Search

Introduction: Elderly people experience a high level of oral diseases, and such conditions were found to be more prevalent among those living in residential aged care facilities (RACFs). Objectives: This study explored the barriers to providing oral health (OH) care for residents living in private residential aged care facilities (RACF) in Malaysia, from the perspective of the supervisors. Methodology: This was a qualitative study, that involved face-to-face interviews with supervisors in seven private RACFs in Selangor, Malaysia. Interviews were conducted using a semi-structured open-ended questionnaire, audio-recorded for analysis, transcribed verbatim, and subjected to thematic analysis. Results: All seven supervisors agreed on a lack of any structured protocol available to residents or workers to promote OH care for residents. They reported that RACF staff received no formal training in providing OH care for residents, and noted various barriers to the provision of routine OH care, categorised into three main themes: (1) residents' factors (e.g. physical limitations, limited family involvement, uncooperative behaviour), (2) caregivers' factors (e.g. lack of knowledge on the part of caregivers, incompetent caregivers and insufficient comprehensive management in RACFs) and (3) environmental factors (e.g. less involvement from government, difficulty in accessing dental clinics, refusal of dentists to manage patients with complex medical conditions, and poor public awareness). Conclusions: The study concluded with the need for the establishment of an OH training program for RACF staff and a protocol for daily and professional OH care for the residents of private RACFs in Malaysia. [ABSTRACT FROM AUTHOR]

Social services for the elderly encompass a wide range of care and support provided with the aim of improving quality of life and promoting independence among older citizens. These services are offered both in home settings and institutional facilities such as nursing homes and day care centers. Social services include various aspects of healthcare, social care, psychological support, and assistance with daily activities, all aimed at enhancing the well-being and welfare of elderly individuals. These services are provided by social workers, medical professionals, occupational therapists, volunteers, and other qualified individuals. Social services for the elderly play a vital role in society by providing support and care for the most vulnerable members of the community, helping them live with dignity and independence. This article provides a brief theoretical overview of the social services available for the elderly in the Republic of Bulgaria, outlining their foundation, key principles, and implementation activities. The authors reference regulatory texts, which provide an excellent insight into social work with this specific target group. The provision of social services for the elderly is guided by principles of dignity, independence, and inclusivity, aiming to empower older individuals to live fulfilling lives within their communities. Through home-based care, day care centers, and residential facilities, these services cater to the unique needs of elderly individuals, promoting physical and mental health, social engagement, and overall well-being. Furthermore, the development and enhancement of social services for the elderly requires continuous attention and innovation to adapt to evolving demographic trends and emerging needs. By investing in research, training, and resource allocation, policymakers and stakeholders can ensure that social services remain responsive, effective, and inclusive for elderly populations in Bulgaria and beyond. [ABSTRACT FROM AUTHOR]

Using three waves of the China Health and Retirement Longitudinal Study, this paper examines whether financial transfers from adult children to elderly parents affect the latter's mental health. Both OLS and instrumental variable (IV) estimates show that financial transfers significantly attenuate depressive symptoms of elderly individuals, with a much larger size of the IV estimates. We also examine the income and cultural channels through which intergenerational transfers work and further discuss the explanatory powers of these two channels through a decomposition analysis. The results suggest the cultural channel accounts for a larger proportion of the financial transfer effect. This means that the unique beneficial impact of intergenerational financial transfers on the mental health of older adults cannot be fully substituted in the foreseeable future. [ABSTRACT FROM AUTHOR]

Introduction: Pharmacological treatment of unresectable hepatocellular carcinoma (uHCC) includes sorafenib and lenvatinib, a tyrosine kinase inhibitor, which are linked to low serum levels of carnitine and reduced skeletal muscle volume. Nowadays, atezolizumab plus bevacizumab (Atezo/Bev) combination therapy is recommended as the first-line treatment for patients with uHCC. However, the association with decreased muscle mass or cardiac function is unknown. Therefore, this study aimed to evaluate the effects of Atezo/Bev on skeletal muscle volume and cardiac function in patients with uHCC. Methods: This retrospective study included 55 adult Japanese patients with chronic liver diseases and uHCC treated with Atezo/Bev. Patients were divided into three groups according to age: middle, preold, and old. Serum levels of carnitine and cardiac function were measured before and after 3 weeks of treatment. The psoas muscle index (PMI) was measured before and after 6 weeks of treatment. Results: After treatment, the global longitudinal strain was significantly lower in the old group, whereas the PMI and ejection fraction were significantly lower in the preold and old groups. However, no significant difference in serum levels of total carnitine and those fractions with treatment in each group was found. Cardiac function decreased in the preold and old groups. Conclusion: When treating patients with uHCC by Atezo/Bev, caution should be taken in preold and old patients because they are vulnerable to decreased skeletal muscle mass and deterioration of cardiac function. Strength training and regular monitoring of cardiac function are encouraged in these groups. [ABSTRACT FROM AUTHOR]

Some studies have identified influencing factors of COVID-19 illness in elderly, such as underlying diseases, but research on the effect of nutritional status is still lacking. This study retrospectively examined the influence of nutritional status on the outcome of elderly COVID-19 inpatients. A retrospective analysis of the clinical data of 4241 COVID-19 patients who were admitted to a third-class hospital of Nanchang between November 1, 2022 and January 31, 2023 was conducted. Nutritional status was assessed using the prognostic nutritional index (PNI) and controlling nutritional status score (CONUT). The influence of nutritional status on the outcome of COVID-19 patients was determined through multivariate adjustment analysis, restrictive cubic spline, and receiver operating characteristic curve (ROC). Compared with mild/no malnutrition, severe malnutrition substantially increased the critical outcome of COVID-19. A linear relationship was observed between the odds ratio (OR) and PNI and CONUT (P > 0.05). The area under the ROC curve indicated that PNI was the better predictor. The optimal cutoff value of PNI was 38.04 (95%CI: 0.797 ~ 0.836, AUC = 0.817), with a sensitivity of 70.7% and a specificity of 79.6%. The critical illness of elderly COVID-19 patients shows a linear relationship with malnutrition at admission. The use of PNI to assess the prognosis of COVID-19 eldeely patients is reliable, highlighting the importance for doctors to closely pay attention to the nutritional status of COVID-19 patients. Focusing on nutritional status in clinical practice can effectively reduce the critical illness of elderly COVID-19 patients. [ABSTRACT FROM AUTHOR]

Objective To analyze the impact of nighttime sleep duration on depressive symptoms in the lifestyle habits of elderly people with multiple comorbidities in China. Methods Using the fifth round of the China Health and Retirement Longitudinal Study project, the depression mood of elderly people with multiple comorbidities was evaluated based on the Center for Disease Control Depression Rating Scale (CSE-D-10). Nighttime sleep was divided into five levels:<6 h, 6 to <7 h, 7 to <8 h, 8 to <9 h, and ≥9 h. Multivariate logistic regression analysis was conducted to investigate the influencing factors of depression in elderly people with multiple comorbidities. Random forest model was used to analyze the importance of nighttime sleep in the risk of depression in elderly people with multiple comorbidities. Restrictive cubic spline curves were used to further explore the dose-response relationship between nighttime sleep duration and the risk of depression. Results A total of 1 249 elderly individuals with multiple comorbidities were included, aged (68.51±5.91) years. Multivariate logistic regression analysis showed that the risk of depression in elderly individuals with multiple comorbidities who slept at night for 6 to <7 hours (OR=0.447 (95%CI: 0.309-0.646)), 7 to <8 hours (OR=0.550 (95%CI: 0.351-0.862)), and 8 to <9 hours (OR=0.498 (95%CI: 0.323-0.768)) was relatively lower compared to those who slept for less than 6 hours. Discomfort caused by pain, ADL, life satisfaction, and stroke are the influencing factors for depression in elderly people with multiple comorbidities (P<0.05). The results of the random forest model show that the importance score of nighttime sleep on depression symptoms is relatively high. The results of the restricted cubic spline curve indicate a non-linear relationship between nighttime sleep and the risk of depression symptoms. The risk of depression symptoms decreases with 6-8 hours of nighttime sleep, and increases with less than 6 hours or more than 8 hours of nighttime sleep. Conclusion Nighttime sleep has an impact on the occurrence of depression in elderly people with multiple comorbidities. It is recommended that elderly people maintain 6-8 hours of nighttime sleep to effectively reduce the risk of depression and have certain significance for early prevention and control of depression in the elderly population. [ABSTRACT FROM AUTHOR]

