Geriatrics最新文献

{"title":"The Use of Direct Oral Anticoagulants (DOACs) in Older Adults Receiving Multidose Drug Dispensing; Interactions, Anticholinergic and Fall-Risk Increasing Drugs.","authors":"Anette Vik Josendal, Ole Martin Sobakk, Anne Gerd Granas, Anne Katrine Eek","doi":"10.3390/geriatrics11020030","DOIUrl":"10.3390/geriatrics11020030","url":null,"abstract":"<p><p><b>Objectives</b>: To examine the prescribing of non-vitamin K-dependent oral anticoagulants (DOACs) among multidose drug dispensing (MDD) users aged ≥65 years, and to describe associated drug-drug interactions (DDIs), concomitant use of fall-risk increasing drugs (FRIDs) and anticholinergic drugs (AC). <b>Methods:</b> Cross-sectional analysis of anonymized MDD medication lists from 87,519 patients in 2018. DDIs were identified using The Norwegian Medical Products Agency interaction tool, FRIDs were defined using the Swedish National Board of Health and Welfare list, and the CRIDECO Anticholinergic Load Scale assessed anticholinergic burden. <b>Results</b>: Among the 13,215 patients aged 65 and older the mean number of prescribed medications was 10.3. At least one DDI involving the prescribed DOACs was present in 26.8% of patients, whereas severe DDIs were rare (0.2%). Almost all (96.7%) used at least one FRID, and nearly half (46.8%) had an anticholinergic score ≥ 3. <b>Conclusions</b>: DOACs are frequently prescribed together with medications that increase the risk of falls and bleeding. These findings highlight the need for individualized risk-benefit evaluations and deprescribing or substituting high impact FRIDS and ACs when clinically appropriate.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503507","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":"Development of a Prediction Model for Community-Dwelling Older Adults at Risk of Long-Term Care with Dementia.","authors":"Kana Kazawa, Ken Sugimoto, Yoko Aihara, Michiko Moriyama","doi":"10.3390/geriatrics11020029","DOIUrl":"10.3390/geriatrics11020029","url":null,"abstract":"<p><p><b>Background:</b> Early detection of modifiable risk factors for long-term care certification with dementia is essential. This study aimed to develop a risk-scoring tool using data from the Kihon Checklist and Questionnaire for the Late-Stage Elderly over a 2-year period to predict long-term care certification with dementia under Japan's Long-Term Care Insurance system. <b>Methods:</b> Participants included 2041 functionally independent, community-dwelling older adults in Kure City, Japan, as of March 2021. A retrospective cohort study was conducted. Associations between KCL and LSEQ domains and certification for long-term care with dementia were examined using logistic regression. To improve practical use, a score chart was developed to predict certification for long-term care with dementia. <b>Results:</b> Two years after completing the Kihon Checklist and Questionnaire, 143 participants (7.0%) were certified for long-term care with dementia. Factors independently associated with certification for long-term care with to dementia included age, homebound status, cognitive decline, and locomotor decline. The prediction model, developed using these variables, showed excellent discriminatory ability, with an area under the curve of 0.790 (95% confidence interval: 0.754-0.827). <b>Conclusions:</b> We developed an effective predictive model for future long-term care certification with dementia using routinely collected administrative data. This tool may help healthcare providers and health planners identify older adults at increased risk of long-term care certification with dementia.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503453","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 Redefined: Cognitive and Physical Improvement with Positive Age Beliefs.","authors":"Becca R Levy, Martin D Slade","doi":"10.3390/geriatrics11020028","DOIUrl":"10.3390/geriatrics11020028","url":null,"abstract":"<p><p><b>Background/Objectives</b>: A widespread assumption exists among scientists, health care providers, and the public that later life is a time of inevitable and universal cognitive and physical decline. This assumption is likely due to considering older persons who improve to be exceptions, and the reliance on aging-health measures that do not allow for improvement. In contrast, we utilized a measure that allowed for an upward trajectory to occur. Our objective was to examine whether a meaningful number of older persons improve with this measure and, if so, to examine whether a promising modifiable culture-based variable, positive age beliefs, contributes to this improvement. <b>Methods</b>: Individuals 65 years and older, who participated in a nationally representative longitudinal study, had their physical health assessed by walking speed and their cognitive health assessed by a global performance measure. We calculated the percentage of the sample that showed improvement in each domain from baseline to the last measurement up to 12 years later. We also examined whether a positive-age-belief measure predicted this improvement in regression models. <b>Results</b>: It was found that 45.15% of persons improved in cognitive and/or physical function over this period, and positive age beliefs predicted these two types of improvement, both with and without adjusting for relevant covariates. <b>Conclusions</b>: Our findings underscore the need to instill or magnify the positivity of age beliefs and to redefine aging so that it includes the possibility of improvement.