Geriatrics最新文献

{"title":"Personalized Hemodialysis Approaches in Frail Older Individuals.","authors":"Guido Gembillo, Luca Soraci, Matteo Floris, Lorenzo Lo Cicero, Claudia Lo Re, Elvira Filicetti, Michela Calderone, Carmelo Giorgio Benenati, Andrea Corsonello, Domenico Santoro","doi":"10.3390/geriatrics11020040","DOIUrl":"https://doi.org/10.3390/geriatrics11020040","url":null,"abstract":"<p><p>The hemodialysis population has progressively aged over the past two decades; in several settings, adults aged ≥75 years represent one of the fastest-growing populations receiving dialysis. Frailty, characterized by reduced physiological reserve and heightened vulnerability to stressors, has emerged as a critical determinant of outcomes and is commonly assessed using validated instruments such as the Fried Frailty Phenotype or the Clinical Frailty Scale (CFS). Reported frailty prevalence in hemodialysis varies widely (approximately 20% to >80%), largely depending on the assessment instrument and the population studied, with consistently higher prevalence in older cohorts. It is consistently associated with older age, female sex, diabetes, lower serum albumin, cardiovascular disease, longer dialysis vintage, and lower physical activity. Compared with non-frail patients, frail hemodialysis patients have a substantially higher risk of death (approximately two-fold in pooled analyses). Seminal trials and large observational programs that shaped hemodialysis targets underrepresented very old, frail, and highly comorbid patients, limiting generalizability. In frail older adults with limited life expectancy and substantial comorbidity burden, standard thrice-weekly schedules, higher ultrafiltration intensity, and a uniform 'fistula-first' approach may increase treatment burden without clear proportional gains in patient-centered outcomes. This review examines evidence supporting individualized hemodialysis strategies in frail older adults. As the dialysis population continues to age, proficiency in goal-concordant, personalized prescribing is increasingly important for nephrologists and dialysis teams.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769133","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 Comprehensive Geriatric Assessments on Dementia Care.","authors":"Shazia Durrani, Minhal Mussawar, Mariam Alaverdashvili","doi":"10.3390/geriatrics11020039","DOIUrl":"https://doi.org/10.3390/geriatrics11020039","url":null,"abstract":"<p><p><b>Introduction:</b> According to the Alzheimer Society of Canada, over 770,000 people in Canada are living with dementia. This number is expected to rise to nearly 1 million people by 2030. Although the provision of team-based interprofessional assessment in gerontological care is critical for the early detection and prevention of dementia, its planning and delivery can be a challenge. In Saskatchewan, previous assessments have identified significant gaps between actual and best practices in dealing with this medical condition. The emergence of Geriatric Services Resource Teams (GSRTs), which apply an innovative, team-based model to improve the diagnosis and care of older adults with complex health practices, can be proven beneficial in this regard. The purpose of this study is to compare the efficacy of the care provision process between a GSRT and a traditional medical care channel (i.e., primary health) with respect to dementia patients. <b>Methods:</b> A retrospective patient chart review was conducted by collecting data from a large Primary Care practice (<i>n</i> = 90) and the GSRT in Regina (<i>n</i> = 75). Collected data included information on patient demographics and treatment, and the diagnosis process itself. <b>Results:</b> While demographic characteristics between patient groups were similar, significant differences (<i>p</i> < 0.05) were found in the involvement of pharmacy and other healthcare professionals, prescriptions for memory loss, and in who made the diagnosis. Moreover, although the dementia diagnosis was usually made first in Primary Care, further clarification of the type of dementia, counseling of diagnosis, review of medication, and assessment of functions and social supports were better managed in the GSRT group. <b>Discussion:</b> The use of Geriatric Services Resource Teams is a relatively new concept in Saskatchewan. As these teams are established, initial results show that their role in complex care management has beneficial outcomes for dementia patients.