Frailty is a state that is closely associated with adverse health outcomes in the aging process. The frailty index (FI), which measures frailty in terms of cumulative deficits, has been widely used for frailty assessment in elderly people, and its advantage of self-reported information collection makes it applicable to a broader group of elderly people. Our study aims to simplify the Frailty Index Assessment Scale, while maintaining its reliability and accuracy, to easily and quickly assess frailty in elderly people. In this study, participants (age ≥ 65 years) from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which had 13,339, 372 and 1214 participants in 2008, 2011, and 2014, respectively, were used. The 2008 dataset was split into 80% for training and 20% for internal validation, and the data from 2011 to 2014 as external validation. In order to obtain effective predictors, we used Lasso regression, Boruta algorithm and random forest classifier score for feature selection. We used six models for predictive model construction and evaluated the models in the validation dataset. Model performance was measured by area under the curve (AUC), accuracy and F1 score. Logistic regression was found to be the best performing and most interpretable algorithm with AUC, accuracy and F1 of 0.974, 0.932 and 0.880 for the validation dataset, respectively. The AUCs for the external independent validation dataset were 0.963 and 0.977, respectively. Subgroup analysis showed that the model had good predictive power in both males and females. The predictive power was stronger among the elderly people over 80 years old, with AUC, accuracy and F1 of 0.973,0.914, and 0.893, respectively. The model also obtained good predictive power in the case of FI measured by different indicators. The model showed good robustness in the follow-up assessment of frailty status in elderly people, with the AUC remaining above 0.95 and accuracy above 0.9 over the long-term follow-up. Using machine learning techniques, we have successfully developed a simple frailty assessment prediction model based on 10 key features to shorten the frailty assessment scale with near full-scale accuracy. A user-friendly website was created to facilitate the application of this prediction model (https://healthy-aging.shinyapps.io/Frailty_Assessment/). [ABSTRACT FROM AUTHOR]

(1) Background: Nutrition is a critical aspect of health and well-being in the elderly population, as physiological changes associated with aging can impact nutrient utilization and dietary needs. The aim of this study was the assessment of nutritional screening and associated factors among community-dwelling elderly people. (2) Methods: This study is the first phase of an intervention trial of people aged 65 years and over who received primary health services and resided in the municipality of Archanes Asterousia in Crete, Greece. Nutritional risk was assessed using the Mini Nutritional Assessment. Diet-related factors were analyzed, including health status (oral hygiene, depression, cognitive decline, impaired functioning, quality of life), social factors (educational attainment, marital status, type of work before 60 years), and lifestyle factors (smoking, drinking, diet). (3) Results: A total of 730 elderly people were evaluated (males, 31.5%), with an average age (±SD) of 76.83 (±6.68) years. MNA was found to have a statistically significant connection with assessment of oral hygiene, mental state, Charlson comorbidity, functional independence (assessed with the Barthel scale), and quality of life. The exception was geriatric depression (GDS), with which no statistically significant association was found (p > 0.05). Nutritional risk analysis revealed 379 participants (51.9%) to be adequately nourished, 205 (28.1%) to be at risk of malnutrition, and 146 (20.0%) to be malnourished. (4) Conclusions: These results clearly demonstrated the key factors that contribute to the nutritional screening of elderly people and need to be addressed by health authorities and social services. [ABSTRACT FROM AUTHOR]

Background: Influenza remains a global public health concern. Understanding the vaccination-induced response in an aging population, which is susceptible and at high risk, is essential for disease prevention and control. Here, we report findings on the safety and immunogenicity of a quadrivalent influenza split-virion vaccine (15 µg/subtype/0.5 ml/dose) (hereinafter referred to as the "quadrivalent influenza vaccine") in a population aged ≥ 60 years. Methods: This open-label, pragmatic post-marketing trial enrolled 1399 older adults to receive one dose of an approved commercially available quadrivalent influenza vaccine manufactured by Hualan Biological Bacterin Inc. (hereinafter referred to as "Hualan Bio"). Participants with contraindications for the vaccine were excluded, while poor health condition was acceptable. All vaccinated subjects experienced adverse events collection within 30 days and serious adverse events within 180 days post-vaccination. 25% subjects, selected randomly, underwent venous blood sampling pre-vaccination and 30 days after post-vaccination, for detecting antibody titers against each subtype of influenza virus by hemagglutination inhibition assay. The incidences of adverse events and antibody titers against each subtype of influenza virus were statistically analyzed using SAS 9.4. Results: No grade 3 adverse reactions occurred within 30 days post-vaccination. The incidences of overall adverse reactions, local adverse reactions and systemic adverse reactions were 3.79%, 2.86% and 1.00%, respectively. No serious adverse reactions occurred within 180 days post-vaccination. There were 350 subjects who completed venous blood sampling pre-vaccination, among whom 348 subjects completed venous blood sampling at 30 days post-vaccination for immunogenicity assessment. With respect to hemagglutination inhibition antibodies against influenza viruses H1N1, H3N2, BV and BY subtypes, at 30 days post-vaccination, the seroconversion rates were 87.64%, 75.57%, 73.28% and 78.74%, respectively; the seropositive rates were 93.97%, 98.56%, 79.31% and 95.40%, respectively; and the geometric mean increase (GMI) in post-immunization/pre-immunization antibodies was 24.80, 7.26, 10.39 and 7.39, respectively. Conclusion: One 15 µg/subtype dose of the vaccine had a good safety profile and elicited favorable immunogenicity among subjects aged ≥ 60 years. The results of this study indicate that Hualan Bio quadrivalent influenza vaccine strike balance between safety and immunogenicity, supporting unnecessity to increase dosage or inoculation frequency for further enhancing immunogenicity. Trial registration: Registered on ClinicalTrials.gov. Registration number: NCT06334510. Registered on 28/03/2024 (retrospectively registered). [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: This study evaluated the association between pelvic organ prolapse (POP), frailty, and sarcopenia to explore how POP treatment can extend healthy life expectancy in elderly women. Methods: We conducted a retrospective study of prospectively collected data, comparing women with mild POP (stages 0–II) with those with advanced POP (stages III and IV). The inclusion criteria for this study were women who visited the clinic with at least one symptom of pelvic floor dysfunction and underwent imaging studies between April 2020 and November 2022. Initially, 119 patients met these inclusion criteria. Patients were excluded if they had a history of previous POP treatment, did not respond to the study survey, or were lost to follow-up. After applying these exclusion criteria, 82 patients were included in the final analysis, of whom 65 underwent surgery (laparoscopic sacrocolpopexy, colpocleisis, tension-free vaginal tape, and native tissue repair). Assessments included POP Quantification, Kihon Checklist, Pelvic Organ Prolapse Quality of Life (P-QOL) questionnaire, International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), and Incontinence Symptom Questionnaire (ICIQ-SF). Pelvic muscles were measured using MRI or CT. Immunohistochemical analysis of estrogen receptor alpha (ERα), estrogen receptor beta , and androgen receptor was performed on surgical specimens from 43 patients. Results: The median age of participants was 75 years. Of the 82 patients, 48 (58.5%) were classified as frail or pre-frail, and 22 (26.8%) exhibited motor impairment. Advanced POP (stages 3 and 4) was seen in 41 patients. These patients had more motor function impairments (advanced, 16; mild, 6; p = 0.01). Patients with advanced POP had poorer P-QOL, ICIQ-SF (median: 9.5 vs 4, p = 0.006) and OABSS (7 vs 4, p = 0.008) scores, and smaller pubococcygeus muscle diameter (2.5 vs 3 cm, p = 0.017). Postoperatively, significant improvements were seen in P-QOL (all domains except personal relationships: p < 0.001), total IPSS (11 vs 4, p < 0.001), OABSS (6 vs 5, p = 0.033), and ICIQ-SF scores (6 vs 2, p < 0.001). ERα expression was associated with preoperative frailty (r = −0.37, p = 0.014). Conclusions: Advanced POP correlates with poorer QOL, worse urinary symptoms, and reduced pubococcygeus muscle diameter, consistent with sarcopenia, compared with mild POP. [ABSTRACT FROM AUTHOR]

Rapid digitalization and an aging population are leading to an increasingly prominent age-based digital divide among the world's elderly population. This study focuses on China, one of the most rapidly aging and digitalizing countries in the world. Employing a mixed-method approach, this research examines how elderly individuals experience the digital transformation and the associated digital divide. The findings suggest that the elderly interviewees encounter multiple barriers to learning and using digital technologies, which highlights the significant role of social support and networks in facilitating their adaptation to the digital society and lifestyle. Attitudes toward digital engagement and digitalization vary greatly among the elderly, ranging from being optimistic to feeling left behind and having multiple concerns. Our findings further reveal that the Chinese government has implemented numerous digital apps tailored to the demands of the elderly and provided training opportunities to bridge the gray digital divide. This emphasizes the responsiveness and adaptiveness of Chinese authorities in addressing pressing societal issues. However, we identify a gap in digital outreach, as most elderly interviewees have limited awareness of government digital inclusion policies and programs. This article contributes to digital divide research and offers practical implications for countries grappling with the gray digital divide. [ABSTRACT FROM AUTHOR]

Background/Objectives: Overweight and obesity are generally considered risk factors for premature mortality. However, scientific evidence suggests that among older populations, mild conditions of overweight might be associated with reduced comorbidity and longer survival. This study investigates the potential association between anthropometric parameters and survival among a cohort of nonagenarians in Sardinia, Italy. Methods: This study included 200 subjects (50% females) aged 89 and older, enrolled in 2018 in the Sardinian Blue Zone—a population known for longevity—and followed for up to six years. Anthropometric variables such as body height, weight, age, sex, comorbidity, disability, and food group intake were collected using validated questionnaires and analyzed through multivariable analysis. Results: Out of 200 participants at baseline, 28 (14%) were still alive after six years of follow-up (females 10%, males 18%). Mean survival was 3.36 years (range 0.1–6.9 years) for males and 3.03 years (range 0.2–6.6 years) for females. Participants with a Body Mass Index (BMI) in the range of 25.0–27.0 kg/m2 among males and 25.0–27.2 kg/m2 among females had longer survival compared to those who were underweight (p = 0.002) or obese (p < 0.0001). The Cox proportional hazards regression model, adjusted for age, sex, and comorbidity, revealed a statistically significant association between the BMI and survival, demonstrating an inverted–U relationship. This indicates that mild overweight was associated with a survival advantage compared to both normal weight and obesity. Conclusions: Our study indicates that mild, but not severe, overweight in nonagenarians is associated with extended lifespan. Therefore, primary care physicians and geriatricians should exercise caution before recommending calorie-restricted diets for mildly overweight elderly patients. [ABSTRACT FROM AUTHOR]

