Geriatrics最新文献

{"title":"Screening for Pre-Frailty Using Phase Angle Derived from Bioelectrical Impedance Analysis in Community-Dwelling Older Adults.","authors":"Masayuki Hoshi, Tomoka Ogata, Maaya Chiguchi, Ayane Nakamaru, Tatsuya Nakanowatari, Akihiko Asao, Natsumi Kimura, Maki Ogasawara, Yuko Horikoshi, Rie Sakuraba-Hirata, Akiomi Yoshihisa, Hiroshi Hayashi, Toshimasa Sone, Yoshitaka Shiba","doi":"10.3390/geriatrics11020049","DOIUrl":"https://doi.org/10.3390/geriatrics11020049","url":null,"abstract":"<p><p><b>Background/Objectives:</b> To evaluate the utility of phase angle (PhA) derived from bioelectrical impedance analysis as a screening indicator for pre-frailty in community-dwelling older adults. <b>Methods:</b> This cross-sectional study included 171 participants (36 men and 135 women) in Japan in 2023. PhA at 50 kHz was measured using bioelectrical impedance analysis and evaluated as a potential screening indicator for pre-frailty. Assessments included body composition, physical function tests (maximum walking speed, Timed Up and Go (TUG), grip strength, knee extension strength, and one-leg stance time with eyes open), cognitive function (MoCA-J), and the Motor Fitness Scale (MFS), a questionnaire assessing physical function, along with the Kihon Checklist (KCL). Frailty status was defined using KCL scores (4-7: pre-frailty; ≥8: frailty), and participants were classified into robust and pre-frail/frail groups. <b>Results:</b> PhA was significantly correlated with physical function measures, including grip strength (r = 0.54, <i>p</i> < 0.01), MFS (r = 0.36, <i>p</i> < 0.01), maximum walking speed (r = 0.20, <i>p</i> < 0.05), knee extension strength (r = 0.16, <i>p</i> < 0.05), and TUG (r = -0.17, <i>p</i> < 0.05). In women, logistic regression analysis showed that PhA was independently associated with pre-frailty (age-adjusted odds ratio: 2.38; 95% CI: 1.08-5.23; <i>p</i> < 0.05). ROC analysis yielded an area under the curve of 0.65 (95% CI: 0.56-0.74), indicating modest discriminative ability. Age-adjusted cutoff values of PhA were 4.19° and 4.74°, corresponding to points prioritizing sensitivity and specificity, respectively. <b>Conclusions:</b> PhA is associated with physical function and may serve as a simple, non-invasive indicator for identifying pre-frailty in community settings. However, given its modest discriminative ability, PhA alone may not be sufficient as a standalone screening tool and should be used in combination with other clinical indicators for clinical application.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriateness and Outcome of a Statin Deprescription Intervention in Hospitalized Frail Older Adults: A Retrospective Study.","authors":"Giuseppe Castiglia, Nicola Veronese, Gianluca Gortan Cappellari, Erica Voinovich, Paolo De Colle, Michela Zanetti","doi":"10.3390/geriatrics11020050","DOIUrl":"https://doi.org/10.3390/geriatrics11020050","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The appropriateness of statin treatment in frail older adults is controversial because of insufficient evidence on its efficacy. The aim of this study was to assess the appropriateness of statin prescription at admission and discharge from hospital and the association of deprescription with one-year mortality in a cohort of older patients. <b>Methods</b>: Monocentric retrospective observational study of older (≥65 year) adults admitted to a Geriatric Unit. Patients underwent comprehensive geriatric assessment and prevalence of statin prescription at admission and discharge was recorded. Appropriateness of prescription was determined using the Medication Appropriateness Index (MAI), multidimensional frailty using the Multidimensional Prognostic Index (MPI). Mortality at 12 months was recorded. <b>Results</b>: Among 528 consecutively admitted patients, 112 (mean age 83.6 ± 6.2 years) were treated with statins and were included in the study. In addition, 87.5% of patients showed at least one inappropriate criterion for statin prescription at admission and 91.7% at discharge. Deprescription occurred in 46.4% of patients at discharge, particularly in those who were older and in MPI