BMC Geriatrics最新文献

Background: Immersive virtual reality (VR) is increasingly used to support cognition, mobility, and emotional well‑being in older adults with mild cognitive impairment (MCI), dementia, or frailty. Evidence is expanding but fragmented across small randomized and feasibility trials. We synthesized recent studies to clarify benefits, risks, and implementation considerations.

Methods: Following PRISMA 2020, we searched PubMed and CINAHL from 1 January 2019 to 15 October 2025. Eligible studies enrolled adults aged ≥ 65 years with MCI, dementia, or frailty/cognitive frailty; delivered immersive or semi‑immersive VR via head‑mounted display or large‑screen projection (interactive tasks or 360° content); and reported cognitive, mobility, or emotional/behavioral outcomes in randomized, quasi‑experimental, or pre-post designs. Two reviewers independently screened and extracted data. Risk of bias was appraised with RoB 2 (randomized trials) or JBI tools (non‑randomized). Heterogeneity precluded meta‑analysis; we conducted a structured narrative synthesis.

Results: Seventy records were identified (PubMed 28; CINAHL 42); after removing 9 duplicates, 61 records were screened, 24 full texts were assessed, and 13 studies were included (10 randomized; 3 feasibility/mixed‑methods). The most consistent improvements occurred in executive function and processing speed among participants with MCI or cognitive frailty; several trials also reported modest gains in global cognition. Multiple trials showed better Timed Up & Go and Berg Balance outcomes and enhanced anticipatory postural adjustments versus comparators. In residential care, immersive reminiscence and group VR reduced anxiety and apathy and were well tolerated. Adverse events were uncommon and mild; adherence was high with supervised delivery. Most randomized trials had some concerns for bias; one was at overall low risk.

Conclusions: Immersive and semi-immersive VR interventions appear feasible for supervised delivery in older adults with MCI or cognitive frailty and may be associated with improvements in cognitive and mobility outcomes. Evidence for emotional and behavioral outcomes in institutional settings is promising but preliminary. Programs with adequate exposure (2-3 sessions/week for 8-12 weeks; ≥ 15 total hours), adaptive challenge, and supervision were most frequently associated with positive outcomes. Larger multicenter randomized trials with standardized outcomes and embedded implementation and economic evaluations are needed.

Aim: To investigate the factors affecting reversible cognitive frailty in older adults in nursing homes, to construct a risk prediction model, and to validate its prediction performance.

Method: Older adults from five nursing homes in Liaoning Province, China, were selected as the study subjects from April to October 2024, and the data were randomly divided into a training set and a validation set according to 8:2. Logistic regression analysis was used to analyze the factors affecting reversible cognitive frailty in older adults in nursing homes, and a column-line graph model was constructed using R software (4.4.1).

Result: A total of 311 cases of older adults were included, of which 86 cases (27.7%) had reversible cognitive frailty. The AUCs of the training and validation sets were 0.852 and 0.805, respectively. The Hosmer-Lemeshow goodness-of-fit test values were P = 0.513 and 0.796 (both > 0.05).

Conclusion: The risk prediction model constructed in this study has good predictive performance, which is beneficial for institutional workers in providing early warning of the risk of reversible cognitive frailty for older adults and intervention.

Objectives: This study aimed to determine the amount of fluid consumed, factors influencing fluid intake, and the symptoms of thirst in elderly individuals living in the community, and to examine the relationship between thirst discomfort, hydration status, and ocular surface health.

Methods: The study employed a quantitative, cross-sectional, descriptive design and was conducted between July 2023 and December 2024, in the Aydıntepe district of Bayburt Province. The study included 110 individuals aged 65 and older who were able to communicate and agreed to participate. Data were collected through face-to-face interviews. Participants' demographic information was recorded using the Introductory Information Form. The level of thirst discomfort was assessed with the Thirst Discomfort Scale (TDS); ocular symptoms were measured with the Ocular Surface Disease Index (OSDI). Information about urine colour and daily fluid consumption was obtained from the participants. The results were analysed using SPSS version 26.0. Descriptive statistics, t-test for independent groups, ANOVA, and Pearson correlation analysis were used to analyse the data.