• Population ageing estimates an increase in institutionalized elderly. • This instrument allows for measuring the outcomes of care in these centres. • This study conducted cross-cultural adaptation and psychometric validation. • Is the first Spanish adaptation assesses well-being in older adults in nursing home. The objective of this study was to culturally adapt the Thriving of Older People Assessment Scale (TOPAS) instrument and evaluate its psychometric properties. The study was carried out in two phases: cross-cultural adaptation and psychometric validation and refinement through a cross-sectional study conducted between 2018 and 2020 with 314 participants. The refinement resulted in an abbreviated version of TOPAS, maintaining the original 5 factors with 16 items. Cronbach alpha was 0.91. Composite reliability (0.72–0.89) and average variance extracted (0.57–0.81), supporting discriminant validity. Maximum shared variance for the factors (0.22–0.50) and average shared variance (0.16–0.31), demonstrating discriminant validity. The abbreviated version of TOPAS showed evidence of being a valid and reliable instrument for measuring the adaptability of elderly residents in institutions. Implementing this instrument in Spanish nursing homes allows for a continuous evaluation of residents' well-being in relation to their environment, a construct not previously assessed with available scales. [ABSTRACT FROM AUTHOR]

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare condition; late adult presentation is extremely rare but, with modern diagnostics, more asymptomatic or mildly symptomatic elderly patients with ALCAPA are found. A 76-year-old woman was admitted to our emergency department in December 2021 with fever, fatigue, cognitive-motor slowing, and hyposthenia of left hemisoma. Cranium computed tomography (CT) was performed, with no signs of stroke. Contrast-enhanced CT, performed with electrocardiogram-gated technique, showed a dilatated left coronary artery arising directly from the main pulmonary artery; right coronary artery was markedly dilated and tortuous and characterized by multiple inter-coronary collateral arteries with left coronary artery, in particular in the retro-aortic side and along the cone artery. ALCAPA syndrome represents one of the most common causes of myocardial ischemia in children and, if left untreated, results in a mortality rate of up to 80–90 % within the first year of life. In our case, no previous history of cardiological disease was found that could have suggested this type of condition. This is extremely rare, especially if we consider that our patient reached the 8th decade of life. • ALCAPA syndrome can present in adulthood. • Collaterals between coronary arteries are essential to guarantee the survival into adulthood. • Cardiac computed tomography imaging is essential for the diagnosis. [ABSTRACT FROM AUTHOR]

Usability and accessibility are crucial factors for users to accept a particular technology. However, users' physical abilities and experiences using new technologies in their environment vary. These individual differences have contributed to the digital divide. This study aims to develop a conceptual framework to explore the correlations between ease of use, ageing, and the adoption of ATM interfaces. The convenience non-probability sampling method was used, with a sample size of 300 older adult participants. A five-point Likert scale questionnaire was employed as the research instrument. The data was analyzed using Spearman's analysis, descriptive analysis, validity and reliability testing, and regression analysis. The results indicate a significant association between ease of use, ageing, and the adoption of ATM interfaces. [ABSTRACT FROM AUTHOR]

Background: The objectives of this pilot study are to compare the oral health status of institutionalised and non-institutionalised elderly people in Xiamen, China, and investigate oral health-related factors among this population. Methods: One elderly residential centre and one community centre in the same district were invited to join this study. Elderly people who were aged 65 years or older and able to participate in the oral health examination and questionnaire survey were recruited. Their demographic information, oral health-related behaviours, and oral health-related quality of life were collected through a questionnaire survey. The Decayed, Missing, and Filled Teeth (DMFT) index and the Community Periodontal Index were adopted to assess caries experience and periodontal status, respectively. A chi-square test, a t-test, and a correlation analysis were conducted for data processing. Results: Forty-nine elderly people participated in this study. There is no significant difference in the demographic background between non-institutionalised and institutionalised people. The mean DMFT index in the institutionalised group is significantly higher than that in the non-institutionalised group (p = 0.004). In contrast, the non-institutionalised group showed a significantly higher prevalence of gingival bleeding (p = 0.013) and a higher prevalence of periodontal pockets (p = 0.006) than the institutionalised group. Monthly income is also associated with the caries experience in this population. Conclusions: Institutionalised elderly people showed a higher severity of dental caries but a lower prevalence of periodontal symptoms than the non-institutionalised group. It is noteworthy that the generalisation of this pilot study is limited. Future research should be conducted to comprehensively investigate the oral health status of this population. [ABSTRACT FROM AUTHOR]

The increasing population aging in China has led to a growing demand for nursing homes. The indoor thermal comfort of nursing homes affects the occupants' quality of life, building energy consumption, and carbon emissions. This study used thermal comfort questionnaires, environment tests, and physiological parameter tests to conduct a field survey of 954 occupants (including the elderly and the adult staff) in nursing homes in Shandong Province, China, and analyzed the thermal comfort of occupants. Results showed that in Shandong Province, there was a significant difference in thermal sensation between the elderly and adults under the same conditions. The neutral temperatures for the elderly and adults were 21.7 and 20.5 °C, the comfort temperature ranges were 19.4–24.0 °C and 18.6–22.5 °C, and the preferred temperatures were 23.8 and 23.1 °C, respectively. The elderly prefer higher temperatures than adults. Personal clothing insulation was significantly negatively correlated with operative temperature. Occupants' average skin temperature was significantly positively correlated with operative temperature and mean thermal sensation votes. Based on the simulation results of building energy consumption and carbon emissions, this paper proposes design strategies for nursing homes that balance thermal comfort and energy savings. [ABSTRACT FROM AUTHOR]

Advancements in digital technologies have transformed the world by providing more opportunities and possibilities. However, elderly persons have several challenges utilizing modern technology, leading to digital exclusion, which can negatively impact sustainable development. This research attempts to address the current digital exclusion by addressing the challenges older people face considering evolving digital technologies, focusing on economic, social, and environmental sustainability. Three distinct goals are pursued in this study: to perform a detailed literature review to identify gaps in the current understanding of digital exclusion among the elderly, to identify the primary factors affecting digital exclusion in the elderly, and to analyze the patterns and trends in different countries, with a focus on differentiating between High-Income Countries (HICs) and Lower Middle-Income Countries (LMICs). The research strategies used in this study involve a combination of a literature review and a quantitative analysis of the digital exclusion data from five cohorts. This study uses statistical analysis, such as PCA, chi-square test, one-way ANOVA, and two-way ANOVA, to present a complete assessment of the digital issues that older persons experience. The expected results include the identification of factors influencing the digital divide and an enhanced awareness of how digital exclusion varies among different socio-economic and cultural settings. The data used in this study were obtained from five separate cohorts over a five-year period from 2019 to 2023. These cohorts include ELSA (UK), SHARE (Austria, Germany, France, Estonia, Bulgaria, and Romania), LASI (India), MHAS (Mexico), and ELSI (Brazil). It was discovered that the digital exclusion rate differs significantly across HICs and LMICs, with the UK having the fewest (11%) and India having the most (91%) digitally excluded people. It was discovered that three primary factors, including socio-economic status, health-related issues, and age-related limitations, are causing digital exclusion among the elderly, irrespective of the income level of the country. Further analysis showed that the country type has a significant influence on the digital exclusion rates among the elderly, and age group plays an important role in digital exclusion. Additionally, significant variations were observed in the life satisfaction of digitally excluded people within HICs and LMICs. The interaction between country type and digital exclusion also showed a major influence on the health rating. This study has a broad impact since it not only contributes to what we know academically about digital exclusion but also has practical applications for communities. By investigating the barriers that prevent older people from adopting digital technologies, this study will assist in developing better policies and community activities to help them make use of the benefits of the digital era, making societies more equitable and connected. This paper provides detailed insight into intergenerational equity, which is vital for the embedding principles of sustainable development. Furthermore, it makes a strong case for digital inclusion to be part of broader efforts (and policies) for creating sustainable societies. [ABSTRACT FROM AUTHOR]

The rapid development of digital technology and its pervasiveness in everyday life requires everybody to develop the skills necessary to engage with such technology for one's mundane tasks and communication needs. The first steps towards developing these skills can be particularly challenging for older adults, who might need to fundamentally adapt their learned and long-practiced routines. Maintaining motivation in these initial steps is crucial for sustained engagement. The present study examines factors that can contribute to promote motivation in a facilitated learning session based on Self-Determination-Theory. We conducted a longitudinal qualitative study in which we examined people's motivation to engage with digital technology, based on observational data as well as interviews with 33 older adults before and immediately after participating in a facilitated learning session. To investigate sustained effects on motivation, further interviews were conducted 3 months after participation. We found that satisfying the need for relatedness by learning together with peers and receiving support from facilitators was a prerequisite for this target group to develop a sense of competence and autonomy, which can lead to sustained motivation. Long-term motivational effects could not only be explained by the immediate effects of the learning intervention, but were identified to be dependent also on individual needs and predispositions. These findings were aggregated in a typology that identifies relevant influence factors and explains the potential motivational effects for different parts of the target group. It supports learning and technology designers to adapt to the addressed user group. [ABSTRACT FROM AUTHOR]

