Pub Date : 2025-09-21DOI: 10.1016/j.archger.2025.106032
Jolyn Johal , Heather Block , Alison Dymmott , Elsa Dent , Helen Exley , Stacey George
Objectives
To identify barriers and enablers to primary care in Australian residential aged care homes (RACHs).
Study design
Scoping review of articles published from 2019 to June 2024 in which barriers and enablers to primary care in Australian RACHs have been quantitatively measured, qualitatively collected or reported following implementation.
Data sources
Medline, CINAHL, AgeLine, Cochrane, Scopus, JBI, and Google Scholar.
Data synthesis
Of 1705 records screened, 28 studies were included, which were predominantly qualitative or mixed methods. They included general practitioner, nurse practitioner, pharmacy, allied health, oral health and dental services. Ninety barriers and 72 enablers were identified, and inductively classified into seven categories: System Level: 1. Funding and Resources; Organisational Level: 2. Employment and Service Models, 3. Management and Culture and, 4. Collaboration, Coordination and Communication; and Individual Level: 5. Workload, Job Satisfaction and Security, 6. Attributes, Skills and Preparedness for Role and, 7. Recipient Needs, Attitudes and Preferences. Barriers and enablers related to ‘Funding and Resources’ and ‘Employment and Service Models’ appeared key, interacting with multiple categories. On-site models were reported to foster greater collaboration and care.
Conclusions
This review revealed the systems-, organisational- and individual-level factors that influence primary care in Australian RACHs. These can be considered when designing future initiatives to increase primary care access in RACHs. With the Australian Government recently introducing funding to employ on-site pharmacists, this is an opportunity for systematic evaluation of on-site models to inform future policies, which can be considered for extension to other professions.
{"title":"Barriers and enablers to primary care in Australian residential aged care homes: A scoping review","authors":"Jolyn Johal , Heather Block , Alison Dymmott , Elsa Dent , Helen Exley , Stacey George","doi":"10.1016/j.archger.2025.106032","DOIUrl":"10.1016/j.archger.2025.106032","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify barriers and enablers to primary care in Australian residential aged care homes (RACHs).</div></div><div><h3>Study design</h3><div>Scoping review of articles published from 2019 to June 2024 in which barriers and enablers to primary care in Australian RACHs have been quantitatively measured, qualitatively collected or reported following implementation.</div></div><div><h3>Data sources</h3><div>Medline, CINAHL, AgeLine, Cochrane, Scopus, JBI, and Google Scholar.</div></div><div><h3>Data synthesis</h3><div>Of 1705 records screened, 28 studies were included, which were predominantly qualitative or mixed methods. They included general practitioner, nurse practitioner, pharmacy, allied health, oral health and dental services. Ninety barriers and 72 enablers were identified, and inductively classified into seven categories: System Level: 1. Funding and Resources; Organisational Level: 2. Employment and Service Models, 3. Management and Culture and, 4. Collaboration, Coordination and Communication; and Individual Level: 5. Workload, Job Satisfaction and Security, 6. Attributes, Skills and Preparedness for Role and, 7. Recipient Needs, Attitudes and Preferences. Barriers and enablers related to ‘Funding and Resources’ and ‘Employment and Service Models’ appeared key, interacting with multiple categories. On-site models were reported to foster greater collaboration and care.</div></div><div><h3>Conclusions</h3><div>This review revealed the systems-, organisational- and individual-level factors that influence primary care in Australian RACHs. These can be considered when designing future initiatives to increase primary care access in RACHs. With the Australian Government recently introducing funding to employ on-site pharmacists, this is an opportunity for systematic evaluation of on-site models to inform future policies, which can be considered for extension to other professions.</div></div><div><h3>Registration</h3><div>Open Science Framework, <span><span>https://osf.io/nyqrm/</span><svg><path></path></svg></span></div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"140 ","pages":"Article 106032"},"PeriodicalIF":3.8,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254097","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 : 2025-09-18DOI: 10.1016/j.archger.2025.106030
Liang-Kung Chen
{"title":"Transforming healthy aging strategies through precision health approaches","authors":"Liang-Kung Chen","doi":"10.1016/j.archger.2025.106030","DOIUrl":"10.1016/j.archger.2025.106030","url":null,"abstract":"","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106030"},"PeriodicalIF":3.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115386","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}
This study aims to examine the association between sleep and intrinsic capacity (IC), employing a machine-learning approach, to promote healthy aging and disability prevention in the community.
Methods
A cohort of 810 community-dwelling individuals aged 50 years were enrolled. Sleep patterns were assessed using the Pittsburgh Sleep Quality Index (PSQI) and its subdomains. Unsupervised machine learning through K-means clustering was applied to classify sleep patterns into four distinct categories, enabling further analysis. IC was evaluated by assessing cognitive, locomotion, vitality, psychological, and sensory functions and was subsequently rescaled using the percent of the maximum possible method.
Results
Low IC was linked to higher PSQI (OR 1.10, 95% CI 1.05-1.15, p<0.001), as well as subdomains indicating poor sleep quality, lower habitual sleep efficiency, and increased sleep disturbances. Poor sleep quality (PSQI >5) was associated with low IC and lower scores in the psychological wellbeing, and vitality subdomains. Results of K-means clustering analysis showed: Category 1 (worst sleepers) (OR 2.54, 95% CI 1.55-4.16, p<0.001), Category 2 (short and inefficient sleepers, OR 1.69, 95% CI 1.18-2.43, p=0.004), and Category 3 (inefficient sleepers, OR 1.50, 95% CI 1.02-2.20, p=0.037) exhibited a higher risk for low IC compared to robust sleepers.