high mortality risk class. Mean MAI did not differ between admission and discharge in the whole study cohort, but it decreased in patients at highest mortality risk (from 3.2 ± 4.0 to 2.0 ± 1.2). In multivariate analysis, compared with patients who continued statins after discharge, those who were deprescribed did not show increased one-year mortality risk. <b>Conclusions</b>: Inappropriate statin prescription is common at hospital admission in frail older patients and deprescription does not affect one-year residual survival. Therefore, rigorous assessment of mortality risk and medication appropriateness should be encouraged.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Intraoperative Prone Versus Supine Positioning on Postoperative Delirium.","authors":"Theresa E Hering, Maria Wittmann, Vera Guttenthaler, Robert Pflugmacher, Rudolf Hering","doi":"10.3390/geriatrics11020048","DOIUrl":"https://doi.org/10.3390/geriatrics11020048","url":null,"abstract":"<p><p><b>Background</b>: Postoperative delirium (POD) is a common complication in geriatric patients. This prospective cohort study evaluated a possible influence of intraoperative positioning on the occurrence of POD, as intraoperative prone positioning could affect cerebral perfusion. <b>Methods:</b> We included 760 patients of ≥60 years scheduled for elective surgery in prone or supine positions. The primary outcome was POD incidence on the first five days after surgery, assessed via 3D-Confusion Assessment Method (3-D CAM) or Confusion Assessment Method for Intensive Care Units (CAM-ICU). Preoperative assessments included the American Society of Anesthesiologists (ASA) and New York Heart Association (NYHA) classifications as well as short screenings for the cognitive (modified Montreal Cognitive Assessment (MoCA)) and self-care status of the patient. Secondary outcomes were length of hospital stay (LOS) and mortality rates. <b>Results</b>: Postoperative delirium rates were similar in prone and supine patients (7.6% vs. 5.5%; <i>p</i> = 0.31), and logistic regression analysis revealed no association of intraoperative prone positioning with POD (odds ratio 1.42 (95% CI 0.68-2.92; <i>p</i> = 0.342)). The overall incidence of POD was 6.1% and was associated with older age (81.5 (CI 76.2-84.8) vs. 72.0 (CI 67.0-79.0) years; <i>p</i> < 0.01), higher ASA and NHYA classifications, lower preoperative modified MoCA, reduced independence in self-care (<i>p</i> < 0.001, respectively), and longer incision-to-suture times (107.0 (CI 73.0-173.0) vs. 85.0 (CI 60.0-130.0) minutes; <i>p</i> < 0.01). Postoperative delirium resulted in longer LOS (14.5 (CI 9.0-27.0) vs. 7.0 (CI 4.0-9.0) days; <i>p</i> < 0.001), and increased mortality (13.0% vs. 1.7%; <i>p</i> < 0.001). <b>Conclusions:</b> Intraoperative prone positioning was not associated with POD in patients aged 60 years or older (OR 1.42; CI 0.68-2.92; <i>p</i> < 0.340), and LOS and mortality as secondary outcome parameters were also similar in patients after prone and supine surgery. Future studies assessing additional and possible confounding factors and intraoperative systemic and regional hemodynamics and oxygenation are needed to verify this result and to evaluate cerebral hypoperfusion as a possible mechanism of POD.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Constipation in Older Adults: Pathophysiology, Clinical Impact, and Management Strategies.","authors":"Shima Mimura, Asahiro Morishita, Atsuo Kitaoka, Kota Sasaki, Hiroki Tai, Rie Yano, Mai Nakahara, Kyoko Oura, Tomoko Tadokoro, Koji Fujita, Joji Tani, Takashi Himoto, Hideki Kobara","doi":"10.3390/geriatrics11020047","DOIUrl":"https://doi.org/10.3390/geriatrics11020047","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Constipation is a common gastrointestinal problem in older adults and is associated with reduced quality of life, functional decline, frailty, and an increased risk of delirium and cognitive impairment. Its pathogenesis is multifactorial, involving age-related changes in gastrointestinal motility, neural regulation, comorbidities, and polypharmacy. However, this condition has traditionally been regarded as a localized