Copyright of Ethik in der Medizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Chronic back pain in adults is often a cause of absenteeism from work, limitations in social interactions, and difficulties in performing daily activities. This study aimed to check whether the functioning of everyday activities in elderly patients after neurosurgery improved over time compared to their condition before the procedure and whether there is a connection between fitness, self-esteem, and pain intensity. This was a cross-sectional study carried out using an anonymous survey. This study included patients over 60 years of age from the neurosurgical ward. The following scales were used to assess cognitive functioning, depression, functional status: basic and instrumental activities of daily living (IADL), back pain disability (QBPDS), pain intensity, and self-esteem. The level of independence in terms of IADL and QBPDS increased, and the intensity of pain decreased. Surgery reduced pain intensity from 8 ± 0.8 to 6.1 ± 1.4 points. The level of self-esteem (RSES) remained at a low level. The passage of time after neurosurgical treatment has a beneficial effect on reducing pain intensity and increasing independence in life activities. Daily physical activity and rehabilitation are important factors supporting the return to independence. [ABSTRACT FROM AUTHOR]

Guoxin Zhang,1,&ast; Liqin Yang,2,&ast; Fang Zhao,1 Xiaoyun Zhao1 1Respiratory and Critical Care Medicine Department, Tianjin Chest Hospital, Tianjin, People’s Republic of China; 2Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiaoyun Zhao, Respiratory and Critical Care Medicine Department, Tianjin Chest Hospital, Tianjin, 300222, People’s Republic of China, Tel +86 8818 2075, Email zxydoctor@163.comObjective: To explore the characteristics of elderly patients with central sleep apnea (CSA).Methods: This retrospective study divided 123 patients with CSA into elderly and non-elderly groups, and compared them in terms of demographic characteristics (age, BMI, etc), underlying diseases (hypertension, coronary heart disease, and cardiac arrhythmias, etc). and polysomnography parameters. Multiple linear regression analysis was conducted to investigate the potential risk factors of central apnea index (CAI).Results: Compared with the non-elderly group, patients in the elderly group had lower body mass index, a higher proportion of comorbidities of coronary heart disease, arrhythmias, and diabetes, lower apnea-hypopnea index (AHI), obstructive apnea index (OAI) and oxygen desaturation index (ODI). CAI of the elderly group showed a trend higher than that of the non-elderly group with no statistical difference. However, the ratio of CAI to AHI in the elderly group was significantly higher (0.264 vs 0.154, P=0.003). True CSA was less prevalent than companion CSA in both groups. The results of multiple regression analysis indicated CAI was independently associated with age (β=0.256, P=0.005), OAI (β=− 0.543, P< 0.001), MAI (β=− 0.267, P=0.005), ODI (β=0.538, P< 0.001), heart failure (β=0.300, P< 0.001).Conclusion: CSA typically coexists with other types of sleep apnea. Elderly CSA patients have characteristics such as a lower BMI, and a milder decrease in blood oxygen saturation, along with higher prevalence of arrhythmia and coronary heart disease. Age may be a potential risk factor for CSA.Keywords: elderly people, sleep apnea, heart failure, oxygen desaturation index

Background The elderly population of the world is projected to continue to increase. There is an anticipated increase in the utilisation of health-care services due to chronic diseases and other impairments with resulting pressure on health systems. Aims This study aimed to determine the health-care utilisation of elderly patients with chronic medical diseases attending a secondary health facility in southwestern Nigeria. Materials and Methods A structured questionnaire was administered to gather the data from 300 older people by random sampling during follow-up care for those receiving care for more than 6 months following a diagnosis of a chronic disease. SPSS software version 26 was used for the data analysis, and the results are presented in the tables. The Chi-square test was applied to test for associations between the categorical variables, and a logistic regression model was used to rule out confounders, while P < 0.05 was considered to indicate statistical significance. Results The mean age (standard deviation) in the study was 68.26 (7.01) years and 58.3% were females. The average number of routine clinic visits was 4.12, whereas 20.7% had emergency room visits, 6.6% were referred to specialists, and 33.3% had laboratory investigations. After logistic regression was applied, living conditions, average monthly income, and treatment for diabetes were found to be significant factors for the utilisation of care. Conclusion The provision of rich social support, improving economic empowerment, and performing screening and timely management for diabetes will improve preventive care while reducing the use of expensive and specialised care for older people.

OBJECTIVES: The objective of this study was to evaluate the frequency of long QT syndrome (LQTS) in the electrocardiographic tracing of elderly people and the concomitant use of drugs that can aggravate this condition. METHODS: This is a crosssectional, observational study of elderly patients in outpatient services at Hospital Santa Casa de Misericórdia de Vitória, over a six-month period. RESULTS: A total of 163 patients with 75 ± 8 (60–94) years of age, 60.7% (n = 99) of whom were female, participated in the study. Of the total number of patients, 33.1% (n = 54) were regularly taking at least one pharmaceutical that increased the risk of QTc prolongation; 34 patients (20.9%) had prolonged QTc and 15 (9,2%) had at-risk QTc. Of these patients with at-risk QTc, 4 (23.4%) were using at least 1 1 pharmaceutical that increases the risk of QT prolongation (p = 0.07). CONCLUSION: In this sample, a high frequency of LQTS was observed, as well as the use of pharmaceuticals that potentially cause LQTS and arrhythmias.

Abstract Some studies have identified influencing factors of COVID-19 illness in elderly, such as underlying diseases, but research on the effect of nutritional status is still lacking. This study retrospectively examined the influence of nutritional status on the outcome of elderly COVID-19 inpatients. A retrospective analysis of the clinical data of 4241 COVID-19 patients who were admitted to a third-class hospital of Nanchang between November 1, 2022 and January 31, 2023 was conducted. Nutritional status was assessed using the prognostic nutritional index (PNI) and controlling nutritional status score (CONUT). The influence of nutritional status on the outcome of COVID-19 patients was determined through multivariate adjustment analysis, restrictive cubic spline, and receiver operating characteristic curve (ROC). Compared with mild/no malnutrition, severe malnutrition substantially increased the critical outcome of COVID-19. A linear relationship was observed between the odds ratio (OR) and PNI and CONUT (P > 0.05). The area under the ROC curve indicated that PNI was the better predictor. The optimal cutoff value of PNI was 38.04 (95%CI: 0.797 ~ 0.836, AUC = 0.817), with a sensitivity of 70.7% and a specificity of 79.6%. The critical illness of elderly COVID-19 patients shows a linear relationship with malnutrition at admission. The use of PNI to assess the prognosis of COVID-19 eldeely patients is reliable, highlighting the importance for doctors to closely pay attention to the nutritional status of COVID-19 patients. Focusing on nutritional status in clinical practice can effectively reduce the critical illness of elderly COVID-19 patients.

Objectives. The study aimed to determine the effectiveness of implementating projects for the introduction of adaptive sports games on the psycho-emotional state of different population groups in Poland and Ukraine. Materials and methods. A total of 341 individuals were involved in the study: 117 children (8-12 years old), 118 middle-aged people (35-60 years old), and 116 elderly people (60 years and older). The participants of the study were divided into two groups: those who took part in the Polish project “Academic Center of Sports and Health Games for Activation of People with Special Needs” (56 children, 65 adults, 73 elderly people), and those who took part in the Polish-Ukrainian project, which was conducted directly in Ukraine, “Ukrainian Center of Occupational Therapy through Adaptive Games” (61 children, 53 adults, 44 elderly people). All study participants were engaged in adaptive games (Cornhole, Jacollo, Elastik, Kulbutto, Boccia, Paka laka) for the first time. At the beginning and end of the event on adaptive games, a survey of participants was conducted. To determine the psycho-emotional state of children, the WAM method (well-being, activity, mood) was used, and the features of adults’ psychological state were assessed using the standard test AWAMW (anxiety, working capacity, activity, mood, well-being). Results. The analysis of the obtained study results revealed positive changes in the psycho-emotional state of different population groups in Poland and Ukraine under the influence of adaptive sports games. Furthermore, the adult population, including the elderly of Poland and Ukraine, demonstrated decreased anxiety levels and a significant enhancement in activity, mood and well-being due to engaging in adaptive sports games. Conclusions. This study emphasizes the potential of adaptive sports games to improve the mental health of different population groups. The findings also indicate the effectiveness of implementating projects for the introduction of adaptive games on the psycho-emotional state of different population groups both in Poland and Ukraine.