Conclusions
The study highlights the crucial role of sleep quality in maintaining intrinsic capacity and promoting healthy aging. Impairments in psychological wellbeing and vitality were identified as the primary contributors. This emphasizes the importance of promoting healthy sleep habits for overall well-being.
本研究旨在研究睡眠与内在能力（IC）之间的关系，采用机器学习方法，促进社区的健康老龄化和残疾预防。方法对810名50岁的社区居民进行队列研究。使用匹兹堡睡眠质量指数（PSQI）及其子域评估睡眠模式。通过K-means聚类的无监督机器学习被应用于将睡眠模式分为四个不同的类别，从而进行进一步的分析。通过评估认知、运动、活力、心理和感觉功能来评估IC，随后使用最大可能百分比法重新缩放IC。结果慢IC与较高的PSQI （OR 1.10, 95% CI 1.05-1.15, p<0.001）以及表明睡眠质量差、习惯性睡眠效率低和睡眠障碍增加的子域有关。睡眠质量差（PSQI >5）与低IC以及心理健康和活力子域得分较低相关。k -均值聚类分析的结果显示：第一类（最差睡眠者）（OR 2.54, 95% CI 1.55-4.16, p<0.001）、第二类（短睡眠者和低效睡眠者，OR 1.69, 95% CI 1.18-2.43, p=0.004）和第三类（低效睡眠者，OR 1.50, 95% CI 1.02-2.20, p=0.037）与健康睡眠者相比，低IC的风险更高。结论本研究强调了睡眠质量在维持内在能力和促进健康衰老方面的重要作用。心理健康和活力的损害被确定为主要因素。这强调了促进健康睡眠习惯对整体健康的重要性。
{"title":"Evaluating sleep patterns and intrinsic capacity with machine learning: Results from the Gan-Dau healthy longevity plan","authors":"Kuan-Yu Peng , Wei-Ju Lee , Heng-Hsin Tung , Shih-Tsung Huang , Su-Yu Chang , Hsiu-Ling Chung , Hsiao-Chien Yeh , Wen-Huey Tsai , Shin-Shang Chou , Fei-Yuan Hsiao","doi":"10.1016/j.archger.2025.106028","DOIUrl":"10.1016/j.archger.2025.106028","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to examine the association between sleep and intrinsic capacity (IC), employing a machine-learning approach, to promote healthy aging and disability prevention in the community.</div></div><div><h3>Methods</h3><div>A cohort of 810 community-dwelling individuals aged 50 years were enrolled. Sleep patterns were assessed using the Pittsburgh Sleep Quality Index (PSQI) and its subdomains. Unsupervised machine learning through K-means clustering was applied to classify sleep patterns into four distinct categories, enabling further analysis. IC was evaluated by assessing cognitive, locomotion, vitality, psychological, and sensory functions and was subsequently rescaled using the percent of the maximum possible method.</div></div><div><h3>Results</h3><div>Low IC was linked to higher PSQI (OR 1.10, 95% CI 1.05-1.15, p<0.001), as well as subdomains indicating poor sleep quality, lower habitual sleep efficiency, and increased sleep disturbances. Poor sleep quality (PSQI >5) was associated with low IC and lower scores in the psychological wellbeing, and vitality subdomains. Results of K-means clustering analysis showed: Category 1 (worst sleepers) (OR 2.54, 95% CI 1.55-4.16, p<0.001), Category 2 (short and inefficient sleepers<strong>,</strong> OR 1.69, 95% CI 1.18-2.43, p=0.004), and Category 3 (inefficient sleepers, OR 1.50, 95% CI 1.02-2.20, p=0.037) exhibited a higher risk for low IC compared to robust sleepers.</div></div><div><h3>Conclusions</h3><div>The study highlights the crucial role of sleep quality in maintaining intrinsic capacity and promoting healthy aging. Impairments in psychological wellbeing and vitality were identified as the primary contributors. This emphasizes the importance of promoting healthy sleep habits for overall well-being.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106028"},"PeriodicalIF":3.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118268","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 : 2025-09-15DOI: 10.1016/j.archger.2025.106027
Stefano Cacciatore , Emanuele Marzetti , Riccardo Calvani , Matteo Tosato , Francesco Landi , Lookup 8+ Study Group
Objectives
To examine the association between cardiovascular health, assessed through an 8-factor cardiovascular health (8F–CVH) score, and self-reported walking difficulty in middle-aged (40–64 years) and older adults (≥65 years) living in the community.
Study design
Cross-sectional study.
Main outcome measures
Self-reported walking difficulty was evaluated by a single-item question: “Do you have any difficulty in walking 400 meters?”. Cardiovascular health was assessed using a composite 8F–CVH score inspired by Life’s Essential 8, including diet, physical activity, body mass index, blood pressure, total cholesterol, fasting blood glucose, smoking status, and sleep quality.
