortality; low socioeconomic status (SES) showed a trend-level association (<em>p</em> = 0.045).</div></div><div><h3>Discussion and implications</h3><div>Despite greater SV, women seem to withstand moderate social deficits better than men. These findings highlight the need for further studies to explain gender differences and develop gender-sensitive public health interventions.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106079"},"PeriodicalIF":3.8,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-05DOI: 10.1016/j.archger.2025.106080
Cho Rong Kim , Jisu Ko , Min Jin Ha , Kui Son Choi , Eun-Cheol Park
Introduction
Considering social isolation in approaches to frailty is important for the early detection of health problems in older adults and the development of appropriate intervention strategies. This study aims to investigate the relationship between changes in social isolation and frailty using the data the Korea Longitudinal Study of Aging (2006–2022).
Methods
A longitudinal study was conducted with 17,932 adults aged ≥65 years. Frailty was assessed using the frailty index, changes in social isolation were categorized into four groups. Associations between changes in social isolation and frailty were examined using generalized estimating equations with logistic regression to account for repeated measures and within-subject correlations.
Results
Compared to participants who remained non-isolated, those whose social isolation status changed from a non-isolated to isolated state had 3.47 times higher odds of frailty (95 % confidence interval [CI]: 3.03–3.96), and those in a consistently isolated state had 3.18 times higher odds (95 % CI: 2.80–3.62). Analysis by frailty type indicated that the transition from non-isolated to isolated status exhibited a stronger association with psychological frailty (odds ratio [OR] 4.38, 95 % CI 4.36–4.39) than physical frailty, and the highest increase was observed in the likelihood of exhibiting both physical and psychological frailty (OR 6.81, 95 % CI 6.77–6.84).
Conclusions
The transition to an isolated state was associated with frailty among older adults. These findings emphasize the need for early identification and active interventions to address social isolation to prevent frailty among older adults.
导言：在处理衰弱问题时考虑到社会孤立对于早期发现老年人的健康问题和制定适当的干预策略很重要。本研究旨在利用韩国老龄化纵向研究（2006-2022）的数据，探讨社会孤立的变化与脆弱性之间的关系。方法：对17932名年龄≥65岁的成年人进行纵向研究。脆弱性是用脆弱性指数来评估的，社会孤立的变化被分为四组。使用广义估计方程和逻辑回归来检验社会隔离变化与脆弱性之间的关联，以解释重复测量和受试者内部相关性。结果：与未隔离的参与者相比，社会隔离状态从非隔离状态变为隔离状态的参与者虚弱的几率高3.47倍（95%置信区间[CI]: 3.03-3.96），持续隔离状态的参与者虚弱的几率高3.18倍（95% CI: 2.80-3.62）。虚弱类型分析表明，与身体虚弱相比，从非孤立状态到孤立状态的转变与心理虚弱的关联更强（比值比[OR] 4.38, 95% CI 4.36-4.39），并且观察到表现出身体和心理虚弱的可能性的最高增加（比值比[OR] 6.81, 95% CI 6.77-6.84）。结论：老年人向孤立状态的转变与虚弱有关。这些发现强调需要及早发现并采取积极干预措施，解决社会孤立问题，以防止老年人虚弱。
{"title":"Association between changes in social isolation status and frailty among older adults","authors":"Cho Rong Kim , Jisu Ko , Min Jin Ha , Kui Son Choi , Eun-Cheol Park","doi":"10.1016/j.archger.2025.106080","DOIUrl":"10.1016/j.archger.2025.106080","url":null,"abstract":"<div><h3>Introduction</h3><div>Considering social isolation in approaches to frailty is important for the early detection of health problems in older adults and the development of appropriate intervention strategies. This study aims to investigate the relationship between changes in social isolation and frailty using the data the Korea Longitudinal Study of Aging (2006–2022).</div></div><div><h3>Methods</h3><div>A longitudinal study was conducted with 17,932 adults aged ≥65 years. Frailty was assessed using the frailty index, changes in social isolation were categorized into four groups. Associations between changes in social isolation and frailty were examined using generalized estimating equations with logistic regression to account for repeated measures and within-subject correlations.</div></div><div><h3>Results</h3><div>Compared to participants who remained non-isolated, those whose social isolation status changed from a non-isolated to isolated state had 3.47 times higher odds of frailty (95 % confidence interval [CI]: 3.03–3.96), and those in a consistently isolated state had 3.18 times higher odds (95 % CI: 2.80–3.62). Analysis by frailty type indicated that the transition from non-isolated to isolated status exhibited a stronger association with psychological frailty (odds ratio [OR] 4.38, 95 % CI 4.36–4.39) than physical frailty, and the highest increase was observed in the likelihood of exhibiting both physical and psychological frailty (OR 6.81, 95 % CI 6.77–6.84).</div></div><div><h3>Conclusions</h3><div>The transition to an isolated state was associated with frailty among older adults. These findings emphasize the need for early identification and active interventions to address social isolation to prevent frailty among older adults.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106080"},"PeriodicalIF":3.8,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-03DOI: 10.1016/j.archger.2025.106077
Natasha Grande de França , Philipe de Souto Barreto , Hyobum Jang , Matteo Cesari , Yves Rolland
Aims
Care coordination is crucial in long-term care (LTC) as it contributes to patient-centered, high-value, and high-quality care. This review presents an overview of how care coordination for older adults with long-term needs is described in the literature.