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769573","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":"Prescribing Cascade as a Therapeutic Error: A Danger for Geriatric Patients with Multimorbidity.","authors":"Adrian Bryła, Jarosław Woroń, Miłosz Miedziaszczyk, Barbara Lorkowska-Zawicka, Beata Bujak-Giżycka, Daniel Orzechowski, Paulina Połetek, Wojciech Pałys","doi":"10.3390/geriatrics11020037","DOIUrl":"https://doi.org/10.3390/geriatrics11020037","url":null,"abstract":"<p><p>The aging of the population and the increasing prevalence of multimorbidity contribute to the widespread use of polypharmacotherapy, which in turn elevates the risk of adverse drug reactions and clinically significant drug-drug interactions. One of the key yet frequently underestimated issues in clinical practice is the prescribing cascade, which occurs when an adverse drug reaction is misinterpreted as a new medical condition, leading to the initiation of an additional medication. This phenomenon is particularly relevant in the older population, in whom altered pharmacokinetics and pharmacodynamics, together with reduced organ reserve, increase susceptibility to adverse drug events, including nephrotoxicity (renal impairment is used throughout the review as a clinically relevant example of organ-specific harm resulting from prescribing cascades, rather than as the sole focus of the analysis). This article discusses the mechanisms and clinical consequences of the prescribing cascade-with particular emphasis on renal function deterioration-as well as strategies for its prevention in the geriatric population. Analysis of the literature indicates that prescribing cascades remain insufficiently recognized in clinical practice, despite the availability of pharmacotherapy assessment tools such as The American Geriatrics Society (AGS) Beers Criteria and the STOPP/START criteria. Documented prescribing cascades have been shown to contribute to deterioration in health status and quality of life, an increased frequency of hospitalizations, and a greater burden on healthcare systems. Particularly concerning are cascades involving cardiovascular, neurological, and analgesic medications, which may induce or exacerbate renal injury, ultimately leading to chronic kidney disease and organ failure. Prescribing cascades represent a significant yet frequently underestimated threat to the efficacy and safety of pharmacotherapy in older adults. Their consequences may extend beyond reduced quality of life and increased treatment costs to include serious complications such as the development of renal failure. Enhancing clinicians' awareness, conducting systematic medication reviews, and employing validated assessment tools are essential for the identification and prevention of prescribing cascades, thereby reducing the risk of renal injury and improving clinical outcomes.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769241","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":"The Need for Standardized Data Collection to Improve Harmonization and Pooling of Information About Modifiable Risk Factors for Alzheimer's Diseases in Italian Clinical Studies: A Systematic Review.","authors":"Patrizio Allegra, Manuela Lodico, Claudia Migliazzo, Domenico Tarantino, Tommaso Piccoli, Nicola Vanacore, Giuseppe Salemi, Laura Maniscalco, Domenica Matranga","doi":"10.3390/geriatrics11020038","DOIUrl":"https://doi.org/10.3390/geriatrics11020038","url":null,"abstract":"<p><strong>Background/objectives: </strong>At the international level, harmonized networks of dementia clinical studies are available, but Italian participation remains limited. This systematic review aims to define harmonization rules to facilitate the inclusion of Italian clinical studies in existing networks and to propose standardized data collection methods to enable comparison of the study results.</p><p><strong>Methods: </strong>A systematic review was conducted (January 2019-December 2024) to identify Italian clinical studies evaluating Alzheimer's disease and other dementias as outcomes. Eight modifiable risk factors were extracted: BMI, arterial hypertension, diabetes, dietary patterns, alcohol consumption, smoking habits, depressive symptomatology, and physical activity. WHO definitions and internationally accepted criteria were used as reference standards. Variable harmonization potential was assessed using the DataSHaPER methodology and classified as complete, partial, or impossible, considering information loss across studies.</p><p><strong>Results: </strong>Of 365 records identified, 18 studies met the inclusion criteria. Obesity assessed via BMI showed the highest harmonization potential (44% complete, 33% partial), along with dietary habits measured by food frequency questionnaires (44% complete). Diabetes and physical inactivity followed (33% complete), assessed through fasting glucose or pharmacological treatment and the IPAQ, respectively. Smoking habits classified as current, former, or never smokers were reported in 28% of studies. Depression (assessed by GDS or CES-D) and hypertension (blood pressure measurement or antihypertensive treatment) showed complete harmonization in only 22% of studies.