Results
Among 4141 participants (mean age 60.5 ± 11.2 years; 53.1 % women), 16.0 % reported walking difficulty. Prevalence was higher in older adults (25.0 %) than in middle-aged individuals (11.0 %; p for trend <0.001). Self-reported walking difficulty was more frequent in participants with low 8F–CVH scores (32.8 %), compared to moderate (15.5 %) and high (4.8 %) scores (p <0.001). ROC curve analysis showed modest discrimination for the total score (area under the curve [AUC] 0.67; 95 % confidence interval [CI] 0.65–0.69), with physical activity performing best among individual components (AUC 0.69; 95 % CI 0.67–0.71). After adjusting for confounders, moderate and high scores were associated with 61 % (OR 0.39, 95 % CI 0.31–0.48) and 84 % (OR 0.16, 95 % CI 0.10–0.24) lower odds of self-reported walking difficulty, respectively.
Conclusions
Better cardiovascular health is independently associated with lower odds of self-reported walking difficulty. Promoting cardiovascular health may help preserve mobility in late life.
目的通过8因素心血管健康（8F-CVH）评分评估心血管健康与社区中年（40-64岁）和老年人（≥65岁）自我报告的行走困难之间的关系。研究设计横断面研究。主要结果测量：自我报告的行走困难通过一个单项问题来评估：“你走400米有困难吗？”心血管健康的评估采用受Life’s Essential 8启发的综合8F-CVH评分，包括饮食、身体活动、体重指数、血压、总胆固醇、空腹血糖、吸烟状况和睡眠质量。结果在4141名参与者中（平均年龄60.5±11.2岁，53.1%为女性），16.0%报告行走困难。老年人的患病率（25.0%）高于中年人（11.0%；p为趋势值<；0.001）。与中等（15.5%）和高（4.8%）评分的参与者相比，8F-CVH评分低的参与者（32.8%）更频繁地自我报告行走困难（p <0.001）。ROC曲线分析显示总分存在适度差异（曲线下面积[AUC] 0.67； 95%可信区间[CI] 0.65-0.69），单项成分中体力活动表现最佳（AUC 0.69; 95% CI 0.67 - 0.71）。在调整混杂因素后，中等和高分分别与61% （OR 0.39, 95% CI 0.31-0.48）和84% （OR 0.16, 95% CI 0.10-0.24）的自我报告行走困难的低几率相关。结论较好的心血管健康状况与较低的自我报告行走困难的几率独立相关。促进心血管健康可能有助于保持晚年的活动能力。
{"title":"Association between cardiovascular health metrics and self-reported walking difficulty in community-dwelling middle-aged and older adults: results from the longevity check-up (Lookup) 8+","authors":"Stefano Cacciatore , Emanuele Marzetti , Riccardo Calvani , Matteo Tosato , Francesco Landi , Lookup 8+ Study Group","doi":"10.1016/j.archger.2025.106027","DOIUrl":"10.1016/j.archger.2025.106027","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the association between cardiovascular health, assessed through an 8-factor cardiovascular health (8F–CVH) score, and self-reported walking difficulty in middle-aged (40–64 years) and older adults (≥65 years) living in the community.</div></div><div><h3>Study design</h3><div>Cross-sectional study.</div></div><div><h3>Main outcome measures</h3><div>Self-reported walking difficulty was evaluated by a single-item question: “Do you have any difficulty in walking 400 meters?”. Cardiovascular health was assessed using a composite 8F–CVH score inspired by Life’s Essential 8, including diet, physical activity, body mass index, blood pressure, total cholesterol, fasting blood glucose, smoking status, and sleep quality.</div></div><div><h3>Results</h3><div>Among 4141 participants (mean age 60.5 ± 11.2 years; 53.1 % women), 16.0 % reported walking difficulty. Prevalence was higher in older adults (25.0 %) than in middle-aged individuals (11.0 %; p for trend <0.001). Self-reported walking difficulty was more frequent in participants with low 8F–CVH scores (32.8 %), compared to moderate (15.5 %) and high (4.8 %) scores (p <0.001). ROC curve analysis showed modest discrimination for the total score (area under the curve [AUC] 0.67; 95 % confidence interval [CI] 0.65–0.69), with physical activity performing best among individual components (AUC 0.69; 95 % CI 0.67–0.71). After adjusting for confounders, moderate and high scores were associated with 61 % (OR 0.39, 95 % CI 0.31–0.48) and 84 % (OR 0.16, 95 % CI 0.10–0.24) lower odds of self-reported walking difficulty, respectively.</div></div><div><h3>Conclusions</h3><div>Better cardiovascular health is independently associated with lower odds of self-reported walking difficulty. Promoting cardiovascular health may help preserve mobility in late life.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106027"},"PeriodicalIF":3.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095504","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 : 2025-09-13DOI: 10.1016/j.archger.2025.106026
Khadijeh Otadi, Kazem Malmir
Background
The six-minute walk test (6MWT) is widely used to assess functional capacity in older adults, but performance differs by various factors. This review compiled 6MWT reference values and identified key predictors of performance.
Methods
Studies on average 6MWT distances in older adults were found through PubMed, Scopus, Web of Science, Ovid, and PEDro, with no date limits. Participant data were summarized using descriptive statistics. A random-effects meta-analysis combined mean distances, with heterogeneity assessed using Cochran's Q test and I² statistics. Subgroup analyses examined variations by age, gender, BMI, height, and region, while regression analyses identified predictors of 6MWT performance.