Methods
This narrative review focused on older adults receiving LTC in institutional settings and the community. A comprehensive and structured search was conducted in PubMed in January 2025 using a combination of key and indexed terms related to care coordination, long-term care, and older adults.
Results
We retained 56 articles published between 1988 and 2024. Most of the information was from North American programs designed for community-dwelling older persons. Description of care coordination is lacking in middle and low-income countries, with limited information on institutional settings. Coordination is commonly performed by a designated health or social worker, responsible for assessing, developing, and monitoring the care plan with the support of a multidisciplinary team (not always including a geriatrician) and electronic health records. Care coordination can be challenging to translate into practice, mainly due to limited time availability and a lack of specific training. Communication across care settings and among the staff is frequently fragmented, partial, and unstandardized.
Conclusions
Care systems for older persons living in the community seem to apply fundamental elements of care coordination. However, their implementation in real life is challenging. The current information on care coordination is not well-documented at the global level, especially in LTC facilities, highlighting the need for more attention to this aspect of care.
{"title":"An overview of care coordination elements for older adults with long-term care needs: A narrative review","authors":"Natasha Grande de França , Philipe de Souto Barreto , Hyobum Jang , Matteo Cesari , Yves Rolland","doi":"10.1016/j.archger.2025.106077","DOIUrl":"10.1016/j.archger.2025.106077","url":null,"abstract":"<div><h3>Aims</h3><div>Care coordination is crucial in long-term care (LTC) as it contributes to patient-centered, high-value, and high-quality care. This review presents an overview of how care coordination for older adults with long-term needs is described in the literature.</div></div><div><h3>Methods</h3><div>This narrative review focused on older adults receiving LTC in institutional settings and the community. A comprehensive and structured search was conducted in PubMed in January 2025 using a combination of key and indexed terms related to care coordination, long-term care, and older adults.</div></div><div><h3>Results</h3><div>We retained 56 articles published between 1988 and 2024. Most of the information was from North American programs designed for community-dwelling older persons. Description of care coordination is lacking in middle and low-income countries, with limited information on institutional settings. Coordination is commonly performed by a designated health or social worker, responsible for assessing, developing, and monitoring the care plan with the support of a multidisciplinary team (not always including a geriatrician) and electronic health records. Care coordination can be challenging to translate into practice, mainly due to limited time availability and a lack of specific training. Communication across care settings and among the staff is frequently fragmented, partial, and unstandardized.</div></div><div><h3>Conclusions</h3><div>Care systems for older persons living in the community seem to apply fundamental elements of care coordination. However, their implementation in real life is challenging. The current information on care coordination is not well-documented at the global level, especially in LTC facilities, highlighting the need for more attention to this aspect of care.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106077"},"PeriodicalIF":3.8,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-03DOI: 10.1016/j.archger.2025.106076
Andrea Fuente-Vidal , Erika Karkauskiene , Javier Jerez-Roig , Ricard Castro-Prat , Eduard Minobes-Molina , Damaso Sanchez , Nadine Barth , Dhayana Dallmeier , Dolores Forgione , Paolo Caserotti , Mathias Skjødt , Guillaume Lefebvre , Charlotte Bascompte-Soler , Aimar Intxaurrondo-Gonzalez , Sergi Blancafort-Alias , Ainhoa Nieto-Guisado , José Luis Socorro-Cumplido , Maria Giné-Garriga , Laura Coll-Planas