Abstract Frailty is a state that is closely associated with adverse health outcomes in the aging process. The frailty index (FI), which measures frailty in terms of cumulative deficits, has been widely used for frailty assessment in elderly people, and its advantage of self-reported information collection makes it applicable to a broader group of elderly people. Our study aims to simplify the Frailty Index Assessment Scale, while maintaining its reliability and accuracy, to easily and quickly assess frailty in elderly people. In this study, participants (age ≥ 65 years) from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which had 13,339, 372 and 1214 participants in 2008, 2011, and 2014, respectively, were used. The 2008 dataset was split into 80% for training and 20% for internal validation, and the data from 2011 to 2014 as external validation. In order to obtain effective predictors, we used Lasso regression, Boruta algorithm and random forest classifier score for feature selection. We used six models for predictive model construction and evaluated the models in the validation dataset. Model performance was measured by area under the curve (AUC), accuracy and F1 score. Logistic regression was found to be the best performing and most interpretable algorithm with AUC, accuracy and F1 of 0.974, 0.932 and 0.880 for the validation dataset, respectively. The AUCs for the external independent validation dataset were 0.963 and 0.977, respectively. Subgroup analysis showed that the model had good predictive power in both males and females. The predictive power was stronger among the elderly people over 80 years old, with AUC, accuracy and F1 of 0.973,0.914, and 0.893, respectively. The model also obtained good predictive power in the case of FI measured by different indicators. The model showed good robustness in the follow-up assessment of frailty status in elderly people, with the AUC remaining above 0.95 and accuracy above 0.9 over the long-term follow-up. Using machine learning techniques, we have successfully developed a simple frailty assessment prediction model based on 10 key features to shorten the frailty assessment scale with near full-scale accuracy. A user-friendly website was created to facilitate the application of this prediction model ( https://healthy-aging.shinyapps.io/Frailty_Assessment/ ).

Summary: Background & aims: The ageing process contributes to the declining function of the smell and taste senses, which consequently modifies the eating behaviour of the elderly and adversely impacts their nutritional status and health. The aim of this research was to determine the decline or loss of olfactory perception and salty taste sensitivity, as well as the nutritional status, body composition, and appetite of elderly people, and to find out if associations between impaired sense of smell and salty taste impact the nutritional status of elderly people in nursing homes. Methods: The study included 123 elderly nursing home residents, mean age of 80.7 ± 5.8 y, 76.4% females, and 70 adults with a mean age of 42.8 ± 8.6 y, 90% females. Olfactory function was determined by The European Test of Olfactory Capabilities, parameters measured were detection and identification and based on the results proportion of subjects with hyposmia was calculated. Gustatory function was expressed by salty taste detection and recognition thresholds and measured by the rapid detection threshold method adapted for the elderly. Based on the recognition threshold, three groups of sensitivity to salty taste were developed. Sensory decline was established in comparison to the young adult group of participants. Nutritional status was determined by several methods: anthropometric measures of body mass index and body composition, the Mini Nutritional Assessment, and the Simplified Nutritional Appetite Questionnaire. Results: The study determined a significant decline in the olfactory function of elderly subjects, with 65% of participants having hyposmia and declining salty taste perception (22.1 ± 14.9 mM) (P < 0.0001). The results showed increased body mass with a trend towards obesity, with a mean body mass index of 29.6 ± 5.2 kg/m2, of which 8.1% of subjects were undernourished and 41.5% were overweight or obese. A mini-nutritional assessment showed that most respondents (75.6%) have a normal nutritional status (13.3 ± 0.9), about a fifth of respondents (22.8%) were at risk of malnutrition (9.8 ± 1.0), and 1.6% of respondents were malnourished (5.5 ± 2.1). Nutritional appetite analysis determined that 32.5% of elderly people were at a significant risk of at least 5% weight loss within six months. A significant impact of chemosensory function on measured parameters of nutritional status was only found in olfactory perception between individuals with normal status and those with malnutrition. Conclusions: Elderly people, residents of nursing homes, have a declining chemosensory function, but there is also a high percentage of overweight and obese individuals. A potential weak effect of olfactory function was found on nutritional status; however, nutritional status seems to be independent of a decline in salty taste perception. Although this research did not show a significant impact of chemosensory function on nutritional status, further research is needed to clarify the causal effect for this group of elderly people.

ObjectiveTo monitor and analyze the epidemiological characteristics of viral pathogens among elderly patients with acute upper respiratory tract infections in Shaoxing City from 2020 to 2023, to guide prevention and treatment.MethodsNasopharyngeal swab samples were collected from elderly patients at the Infectious Disease Outpatient Department of Shaoxing infectious disease surveillance sentinel hospital for acute upper respiratory tract infections between January 2020 and December 2023. The multiple nucleic acid detection method was used to detect the influenza A virus (Flu A), influenza B virus (Flu B), respiratory syncytial virus (RSV), human rhinovirus (HRV), adenoviruses (ADV), and Mycoplasma pneumoniae (MP). Epidemiological analysis was conducted on the six pathogens mentioned above. χ2 test was used for statistical analysis.ResultsOf the 3 670 nasopharyngeal swab samples collected from the elderly patients with acute upper respiratory tract infections aged 60-89,2 330 were positive, with a detection rate of 63.49%. Among these, 2 293 were single pathogen infections, including 1 255 Flu A, 356 Flu B, 63 ADV, 76 RSV, 363 HRV, and 180 MP cases, with positive rates of 34.20%, 9.70%, 1.72%, 2.07%, 9.89%, and 4.90%, respectively. A total of 37 cases were mixed infections with two or more pathogens, with a positive detection rate of 1.01%. The rate of severe cases was significantly higher in patients with mixed infections compared to single pathogen infections (χ2=24.468, P

The last decade has witnessed the exponential growth of Virtual Reality (VR) as an affordable, powerful, and disruptive technology in a variety of fields, among which, notably, are healthcare and well-being. Particularly for the elderly people, VR has already been demonstrated, by a plethora of experiments and studies, as extremely effective in supporting a multitude of therapeutical interventions, from neuromotor and cognitive recovery and maintenance to mental health and wellbeing and socialisation. However, due to the novelty of the technology, the scientific and industry communities are missing both an overarching perspective covering all these intervention areas, as well as a common understanding of the results, challenges, limitations, possibilities, specificity, best practices, design approaches, and integration with traditional therapies, for each area. This hinders the development of commercial-level solutions and widespread adoption in clinical guidelines. This paper aims to cover these gaps, by identifying and analysing five of the most relevant VR intervention areas for elderlies, providing an overview and examples, for each area, and concluding with cross-area perspectives and pinpoints of the most needed research topics, to support the widespread adoption of VR-based interventions for elderly healthcare and wellbeing.

To review the scope of interventional studies on horticultural therapy (HT) applied to elderly people in nursing institutions to support the efficient implementation of HT among this target group.

Abstract Background Influenza remains a global public health concern. Understanding the vaccination-induced response in an aging population, which is susceptible and at high risk, is essential for disease prevention and control. Here, we report findings on the safety and immunogenicity of a quadrivalent influenza split-virion vaccine (15 µg/subtype/0.5 ml/dose) (hereinafter referred to as the “quadrivalent influenza vaccine”) in a population aged ≥ 60 years. Methods This open-label, pragmatic post-marketing trial enrolled 1399 older adults to receive one dose of an approved commercially available quadrivalent influenza vaccine manufactured by Hualan Biological Bacterin Inc. (hereinafter referred to as “Hualan Bio”). Participants with contraindications for the vaccine were excluded, while poor health condition was acceptable. All vaccinated subjects experienced adverse events collection within 30 days and serious adverse events within 180 days post-vaccination. 25% subjects, selected randomly, underwent venous blood sampling pre-vaccination and 30 days after post-vaccination, for detecting antibody titers against each subtype of influenza virus by hemagglutination inhibition assay. The incidences of adverse events and antibody titers against each subtype of influenza virus were statistically analyzed using SAS 9.4. Results No grade 3 adverse reactions occurred within 30 days post-vaccination. The incidences of overall adverse reactions, local adverse reactions and systemic adverse reactions were 3.79%, 2.86% and 1.00%, respectively. No serious adverse reactions occurred within 180 days post-vaccination. There were 350 subjects who completed venous blood sampling pre-vaccination, among whom 348 subjects completed venous blood sampling at 30 days post-vaccination for immunogenicity assessment. With respect to hemagglutination inhibition antibodies against influenza viruses H1N1, H3N2, BV and BY subtypes, at 30 days post-vaccination, the seroconversion rates were 87.64%, 75.57%, 73.28% and 78.74%, respectively; the seropositive rates were 93.97%, 98.56%, 79.31% and 95.40%, respectively; and the geometric mean increase (GMI) in post-immunization/pre-immunization antibodies was 24.80, 7.26, 10.39 and 7.39, respectively. Conclusion One 15 µg/subtype dose of the vaccine had a good safety profile and elicited favorable immunogenicity among subjects aged ≥ 60 years. The results of this study indicate that Hualan Bio quadrivalent influenza vaccine strike balance between safety and immunogenicity, supporting unnecessity to increase dosage or inoculation frequency for further enhancing immunogenicity. Trial registration Registered on ClinicalTrials.gov. Registration number: NCT06334510. Registered on 28/03/2024 (retrospectively registered).