Results: The study found that the mean total TDS score was 20.61 ± 6.43, indicating moderate levels of thirst discomfort among elderly individuals. According to the OSDI results, individuals with severe ocular symptoms exhibited significantly higher discomfort related to thirst (F = 3.936, p = 0.010). A trend toward significance was observed between hydrated, moderately dehydrated, and dehydrated individuals regarding thirst discomfort levels; dehydrated individuals tended to have higher scores (F = 3.019, p = 0.053).

Conclusions: In elderly individuals, thirst discomfort was moderate, and ocular symptoms influenced the perception of thirst. The findings emphasise the importance of individualised approaches to thirst management and regular monitoring of hydration status in older adults.

Clinical relevance: Dehydration is a significant issue that can impact the quality of life for elderly individuals. Health professionals should regularly assess individuals' hydration status and develop individualised strategies to improve fluid intake. Given the relationship between ocular surface disease symptoms and fluid intake, interventions should be planned using a multidisciplinary approach.

Trial registration: Not applicable.

Background: Given the increasing prevalence of Mild Cognitive Impairment (MCI) among the elderly as a precursor to dementia, understanding how targeted interventions can improve daily functioning and delay cognitive decline is critical to improving quality of life in aging populations.

Objective: To investigate the effects of hand exercises and cognitive training on cognitive functions, hand skills, grip strength, dual-task-performance and interactions in elderly individuals with MCI.

Materials and methods: A randomized, single-blind study was conducted with 47 participants aged 65 and older living in nursing homes. Participants were divided into hand exercise group (HEG = 15), cognitive exercise group (CEG = 15) and control group (CG = 17). Exercise was applied to HEG and CEG for 8 weeks. Cognitive functions, grip strength, hand skills, motor-motor dual task performance (MMDTP), motor-cognitive dual task performance (MCDTP), motor-motor dual task interaction (MMDTI), motor-cognitive dual task interaction(MCDTI) and Manual Ability Measurement (MAM-36) were assessed.

Results: HEG improved in hand skills, grip strength, MCDTP, MMDTP, and MAM-36, with reduced MCDTI. CEG showed gains in cognition, MMDTP, and hand use (p < 0.05).

Conclusions: Hand exercises enhance motor and functional ability, while cognitive exercises supports cognitive performance and MMDTP.

Trial registration: The clinical protocol of the study was registered in the ClinicalTrials.gov system, registration number: NCT06837493.

Background: Older adults usually experience polypharmacy which increases their risk of adverse drug events, drug-drug interactions, and medication non-adherence. Clinical pharmacists, with specialized expertise in pharmacotherapy, are capable of engaging in deprescribing interventions aimed at reducing potentially inappropriate medications and overall medication burden. However, the overall impact of these pharmacist-led strategies remains unclear due to heterogeneity in study designs, settings, and outcomes.

Objectives: The aim of this study was to assess the impact of pharmacist-led deprescribing interventions among older adults across different settings.

Methods: We searched PubMed/MEDLINE, ScienceDirect, the Cochrane Library, and Google Scholar for English language randomized controlled trials and high-quality nonrandomized studies published from January 2015 onward, comparing pharmacist-led deprescribing interventions to usual care in any setting (community, outpatient, hospital, or long-term care). Primary outcomes were mean change in total number of medications per patient and the proportion of patients achieving effective deprescribing (discontinuation of ≥ 1 PIM or ≥ 0.5 reduction in a drug burden index).

Results: Seven studies (five RCTs, two non-randomized) encompassing 3,607 older adults met inclusion criteria. The pooled mean difference (MD) in total medications at last follow-up favored intervention by - 0.55 medications (95% CI - 2.17 to 1.07; I² = 83.1%), and the pooled risk ratio (RR) for effective deprescribing was 1.85 (95% CI 0.63-5.45; I² = 73.5%), though neither reached statistical significance. Secondary outcomes indicated improvements in medication burden indices without increased adverse events.

Conclusion: Pharmacist-led deprescribing reduces inappropriate medication use in targeted settings, while pooled effects on total medication count and hard clinical outcomes remain uncertain. Variability in study designs and outcomes underscores the need for larger, thoroughly designed trials with standardized protocols, longer follow-up, and comprehensive evaluations of clinical, economic, and patient-reported outcomes to establish scalable, sustainable deprescribing practices across diverse healthcare settings.

Protocol registration: The protocol for this systematic review was registered in International Prospective Register of Systematic Reviews (PROSPERO identifier: CRD420251072072).