The global ageing population faces significant health challenges linked to insufficient physical activity (PA). Although PA offers emotional, cognitive, and physical benefits, long-term participation among older adults remains low. Enhancing enjoyment may boost their motivation and sustain engagement, while improving inclusivity is essential to reach underserved groups. This study describes the process of co-designing strategies to enhance enjoyment and social inclusion in PA interventions for community-dwellers and nursing home residents, guided by the Octalysis gamification framework. Using a qualitative phenomenological approach, we conducted 13 focus groups and 3 online individual interviews, with 98 participants in total, including 51 older adults, 29 formal caregivers, 5 family members, 10 policymakers, and 3 students, from Spain, Denmark, France, Germany, and Italy. Analysis revealed barriers such as fatigue, fear of injury, and social isolation, as well as facilitators including enjoyment, adaptability, and community support. Participants emphasized tailoring interventions to individual abilities and cultural contexts, integrating social connection, and fostering supportive environments. Stakeholders proposed innovative strategies to improve accessibility and enjoyment of PA. The findings underscore the value of co-design in meeting the needs of older adults and fostering a sense of ownership and commitment to PA programmes. Group-based initiatives will be able to benefit from the Join4Joy approach, which promotes enjoyment, improves movement behaviour, and mitigates social isolation. Following the co-design process, practical strategies are presented to increase PA and reduce sedentary behaviour, offering a pathway to more impactful, inclusive, and sustainable interventions for older adults.
{"title":"Co-designing the Join4Joy approach to boost enjoyment and social inclusion for the increase of physical activity among older people in nursing homes and community settings: a qualitative study in Spain, Denmark, Germany, Italy and France","authors":"Andrea Fuente-Vidal , Erika Karkauskiene , Javier Jerez-Roig , Ricard Castro-Prat , Eduard Minobes-Molina , Damaso Sanchez , Nadine Barth , Dhayana Dallmeier , Dolores Forgione , Paolo Caserotti , Mathias Skjødt , Guillaume Lefebvre , Charlotte Bascompte-Soler , Aimar Intxaurrondo-Gonzalez , Sergi Blancafort-Alias , Ainhoa Nieto-Guisado , José Luis Socorro-Cumplido , Maria Giné-Garriga , Laura Coll-Planas","doi":"10.1016/j.archger.2025.106076","DOIUrl":"10.1016/j.archger.2025.106076","url":null,"abstract":"<div><div>The global ageing population faces significant health challenges linked to insufficient physical activity (PA). Although PA offers emotional, cognitive, and physical benefits, long-term participation among older adults remains low. Enhancing enjoyment may boost their motivation and sustain engagement, while improving inclusivity is essential to reach underserved groups. This study describes the process of co-designing strategies to enhance enjoyment and social inclusion in PA interventions for community-dwellers and nursing home residents, guided by the Octalysis gamification framework. Using a qualitative phenomenological approach, we conducted 13 focus groups and 3 online individual interviews, with 98 participants in total, including 51 older adults, 29 formal caregivers, 5 family members, 10 policymakers, and 3 students, from Spain, Denmark, France, Germany, and Italy. Analysis revealed barriers such as fatigue, fear of injury, and social isolation, as well as facilitators including enjoyment, adaptability, and community support. Participants emphasized tailoring interventions to individual abilities and cultural contexts, integrating social connection, and fostering supportive environments. Stakeholders proposed innovative strategies to improve accessibility and enjoyment of PA. The findings underscore the value of co-design in meeting the needs of older adults and fostering a sense of ownership and commitment to PA programmes. Group-based initiatives will be able to benefit from the Join4Joy approach, which promotes enjoyment, improves movement behaviour, and mitigates social isolation. Following the co-design process, practical strategies are presented to increase PA and reduce sedentary behaviour, offering a pathway to more impactful, inclusive, and sustainable interventions for older adults.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106076"},"PeriodicalIF":3.8,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-03DOI: 10.1016/j.archger.2025.106078
Muaz Belviranlı, Nilsel Okudan, Tuğba Sezer