</p><p><strong>Conclusions: </strong>Italian studies show substantial limitations in the harmonization of modifiable risk factor data for Alzheimer's disease, mainly due to heterogeneous and non-standardized data collection methods, highlighting the need for uniform research protocols.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769220","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":"Emergency Ventral Hernia Management in Older Adults: A Retrospective Cohort Study and Structured Review of the Literature.","authors":"Ivan Tomasi, Jeremy Samuel, Eimante Raupelyte, Antonia Elizabeth Loizou, Angela Wang Yihui, Lilian Chioma Ujunwa Nwosu, Sneha Mehrotra, Mariia Druziagina, Kenneth Wing Ngai Law, Magda Sbai","doi":"10.3390/geriatrics11020036","DOIUrl":"https://doi.org/10.3390/geriatrics11020036","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Older adults frequently present with emergency ventral hernias, a situation that carries significant physiological risks and often requires challenging clinical decisions. Despite the prevalence of these cases, there is a lack of robust evidence to inform emergency care in this demographic, as most existing research centres on short-term mortality rates and operative variables. Key aspects such as the impact of frailty and the course of recovery following surgery are insufficiently addressed in the literature. This study aimed to describe management strategies, frailty burden and postoperative outcomes in older adults presenting with emergency ventral hernias. <b>Methods</b>: This study retrospectively examined patients aged 65 and older who were admitted to a UK tertiary centre with emergency ventral hernias from February 2016 to July 2024. Data, including patient demographics, comorbid conditions, frailty status (as measured by the Clinical Frailty Scale), management approach, healthcare resource use, and clinical outcomes, were analysed descriptively. Additionally, a structured literature review was conducted in accordance with PRISMA guidelines to identify research on emergency ventral hernia treatment outcomes in adults aged 60 years and older. <b>Results</b>: A total of 67 patients met the inclusion criteria for the cohort. High rates of frailty and multiple coexisting health conditions were observed. While surgical intervention was the predominant management strategy, a subset of patients received conservative or palliative care. Greater degrees of frailty correlated with longer hospital stays and an increased need for critical care, even though six-month mortality remained comparatively low. Traditional risk assessment tools tended to overpredict mortality risk and failed to reflect the true postoperative burden or the recovery process. The systematic review yielded 7 studies, most of which documented mortality and complication rates, but few addressed frailty or provided detailed postoperative recovery data. <b>Conclusions</b>: The management of emergency ventral hernias in older adults is highly variable, with a significant postoperative impact that extends beyond mortality statistics. Assessing frailty appears to provide additional information that may support clinical decision-making and help anticipate recovery after surgery. Integrating frailty evaluation into emergency hernia care could enhance multidisciplinary collaboration and help ensure that treatment plans are better tailored to patient vulnerability and individual care goals.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769611","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":"Neoplastic Disorders and Cardiovascular Comorbidities in Geriatric Patients: A Simple Association?","authors":"Andreea Taisia Tiron, Marian-Vlad Lăpădat, Maria Mădălina Georgică, Lavinia Alice Bălăceanu, Ion Daniel Baboi, Ion Dina","doi":"10.3390/geriatrics11020035","DOIUrl":"https://doi.org/10.3390/geriatrics11020035","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) and cancer frequently coexist in older patients, posing significant challenges in clinical management due to overlapping risk factors and treatment-related complications. This narrative review summarizes current knowledge on the epidemiology, shared pathophysiological mechanisms and clinical impact of neoplastic comorbidities in older adults with cardiovascular diseases. It highlights the increased mortality, morbidity and diminished quality of life resulting from the coexistence of these conditions. The review also discusses personalized management strategies, emphasizing comprehensive geriatric and cardiac assessments, and tailoring oncologic treatments to minimize cardiotoxicity, as well as the role of prevention and rehabilitation programs. As the population ages and cancer survival improves, integrated cardio-oncology care adapted to older adults becomes increasingly essential to optimize outcomes and preserve functional status.