gastrointestinal disorder, which may not fully reflect its systemic clinical significance in older populations. While prior narrative reviews have described multifactorial contributors to constipation, none have formally applied a geriatric syndrome framework to integrate these dimensions. This review proposes a three-criterion operational definition-multifactorial pathogenesis, association with functional decline and frailty, and contribution to adverse systemic outcomes-to characterize constipation in older adults as a \"systemic geriatric syndrome,\" and evaluates available evidence against each criterion. <b>Methods:</b> A narrative literature search was conducted using PubMed to identify relevant studies published between 1 January 2023, and 31 December 2025. MeSH terms included \"Constipation\" [Major Topic] and \"Aged\" [MeSH Terms]. Eligible articles included English-language original studies, systematic reviews, and clinical or epidemiological studies involving individuals aged ≥65 years. <b>Results:</b> Diagnosis in older adults is often complicated by secondary causes, including medications and neurological disorders, as well as atypical symptom presentations in individuals with cognitive impairment. Key pathophysiological mechanisms include reductions in interstitial cells of Cajal, impaired smooth muscle contractility, dysfunction of the enteric and autonomic nervous systems, and gut microbiota dysbiosis, which may promote chronic low-grade inflammation. Major contributing factors include physical inactivity, sarcopenia, dehydration, inappropriate defecation posture, and polypharmacy, particularly opioids and anticholinergic agents. Importantly, these factors interact through the brain-gut-microbiota axis, contributing not only to gastrointestinal dysfunction but also to systemic outcomes such as frailty, cognitive decline, and increased healthcare burden, thereby supporting a multidimensional disease framework. <b>Conclusions:</b> The available evidence collectively supports the plausibility of framing constipation in older adults as a systemic geriatric syndrome, though formal validation of this classification requires further longitudinal and mechanistic research. Comprehensive and individualized management strategies, extending beyond simple laxative use, are essential to reduce complications and preserve functional health in aging populations. Further studies are required to validate this framework.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Utility of Gait Speed Indices for Identifying Sarcopenia in Older Adults with Type 2 Diabetes.","authors":"Kensaku Kashima, Rie Nishimura, Hisashi Sugano, Shimpei Fujimoto","doi":"10.3390/geriatrics11020046","DOIUrl":"https://doi.org/10.3390/geriatrics11020046","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This study aimed to compare the diagnostic performance of usual gait speed (UGS), maximal gait speed (MGS), and gait speed reserve (GSR) for identifying sarcopenia in older adults with type 2 diabetes (T2D), and to examine whether combining gait indices improves diagnostic performance. <b>Methods</b>: This cross-sectional study included 117 older adults with T2D hospitalized for glycemic control. UGS and MGS were measured in the central 10-m section of a 16-m course, which included 3-m acceleration and deceleration zones on either side. GSR was calculated as the difference between MGS and UGS. Sarcopenia was diagnosed according to the AWGS 2025 criteria. Multivariable logistic regression was used to examine the associations between each gait index and sarcopenia. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis, and the usefulness of a combined criterion based on UGS and GSR was also assessed. <b>Results</b>: Sarcopenia was identified in 32 participants (27.4%). UGS, MGS, and GSR were each associated with sarcopenia independently of clinical factors. UGS showed the highest sensitivity (90.6%), suggesting its potential usefulness as a screening measure, whereas GSR showed the highest specificity (83.5%), suggesting its potential usefulness in reducing false positives when identifying sarcopenia. In the ROC analysis of the three gait-related indices, the area under the curve (AUC) for MGS was the highest (0.79), but it was not significantly different from the AUC for UGS. The combined criterion of UGS < 1.07 m/s and GSR < 0.21 m/s improved specificity and yielded a high positive likelihood ratio (PLR = 6.5). <b>Conclusions</b>: UGS, MGS, and GSR each exhibit distinct diagnostic characteristics for sarcopenia. UGS may be useful for screening, whereas GSR may help improve specificity. In particular, combining UGS and GSR may provide complementary diagnostic information for identifying sarcopenia in older adults with T2D.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Physical Performance and Muscle Thickness Between Older Women with High and Low Fall Risk: A Bayesian Approach.","authors":"Claudineia Matos de Araujo, Rafael Pereira, Joanderson Felipe Soares Silva, Cláudia Thais Pereira Pinto, Alinne Alves Oliveira, Luciano Magno de Almeida Faria, Ludmila Schettino, Mikhail Santos Cerqueira, Marcos Henrique Fernandes","doi":"10.3390/geriatrics11020044","DOIUrl":"https://doi.org/10.3390/geriatrics11020044","url":null,"abstract":"<p><p><b>Objective:</b> The present study aimed to compare muscle thickness and physical performance in different functional tests predicting falls between older adults with low and high fall risk. <b>Methods:</b> Seventy-one community-dwelling older women (74.5 ± 8.5 years old) volunteered for this study. The Berg Balance Scale (BBS) was used to stratify the sample as low and high risk for fall (BBS cutoff = ≥ 50 points). The performance in the Timed Up and Go Test (TUGT), 5-repetition sit-to-stand test (5xSST), 3 m walk test (3mWT), and 3 m backward walk test (3mBWT) was assessed. The elbow flexor and knee extensor muscle thickness were obtained by ultrasound (USD). A linear mixed model analysis was used to determine between-group differences in functional mobility and muscle thickness, and Bayesian analysis was applied to check the probability to replicate the same results (i.e., the magnitude of the evidence). <b>Results:</b> The low-fall-risk group exhibited significantly better performance only in 3mWT (mean difference = 0.84 s [95% CI: 0.40 to 1.29 s]; <i>p</i> = 0.001) and 3mBWT (mean difference = 1.54 s [95% CI: 0.21 to 2.85 s]; <i>p</i> = 0.024). The Bayes Factor (BF) for performance on the 3mWT and 3mBWT shows that the low-fall-risk group has a probability of 98.7% (BF10 = 77.3) and 99.7% (BF10 = 368), respectively, of performing better than the high-fall-risk group. <b>Conclusions:</b> Based on inferential and Bayesian analysis, the performance in 3mWT and that in 3mBWT were classified as very strong to excellent instruments, respectively, for differentiating older women with high fall risk.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Testing in Spanish Older Adults: A Scoping Review.","authors":"Lucía Sáez-González, Luis A Martínez, Gema Blázquez-Abellán, José Antonio Carbajal de Lara, Rosa M Martinez-Garcia, Lucía Castro-Vázquez","doi":"10.3390/geriatrics11020045","DOIUrl":"https://doi.org/10.3390/geriatrics11020045","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Cognitive impairment is a major concern in aging populations. Early detection through validated neuropsychological tests is essential for dementia risk stratification and preventive interventions. This scoping review (PRISMA-ScR, 2013-2023, registration protocol: 10.17605/OSF.IO/8NHJF) evaluated cognitive testing trends in aging research and identified the most frequently used neuropsychological screening tests in Spanish populations. <b>Methods:</b> Searches in PubMed and Web of Science (March 2024) yielded 730 records; 156 were reviewed in full, and 15 met inclusion criteria for Spanish adults ≥65 years. <b>Results:</b> The Mini-Mental State Examination was the most-used test, followed by verbal fluency and Trail Making Test. No test covered all six DSM-5 cognitive domains, and social cognition was never assessed in any of the studies. The Montreal Cognitive Assessment was underused despite its superior sensitivity. <b>Conclusions:</b> Findings support developing a tailored, multidomain battery combining global and domain-specific tests. Social cognition assessments should be included to ensure a complete cognitive domain coverage.