Chronic physical exercise is a promising non-pharmacological strategy to mitigate the progression of Alzheimer's disease (AD), yet the underlying molecular mechanisms remain incompletely understood. This study investigated the effects of chronic treadmill exercise on behavioral deficits and key molecular pathways in a d-galactose and AlCl3-induced rat model of sporadic AD. Animals were assigned to control, AD, exercise and AD + exercise (AE) groups for a ten-week intervention. Behavioral assessments included the elevated plus maze and Morris Water Maze, followed by molecular and biochemical analyses (RT-qPCR, ELISA) of the hippocampus, skeletal muscle, and plasma. Our results demonstrate that the AD model induced profound cognitive impairments, diminished locomotor activity, heightened anxiety-like behavior, and elevated plasma tau levels. These pathological changes were accompanied by a significant downregulation of the AMPK/SIRT1/PGC-1α mitochondrial biogenesis pathway and, notably, a marked suppression of the membrane repair protein Mitsugumin 53 (MG53) in both the hippocampus and skeletal muscle. The physical exercise regimen successfully ameliorated these behavioral deficits and normalized plasma tau. Mechanistically, physical exercise potently upregulated the AMPK/PGC-1α/FNDC5/BDNF axis in both central and peripheral tissues. Crucially, this study reveals for the first time that physical exercise also triggers a robust upregulation of MG53 at both the gene and protein levels in the brain, muscle, and circulation. These findings identify the physical exercise-induced mobilization of MG53 as a novel and powerful neuroprotective mechanism, linking systemic cellular repair capacity to the enhancement of cognitive resilience against AD.
{"title":"Exercise upregulates Mitsugumin 53 and ameliorates behavioral deficits and mitochondrial biogenesis in a sporadic Alzheimer's disease model in rats","authors":"Muaz Belviranlı, Nilsel Okudan, Tuğba Sezer","doi":"10.1016/j.archger.2025.106078","DOIUrl":"10.1016/j.archger.2025.106078","url":null,"abstract":"<div><div>Chronic physical exercise is a promising non-pharmacological strategy to mitigate the progression of Alzheimer's disease (AD), yet the underlying molecular mechanisms remain incompletely understood. This study investigated the effects of chronic treadmill exercise on behavioral deficits and key molecular pathways in a d-galactose and AlCl<sub>3</sub>-induced rat model of sporadic AD. Animals were assigned to control, AD, exercise and AD + exercise (AE) groups for a ten-week intervention. Behavioral assessments included the elevated plus maze and Morris Water Maze, followed by molecular and biochemical analyses (RT-qPCR, ELISA) of the hippocampus, skeletal muscle, and plasma. Our results demonstrate that the AD model induced profound cognitive impairments, diminished locomotor activity, heightened anxiety-like behavior, and elevated plasma tau levels. These pathological changes were accompanied by a significant downregulation of the AMPK/SIRT1/PGC-1α mitochondrial biogenesis pathway and, notably, a marked suppression of the membrane repair protein Mitsugumin 53 (MG53) in both the hippocampus and skeletal muscle. The physical exercise regimen successfully ameliorated these behavioral deficits and normalized plasma tau. Mechanistically, physical exercise potently upregulated the AMPK/PGC-1α/FNDC5/BDNF axis in both central and peripheral tissues. Crucially, this study reveals for the first time that physical exercise also triggers a robust upregulation of MG53 at both the gene and protein levels in the brain, muscle, and circulation. These findings identify the physical exercise-induced mobilization of MG53 as a novel and powerful neuroprotective mechanism, linking systemic cellular repair capacity to the enhancement of cognitive resilience against AD.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106078"},"PeriodicalIF":3.8,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-02DOI: 10.1016/j.archger.2025.106072
Ilana I. Logvinov, Victoria Loerzel
Vitality is increasingly recognized as a multidimensional biophysiological state influenced by physical, emotional, cognitive, social, and subjective factors. However, there is no consensus on its definition, and existing nursing theories and related constructs, such as quality of life and functional status, fail to fully capture its complexity. This state-of-the-science review synthesized findings from 35 research studies to examine how vitality is defined, assessed, and influenced in older adults. The review identified significant variability in measurement tools, with most instruments assessing only one or two domains of vitality. Key findings indicate that low-intensity physical activities, psychological well-being, social engagement, and good physical health enhance vitality, while chronic illness, isolation, and mental health challenges diminish it. Notable gaps include the lack of culturally inclusive research and inadequate integration of older adults’ perspectives. These findings underscore the need for a unified conceptual framework and comprehensive assessment tools that reflect the perceptions and experiences of older adults and support person-centered interventions to promote healthy aging.
