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Objectives: The World Health Organization’s Integrated Care for Older People (ICOPE) framework launched in 2019 is used to assess the intrinsic capacity of older individuals. Older women may face greater socioeconomic disadvantages, which can impact their physical and mental well-being. Therefore, we examined sex differences in intrinsic capacity and the influence of socioeconomic status. Methods: We conducted a cross-sectional study in Tainan, Taiwan, recruiting 1,268 adults aged 60 or older in 2022. The ICOPE screening assessed cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss, and depressive symptoms. Intrinsic capacity scores ranged from 0 to 6 and were categorized as impairment (1 or higher) or no impairment (0). Binary logistic regression models were used to analyze sex differences in intrinsic capacity, adjusting sequentially for demographics, lifestyle, and socioeconomic factors. Results: The prevalence of intrinsic capacity impairment was 34 %. Women had significantly higher odds of intrinsic capacity impairment (women vs. men, odds ratio [OR] = 1.39, 95 % CI = 1.10–1.75). After sequentially adjusting for demographic characteristics, lifestyle, and socioeconomic factors, the ORs were 1.46 (95 % CI = 1.12–1.90), 1.69 (95 % CI = 1.23–2.31), and 1.24 (95 % CI = 0.88–1.73), respectively. Stratified analyses showed that higher odds of impairment in women than in men was evident only in the financially dependent group (P for interaction = 0.059). Conclusions: Older women in Taiwan have poorer intrinsic capacity than men, a disparity largely attributable to women’s lower socioeconomic status. Strategies to promote healthy aging among women from disadvantaged socioeconomic backgrounds may help mitigate this sex difference in intrinsic capacity.

Objectives: Medication non-adherence among older adults with non-communicable diseases (NCDs) remains prevalent worldwide, which causes hospitalization and mortality. Our study aimed to examine the association of medication non-adherence with level of overall intrinsic capacity (IC), pattern of IC, and specific IC component among older adults with NCDs. Methods: A cross-sectional questionnaire-based survey of 1268 older adults aged 60 years and above was conducted in 2022 in southern Taiwan. Among them, 894 suffered from 1 more NCD were included in this study. The Integrated Care for Older People Screening Tool for Taiwanese and the Adherence to Refills and Medication Scale were used to assess IC and medication non-adherence, respectively. Latent class analysis (LCA) was used to identify patterns of IC impairment, and binary logistic regression was used to assess the association between medication non-adherence and IC. Results: Older adults in the moderate (score: 1–2) or low (score≧3) overall IC groups were more likely to experience medication non-adherence (moderate: adjusted odds ratio (aOR) 1.57 [95% CI: 1.05–2.36]; low: 2.26 [1.40–3.67]). The “physical and nutritional impairments accompanied by depressive symptoms” group was associated with statistically higher odds of medication non-adherence (aOR 1.66 [1.01–2.73]). Older adults with cognitive impairment, hearing loss, or depressive symptoms showed greater likelihood of medication non-adherence (cognitive impairment: aOR 1.53 [1.03–2.27]; hearing loss: aOR 1.57 [1.03–2.37]; depressive symptoms: aOR 1.81 [1.17–2.80]). Conclusions: Intervention for improving medication non-adherence among older adults with NCDs should consider IC.

Background: Patients with epilepsy have an increased risk of stroke. However, the detailed risk and characteristics of postepilepsy stroke have not been investigated. Methods: This study utilized the National Health Insurance Research Database in Taiwan. We classified adult patients with newly diagnosed epilepsy from 2003 to 2016 as the epilepsy cohort. Patients in the nonepilepsy cohort were selected with propensity score matching at a case–control ratio of 1:5. The incidence, hazard ratio (HR), period-specific HR, recurrent HR in the Wei-Lin-Weissfeld model, stroke severity index, complications, and mortality of all stroke, ischemic stroke (IS) and hemorrhagic stroke events in the two cohorts were analyzed. Results: We enrolled 23,810 patients in the epilepsy cohort and 119,050 persons in the nonepilepsy cohort. The period-specific HRs of all stroke, IS and hemorrhagic stroke peaked immediately after epilepsy diagnosis and trended downward [Adjusted HRs of all stroke: 4.88 (3.88–6.14), 4.47 (3.50–5.70), 3.17 (2.62–3.84), 2.81 (2.27–3.48), 2.81 (2.36–3.34) and 2.33 (2.07–2.62) in 0–0.5, 0.5–1, 1–2, 2–3, 3–5 and ≥5 years after epilepsy diagnosis, respectively]. The recurrent stroke HRs in the epilepsy cohort were >1 from the first [3.06 (2.71–3.34)] to the fourth events [6.33 (1.08–37.03)]. IS events in the epilepsy cohort were associated with a younger onset age, a higher IS severity index, a higher rate of urinary tract infection, a lower in-hospital mortality, while 90-day stroke mortality was similar between the 2 cohorts. Conclusion: Since the increased risk of stroke in epilepsy cohort peaked immediately after epilepsy diagnosis, early implementation of prevention strategies is considered.

Cryptococcus meningoencephalitis is increasing in human immunodeficiency virus (HIV)-negative patients, especially in Asian population. In patients who respond well to anti-cryptococcal therapy, some later developed muscle atrophy and weakness. The possibility of spinal arachnoiditis raised. We reported a 65-year-old man with DM, HTN, diagnosed with cryptococcal meningoencephalitis. He underwent a long duration of admission and was finally successfully discharged with salvage consolidation treatment. Despite getting good infection control, he had progressive flaccid paraplegia with profound atrophy, sphincter dysfunction and lower back pain. He was re-admitted and diagnosed with adhesive arachnoiditis after comprehensive studies of spinal cord MRI and CSF sampling. We applied short-term steroid pulse therapy and he had significant neurological improvement without relapsing of his cryptococcal meningoencephalitis. He is currently under rehabilitation programme. The diagnosis of cryptococcal spinal arachnoiditis comorbid with cryptococcal meningoencephalitis is often overlooked because the specific symptoms of bladder dysfunction and gait disturbance might be caused by increased intracranial pressure as well. Our report may give hints to other neurologist facing with these patients, aiming for earlier diagnosis, treatment and better prognosis.