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503723","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 Community-Based Multi-Component Intervention on Subjective Well-Being in Older Adults: The Chofu-Digital-Choju Project in Japan.","authors":"Tsubasa Nakada, Kayo Kurotani, Satoshi Seino, Takako Kozawa, Shinichi Murota, Miki Eto, Junko Shimasawa, Yumiko Shimizu, Shinobu Tsurugano, Fuminori Katsukawa, Kazunori Sakamoto, Hironori Washizaki, Yo Ishigaki, Maki Sakamoto, Keiki Takadama, Keiji Yanai, Osamu Matsuo, Chiyoko Kameue, Hitomi Suzuki, Kazunori Ohkawara","doi":"10.3390/geriatrics11020027","DOIUrl":"10.3390/geriatrics11020027","url":null,"abstract":"<p><p><b>Background:</b> Subjective well-being (SWB) is an essential indicator of successful aging. Although social connections enhance SWB among older adults, few interventions have integrated community-based approaches with information and communication technology (ICT). This study evaluated the Chofu-Digital-Choju (CDC) project, a multi-component community intervention fostering in-person and online social connections among community-dwelling older adults in urban Japan. <b>Methods:</b> This quasi-experimental study (January 2022 to March 2024) included community-dwelling older adults aged 65-84 years in Chofu City, Tokyo, Japan. The intervention consisted of online classes, community hubs as local third places, and community events. Baseline and follow-up data were collected using self-administered questionnaires. Propensity score matching (1:1) was used to reduce selection bias, and generalized estimating equations were applied to evaluate the intervention effects. The primary outcome was SWB (Cantril Ladder). The secondary outcomes included social isolation, neighborhood relationships, social participation, health literacy, psychological health, physical activity, and ICT use. <b>Results:</b> Among the 1599 participants who completed both surveys, 209 (13.1%) participated in at least one CDC intervention component. After propensity score matching, 195 pairs were analyzed. No significant interaction effect was observed for SWB (β = 0.08, 95% confidence interval [CI]: -0.20, 0.37; <i>p</i> = 0.565). However, a significant interaction effect favored the intervention group for Internet usage frequency (odds ratio = 1.53, 95% CI: 1.08, 2.16; <i>p</i> = 0.016). A significant borderline interaction was also observed in health literacy (β = 0.13, 95% CI: -0.00, 0.26; <i>p</i> = 0.056), which reached significance in covariate-adjusted sensitivity analysis (<i>p</i> = 0.044). Subgroup analyses revealed that community hub participants showed significant interaction effects in health literacy (<i>p</i> = 0.021) and a trend toward reduced depressive symptoms (<i>p</i> = 0.084). <b>Conclusions:</b> The CDC intervention did not improve SWB over 2 years but enhanced Internet use and supported health literacy and depressive symptoms, particularly among hub participants. Community-based, multi-component interventions that integrate online and in-person activities may foster digital inclusion and specific health behaviors. Although SWB did not change in this study, these proximal gains may serve as foundational steps for long-term improvement. The study protocol was preregistered in the UMIN Clinical Trials Registry (UMIN000051393; Registered on 21 June 2023).</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503458","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 Successfully Despite Limitations? Meanings and Perceptions of Aging Well Among Older Adults Living in Long-Term Care Institutions.","authors":"Feliciano Villar, Nuria Ramón, Juan José Zacarés","doi":"10.3390/geriatrics11020026","DOIUrl":"10.3390/geriatrics11020026","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Dominant models of successful aging emphasize health, autonomy, and active engagement, often excluding older adults belonging to vulnerable groups, such as those living in long-term care facilities (LTCFs). This study aims to address this limitation by exploring how LTCF residents define \"aging well\" and by examining whether they perceive themselves as aging well according to their own criteria. <b>Methods</b>: A qualitative design was employed using semi-structured interviews