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Interplay Between Core Stability, Pulmonary Function, and Cardiorespiratory Fitness in Older Adults: A Randomized Controlled Trial of an 8-Week Mat Pilates Intervention.","authors":"Bulin Jirapongsatorn, Decha Chinaksorn, Kanapot Pengked, Wannaporn Tongtako, Timothy Mickleborough","doi":"10.3390/geriatrics11020043","DOIUrl":"https://doi.org/10.3390/geriatrics11020043","url":null,"abstract":"<p><p><b>Background:</b> Identifying multimodal interventions to counteract age-related physiological decline is a critical public health priority. This study investigated the impact of an 8-week Mat Pilates intervention (MPT) on the interplay between core stability, pulmonary function, and cardiorespiratory fitness in older adults, specifically examining the mechanistic link between trunk stabilization and respiratory mechanics. <b>Methods:</b> Twenty older adults (18 females, 2 males; age 60-77 years) were randomized (stratified by sex, age, and baseline stability) into an MPT group (<i>n</i> = 10; 60-min sessions, 3×/week) or a control group (CON, <i>n</i> = 10). Primary outcomes included core stability (plank test), functional flexibility (sit-and-reach; back-scratch), pulmonary function (FVC, FEV₁, FEV₁/FVC, FEF_25-75%, MVV), and cardiorespiratory fitness (6-min walk test; 6MWT). <b>Results:</b> Post-intervention, the MPT group demonstrated significant improvements in core stability, flexibility, and all pulmonary variables (FVC, FEV₁, FEF_25-75%, MVV) compared to the CON group (<i>p</i> < 0.001). A significant reduction in body weight was also observed (<i>p</i> < 0.001). Notably, MPT participants achieved superior 6MWT distances and reduced perceived exertion (<i>p</i> = 0.006). Correlation analysis revealed strong positive associations between core stability gains and pulmonary function (r = 0.892, <i>p</i> < 0.01), supporting the mechanistic link between trunk stabilization, enhanced ventilatory mechanics, and functional aerobic capacity. <b>Conclusions:</b> Mat Pilates is a potent intervention for older adults, facilitating a physiological synergy where core strengthening optimizes pulmonary function and cardiorespiratory endurance. These findings suggest MPT is a comprehensive modality for maintaining musculoskeletal and respiratory health, proving superior to habitual activity alone in promoting functional independence.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Inflammation and Muscle Mass on Prognosis in Hospitalized Patients with Suspected Dysphagia at a Tertiary Hospital.","authors":"Mario Alfredo Saavedra-Vásquez, Juan José López-Gómez, Beatriz Ramos-Bachiller, Olatz Izaola-Jauregui, Eva López-Andrés, Isabel Pérez-Mellén, Sara Cuenca-Becerril, María Jesús Villameriel-Galván, Jaime González-Gutiérrez, Lucia Estevez-Asensio, María Ángeles Castro-Lozano, Daniel Antonio De Luis-Román","doi":"10.3390/geriatrics11020042","DOIUrl":"https://doi.org/10.3390/geriatrics11020042","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Dysphagia is associated with an increased risk of in-hospital complications and adverse outcomes. Prognosis in frail hospitalized populations is influenced by systemic inflammation and reduced muscle mass. Calf circumference (CC) and an estimated appendicular skeletal muscle index (ASMI) can serve as indirect measures of muscle mass, while inflammatory status may be captured by C-reactive protein (CRP), albumin, and the CRP/albumin ratio. This study aimed to evaluate the prognostic value of indirect biomarkers of inflammation and muscle mass to predict prognosis in hospitalized patients with suspected dysphagia. <b>Methods</b>: A retrospective observational study was conducted at a tertiary hospital and included patients admitted with suspected dysphagia between April 2015 and October 2024. On admission, demographic variables (sex and age), anthropometry (weight, height, and CC), EAT-10 (Eating Assessment Tool) score, and serum laboratory parameters (CRP, albumin) were collected. ASMI was estimated using