Results
Of 72 studies, 28 were included in the meta-analysis. Men walked farther (473.11 m) than women (428.35 m). Distance declined with age, from 587.43 m (age 60–64) to 325.53 m (age ≥80). Overweight participants walked more (461.24 m) than those with normal BMI (425.33 m). By region, Oceania showed the highest distance (485.42 m), followed by Europe, the Americas, and Asia. Meta-regression showed distance decreased by 10.25 m per year of age and increased by 4.44 m per kg of weight. Gender, BMI, and height were not significant predictors.
Conclusions
The 6MWT remains a valuable tool for assessing functional capacity in older adults. Age and weight were the most significant predictors of 6MWT performance, with distance decreasing markedly with age and increasing with body weight. Regional factors also influenced outcomes, while gender, BMI, and body height had less impact. Clinicians should use age-adjusted evaluations and promote weight management strategies to preserve mobility in older adults.
背景：6分钟步行测试（6MWT）被广泛用于评估老年人的功能能力，但其表现因各种因素而不同。这篇综述汇编了6MWT参考值，并确定了关键的性能预测指标。方法：通过PubMed， Scopus, Web of Science， Ovid和PEDro找到老年人平均6MWT距离的研究，没有日期限制。使用描述性统计对参与者数据进行汇总。随机效应荟萃分析结合平均距离，异质性评估使用科克伦的Q检验和I²统计量。亚组分析考察了年龄、性别、BMI、身高和地区的差异，而回归分析确定了6MWT表现的预测因子。结果：72项研究中，有28项纳入meta分析。男性步行距离（473.11米）比女性（428.35米）更远。随着年龄的增长，距离从587.43 m（60 ~ 64岁）下降到325.53 m（≥80岁）。超重的参与者比BMI正常的参与者（425.33米）走得多（461.24米）。从区域来看，大洋洲的距离最高（485.42米），其次是欧洲、美洲和亚洲。元回归结果显示，每年龄减少10.25米，每公斤体重增加4.44米。性别、体重指数和身高不是显著的预测因子。结论：6MWT仍然是评估老年人功能能力的有价值的工具。年龄和体重是6MWT表现最显著的预测因子，距离随年龄显著降低，随体重显著增加。地区因素也会影响结果，而性别、体重指数和身高的影响较小。临床医生应该使用年龄调整评估和促进体重管理策略，以保持老年人的活动能力。
{"title":"Normative reference values for the six-minute walk test in older adults: A systematic review and meta-analysis","authors":"Khadijeh Otadi, Kazem Malmir","doi":"10.1016/j.archger.2025.106026","DOIUrl":"10.1016/j.archger.2025.106026","url":null,"abstract":"<div><h3>Background</h3><div>The six-minute walk test (6MWT) is widely used to assess functional capacity in older adults, but performance differs by various factors. This review compiled 6MWT reference values and identified key predictors of performance.</div></div><div><h3>Methods</h3><div>Studies on average 6MWT distances in older adults were found through PubMed, Scopus, Web of Science, Ovid, and PEDro, with no date limits. Participant data were summarized using descriptive statistics. A random-effects meta-analysis combined mean distances, with heterogeneity assessed using Cochran's Q test and I² statistics. Subgroup analyses examined variations by age, gender, BMI, height, and region, while regression analyses identified predictors of 6MWT performance.</div></div><div><h3>Results</h3><div>Of 72 studies, 28 were included in the meta-analysis. Men walked farther (473.11 m) than women (428.35 m). Distance declined with age, from 587.43 m (age 60–64) to 325.53 m (age ≥80). Overweight participants walked more (461.24 m) than those with normal BMI (425.33 m). By region, Oceania showed the highest distance (485.42 m), followed by Europe, the Americas, and Asia. Meta-regression showed distance decreased by 10.25 m per year of age and increased by 4.44 m per kg of weight. Gender, BMI, and height were not significant predictors.</div></div><div><h3>Conclusions</h3><div>The 6MWT remains a valuable tool for assessing functional capacity in older adults. Age and weight were the most significant predictors of 6MWT performance, with distance decreasing markedly with age and increasing with body weight. Regional factors also influenced outcomes, while gender, BMI, and body height had less impact. Clinicians should use age-adjusted evaluations and promote weight management strategies to preserve mobility in older adults.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"140 ","pages":"Article 106026"},"PeriodicalIF":3.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202311","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 : 2025-09-12DOI: 10.1016/j.archger.2025.106023
Gee Youn Song , Sung-Bum Lee , Minkyeung Jo , Ji-Eun Moon , Inki Moon , Jong-Koo Kim
Background and aims
Handgrip strength (HGS) has been identified as a predictor of various comorbidities, including pneumonia, chronic kidney disease, and cancer. Additionally, HGS has been associated with the prevalence of cardiovascular disease (CVD). However, the usefulness of HGS as an indicator of incident CVD remains unclear.
Methods
In this nationwide cohort study, 173,195 subjects were enrolled and followed for 4.1 years. A total of 35,664 participants were included in the final analysis. During the follow-up, 131 participants developed cerebrovascular disease, 401 experienced coronary heart disease (CHD), and 526 developed CVD. Anthropometric, laboratory, and lifestyle factors were assessed in relation to CVD risk.