Summary: Background & Aims: Nowadays, research on extraskeletal effects of Vitamin D on human health is growing This study aimed to Serum vitamin D levels measurement in older adults with and without dyslipidemia: a comparison using baseline data from the Birjand Longitudinal Aging Study (BLAS). Methods: This cross-sectional study included 420 elderly people over 60 years old divided into in two equal groups with and without dyslipidemia. Data were drawn from the first phase of Birjand Longitudinal Aging Study (BLAS). A questionnaire containing demographic information and Mini nutritional assessment (MNA) was completed through interviews. Body mass index (BMI) was calculated, and after 12 hours of fasting, 5 mL of venous blood was taken to measure the serum levels of 25(OH) D and lipid profile. Results: Among the elderly, 37.3%, 33.3% and 29.3% had sufficient, insufficient and deficient Vitamin D levels, respectively. A significant difference in triglyceride levels was observed between the two groups of elderly individuals with insufficient and deficient Vitamin D levels (P=0.011). Multiple logistic regression showed that an increase in the atherogenic index of plasma (AIP) (P = 0.005, OR = 18.46) and BMI (P = 0.001, OR = 18.46) significantly increased the odds of dyslipidemia. Conclusions: Vitamin D deficiency or insufficient was common among the elderly and was associated with elevated serum triglyceride levels.

We conducted a community-based cohort study to predict the 3-year occurrence of chronic kidney disease (CKD) among population aged ≥60 years. Participants were selected from two communities through randomized cluster sampling in Jiading District of Shanghai, China. The two communities were randomly divided into a development cohort (n = 12012) and a validation cohort (n = 6248) with a 3-year follow-up. Logistic regression analysis was used to determine the independent predictors. A nomogram was established to predict the occurrence of CKD within 3 years. The area under the curve (AUC), the calibration curve and decision curve analysis (DCA) curve were used to evaluate the model. At baseline, participants in development cohort and validation cohort were with the mean age of 68.24 ± 5.87 and 67.68 ± 5.26 years old, respectively. During 3 years, 1516 (12.6%) and 544 (8.9%) new cases developed CKD in the development and validation cohorts, respectively. Nine variables (age, systolic blood pressure, body mass index, exercise, previous hypertension, triglycerides, fasting plasma glucose, glycated hemoglobin and serum creatinine) were included in the prediction model. The AUC value was 0.742 [95% confidence interval (CI), 0.728–0.756] in the development cohort and 0.881(95%CI, 0.867–0.895) in the validation cohort, respectively. The calibration curves and DCA curves demonstrate an effective predictive model. Our nomogram model is a simple, reasonable and reliable tool for predicting the risk of 3-year CKD in community-dwelling elderly people, which is helpful for timely intervention and reducing the incidence of CKD. [ABSTRACT FROM AUTHOR]

Few studies have evaluated the association between circulating levels of 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)2D), and the endocrine disruptor bisphenol A (BPA), with risk of cardiovascular (CV) disease in elderly individuals. This was a cross-sectional study in a subgroup of elderly people from the InCHIANTI Biobank in Italy. We examined the association between circulating serum vitamin D metabolites, 1,25(OH)2D, 25(OH)D, and the endocrine disrupting agent BPA, with an arbitrary CV risk score and the European Society of Cardiology-based 10-year CV risk (SCORE2/SCORE2-OP) using univariate and multiple regression. In 299 individuals, blood samples were tested for serum values of 25(OH)D, 1,25(OH)2D and urinary BPA levels. One hundred eighty individuals (60.2%) were deficient (< 20 ng/ml) in 25(OH)D. Levels of 25(OH)D and 1,25(OH)2D were negatively correlated with CV risk score (p < 0.0001 for both) as well as SCORE2/SCORE2-OP (p < 0.0001 for both) while BPA levels were positively correlated with both CV risk scores (p < 0.0001 for both). In a logistic regression model, male gender (odds ratio; OR: 2.1, 95% CI:1.1–3.8, p = 0.022), obesity (OR:2.8, 95% CI:1.2–6.5, p = 0.016) and BPA levels ≥ 110 ng/dl (OR:20.9, 95% CI:9.4–46.8, p < 0.0001) were associated with deficient levels of 25(OH)D. 1,25(OH)2D levels < 41 ng/dl and 25(OH)D levels < 20 ng/ml were associated with CV risk score ≥ 3 (OR: 4.16, 95% CI: 2.32–7.4, p < 0.0001 and OR: 1.86, 95% CI: 1.02–3.39, p = 0.044) respectively and 1,25(OH)2D levels < 41 ng/dl were associated with SCORE2/SCORE2-OP of ≥ 20% (OR:2.98, 95% CI: 1.7–5.2, p = 0.0001). In this cross-sectional analysis, BPA exposure was associated with significantly reduced levels of vitamin D that in turn were significantly associated with increased CV risk. [ABSTRACT FROM AUTHOR]

Abstract Background Several studies have demonstrated that older adults with type 2 diabetes mellitus (T2DM) have a higher risk of falls compared to those without T2DM, which may lead to disability and a lower quality of life. While, limited prospective studies have quantified the associations in southern China. We conducted a longitudinal cohort study to quantify the associations between T2DM and falls and investigate the risk factors of falls among community-dwelling elderly people in Guangzhou, China. Methods The population-based study included 8800 residents aged 65 and over in 11 counties of Guangzhou at baseline in 2020 and then prospectively followed up through 2022. Of 6169 participants had complete follow-up and were included in the present study. A fall event was identified by self-reported. The Cox regression was applied to quantify the associations between T2DM and falls, and hazard ratios (HRs) were calculated to the factors associated with falls among participants. Results The median follow-up time for participants was 2.42 years. During the follow-up period, the incidence of falls among all participants was 21.96%. After adjusting for covariates in Cox regression models, T2DM remained a significant risk factor for falls, with HR of 1.781 (95% CI: 1.600-1.983) in the unadjusted covariates model and 1.757 (1.577–1.957) in the adjusted covariates model. Female (1.286, 1.136–1.457), older age (≥ 80: 1.448, 1.214–1.729), single marital status (1.239, 1.039–1.477), lower education level (primary school and below: 1.619, 1.004–1.361), hypertension (1.149, 1.026–1.286) and stroke (1.619, 1.176–2.228) were associated with a higher risk of falls, whereas everyday physical exercise (0.793, 0.686–0.918) was associated with a lower risk of falls. Conclusion Falls are common, with risks between T2DM and falls quantified and several factors investigated in the longitudinal cohort study among community-dwelling elderly people in Guangzhou, China. Targeted action on the risk factors may reduce the burden of falls in elderly people with T2DM in the future.

Abstract Background Globally, the demographic shift towards an aging population leads to significant challenges in healthcare systems, specifically due to an increasing incidence of multimorbidity resulting in polypharmacy among the elderly. Simultaneously, sleep disorders are a common complaint for elderly people. A treatment with pharmacological therapies often leads to side effects causing a high potential for dependency. Within this context, there is a high need to explore non-pharmacological therapeutic approaches. The purpose of this study is to evaluate the effectiveness of acupuncture and music therapy, both individually and combined as a multimodal therapy, in the treatment of sleep disorders in individuals aged 70 years and older. Methods We conduct a confirmatory randomized controlled trial using a two-factorial study design. A total of n = 100 elderly people receive evidence-based standard care information for age-related sleep disorders. Beyond that, patients are randomly assigned into four groups of n = 25 each to receive acupuncture, receptive music therapy with a monochord, multimodal therapy with both acupuncture and music therapy, or no further therapy. The study’s primary outcome measurement is the improvement in sleep quality as assessed by the Pittsburgh Sleep Quality Index (PSQI) (global score), at the end of intervention. Additionally, depression scores (Geriatric Depression Scale), health-related quality of life (Short-Form-Health Survey-12), neurovegetative activity measured via heart rate variability, and safety data are collected as secondary outcomes. Using a mixed-methods approach, a qualitative process evaluation will be conducted to complement the quantitative data. Discussion The study is ongoing and the last patient in is expected to be enrolled in April 2024. The results can provide valuable insights into the effectiveness of non-pharmacological interventions for sleep disorders among the elderly, contributing to a more personalized and holistic approach in geriatric healthcare. Trial registration German Clinical Trials Register (DRKS00031886).

Elderly people avoid eating red meat and dried meat product due to its texture and stiffness; they deprive them of rich sources of nutrients. In addition, food-related diseases are exponentially increasing due to using synthetic additives in food products. Therefore, this research aimed to develop semi-dried goat meat jerky considering geriatric preferences by using natural tenderizers and nitrate. Four treatments were formulated negative control (NC [synthetic nitrite without tenderizers]), positive control (PC [Swiss chard without tenderizers]), T1 (Swiss chard with pineapple powder), and T2 (Swiss chard with pineapple and tomato powder). T1 and T2 had higher processing yield, and rehydration capacity compared with NC and PC. The fat content of T1 and T2 was lower than the control groups. Moisture was significantly higher in T1, NC, and T2 than in PC (p < 0.05). T2 showed the lowest water activity (0.87), lowest shear force (4.82 kgf), and lowest total plate count (TPC). The lowest pH and thiobarbituric acid reactive substances (TBARS) were observed in T1 and T2. T1 showed the lowest lightness and the maximum redness (p < 0.05) while PC showed the lowest yellowness. During the storage period, moisture and pH decreased, and TPC and TBARS significantly increased whereas water activity is stable regardless of the treatment. The results of the myofibrillar fragmentation index (MFI) and sodium dodecyl sulfate-polyacrylamide gel revealed that T1 and T2 more effectively converted protein to polypeptides. In addition, tenderizers positively affected thrombogenicity, atherogenicity, and hypocholesterolemic/hypercholesterolemic indices. T2 observed the highest overall sensory acceptance by reducing goaty flavor. Overall, jerky treated with tenderizers is easily chewable and digestible for the elderly due to its tenderness and essential fatty acids that would be senior-friendly food.