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769097","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":"Integrating a Palliative Approach into Cardiogeriatric Decision-Making for Frail Older Adults with Heart Failure.","authors":"Rémi Esser, Marine Larbaneix, Alejandro Mondragon, Marlène Esteban, Christine Farges, Sophie Nisse Durgeat, Marc Harboun, Olivier Maurou","doi":"10.3390/geriatrics11020034","DOIUrl":"https://doi.org/10.3390/geriatrics11020034","url":null,"abstract":"<p><p><b>Background</b>: Advanced heart failure (HF) in very old patients follows an unpredictable trajectory marked by recurrent decompensations, progressive functional decline, and high mortality. In this population, decision-making regarding goals of care and treatment proportionality is particularly complex due to multimorbidity, frailty, cognitive vulnerability, and prognostic uncertainty, and remains insufficiently addressed by conventional disease-centred heart failure pathways. <b>Methods</b>: This narrative review synthesizes current evidence from heart-failure guidelines, geriatric medicine, and palliative care literature to propose a cardiogeriatric framework for end-of-life decision-making in advanced HF. <b>Results</b>: In older adults, functional decline and geriatric vulnerability often progress independently of cardiac parameters, limiting the relevance of prognosis-based thresholds. The palliative turning point should be understood as a multidimensional process resulting from converging cardiological, geriatric, organizational, and patient-reported signals. Therapeutic decisions should be guided by proportionality between expected benefit, treatment burden, and patient priorities. Longitudinal, iterative communication is essential to align care with evolving goals. <b>Conclusions</b>: A cardiogeriatric approach integrating cardiology, geriatrics, and palliative principles supports timely palliative integration, shared decision-making, and coordinated care in very old patients with advanced HF.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769003","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":"Reliability and Construct Validity of the Short Physical Performance Battery in Croatian Older Adults.","authors":"Tatjana Njegovan Zvonarević, Ivan Jurak, Mirjana Telebuh, Ana Mojsović Ćuić, Edina Pulić, Ivna Kocijan, Želimir Bertić, Miljenko Franić, Igor Filipčić, Vlatko Brezac, Klara Turković, Lana Feher Turković","doi":"10.3390/geriatrics11020033","DOIUrl":"10.3390/geriatrics11020033","url":null,"abstract":"<p><p><b>Background</b>: Population aging represents a major public health challenge, accompanied by an increasing prevalence of chronic diseases and age-related functional decline. Declines in lower-extremity physical function are particularly important, as they are strongly associated with mobility limitations, loss of independence, increased risk of falls, hospitalization, and mortality in older adults. Reliable and valid tools to assess physical performance are therefore essential in both clinical and research settings. The Short Physical Performance Battery (SPPB) is a widely used instrument for assessing lower-extremity physical performance in older adults and is recommended within the diagnostic algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP2) for evaluating physical performance severity. However, the SPPB has not yet been psychometrically validated in the Croatian older population. This study aimed to evaluate the reliability and validity of the SPPB in Croatian older adults. <b>Methods</b>: This study examined the metric properties of the SPPB in a sample of 153 older adults recruited from nursing homes and community settings. <b>Results</b>: The SPPB demonstrated acceptable internal consistency (Cronbach's alpha = 0.74) and good test-retest reliability (ICC = 0.893) for the total score. Convergent and construct validity were supported by significant associations with established measures of functional mobility and muscle strength. <b>Conclusions</b>: The Croatian version of the SPPB is a reliable and valid instrument for assessing lower-extremity physical performance in older adults. Its use is supported in clinical practice and research settings in Croatia. Further studies should examine responsiveness and predictive validity in nationally representative samples.