Results
Participantswere categorised into quartiles based on their relative handgrip strength (RGS). Cox regression analyses revealed an inverse association between RGS and new-onset cerebrovascular disease, CHD, and CVD. After controlling for confounders, the hazard ratios (HRs) [95 % confidence intervals (CIs)] for new-onset CHD were 0.63 (0.41–0.98) in men and 0.50 (0.26–0.95) in women. Additionally, after adjusting for confounders, the HRs [95 % CIs] for incident CVD in the highest quartile (Q4)were 0.68 (0.47–1.00) in men and 0.50 (0.28–0.89) in women. As RGS increased, the incidence of CHD and CVD significantly decreased, with stronger associations observed in women.
Discussion and Conclusions
This novel study demonstrates an association between RGS and incident CHD and CVD, with stronger significance in women. In clinical settings, RGS can be a useful surrogate markerof CHD and CVD, and regular assessments may help detect these conditions early.
{"title":"Handgrip strength as a predictor of new-onset cardiovascular disease: insights from the Korean genome and epidemiology study (KoGES) cohort","authors":"Gee Youn Song , Sung-Bum Lee , Minkyeung Jo , Ji-Eun Moon , Inki Moon , Jong-Koo Kim","doi":"10.1016/j.archger.2025.106023","DOIUrl":"10.1016/j.archger.2025.106023","url":null,"abstract":"<div><h3>Background and aims</h3><div>Handgrip strength (HGS) has been identified as a predictor of various comorbidities, including pneumonia, chronic kidney disease, and cancer. Additionally, HGS has been associated with the prevalence of cardiovascular disease (CVD). However, the usefulness of HGS as an indicator of incident CVD remains unclear.</div></div><div><h3>Methods</h3><div>In this nationwide cohort study, 173,195 subjects were enrolled and followed for 4.1 years. A total of 35,664 participants were included in the final analysis. During the follow-up, 131 participants developed cerebrovascular disease, 401 experienced coronary heart disease (CHD), and 526 developed CVD. Anthropometric, laboratory, and lifestyle factors were assessed in relation to CVD risk.</div></div><div><h3>Results</h3><div>Participantswere categorised into quartiles based on their relative handgrip strength (RGS). Cox regression analyses revealed an inverse association between RGS and new-onset cerebrovascular disease, CHD, and CVD. After controlling for confounders, the hazard ratios (HRs) [95 % confidence intervals (CIs)] for new-onset CHD were 0.63 (0.41–0.98) in men and 0.50 (0.26–0.95) in women. Additionally, after adjusting for confounders, the HRs [95 % CIs] for incident CVD in the highest quartile (Q4)were 0.68 (0.47–1.00) in men and 0.50 (0.28–0.89) in women. As RGS increased, the incidence of CHD and CVD significantly decreased, with stronger associations observed in women.</div></div><div><h3>Discussion and Conclusions</h3><div>This novel study demonstrates an association between RGS and incident CHD and CVD, with stronger significance in women. In clinical settings, RGS can be a useful surrogate markerof CHD and CVD, and regular assessments may help detect these conditions early.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106023"},"PeriodicalIF":3.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095505","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 : 2025-09-11DOI: 10.1016/j.archger.2025.106025
Lorinda A. Coombs , Myoungsuk Kim
Objective
This study examined the effects of web-based interventions on depression and anxiety in older adults.
Methods
We conducted a systematic search of PubMed, CINAHL, Cochrane, Embase, PsycINFO, and Web of Science from their inception to March 05, 2025. We included randomized controlled trials (RCTs) examining the effects of web-based interventions on depression and anxiety in individuals aged 60 and older. The quality of included studies was evaluated using the revised Cochrane risk-of-bias tool for RCTs. A random-effects model was applied for the meta-analysis, with pooled standardized mean differences (SMD) used to estimate intervention effects. Heterogeneity was quantified using the I² statistic, and subgroup and meta-regression analyses were performed to investigate potential moderators.
Results
A total of 19 studies were included in the final analysis. The meta-analysis showed that web-based interventions significantly reduced depression (SMD = -0.48, 95 % CI = -0.72 to -0.24) and anxiety (SMD = -0.70, 95 % CI = -0.97 to -0.43) in older adults. Subgroup analyses indicated that participant characteristics and publication year significantly moderated heterogeneity, while meta-regression analysis revealed that mean age significantly moderated the intervention effect.
Conclusion
This meta-analysis confirmed that web-based interventions effectively reduce depression and anxiety in older adults. The effects were particularly pronounced among older adults with existing or diagnosed symptoms of depression or anxiety. Furthermore, the observed reduction in intervention effectiveness after COVID-19 highlights the need to investigate the underlying causes of this decline.