Abstract Vitamin D deficiency (VDD) is associated with increased risk of type 2 diabetes mellitus (T2DM) and insulin resistance (IR). We aimed to investigate the association between the triglyceride-glucose (TyG) index that represents IR and VDD in elderly patients with T2DM. We enrolled 572 elderly participants with T2DM in this study. TyG index was calculated as ln [fasting triglyceride (TG, mg/dL) × fasting blood glucose (mg/dL)/2]. Serum 25-hydroxyvitamin D [25(OH)D] level below 50 nmol/L was defined as VDD. The association between the TyG index and the VDD risk was evaluated by multivariate logistic regression analysis. We observed a significant decreased 25(OH)D level with the increase of the TyG index in elderly diabetic patients, and a negative correlation between the TyG index and 25(OH)D level. The participants in the highest TyG quartile had a 2.40-fold higher risk of VDD than those in the lowest TyG index quartile [OR 2.40; 95% CI 1.47–3.92; P

Background: The objectives of this pilot study are to compare the oral health status of institutionalised and non-institutionalised elderly people in Xiamen, China, and investigate oral health-related factors among this population. Methods: One elderly residential centre and one community centre in the same district were invited to join this study. Elderly people who were aged 65 years or older and able to participate in the oral health examination and questionnaire survey were recruited. Their demographic information, oral health-related behaviours, and oral health-related quality of life were collected through a questionnaire survey. The Decayed, Missing, and Filled Teeth (DMFT) index and the Community Periodontal Index were adopted to assess caries experience and periodontal status, respectively. A chi-square test, a t-test, and a correlation analysis were conducted for data processing. Results: Forty-nine elderly people participated in this study. There is no significant difference in the demographic background between non-institutionalised and institutionalised people. The mean DMFT index in the institutionalised group is significantly higher than that in the non-institutionalised group (p = 0.004). In contrast, the non-institutionalised group showed a significantly higher prevalence of gingival bleeding (p = 0.013) and a higher prevalence of periodontal pockets (p = 0.006) than the institutionalised group. Monthly income is also associated with the caries experience in this population. Conclusions: Institutionalised elderly people showed a higher severity of dental caries but a lower prevalence of periodontal symptoms than the non-institutionalised group. It is noteworthy that the generalisation of this pilot study is limited. Future research should be conducted to comprehensively investigate the oral health status of this population.

This study is devoted to analyzing the extent to which older people are involved in aid exchange with their social environment. We also analyze how providing (receiving) financial and instrumental assistance to children (from children) is correlated with the subjective well-being of older people. The study is based on data from the National Survey of the Older Generation (NISP) 2021. Data analysis was carried out using multiple regressions. Respondents aged 60 years and up were selected for descriptive analysis. The sample consisted of 1782 respondents. For regression analysis we selected elderly people aged 60 years and up who had children (1536 respondents). Our analysis shows that almost one in 5 elderly people receives assistance from other people with household chores or document related work. About 20% of the elderly take it upon themselves to provide practical assistance to other people. Approximately 25% of older people provided financial assistance or gave expensive gifts to other people. The elderly themselves were somewhat less likely to be recipients of financial assistance or expensive gifts from other people. The bulk of the aid exchange takes place between older people and their children. It was found that receiving instrumental assistance from children had a negative association with life satisfaction among the elderly. At the same time, receiving financial assistance from children was positively associated with the level of life satisfaction among older people. Furthermore, receiving financial assistance from children is important primarily for mothers, as well as elderly parents who have health problems. The relationship between life satisfaction and the provision of financial or instrumental assistance to children did not reach statistical significance.

Abstract Background A prevalent challenge in neuropsychological assessment, particularly when utilizing instruments designed for controlled laboratory environments, is that the outcomes may not correspond to an individual’s real-life status. Accordingly, assessments of visuospatial working memory (VSWM) conducted in such settings might fail to capture certain facets of this function, as it operates in real life. On the other hand, entirely ecological assessments may risk compromising internal validity. This study aimed to develop an intermediate mode of assessment that measures VSWM in older adults by employing a setting, a task, and a response format that aligns closely with both laboratory and ecological assessments. Furthermore, a preliminary investigation was carried out to study the variations in spatial cognition among different demographic groups. Methods In a two-session study, 77 healthy older adults, eight patients with mild cognitive impairment (MCI), and seven patients with Alzheimer’s disease (AD) were recruited to complete the wayfinding questionnaire (WQ), the Corsi block-tapping task (CBTT), and the Spatial Memory Table (SMT). The SMT is a novel instrument developed specifically for this study, aiming to provide a more accurate measure of VSWM performance in older adults’ everyday life. Test-retest and split-half reliabilities, as well as the face, content, concurrent, convergent, and known-groups validities, were analyzed to investigate the psychometric properties of the SMT. Results The analyses were mainly centered on studying the psychometric properties of the SMT. Test-retest reliability (r = .753, p

Background and Study Aim. The World Health Organization has recognized that insufficient physical activity is a serious public health problem. A large number of studies are devoted to improving livelihoods and increasing life expectancy of the population through the formation of guidelines for a healthy lifestyle. Regular physical activity is one of the most important components of maintaining health and healthy aging. Many European countries already have well-developed social programs to support physical activity among older people. This includes the organization of sporting events, financial support for clubs for seniors, as well as infrastructure that promotes an active lifestyle (active parks, walking and cycling paths, a sufficient number of swimming pools, etc.). Therefore, the purpose of the study was to identify the effectiveness of complex motor training on the morphofunctional and psycho-emotional state of elderly people from different countries of Europe and Asia. Material and Methods. The study involved 240 (30 men and 30 women each from Poland, Kazakhstan, Kyrgyzstan and Ukraine) elderly people (the average age of the study participants was 68.24±3.01 years). The groups were homogeneous in age, gender, social status, interests, level of physical fitness, functionality and motivation. The study participants followed a developed physical activity program for older people. Classes lasted a year, 3 times a week, lasting 60 minutes each. The program included theoretical and practical parts. Theoretical material concerned the benefits of physical activity, motor mode and dosage of exercise for older people. The practical part included the most common types of physical education and health activities among older people (swimming, Nordic walking, health tourism). The study involved assessing the morphofunctional state of older people by determining body mass indexes, functional changes and Robinsonal, as well as the Skibinsky and Rufier tests, and the assessment of well-being, activity and mood (WAM) was carried out using a questionnaire Results. During the study, we measured morphofunctional indicators and determined the psycho-emotional state of elderly people from Poland, Kazakhstan, Kyrgyzstan and Ukraine, who were engaged in a developed program using various types of physical activity, namely: swimming, Nordic walking, health tourism Conclusions. The results obtained indicate the effectiveness of using a comprehensive physical activity program among older women and men from different countries of Europe and Asia. All participants showed positive changes in all indicators. Minor changes over the course of a year of training according to the developed program in the indicators of the morphofunctional and psycho-emotional state of elderly people from Poland indicate that a healthy lifestyle is being popularized in the European Union country and conditions are being created for regular physical activity of the population, including older people.

Wen Jing Sun,1,2 Yu Jin Liu1 1Department of Nursing Welfare, Changchun Humanities and Sciences College, Changchun, Jilin, 130117, People’s Republic of China; 2Department of Counseling Psychology, Dongshin University, Naju-si, Jeollanam, Republic of KoreaCorrespondence: Wen Jing Sun, Department of Nursing Welfare, Changchun Humanities and Sciences College, No. 1488, Boshuo Road, Jingyue National High-Tech Industrial Development Zone, Changchun City, Jilin, 130117, People’s Republic of China, Tel +8615904405614, Email 179403066@qq.comPurpose: The aim of this study was to investigate the sleep quality as well as the influence of social support on the sleep quality of elderly people in nursing homes in northeast China, and analyze the chain-mediating role of psychological adjustment and coping styles in social support and sleep quality, thereby to provide a scientific basis for the development of effective intervention measures in this direction.Patients and Methods: This study was conducted during January–March 2023 and adopted a cluster sampling method to select 5 elderly care institutions from across the Jilin, Liaoning, and Heilongjiang provinces in Northeast China. A questionnaire survey was conducted using the Self-mate General Situation Questionnaire, Pittsburgh Sleep Quality Index, Nursing Home Adjustment Scale for the Elderly, Social Support Rating Scale, and Medical Coping Modes Questionnaire. Statistical analysis methods, including ANOVA, logistic multi-factor regression, and Pearson’s correlation were employed in SPSS 26.0, while Amos 26.0 was used to build a structural equation model to analyze the interaction path and the mediating role between the variables.Results: The sleep quality of elderly individuals in elderly care institutions was relatively low 8.43(3.456). Social support of elderly individuals in elderly care institutions affected their sleep quality through i) both psychological adjustment and face-to-face coping style (B = 0.493, P < 0.001, 95% CI = 0.050– 0.122) and ii) both psychological adjustment and avoidance coping style (B = − 0.302, P < 0.001, 95% CI = − 0.119 to − 0.048). Psychological adjustment, confrontation coping, and avoidance coping played a mediating role in the sequential relationship between social support and the sleep quality of elderly individuals in elderly care institutions.Conclusion: Psychological adjustment and coping styles have a chain-mediating effect between social support and sleep quality of the elderly in northeast China’s elderly care institutions.Keywords: elderly care institutions, elderly people, sleep quality, psychological adjustment, social support, nursing

Artificial Intelligence (AI) and robotic technologies have been applied in healthcare sectors for many years. Along with the ageing trend rising globally, the use of AI and intelligent service robots in home care for elderly or disabled bedridden people has generated considerable attention. A robot that can physically assist care-workers and the elderly or disabled bedridden people in daily activities may help ease care-workers’ burden and help older people live independently for longer with higher quality of life. This survey gives a comprehensive overview in the latest AI and robotic technologies applications in elderly care, providing a detailed analysis on the current products in the market, and discusses the problems and the future trend in this topic.

