Geriatrics最新文献

{"title":"Nonlinear Association of Length of Stay with In-Hospital Mortality in Alzheimer's Disease Hospitalizations: Admission-Only vs. Inpatient-Course Prediction Using Explainable Machine Learning.","authors":"Tursun Alkam, Ebrahim Tarshizi, Andrew H Van Benschoten","doi":"10.3390/geriatrics11050136","DOIUrl":"10.3390/geriatrics11050136","url":null,"abstract":"<p><p><b>Background:</b> Hospitalizations among patients with Alzheimer's disease (AD) carry substantial mortality risk, but length of stay (LOS) is time-dependent and may reflect heterogeneous inpatient trajectories. We examined unadjusted and adjusted LOS-mortality patterns and compared admission-only versus inpatient-course prediction using explainable machine learning. <b>Methods:</b> Using the full 2017 Nationwide Readmissions Database (NRD), we identified hospitalizations among adults aged ≥60 years with an ICD-10-CM G30.x AD code in any diagnosis position. Records with missing in-hospital mortality status were excluded. LOS was summarized in clinically interpretable bins and modeled using restricted cubic splines. Model A excluded explicit inpatient-course measures, whereas Model B added LOS, procedure count, and total charges. Performance was evaluated using patient-grouped 5-fold out-of-fold validation and summarized by AUROC and AUPRC; SHAP was used for interpretation. <b>Results:</b> Among 249,507 AD hospitalizations, 12,666 in-hospital deaths occurred (5.08%; weighted mortality 4.97%). Unadjusted mortality was highest at LOS 0-1 day (13.00%), lowest at 4-6 days (3.47%), and increased to 7.77% at ≥22 days. After multivariable adjustment, LOS remained strongly nonlinear, but adjusted predicted mortality declined across the modeled LOS range. Model A achieved AUROC/AUPRC of 0.780/0.180, whereas Model B improved to 0.828/0.329. Sepsis, diagnostic burden, acute kidney injury, age, stroke, and pneumonia were stable predictors; LOS and procedure burden added prognostic information in Model B. <b>Conclusions:</b> The crude LOS-mortality pattern was U-shaped, whereas the adjusted pattern suggests that the late-stay increase in unadjusted mortality is partly explained by patient complexity and evolving inpatient-course factors. Admission-only prediction provides meaningful early risk stratification, while inpatient-course information improves prognostic assessment as hospitalization evolves.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030448","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":"Aging as Loss of Biological Self-Correction: A Geroscience Framework for Longevity, Inflammaging, and Restored Resilience.","authors":"David Bar-Or, Jason Williams, Daniel Paredes","doi":"10.3390/geriatrics11050134","DOIUrl":"10.3390/geriatrics11050134","url":null,"abstract":"<p><p>Longevity science has shifted from the pursuit of lifespan extension toward preservation of healthspan, resilience, and functional independence. The hallmarks of aging provide a powerful descriptive structure, but they do not by themselves specify how diverse molecular defects translate into loss of adaptive function. We propose a complementary conceptual framework in which aging is viewed as progressive impairment of biological self-correction: the distributed capacity to sense consequential perturbations, scale an appropriate response, repair or remove damage, terminate the response, and recover or adaptively re-equilibrate while preserving future functional reserve. This framework is not intended to replace homeostasis, homeodynamics, allostasis, physiological reserve, or resilience; rather, it links these established concepts to the molecular machinery that generates dynamic recovery. Correction fidelity is proposed to be measured independently of the hallmarks using stress-response trajectories, including response latency, magnitude of deviation, recovery slope or half-time, integrated deviation, residual deficit, overshoot, biological cost, final functional state, and preservation of subsequent reserve. Importantly, successful recovery need not mean return to a fixed youthful baseline because aging may also shift the physiological setpoint toward a less favorable but actively defended equilibrium. We integrate evolutionary and biodemographic principles with inflammaging, nutrient sensing, NAD+ biology, senescence, autophagy, partial reprogramming, and resilience research, and propose falsifiable predictions for testing whether dynamic recovery adds information beyond chronological age, frailty, and static aging biomarkers.