目的：本研究考察了网络干预对老年人抑郁和焦虑的影响。方法：系统检索PubMed、CINAHL、Cochrane、Embase、PsycINFO和Web of Science自成立至2025年3月5日的数据库。我们纳入了随机对照试验（rct），检查了网络干预对60岁及以上个体抑郁和焦虑的影响。使用修订后的Cochrane随机对照试验风险偏倚工具评估纳入研究的质量。采用随机效应模型进行meta分析，采用标准平均差异（SMD）估计干预效果。异质性使用I²统计量进行量化，并进行亚组和元回归分析以调查潜在的调节因素。结果：共纳入19项研究。荟萃分析显示，基于网络的干预显著降低了老年人的抑郁（SMD = -0.48, 95% CI = -0.72至-0.24）和焦虑（SMD = -0.70, 95% CI = -0.97至-0.43）。亚组分析显示，受试者特征和出版年份显著调节异质性，而元回归分析显示，平均年龄显著调节干预效果。结论：本荟萃分析证实，基于网络的干预有效地减少了老年人的抑郁和焦虑。这种影响在存在或被诊断为抑郁或焦虑症状的老年人中尤为明显。此外，观察到的2019冠状病毒病后干预效果下降的情况突出表明，有必要调查这种下降的根本原因。
{"title":"Effectiveness of web-based interventions on depression and anxiety in older adults: a systematic review and meta-analysis of randomized controlled trials","authors":"Lorinda A. Coombs , Myoungsuk Kim","doi":"10.1016/j.archger.2025.106025","DOIUrl":"10.1016/j.archger.2025.106025","url":null,"abstract":"<div><h3>Objective</h3><div>This study examined the effects of web-based interventions on depression and anxiety in older adults.</div></div><div><h3>Methods</h3><div>We conducted a systematic search of PubMed, CINAHL, Cochrane, Embase, PsycINFO, and Web of Science from their inception to March 05, 2025. We included randomized controlled trials (RCTs) examining the effects of web-based interventions on depression and anxiety in individuals aged 60 and older. The quality of included studies was evaluated using the revised Cochrane risk-of-bias tool for RCTs. A random-effects model was applied for the meta-analysis, with pooled standardized mean differences (SMD) used to estimate intervention effects. Heterogeneity was quantified using the I² statistic, and subgroup and meta-regression analyses were performed to investigate potential moderators.</div></div><div><h3>Results</h3><div>A total of 19 studies were included in the final analysis. The meta-analysis showed that web-based interventions significantly reduced depression (SMD = -0.48, 95 % CI = -0.72 to -0.24) and anxiety (SMD = -0.70, 95 % CI = -0.97 to -0.43) in older adults. Subgroup analyses indicated that participant characteristics and publication year significantly moderated heterogeneity, while meta-regression analysis revealed that mean age significantly moderated the intervention effect.</div></div><div><h3>Conclusion</h3><div>This meta-analysis confirmed that web-based interventions effectively reduce depression and anxiety in older adults. The effects were particularly pronounced among older adults with existing or diagnosed symptoms of depression or anxiety. Furthermore, the observed reduction in intervention effectiveness after COVID-19 highlights the need to investigate the underlying causes of this decline.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106025"},"PeriodicalIF":3.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082649","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 : 2025-09-10DOI: 10.1016/j.archger.2025.106024
Xiaowei Li , Chenxi Wu , Tao Feng , Xinyu Chen , Huan Chen , Xianying Lu , Jing Gao , Chaoming Hou
Background
Loneliness in older adults is a critical public health issue with dynamic changes over time. Understanding its longitudinal patterns is vital for identifying high-risk individuals and developing timely interventions. This review synthesizes evidence on loneliness trajectories, their predictors, and associated health outcomes in older populations.
Methods
A systematic search across nine databases (PubMed, Web of Science, Embase, Cochrane Library, CINAHL, PsycINFO, CNKI, VIP, Wanfang) was conducted from inception to December 1, 2024, updated on August 18, 2025, focusing on longitudinal studies of adults aged ≥60 years. Quality was assessed using JBI tools, and a narrative synthesis was performed due to methodological heterogeneity.
Results
Of the 2985 screened records, 16 studies met the predefined inclusion criteria. Fifteen of these studies were rated as moderate or high quality. Despite heterogeneity in analytical approaches, four loneliness trajectory patterns were identified: stable-low, stable-high, ascending, and descending. The stable-high and ascending trajectories were consistently associated with adverse health outcomes, including accelerated cognitive decline and greater severity of depressive symptoms. Key predictors of high-risk loneliness trajectories included social isolation, functional impairment, and exposure to major life stressors.
Conclusions
Loneliness among older adults follows heterogeneous trajectories, with the stable-high and ascending patterns indicating the highest risk for adverse health outcomes. These findings underscore the need for early screening of key risk factors and the implementation of trajectory-tailored interventions. Future research should prioritize standardized loneliness measurement tools and integrated analytical approaches to enhance the comparability of findings and their translation into clinical practice.