Background: Several studies have demonstrated that older adults with type 2 diabetes mellitus (T2DM) have a higher risk of falls compared to those without T2DM, which may lead to disability and a lower quality of life. While, limited prospective studies have quantified the associations in southern China. We conducted a longitudinal cohort study to quantify the associations between T2DM and falls and investigate the risk factors of falls among community-dwelling elderly people in Guangzhou, China. Methods: The population-based study included 8800 residents aged 65 and over in 11 counties of Guangzhou at baseline in 2020 and then prospectively followed up through 2022. Of 6169 participants had complete follow-up and were included in the present study. A fall event was identified by self-reported. The Cox regression was applied to quantify the associations between T2DM and falls, and hazard ratios (HRs) were calculated to the factors associated with falls among participants. Results: The median follow-up time for participants was 2.42 years. During the follow-up period, the incidence of falls among all participants was 21.96%. After adjusting for covariates in Cox regression models, T2DM remained a significant risk factor for falls, with HR of 1.781 (95% CI: 1.600-1.983) in the unadjusted covariates model and 1.757 (1.577–1.957) in the adjusted covariates model. Female (1.286, 1.136–1.457), older age (≥ 80: 1.448, 1.214–1.729), single marital status (1.239, 1.039–1.477), lower education level (primary school and below: 1.619, 1.004–1.361), hypertension (1.149, 1.026–1.286) and stroke (1.619, 1.176–2.228) were associated with a higher risk of falls, whereas everyday physical exercise (0.793, 0.686–0.918) was associated with a lower risk of falls. Conclusion: Falls are common, with risks between T2DM and falls quantified and several factors investigated in the longitudinal cohort study among community-dwelling elderly people in Guangzhou, China. Targeted action on the risk factors may reduce the burden of falls in elderly people with T2DM in the future. [ABSTRACT FROM AUTHOR]

Objective To show that the current situation and influencing factors of loneliness in the elderly under different chronic diseases, and propose targeted solutions. Methods This survey adopted the convenience sampling method, selecting elderly people from five communities in Harbin for physical examinations and distributing questionnaires to conduct statistical analysis of the survey data. Results The loneliness scores of the elderly without chronic diseases, single chronic diseases and multiple chronic diseases were (42. 83 ± 9. 08), (44. 46 ± 9. 14) and (46. 21 ± 8. 66), respectively. Age, education level, marital status, per capita monthly income of households, residence status, social support, and death anxiety were the common factors affecting loneliness in the three types of elderly (P <0. 05). In terms of elderly people with multiple chronic diseases, those who worked as civil servants (95% Cf: - 11. 515 - 3. 602), employees of enterprises/institutions (95% CI: - 6. 117 - 2. 443), and farmers (95% CI: - 7. 485 - 0. 909) before retirement had lower levels of loneliness (P < 0. 05). Conclusion Elderly people with chronic diseases have a higher sense of loneliness and need to pay more attention to their mental health. It is necessary to reduce the level of loneliness by improving the level of social support, reducing death anxiety, improving social welfare and medical policies, reducing the financial burden, and improving family relations. [ABSTRACT FROM AUTHOR]

Objective To investigate the current distribution status and multimorbidity patterns of chronic diseases among the elderly population in China, and provide reference for formulating chronic disease management measures. Methods Based on the CHARLS database in 2020, a total of 10, 635 elderly individuals aged 60 and above were included to investigate the prevalence trends of 15 common chronic diseases. The actual expected ratio (0/E) and agglomerative hierarchical clustering analysis were employed to explore the patterns of comorbidity. Results The prevalence of chronic diseases among elderly people in China was 86. 39%, with hypertension (48.49%), arthritis (43. 12%), and stomach diseases (excluding tumors or cancer) (32.06%) being the main causes. The multimorbidity rate was 66.30%, and the top three coexisting diseases were n hypertension + arthritis,r (22. 28%, 0/E = 1. 07),r hypertension + dyslipidemia" (20. 25%, 0/E = 1. 44), and,r stomach disease + arthritis" (18. 65%, 0/E = 1. 35). The top three coexisting diseases were,r hypertension + arthritis + dyslipidemia,r (10. 31%, 0/E = 1. 70),r hypertension + dyslipidemia + heart disease" (9.70%, 0/E = 2. 65), and,r arthritis + stomach disease + hypertension" (9.49%, 0/E = 1.42). Agglomeration hierarchical cluster analysis was divided into clusters according to malignant tumors, emotional and mental diseases,r stroke + memory related diseases + Parkinson, s disease", H dyslipidemia + diabetes + hypertension + heart disease", H chronic lung disease + asthma + stomach disease + arthritis + liver disease + kidney disease,r, forming a multimorbidity model. Condusion The overall prevalence of chronic diseases among elderly people in China is increasing year by year, and there is a clustering trend. [ABSTRACT FROM AUTHOR]

(1) Background: Currently, numerous qualitative research studies on food and its influence on health are being conducted. In qualitative research, data are obtained by analyzing participants' responses. However, silence during conversation has been little studied. The aim of this study was to interpret the silences in the narratives of elderly people living alone about the potential risks of not keeping a healthy diet. (2) Methods: This is a descriptive and interpretative observational study under the qualitative research paradigm following a phenomenological and ethnographic perspective. The study was developed in two phases with people over 65 years old. In the first phase, from June 2021 to January 2022, 90 interviews, 12 life history analyses, 58 food diaries and 51 free listings (cultural domain technique) were conducted. In the second phase, from March to June 2022, 3 participatory workshops and 24 pile sorts (cultural domain technique) were conducted, as well as 3 focus groups. Only data from participants over 65 years old living alone are analyzed in this paper. The ATLAS-ti (Version 22) qualitative analysis software was used for coding and data analysis. (3) Results: The results show that elderly people living alone would sometimes remain silent during the various conversations conducted within the research. This silence reflects their desire to downplay the risks to their health from not eating well due to their unwanted loneliness. The people participating in our research had chronic health problems, financial insecurity and emotional problems. (4) Conclusions: We concluded that elderly people living alone are unable to maintain a healthy diet because they downplay their risk of malnutrition. This mindset is caused by their loneliness and bolstered by a situation of learned helplessness and social injustice. [ABSTRACT FROM AUTHOR]

Background: This longitudinal study aimed to evaluate whether prior engagement in a physical exercise program correlated with enhanced perceptions of quality-of-life components among older adults during the COVID-19 lockdown period. Methods: The cohort comprised elderly individuals (aged ≥ 65 years) who had previously partaken in a 12-week randomized controlled trial investigating the effects of a mixed aerobic–anaerobic, moderate-intensity exercise program. Participants' health-related quality of life was assessed using the Short Form Health Survey-12 item (SF-12) at the beginning of the initial trial and, again, one year later during the COVID-19 lockdown. In the exercise group, 44 participants were included, while the control group consisted of 49 participants, with computer-based, double-blind randomization conducted in Cagliari, Italy. The differences in scores for each SF-12 item between the two groups from T0 to T1 were compared using one-way ANOVA with Bonferroni corrections. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 27. Results: No statistically significant differences were observed on average by age (exercise group vs. control group 72.20 ± 4.78 vs. 72.91 ± 4.77; F = 0.513, p = 0.476). A decrease from T0 to T1 towards a better score on the SF-12 was observed in the exercise group compared to the control group in item 1 (F = 67.463, p < 0.0001); in item 5 (F = 4.319, p = 0.041); item 8 (F = 4.269, p = 0.041); item 9 (F = 10.761, p = 0.001); item 10 (F = 170.433, p < 0.001); and item 11 (F = 4.075, p = 0.046). Conclusions: The results suggest that participation in a moderate physical exercise program one year prior may have equipped older adults with better coping mechanisms to navigate the stress and isolation imposed by the COVID-19 lockdown, as reflected by their enhanced scores on quality-of-life components pertaining to mental well-being. Exercise may confer a protective effect against the adverse psychological impacts of stressful events like the pandemic, even among older adults with chronic conditions. This study underscores the potential benefits of exercise interventions for promoting quality of life and preventing mood disorders in the elderly population. [ABSTRACT FROM AUTHOR]