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030156","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":"Real-World Long-Term Safety of Statin-Fibrate Combination Therapy in Older Patients (≥75 Years): A European Cohort Analysis.","authors":"Nikolaos Papadopoulos, John Doupis, Theodoros Angelopoulos, Elias Tsougos, Manuel Suarez Tembra, José Luis Diaz, Diego Bellido Guerrero, Maria Antonia Sanchez-Calavera, Juan Carlos Garcia Alvarez, Antonio Robles Iniesta, Sonia Redondo, Antonio Ruiz Garcia, Jose Antonio Diaz, Daniel Zambon Rados, Pere Alvarez Garcia, Daiana Ibarretxe, Belen Fraille, Jose Maria Tirado Moliner, Luis Enrique Morales Cobo, Maria Jesus Barreda, Juan Luis Frigola, Fernando Gomez Peralta, Juan Carlos Moreno, Nuria Font, Antonio Fernandez, Jorge Manuel Romero Requena, José Porta, Stephanie Da Silva, Sophie De Niet","doi":"10.3390/geriatrics11050135","DOIUrl":"10.3390/geriatrics11050135","url":null,"abstract":"<p><p><b>Background</b>: Given the increasing prevalence of dyslipidemia and multimorbidity in the older patient population, the lack of safety data on combined statin-fenofibrate therapy in this age group represents a critical gap. The post hoc subgroup analysis of the POSE study addresses this issue. <b>Materials and Methods</b>: The POSE study was a 3-year, real-world, observational, comparative, non-interventional study conducted in Europe. Patients with mixed dyslipidemia treated either by a fixed-dose combination of pravastatin 40 mg/fenofibrate 160 mg or a moderate-intensity statin monotherapy were enrolled. Safety outcomes included the occurrence of renal or urinary disorders, musculoskeletal or connective tissue disorders, hepatobiliary disorders, cholelithiasis, thromboembolic events, pancreatitis, worsening diabetes mellitus, elevated blood homocysteine levels, interstitial pneumopathy, phototoxicity, and fatal or non-fatal cardiovascular events. Laboratory parameters related to lipid control and renal, muscular, and hepatic functions were additionally evaluated. The post hoc analysis focused on a subgroup of patients aged 75 years and older. <b>Results</b>: A total of 458 patients were included in the analysis. The majority had hypertension (79.3%) and diabetes mellitus (55.0%). Over the 3-year study period, the incidence rate of composite safety events was numerically higher with the combination, though this did not reach statistical significance (RR = 2.18 [95% CI = 0.99-4.81]). Renal and urinary disorders were more frequent with the combination (5.5% vs. 0.8%), whereas musculoskeletal disorders, aggravated diabetes mellitus, and cardiovascular events showed no significant difference between groups, as the 95% confidence interval included 1. Globally, there were no significant differences regarding evolution of the hepatic, muscle, and renal biological parameters. From baseline to Year 3, TG levels decreased by 44.3% with pravastatin/fenofibrate and by 10.7% with statin monotherapy, while HDL-C levels increased by 26.5% and 0.4%, respectively. <b>Conclusions</b>: This real-life observational post hoc subgroup analysis suggests that in patients aged 75 years and older with mixed dyslipidemia at high or very high CV risk, pravastatin 40 mg/fenofibrate 160 mg demonstrates an acceptable long-term safety profile. The combination offers additional TG lowering and HDL-C improvement beyond moderate-intensity statin monotherapy, without a significant increase in overall safety events over three years.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030384","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":"Aging in Schizophrenia: Clinical, Biological, and Psychosocial Perspectives.","authors":"Constanza Morén, Alonso Pérez-Toribio, Enric Rubio-Contreras, Patricia Álvaro, Antonio Rosa, Sara Pedregosa","doi":"10.3390/geriatrics11050133","DOIUrl":"10.3390/geriatrics11050133","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Schizophrenia is a chronic psychiatric disorder traditionally associated with early adulthood; however, an increasing number of individuals are now reaching older age, highlighting the need to better understand the aging process in this population. Emerging evidence suggests that schizophrenia may be associated with accelerated aging, characterized by an earlier onset of age-related conditions and increased vulnerability to physical and cognitive decline. <b>Methods</b>: We provide an integrative overview of aging in schizophrenia, focusing on biological mechanisms, clinical manifestations, and psychosocial dimensions. <b>Results</b>: Key biological processes, including oxidative stress, mitochondrial dysfunction, chronic immune activation, and dysregulation of stress-response systems, are discussed as potential contributors to accelerated aging. Clinically, older individuals with schizophrenia present a high burden of cardiometabolic comorbidities, persistent cognitive impairment, and increased functional dependency, often compounded by the complexity of pharmacological management in this age group. In addition, psychosocial factors such as social isolation, stigma, and caregiver burden play a critical role in shaping health outcomes and quality of life. <b>Conclusions</b>: Despite growing recognition of these challenges, aging in schizophrenia remains an underexplored area, with significant gaps in longitudinal research and limited focus on older populations. A comprehensive approach that integrates biological, clinical, and psychosocial perspectives is essential to better characterize aging trajectories and to inform more effective and person-centered care strategies in this vulnerable population.