{"title":"Vitality in older adults: A state-of-the-science review","authors":"Ilana I. Logvinov, Victoria Loerzel","doi":"10.1016/j.archger.2025.106072","DOIUrl":"10.1016/j.archger.2025.106072","url":null,"abstract":"<div><div>Vitality is increasingly recognized as a multidimensional biophysiological state influenced by physical, emotional, cognitive, social, and subjective factors. However, there is no consensus on its definition, and existing nursing theories and related constructs, such as quality of life and functional status, fail to fully capture its complexity. This state-of-the-science review synthesized findings from 35 research studies to examine how vitality is defined, assessed, and influenced in older adults. The review identified significant variability in measurement tools, with most instruments assessing only one or two domains of vitality. Key findings indicate that low-intensity physical activities, psychological well-being, social engagement, and good physical health enhance vitality, while chronic illness, isolation, and mental health challenges diminish it. Notable gaps include the lack of culturally inclusive research and inadequate integration of older adults’ perspectives. These findings underscore the need for a unified conceptual framework and comprehensive assessment tools that reflect the perceptions and experiences of older adults and support person-centered interventions to promote healthy aging.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106072"},"PeriodicalIF":3.8,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-02DOI: 10.1016/j.archger.2025.106075
Hu Lizi, Wang Qingyuan, Wang Shuyao, Wang Dan, Hua Kang
Objective
This study compares the effects of non-pharmacological interventions on delirium incidence and other outcomes in elderly patients in ICU.
Methods
A comprehensive search of eight electronic databases to identify randomized controlled trials (RCTs). The search covered studies from the inception to June 2024. Two reviewers independently screened titles and abstracts according to pre-defined inclusion and exclusion criteria. The analysis was conducted using Stata (version 15.0).
Results
A total of 38 studies involving 7229 critically ill patients and 12 interventions were included. While the network meta-analysis results suggest that nurse-led cluster nursing is the superior intervention for reducing delirium incidence (SUCRA=80.5 %), delirium duration (SUCRA=92.2 %), and mechanical ventilation duration (SUCRA=84.4 %) in elderly patients, it’s important to note that physical exercise (SUCRA=92.9 %) and cluster care (SUCRA=82.4 %) also demonstrated significant effects in decreasing ICU stay duration. However, these findings should be approached with caution.
Conclusion
Our findings indicated that nurse-led cluster nursing showed reliable performance in managing outcome indicators of delirium in the elderly. Our study provides important evidence for clinical medical staff to optimize intensive care programs, but the results should be interpreted with caution.
{"title":"Non-pharmacological interventions for preventing delirium in older adults in intensive care units: a systematic review and network meta-analysis","authors":"Hu Lizi, Wang Qingyuan, Wang Shuyao, Wang Dan, Hua Kang","doi":"10.1016/j.archger.2025.106075","DOIUrl":"10.1016/j.archger.2025.106075","url":null,"abstract":"<div><h3>Objective</h3><div>This study compares the effects of non-pharmacological interventions on delirium incidence and other outcomes in elderly patients in ICU.</div></div><div><h3>Methods</h3><div>A comprehensive search of eight electronic databases to identify randomized controlled trials (RCTs). The search covered studies from the inception to June 2024. Two reviewers independently screened titles and abstracts according to pre-defined inclusion and exclusion criteria. The analysis was conducted using Stata (version 15.0).</div></div><div><h3>Results</h3><div>A total of 38 studies involving 7229 critically ill patients and 12 interventions were included. While the network meta-analysis results suggest that nurse-led cluster nursing is the superior intervention for reducing delirium incidence (SUCRA=80.5 %), delirium duration (SUCRA=92.2 %), and mechanical ventilation duration (SUCRA=84.4 %) in elderly patients, it’s important to note that physical exercise (SUCRA=92.9 %) and cluster care (SUCRA=82.4 %) also demonstrated significant effects in decreasing ICU stay duration. However, these findings should be approached with caution.</div></div><div><h3>Conclusion</h3><div>Our findings indicated that nurse-led cluster nursing showed reliable performance in managing outcome indicators of delirium in the elderly. Our study provides important evidence for clinical medical staff to optimize intensive care programs, but the results should be interpreted with caution.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106075"},"PeriodicalIF":3.8,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-02DOI: 10.1016/j.archger.2025.106074
Bosen Lv , Xiaohui Li , Qianning Lu , Xiangjie Kong , Bixuan Liu , Yan Wu , Liying Jing , Jingyi Wang , Wenjing Feng , Yili Wu
Background
New evidence has revealed the dynamic transition characteristics of frailty. However, the potential differences in the effects of different types of obesity on the transition of frailty remain unclear. This prospective study aims to assess the association between obesity-related indicators and frailty transition in older adults.