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503470","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":"Dose-Response Relationship Between Sleep Regularity Index and Stage-Specific Alzheimer's Disease: Cross-Sectional Evidence from Japanese Adults.","authors":"Yue Cao, Jaehee Lee, Jaehoon Seol, Kenji Tsunoda, Kyohei Shibuya, Jieun Yoon, Tetsuaki Arai, Tomohiro Okura","doi":"10.3390/geriatrics11020032","DOIUrl":"10.3390/geriatrics11020032","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Daily sleep patterns are associated with cognitive health and Alzheimer's disease (AD). However, it remains unclear how suboptimal irregular sleep manifests in AD from the preclinical stage to dementia. This study aimed to establish the dose-response association between sleep irregularity and psychometrically defined stage-specific AD as well as executive dysfunction, among adults with subjective cognitive and sleep issues. <b>Methods</b>: Cross-sectional data were obtained from 532 Japanese adults (mean age = 63.9 years) between March 2023 and April 2024. Sleep irregularity was quantified using the Sleep Regularity Index (SRI) with 24/7 accelerometer data. A modified Poisson regression with cubic splines was performed to establish the dose-response association. <b>Results</b>: This study identified novel non-linear associations. The prevalence ratios of cognitive impairment, defined as being in the preclinical and more advanced stages of AD, significantly declined beyond a median SRI of 60. Participants within this SRI range also showed significantly lower prevalence ratios of poorer Trail Making Test B performance. All results were independent of age, sleep duration, and risk of depression. <b>Conclusions</b>: Maintaining balanced-to-regular daily sleep patterns might be optimal for AD progress from its preclinical stages, with a potential benchmark at SRI of 60, especially for those individuals at risk for cognitive decline and sleep disorders. Further research is needed to replicate this benchmark in diverse populations and to evaluate the effect of rigid sleep regularity on cognitive health.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503509","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 a Proactive Driving Transition Class on Extending Safe Driving and Preparing for Life After Driving Cessation Among Older Drivers.","authors":"Tsutomu Sasaki, Kyohei Yamada, Takeshi Yamakita, Naoto Sakuta, Hajime Yoshida, Takeshi Tominaga","doi":"10.3390/geriatrics11020031","DOIUrl":"10.3390/geriatrics11020031","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Driving cessation is associated with adverse health outcomes. Proactive support that extends safe driving while preparing for life after driving cessation has been emphasized, but empirical evidence remains limited. This study examined the effects of a proactive class for older drivers on awareness and behavior related to driving and mobility (Study 1) and on longitudinal changes in on-road driving behavior (Study 2). <b>Methods:</b> The proactive class was implemented as a municipal program, including information provision, training activities, group discussions, and optional on-road driving evaluations. Study 1 included 71 older drivers who attended the class at least five times annually and completed an anonymous questionnaire assessing perceived changes in awareness and behavior. Study 2 included 29 participants who completed standardized on-road driving evaluations at baseline and at a 1-year follow-up. Paired <i>t</i>-tests or Wilcoxon signed-rank tests with effect sizes were applied. <b>Results:</b> In Study 1, participants reported increased awareness of safe driving, greater confidence in continuing to drive, heightened risk perception, initiation of health-related behaviors, trial use of public transportation, and increased healthcare utilization, particularly ophthalmology visits. In Study 2, total scores on the on-road driving skill test improved significantly at follow-up (Cohen's dz = 0.805). No significant changes were observed in individual on-road driving skill subitems, physical function, cognitive function, or daily functioning after correction for multiple comparisons, except for a reduction in driving simulator accidents. <b>Conclusions:</b> Participation in a proactive, continuous driving transition support class was associated with multidimensional behavioral changes and improved on-road driving performance among older drivers, potentially contributing to safer mobility and healthier aging.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503485","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}