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030269","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":"Sociodemographic Inequalities in Healthy Food Consumption Markers Among Older Adults Receiving Primary Health Care in Roraima, Brazil.","authors":"Guilherme José Silva Ribeiro, Gabrielle Andrade da Silva, Nalva de Paula Dias, Rafaela Nogueira Gomes de Morais, Gabriela Rocha Dos Santos, André de Araújo Pinto","doi":"10.3390/geriatrics11050132","DOIUrl":"10.3390/geriatrics11050132","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Noncommunicable diseases represent a major public health challenge, particularly among older adults. In this context, a healthy diet plays a key role in the prevention and management of these conditions. However, evidence on the associations between sociodemographic characteristics and previous-day food consumption markers among older adults remains limited. This study aimed to evaluate the association between sociodemographic factors and healthy food consumption markers among older adults in Roraima, Brazil. <b>Methods</b>: This cross-sectional study included 1322 older adults previously diagnosed with COVID-19 in the state of Roraima, Brazil. Sociodemographic information was obtained from electronic health records within the statewide Primary Health Care network. Healthy food consumption was assessed using the Food Consumption Markers Form from Brazil's Food and Nutrition Surveillance System (Sistema de Vigilância Alimentar e Nutricional [SISVAN]). Multivariable Poisson regression models were fitted to examine potential associations. <b>Results</b>: Male participants had a lower prevalence of consuming fresh fruit + beans and fresh fruit + vegetables. Older adults who self-identified as Brown (pardo) had a higher prevalence of consuming fresh fruit + vegetables than those who self-identified as Yellow. Participants residing in the state capital showed a higher prevalence of consuming fresh fruit + beans, fresh fruit + vegetables, beans + vegetables, and all three food groups combined. <b>Conclusions</b>: Sociodemographic factors were associated with both individual and combined consumption of fresh fruit, beans, and vegetables among older adults in Roraima, Brazil.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030382","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":"Food Insecurity, Physical Activity, and Psychological Factors as Predictors of Life Satisfaction in Older Adults.","authors":"Mónica Lorena Hernández-Trujillo, Wilter C Morales-García, Mardel Morales-García","doi":"10.3390/geriatrics11050131","DOIUrl":"10.3390/geriatrics11050131","url":null,"abstract":"<p><p><b>Background:</b> Life satisfaction is a key component of subjective well-being in later life and may be associated with psychological, economic, family, functional, and food-related factors. <b>Objective:</b> This study aimed to identify factors associated with life satisfaction among older adults, considering sociodemographic characteristics, food insecurity, physical activity, and psychological factors. <b>Methods:</b> A quantitative, observational, analytical, cross-sectional study was conducted with 200 noninstitutionalized older adults from Sogamoso, Colombia. Self-report instruments assessed life satisfaction, food insecurity, physical activity, depression, anxiety, and perceived stress. Data were analyzed using descriptive statistics, group comparison tests, Pearson correlations, and multiple linear regression. <b>Results:</b> Higher perceived stress (<i>B</i> = -0.762, <i>p</i> < 0.001), perceived insufficient income (<i>B</i> = -3.380, <i>p</i> < 0.001), self-employment (<i>B</i> = -2.153, <i>p</i> = 0.009), other sources of income (<i>B</i> = -2.569, <i>p</i> = 0.017), and technical education (<i>B</i> = -4.744, <i>p</i> = 0.003) were associated with lower life satisfaction. Conversely, combined engagement in strength and flexibility exercises (<i>B</i> = 3.203, <i>p</i> < 0.001), having two children (<i>B</i> = 3.498, <i>p</i> = 0.002), and having three or more children (<i>B</i> = 2.618, <i>p</i> = 0.008) were associated with higher life satisfaction. Primary education was not significantly associated with life satisfaction after adjustment (<i>p</i> = 0.093). Food insecurity was associated with life satisfaction in the bivariate analysis but did not remain statistically significant in the adjusted model. The regression model explained 48.7% of the variance in life satisfaction (<i>R</i>² = 0.487; adjusted <i>R</i>² = 0.457). <b>Conclusions:</b> Life satisfaction among older adults was associated with psychological, economic, family, and functional factors. The findings highlight the relevance of perceived stress, economic security, functional physical activity, and family resources when addressing subjective well-being in later life.