the formula -10.427 + (CC × 0.768) - (age × 0.029) + (sex × 7.523)/(height²). Outcomes were in-hospital mortality and length of hospital stay. Comparisons were performed between survivors and non-survivors, and multivariable models adjusted for age and sex were used to identify independent associations with mortality. <b>Results</b>: A total of 4241 patients were included (51.2% women), with a median age of 85 (Interquartile range [IQR] 14) years and a mean EAT-10 score of 15.98 (SD 7.79). In-hospital mortality was 18.13% (<i>n</i> = 769). Non-survivors were older (86 [IQR 11] vs. 84 [IQR 14] years; <i>p</i> < 0.001) and displayed a more inflammatory profile, with higher CRP (78.1 [IQR 114.28] vs. 44 [IQR 96] mg/L) and CRP/albumin ratio (27.27 [IQR 43.04] vs. 13.64 [IQR 31.77]; <i>p</i> < 0.001), and lower albumin (3 [IQR 0.8] vs. 3.3 [IQR 0.8] g/dL; <i>p</i> < 0.001). They also had lower muscle mass, with reduced CC and lower ASMI in both sexes. In multivariable analysis, a higher CRP/albumin ratio was independently associated with increased odds of death (OR 1.011; 95% CI 1.008-1.014; <i>p</i> < 0.001), whereas a higher ASMI was protective (OR 0.885; 95% CI 0.801-0.978; <i>p</i> = 0.017). Higher CRP/albumin ratios were also associated with longer hospital stays and lower albumin, CC, and ASMI values. <b>Conclusions</b>: In hospitalized patients with suspected dysphagia, systemic inflammation and lower muscle mass were associated with worse clinical outcomes. The CRP/albumin ratio independently predicted higher in-hospital mortality and prolonged hospitalization, whereas higher estimated ASMI was associated with lower mortality risk, supporting the combined prognostic value of inflammatory and muscle-mass indicators in this population.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between the Color Kanji Pick-Out Test App Performance and Cognitive Frailty as a Potential Early Screening Marker for Cognitive Decline.","authors":"Akio Goda, Hideki Nakano, Yuki Kikuchi, Tsuyoshi Katsurasako, Kohei Mori, Atsuko Kubo, Kayoko Nonaka, Kohei Iwamoto, Nozomi Mitsumaru, Takaki Shimura, Shin Murata","doi":"10.3390/geriatrics11020041","DOIUrl":"https://doi.org/10.3390/geriatrics11020041","url":null,"abstract":"<p><p><b>Background/Objective</b>: Cognitive frailty, the coexistence of physical frailty and cognitive impairment, is a potentially reversible and high-risk state for dementia. This study examined the association between Color Kanji Pick-out Test (CKPT) app performance and cognitive frailty independent of Mini-Mental State Examination (MMSE) scores in community-dwelling older women. <b>Methods</b>: In this cross-sectional study, the participants were 102 community-dwelling older women without dementia and with MMSE scores ≥ 27 (73.6 ± 6.0 years). Reversible cognitive frailty was defined as subjective cognitive decline (≥1 point in the cognitive domain of the Kihon Checklist) plus physical frailty or prefrailty, according to the Japanese Cardiovascular Health Study (J-CHS) criteria. Firth's penalized logistic regression using three prespecified models, adjusted for age and education, was used to examine the independent associations between CKPT app performance and MMSE scores with reversible cognitive frailty. <b>Results</b>: Fourteen participants (13.7%) met the criteria for cognitive frailty. In separate models, higher CKPT app and MMSE scores were significantly associated with lower odds of cognitive frailty (CKPT: odds ratio [OR] 0.470, <i>p</i> = 0.019; MMSE: OR 0.548, <i>p</i> = 0.020). In a multivariable model including both measures, the CKPT app (OR 0.499, <i>p</i> = 0.031) and MMSE scores (OR 0.553, <i>p</i> = 0.031) remained independently associated with cognitive frailty, and this model had the lowest Akaike information criterion. <b>Conclusions</b>: The CKPT app performance was independently associated with cognitive frailty beyond global cognition. The CKPT app may detect subtle executive and attentional vulnerabilities not captured by the MMSE, supporting practical, objective, early screening and risk stratification of cognitive frailty.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}