背景：老年人的孤独感是一个重要的公共卫生问题，随着时间的推移而发生动态变化。了解其纵向模式对于识别高危个体和制定及时的干预措施至关重要。本综述综合了老年人孤独轨迹、预测因素和相关健康结果的证据。方法：系统检索9个数据库（PubMed、Web of Science、Embase、Cochrane Library、CINAHL、PsycINFO、CNKI、VIP、万方），检索时间为研究开始至2024年12月1日，更新时间为2025年8月18日，重点检索年龄≥60岁成人的纵向研究。使用JBI工具评估质量，由于方法的异质性，进行了叙述综合。结果：在2985项筛选记录中，16项研究符合预定义的纳入标准。其中15项研究被评为中等或高质量。尽管分析方法存在异质性，但确定了四种孤独轨迹模式：稳定-低、稳定-高、上升和下降。稳定-高和上升轨迹始终与不良健康结果相关，包括认知能力下降加速和抑郁症状更严重。高风险孤独轨迹的关键预测因素包括社会隔离、功能障碍和暴露于主要生活压力源。结论：老年人的孤独感遵循异质性轨迹，稳定-高和上升模式表明不良健康结果的风险最高。这些发现强调了早期筛查关键风险因素和实施针对性干预措施的必要性。未来的研究应优先考虑标准化的孤独感测量工具和综合分析方法，以提高研究结果的可比性，并将其转化为临床实践。
{"title":"Loneliness trajectories in older adults: A systematic review","authors":"Xiaowei Li , Chenxi Wu , Tao Feng , Xinyu Chen , Huan Chen , Xianying Lu , Jing Gao , Chaoming Hou","doi":"10.1016/j.archger.2025.106024","DOIUrl":"10.1016/j.archger.2025.106024","url":null,"abstract":"<div><h3>Background</h3><div>Loneliness in older adults is a critical public health issue with dynamic changes over time. Understanding its longitudinal patterns is vital for identifying high-risk individuals and developing timely interventions. This review synthesizes evidence on loneliness trajectories, their predictors, and associated health outcomes in older populations.</div></div><div><h3>Methods</h3><div>A systematic search across nine databases (PubMed, Web of Science, Embase, Cochrane Library, CINAHL, PsycINFO, CNKI, VIP, Wanfang) was conducted from inception to December 1, 2024, updated on August 18, 2025, focusing on longitudinal studies of adults aged ≥60 years. Quality was assessed using JBI tools, and a narrative synthesis was performed due to methodological heterogeneity.</div></div><div><h3>Results</h3><div>Of the 2985 screened records, 16 studies met the predefined inclusion criteria. Fifteen of these studies were rated as moderate or high quality. Despite heterogeneity in analytical approaches, four loneliness trajectory patterns were identified: stable-low, stable-high, ascending, and descending. The stable-high and ascending trajectories were consistently associated with adverse health outcomes, including accelerated cognitive decline and greater severity of depressive symptoms. Key predictors of high-risk loneliness trajectories included social isolation, functional impairment, and exposure to major life stressors.</div></div><div><h3>Conclusions</h3><div>Loneliness among older adults follows heterogeneous trajectories, with the stable-high and ascending patterns indicating the highest risk for adverse health outcomes. These findings underscore the need for early screening of key risk factors and the implementation of trajectory-tailored interventions. Future research should prioritize standardized loneliness measurement tools and integrated analytical approaches to enhance the comparability of findings and their translation into clinical practice.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106024"},"PeriodicalIF":3.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087951","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 : 2025-09-10DOI: 10.1016/j.archger.2025.106022
Thomas Iverson , Marie Schulze , Kaylen Gill , Yola Switkowski , Isis Kelly dos Santos , Maureen C. Ashe
Objectives
Social support may assist people’s health as they age but less is known about how this relationship may differ for older adults living in rural communities. Knowledge of this information can inform the implementation of social prescribing, a care model aiming to address people’s unmet non-medical social needs.
Methods
This was a systematic rapid mixed-methods review following guidelines. We searched 10 electronic sources (all languages from 2000 and later) for peer-reviewed studies; our last search was on May 5, 2025. We followed the Joanna Briggs Institute (JBI) mixed-methods approach and used a convergent integrated method to create qualitative findings from quantitative studies and merged them with data from qualitative studies.
Synthesis
We included 12 studies (14 publications) with six quantitative studies, five qualitative studies, and one mixed methods study. Data were from Canada-wide surveys, or the provinces of New Brunswick, Ontario, Quebec, and Saskatchewan. There were some differences in findings between older adults from rural and urban settings for social support and satisfaction. Older people in rural settings may have less access to “formal” support and may rely more on family or friends, but this “patchwork” of support in rural communities may be less sustainable.
Conclusion
Social support is an important part of aging, but there may be some unique differences for people living in rural Canadian communities. Although the support provided in rural settings may offer some advantages, it may also be precarious in the long term and innovations to support aging in place (like social prescribing) are long overdue.
{"title":"Older adults and social support in rural Canada: A rapid mixed methods systematic review to inform social prescribing","authors":"Thomas Iverson , Marie Schulze , Kaylen Gill , Yola Switkowski , Isis Kelly dos Santos , Maureen C. Ashe","doi":"10.1016/j.archger.2025.106022","DOIUrl":"10.1016/j.archger.2025.106022","url":null,"abstract":"<div><h3>Objectives</h3><div>Social support may assist people’s health as they age but less is known about how this relationship may differ for older adults living in rural communities. Knowledge of this information can inform the implementation of social prescribing, a care model aiming to address people’s unmet non-medical social needs.</div></div><div><h3>Methods</h3><div>This was a systematic rapid mixed-methods review following guidelines. We searched 10 electronic sources (all languages from 2000 and later) for peer-reviewed studies; our last search was on May 5, 2025. We followed the Joanna Briggs Institute (JBI) mixed-methods approach and used a convergent integrated method to create qualitative findings from quantitative studies and merged them with data from qualitative studies.</div></div><div><h3>Synthesis</h3><div>We included 12 studies (14 publications) with six quantitative studies, five qualitative studies, and one mixed methods study. Data were from Canada-wide surveys, or the provinces of New Brunswick, Ontario, Quebec, and Saskatchewan. There were some differences in findings between older adults from rural and urban settings for social support and satisfaction. Older people in rural settings may have less access to “formal” support and may rely more on family or friends, but this “patchwork” of support in rural communities may be less sustainable.</div></div><div><h3>Conclusion</h3><div>Social support is an important part of aging, but there may be some unique differences for people living in rural Canadian communities. Although the support provided in rural settings may offer some advantages, it may also be precarious in the long term and innovations to support aging in place (like social prescribing) are long overdue.</div></div><div><h3>Systematic Review Registration</h3><div>PROSPERO 2024 CRD42024591884</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106022"},"PeriodicalIF":3.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095509","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 : 2025-09-08DOI: 10.1016/j.archger.2025.106021
Xuan Huang , Cui Ye , Ai Zhao , Ziyu Wang , Shufang Zuo , Lu Lin
Objectives
To evaluate the effectiveness of reminiscence therapy in enhancing cognitive function among older adults with cognitive impairment and to identify optimal intervention strategies in terms of format, session duration, frequency, and intervention period.