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030290","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":"Prediction Model for Discharge Destination in Older Patients After Hip Fracture Surgery Using Early Predictors.","authors":"Sanne M Krakers, Dieuwke van Dartel, Marloes Vermeer, Miriam M R Vollenbroek-Hutten, Johannes H Hegeman","doi":"10.3390/geriatrics11050130","DOIUrl":"10.3390/geriatrics11050130","url":null,"abstract":"<p><p><b>Objectives</b>: To identify early predictors of discharge destination in patients aged ≥70 years following hip fracture surgery, using the Dutch Hip Fracture Audit (DHFA) Indicator Taskforce database with the aim of developing and validating a prediction model. <b>Methods</b>: Patients living in a (residential) home prior to the hip fracture were categorized into three discharge groups: home (<i>n</i> = 1322), geriatric rehabilitation (<i>n</i> = 2181), and nursing home (<i>n</i> = 337). The dataset was randomly split into a training set (75%) and a test set (25%). Potential predictors of discharge destination were collected immediately after hip fracture surgery and first tested univariately in the training set. Variables showing <i>p</i> < 0.15 were entered into a multinomial regression model. The model was validated on the test set. <b>Results</b>: The training set consisted of 2878 patients (median age: 83 years (IQR 77-89 years), 2012 females (70%)). The final multinomial regression model included age, gender, PFMS, premorbid Katz-ADL, ASA score, polypharmacy, history of dementia, delirium during previous hospital admissions, fall in the past six months, surgical treatment, anaesthesia type, and co-treatment by a geriatrician. The strength and direction of the associations between these variables and discharge destination varied across the three pairwise comparisons. The validated model predicted discharge to geriatric rehabilitation, home, and a nursing home with sensitivities of 86.7%, 37.9%, and 9.6%, respectively. Precision ranged from 33.3% (nursing home) to 60.9% (home) and 66.7% (geriatric rehabilitation). <b>Conclusions</b>: Discharge destination could be predicted with relatively high sensitivity and moderate precision for geriatric rehabilitation, whereas sensitivity and precision for predicting discharge home and to a nursing home remained limited. This highlights the need to refine the model before clinical implementation can be considered.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030391","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":"Shared Experiences with Caregiving for Loved Ones Living with Dementia in an Adult Day Health and Resource Center: A Thematic Analysis.","authors":"Michelle D Hand, Megumi Inoue, Li-Mei Chen, Naoru Koizumi, Emma Booker, Sarah Nosrat, Samreen Mehak, Eyesha Shaikh","doi":"10.3390/geriatrics11050129","DOIUrl":"10.3390/geriatrics11050129","url":null,"abstract":"<p><p><b>Background:</b> Slowing the progression of dementia and maintaining mental and social health and well-being are important aspects of health and healthcare for people living with dementia (PLwD). Relationships with family caregivers and unique caregiver insights are also important aspects of the health and well-being of PLwD. <b>Methods:</b> A group-based gaming system was developed to promote health and well-being for PLwD through movement, cognitive exercises, and social interaction. Included were family caregivers of clients living with mild- or moderate-stage impairment in an adult day center selected for the gaming intervention. Prior to implementing the intervention, three separate focus groups were conducted with 21 caregivers of PLwD, divided into each of the three focus groups based on their availability, to explore what it is like to care for someone living with dementia, their loved ones' mood, and their questions or concerns regarding the gaming intervention. Responses were thematically analyzed. <b>Results:</b> In total, 21 caregivers participated in the focus groups. Six themes were identified: mutuality and strategies for coping with varying emotions; new challenges and successes with connecting and relating; multidimensional challenges with adjusting to decline, help-seeking, and providing care; community, social support, and resilience; technology and community resources as tools to ease caregiving burdens, and interest in digital gaming for PLwD. <b>Conclusions:</b> Our results suggest that group-based digital gaming interventions may be useful to both caregivers and PLwD, by offering meaningful opportunities for social engagement.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030399","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":"Depression and Risk of Delirium in Older Adults: A Retrospective Cohort Study Using German Primary Care Data.","authors":"Christina Ryngler, Jens Bohlken, Nguyen Tien Huy, Karel Kostev","doi":"10.3390/geriatrics11050127","DOIUrl":"10.3390/geriatrics11050127","url":null,"abstract":"<p><p><b>Background:</b> Depression and delirium are common neuropsychiatric disorders in older adults. Although studies suggest an association between the two conditions, evidence regarding the long-term risk of delirium in older patients with depression in outpatient primary care remains limited. <b>Objective:</b> This study examined the relationship between depression and delirium in individuals