Methods
This study included 2375 individuals aged ≥60, excluding underweight ones from the English Longitudinal Study of Aging (ELSA) 2008–2016. Frailty was assessed via a 60-item frailty index. Obesity was rated by 4 indicators including body mass index (BMI), waist circumference (WC), conicity index, and body roundness index (BRI). Using multi-state Markov model to evaluate how the obesity affected the probability of frailty state transitions.
Results
During 8 years follow-up, 2517 frailty transitions were observed, with 1484 worsening and 1033 improving. Compared with normal participants, people with obesity were linked to higher risks of deterioration (non-frail to pre-frail: HRBMI=1.32, 95 % CI=1.07–1.63, HRWC=1.16, 95 % CI=1.00–1.35; pre-frail to frail: HRBMI=1.90, CI=1.30–2.78; HRWC=1.36, 95 % CI=1.03–1.81) and reduced likelihood of recovery (pre-frail to non-frail: HRBMI=0.52, CI=0.40–0.67, HRWC=0.66, CI=0.55–0.80). Compared with the low tertiles, the high tertiles of conicity index or BRI similarly accelerated the deterioration (non-frail to pre-frail: HRconicity index=1.29, 95 % CI=1.04–1.59, HRBRI=1.45, 95 % CI=1.20–1.76; pre-frail to frail: HRBRI=1.58, 95 % CI=1.13–2.20) and hindered the recovery (pre-frail to non-frail: HRconicity index=0.67, 95 % CI=0.53–0.84, HRBRI=0.57, 95 % CI=0.46–0.72).
Conclusions
Different types of obesity all show that they accelerate the deterioration of frailty and hinder their ability to recover from frailty among older adults in UK.
{"title":"Association between obesity and the transitions of frailty based on multi-state Markov model: A prospective study","authors":"Bosen Lv , Xiaohui Li , Qianning Lu , Xiangjie Kong , Bixuan Liu , Yan Wu , Liying Jing , Jingyi Wang , Wenjing Feng , Yili Wu","doi":"10.1016/j.archger.2025.106074","DOIUrl":"10.1016/j.archger.2025.106074","url":null,"abstract":"<div><h3>Background</h3><div>New evidence has revealed the dynamic transition characteristics of frailty. However, the potential differences in the effects of different types of obesity on the transition of frailty remain unclear. This prospective study aims to assess the association between obesity-related indicators and frailty transition in older adults.</div></div><div><h3>Methods</h3><div>This study included 2375 individuals aged ≥60, excluding underweight ones from the English Longitudinal Study of Aging (ELSA) 2008–2016. Frailty was assessed via a 60-item frailty index. Obesity was rated by 4 indicators including body mass index (BMI), waist circumference (WC), conicity index, and body roundness index (BRI). Using multi-state Markov model to evaluate how the obesity affected the probability of frailty state transitions.</div></div><div><h3>Results</h3><div>During 8 years follow-up, 2517 frailty transitions were observed, with 1484 worsening and 1033 improving. Compared with normal participants, people with obesity were linked to higher risks of deterioration (non-frail to pre-frail: <em>HR</em><sub>BMI</sub>=1.32, 95 % <em>CI</em>=1.07–1.63, <em>HR</em><sub>WC</sub>=1.16, 95 % <em>CI</em>=1.00–1.35; pre-frail to frail: <em>HR</em><sub>BMI</sub>=1.90, <em>CI</em>=1.30–2.78; <em>HR</em><sub>WC</sub>=1.36, 95 % <em>CI</em>=1.03–1.81) and reduced likelihood of recovery (pre-frail to non-frail: <em>HR</em><sub>BMI</sub>=0.52, <em>CI</em>=0.40–0.67, <em>HR</em><sub>WC</sub>=0.66, <em>CI</em>=0.55–0.80). Compared with the low tertiles, the high tertiles of conicity index or BRI similarly accelerated the deterioration (non-frail to pre-frail: <em>HR</em><sub>conicity index</sub>=1.29, 95 % <em>CI</em>=1.04–1.59, <em>HR</em><sub>BRI</sub>=1.45, 95 % <em>CI</em>=1.20–1.76; pre-frail to frail: <em>HR</em><sub>BRI</sub>=1.58, 95 % <em>CI</em>=1.13–2.20) and hindered the recovery (pre-frail to non-frail: <em>HR</em><sub>conicity index</sub>=0.67, 95 % <em>CI</em>=0.53–0.84, <em>HR</em><sub>BRI</sub>=0.57, 95 % <em>CI</em>=0.46–0.72).</div></div><div><h3>Conclusions</h3><div>Different types of obesity all show that they accelerate the deterioration of frailty and hinder their ability to recover from frailty among older adults in UK.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106074"},"PeriodicalIF":3.8,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frailty is a relevant clinical issue in rheumatoid arthritis (RA) patients, particularly as the population ages. Malnutrition, decreased physical function, and a loss of social connections are key contributors to frailty. This study aimed to investigate the association of nutritional status with frailty in RA patients, with a focus on physical function and social frailty.