Methods
A systematic search of randomized controlled trials (RCTs) on reminiscence therapy for cognitively impaired older adults was conducted across PubMed, Web of Science, Cochrane Library, Embase, CNKI, CBM, VIP, and Wanfang databases from inception to October 2024. Two reviewers independently assessed the methodological quality of included studies using Cochrane Risk of Bias Tool (ROB 2.0). Data were extracted using standardized forms and analyzed with Review Manager version 5.4 and Stata version 18.0.
Results
A total of 18 studies were included, of which 14 studies (19 trials) provided complete data for meta-analysis. Study settings included hospitals, nursing facilities, and community centers, with all interventions based on simple recall reminiscence. Meta-analysis showed a significant effect of reminiscence therapy on cognitive function in older adults with cognitive impairment (SMD=1.15, 95%CI: 0.78-1.52, P<0.001). Subgroup analyses revealed greater effectiveness in participants from Asia (SMD=1.50, 95%CI: 0.98-2.01, P<0.001) and those with mild cognitive impairment (MCI)(SMD=1.56, 95%CI: 0.78-2.34, P<0.001). The optimal delivery strategies involved group sessions with more than six participants (SMD=1.63, 95%CI: 0.48-2.78, P=0.005), conducted weekly (SMD=1.37, 95%CI: 0.83-1.91, P<0.001) for 30-45 minutes per session (SMD=1.29, 95%CI: 0.59-1.99, P<0.001), over a 12-week period (SMD=1.60, 95%CI: 0.83-2.38, P<0.001).
Conclusion
Reminiscence therapy effectively improves cognitive function in older adults with cognitive impairment, especially those with MCI. It is recommended as an early non-pharmacological intervention delivered through weekly group sessions of 30-45 minutes, with six or more participants over at least 12 weeks. Future research should involve high-quality studies with extended follow-up periods to fully validate the sustained effectiveness of reminiscence therapy.
{"title":"Effects of reminiscence therapy on cognitive function in older adults with cognitive impairment: a systematic review and meta-analysis of randomized controlled trials","authors":"Xuan Huang , Cui Ye , Ai Zhao , Ziyu Wang , Shufang Zuo , Lu Lin","doi":"10.1016/j.archger.2025.106021","DOIUrl":"10.1016/j.archger.2025.106021","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effectiveness of reminiscence therapy in enhancing cognitive function among older adults with cognitive impairment and to identify optimal intervention strategies in terms of format, session duration, frequency, and intervention period.</div></div><div><h3>Methods</h3><div>A systematic search of randomized controlled trials (RCTs) on reminiscence therapy for cognitively impaired older adults was conducted across PubMed, Web of Science, Cochrane Library, Embase, CNKI, CBM, VIP, and Wanfang databases from inception to October 2024. Two reviewers independently assessed the methodological quality of included studies using Cochrane Risk of Bias Tool (ROB 2.0). Data were extracted using standardized forms and analyzed with Review Manager version 5.4 and Stata version 18.0.</div></div><div><h3>Results</h3><div>A total of 18 studies were included, of which 14 studies (19 trials) provided complete data for meta-analysis. Study settings included hospitals, nursing facilities, and community centers, with all interventions based on simple recall reminiscence. Meta-analysis showed a significant effect of reminiscence therapy on cognitive function in older adults with cognitive impairment (SMD=1.15, 95%CI: 0.78-1.52, P<0.001). Subgroup analyses revealed greater effectiveness in participants from Asia (SMD=1.50, 95%CI: 0.98-2.01, P<0.001) and those with mild cognitive impairment (MCI)(SMD=1.56, 95%CI: 0.78-2.34, P<0.001). The optimal delivery strategies involved group sessions with more than six participants (SMD=1.63, 95%CI: 0.48-2.78, P=0.005), conducted weekly (SMD=1.37, 95%CI: 0.83-1.91, P<0.001) for 30-45 minutes per session (SMD=1.29, 95%CI: 0.59-1.99, P<0.001), over a 12-week period (SMD=1.60, 95%CI: 0.83-2.38, P<0.001).</div></div><div><h3>Conclusion</h3><div>Reminiscence therapy effectively improves cognitive function in older adults with cognitive impairment, especially those with MCI. It is recommended as an early non-pharmacological intervention delivered through weekly group sessions of 30-45 minutes, with six or more participants over at least 12 weeks. Future research should involve high-quality studies with extended follow-up periods to fully validate the sustained effectiveness of reminiscence therapy.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106021"},"PeriodicalIF":3.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060388","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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