aged ≥65 years. <b>Methods:</b> This retrospective cohort study used data from the German IQVIA Disease Analyzer database. It included individuals aged ≥65 years who received their first diagnosis of depression between 2005 and 2023. Using propensity score matching, patients with depression were matched 1:1 with individuals without depression. The primary outcome was incident delirium (ICD-10: F05). Time-dependent Cox regression models were applied for up to ten years of follow-up. <b>Results:</b> After matching, the study population consisted of 203,888 individuals (mean age: 75.8 years; 66% female). The incidence of delirium was higher in patients with depression than in controls (2.0% vs. 1.3%). Depression was associated with an elevated risk of delirium within the first two years after diagnosis (HR 1.42; 95% CI 1.14-1.75) and between six and ten years (HR 1.48; 95% CI 1.05-2.11). No statistically significant association was observed between years 3 and 5. Incident dementia was also associated with delirium (HR 1.52; 95% CI 1.14-2.02). <b>Conclusions:</b> Among older adults receiving outpatient care, depression was associated with a higher rate of subsequently documented delirium. These results complement existing evidence from inpatient settings. Due to the observational nature of the study, causal inferences cannot be made. In a sensitivity analysis excluding individuals with dementia at baseline, the association remained statistically significant across all intervals (HR 1.74, 1.53, and 1.82 for 0-2, 3-5, and 6-10 years, respectively).</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030329","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":"A Scoping Review of Integrated Care Models for Managing Depression in Older Adults.","authors":"Mia Haddad, Jittima Panyasarawut, Chaowalit Srisoem, Dennis Miezah, Ling Shi","doi":"10.3390/geriatrics11050126","DOIUrl":"10.3390/geriatrics11050126","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Depression is a major health issue among older adults and is frequently accompanied by chronic physical conditions. Conventional care of depression in older adults is delivered through primary care settings and often fails to address the complex interactions between mental health, physical illness, and social determinants of health in this population. Integrated care models, characterized by coordinated, multidisciplinary, and patient-centered approaches, have emerged as a promising strategy for improving depression outcomes in late life. &lt;b&gt;Objective:&lt;/b&gt; This scoping review aimed to characterize integrated care models for managing depression in older adults. The review examined the structure and implementation of these models and evaluated depression-related outcomes. &lt;b&gt;Methods:&lt;/b&gt; A systematic literature search was conducted in PubMed and Google Scholar. Studies published in English between 2006 and February 2026 were considered. Eligible studies included randomized controlled trials (RCTs), cluster RCTs, and quasi-RCTs that evaluated integrated care interventions targeting depression in adults aged 65 years or older or mixed adult populations that included older adults. One reviewer conducted the search and initial screening, and four additional reviewers evaluated the eligibility of full-text reports and extracted data using a structured template. Results were synthesized descriptively. &lt;b&gt;Results:&lt;/b&gt; Seventeen studies met the inclusion criteria. Integrated care interventions were implemented across primary care clinics, community health centers, and home healthcare programs in several countries. Participants commonly had depression alongside chronic medical conditions, including diabetes, hypertension, heart failure, or chronic obstructive pulmonary disease. Integrated care models varied in staffing, therapeutic components, specialist involvement, delivery intensity, and comparator conditions. Most interventions incorporated multidisciplinary care teams; structured symptom monitoring; care coordination; behavioral or psychological interventions; and, in some studies, chronic disease management, social support, or technology-supported follow-up. Thirteen studies reported a favorable depression-related finding at one or more assessment points; however, benefits were not always sustained, and some studies reported null- or comparator-favoring findings. &lt;b&gt;Conclusions:&lt;/b&gt; Integrated care for depression in older adults encompasses heterogeneous models implemented across diverse healthcare contexts. Common themes included multidisciplinary collaboration, coordinated follow-up, structured psychological or behavioral treatment, symptom monitoring, and integration of mental and physical health management. Favorable outcomes were reported in most studies, but findings varied by population, setting, comparator, intervention intensity, and follow-up duration. These findings may inform future program design, although the eff","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030251","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}