Methods
This cross-sectional study examined RA patients from a multicenter cohort at three hospitals. Nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI). Frailty was defined using the Kihon Checklist, physical function using the Health Assessment Questionnaire Disability Index (HAQ-DI), and social frailty using the Makizako Social Frailty Index. Multivariate logistic regression was performed to identify independent associations with frailty.
Results
A total of 667 patients were included (median age, 72 years; 73 % women). Frailty prevalence increased progressively with worsening nutritional status (GNRI), from 29.6 % in the no risk group to 66.7 % in the major risk group (P < 0.001). In multivariate models, GNRI and social frailty were significantly associated with frailty. This association, however, was no longer significant after adjusting for HAQ-DI, suggesting that physical function may influence this relationship. Stratified analysis confirmed that poor nutritional status was associated with increased frailty prevalence even among patients in HAQ remission (HAQ-DI ≤0.5).
Conclusion
Nutritional status is associated with frailty in RA patients, and this association may be influenced by physical function. A multidimensional approach addressing nutrition, physical function, and social factors is warranted in RA management.
{"title":"Nutritional status and frailty in rheumatoid arthritis: A multicenter observational study (T-FLAG)","authors":"Mochihito Suzuki , Shuji Asai , Yoshifumi Ohashi , Yasumori Sobue , Kenya Terabe , Shiro Imagama","doi":"10.1016/j.archger.2025.106073","DOIUrl":"10.1016/j.archger.2025.106073","url":null,"abstract":"<div><h3>Objective</h3><div>Frailty is a relevant clinical issue in rheumatoid arthritis (RA) patients, particularly as the population ages. Malnutrition, decreased physical function, and a loss of social connections are key contributors to frailty. This study aimed to investigate the association of nutritional status with frailty in RA patients, with a focus on physical function and social frailty.</div></div><div><h3>Methods</h3><div>This cross-sectional study examined RA patients from a multicenter cohort at three hospitals. Nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI). Frailty was defined using the Kihon Checklist, physical function using the Health Assessment Questionnaire Disability Index (HAQ-DI), and social frailty using the Makizako Social Frailty Index. Multivariate logistic regression was performed to identify independent associations with frailty.</div></div><div><h3>Results</h3><div>A total of 667 patients were included (median age, 72 years; 73 % women). Frailty prevalence increased progressively with worsening nutritional status (GNRI), from 29.6 % in the no risk group to 66.7 % in the major risk group (<em>P</em> < 0.001). In multivariate models, GNRI and social frailty were significantly associated with frailty. This association, however, was no longer significant after adjusting for HAQ-DI, suggesting that physical function may influence this relationship. Stratified analysis confirmed that poor nutritional status was associated with increased frailty prevalence even among patients in HAQ remission (HAQ-DI ≤0.5).</div></div><div><h3>Conclusion</h3><div>Nutritional status is associated with frailty in RA patients, and this association may be influenced by physical function. A multidimensional approach addressing nutrition, physical function, and social factors is warranted in RA management.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106073"},"PeriodicalIF":3.8,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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