with 30 residents aged 67-95 living in three long-term care facilities located in Barcelona, Spain. Interview transcripts were analyzed using inductive thematic analysis. <b>Results</b>: Five core themes emerged in the participants' definitions of aging well: health, attitude, social ties, security, and activities. Health was the most frequently mentioned domain but was conceptualized in undemanding terms, focusing on basic autonomy and cognitive functioning. Psychological attitudes and meaningful social relationships were also key, alongside contextual factors, such as security and access to activities. Two-thirds of the participants perceived themselves as aging well, with justifications closely aligned with their personal definitions; negative self-perceptions were mainly associated with poor health, loss of autonomy, or loneliness. <b>Conclusions</b>: The findings suggest that, in contrast with academic definitions, LTCF residents define aging well in a broader, more context-sensitive manner, which allows them to view themselves positively despite their limitations. Person-centered care environments may play a crucial role in supporting aging well in institutional settings.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503634","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":"Tablet Acceptability in Older Outpatients Undergoing Cancer Chemotherapy.","authors":"Eri Hikita, Mami Oosaki, Ayano Suzuki, Maiko Anzai, Nanako Yoshioka, Yoshiyasu Terayama, Takeo Yasu","doi":"10.3390/geriatrics11020025","DOIUrl":"10.3390/geriatrics11020025","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Patient acceptability of oral anticancer drugs is a critical factor that influences treatment in older outpatients receiving cancer chemotherapy and plays a central role in enhancing adherence and treatment effectiveness. Identifying older outpatients receiving cancer chemotherapy who exhibit poor tablet acceptability before initiating oral anticancer therapy and offering alternative treatment options are beneficial. Therefore, we investigated the characteristics of patients with poor tablet acceptability by focusing on the tablet size, geriatric assessment, and polypharmacy. <b>Methods:</b> A questionnaire survey on experiences with tablet medication was conducted among patients who received chemotherapy at the Outpatient Treatment Center of Tokyo Metropolitan Bokutoh Hospital from September 2024 to September 2025. The median values of the long diameter (12 mm) and the combined length, width, and thickness (26 mm) of the tablets reported as acceptable in the questionnaire described in Method 1 were used as cutoff values. Patients whose reported acceptable tablet dimensions were below these median values were classified as \"poor tablet acceptability,\" whereas those with values above the median were classified as \"good tablet acceptability\". Univariate and multivariate logistic regression analysis was performed to identify characteristic factors associated with poor tablet acceptability in older outpatients receiving cancer chemotherapy, with poor tablet acceptability as the dependent variable and patient sex, body mass index, Geriatric 8 score, each item of the Oral Frailty 5-item Checklist, and polypharmacy as explanatory variables. <b>Results:</b> 90 patients completed the questionnaire survey. Female sex and polypharmacy were independent factors associated with poor tablet acceptability in older outpatients receiving cancer chemotherapy. In addition, subjective difficulty in chewing tended to be associated with poor tablet acceptability. <b>Conclusions:</b> This study suggests that assessing polypharmacy and oral function, along with early multidisciplinary intervention before and during oral anticancer therapy, particularly in females, patients taking multiple medications, and those reporting difficulty in chewing, may help maintain tablet acceptability and improve adherence.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503468","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":"Comparisons of Functional, Physical, and Mental Health Outcomes Among Young and Old Stroke Survivors.","authors":"Molly M Jacobs, Charles Ellis","doi":"10.3390/geriatrics11020024","DOIUrl":"10.3390/geriatrics11020024","url":null,"abstract":"<p><p><b>Objective:</b> The objective of this study was to examine how functional, mental, and physical health outcomes differ between younger (<age 50) and older (≥age 50) stroke survivors. <b>Methods:</b> Data from adult stroke survivors examined health-related outcomes (physical and mental health) over the past 30 days. Logistic regression models were used for binary functional outcomes, and Poisson regression models were used to estimate count outcomes for poor mental and physical health days. <b>Results:</b> Compared with older adults, younger stroke survivors were more likely to report difficulty concentrating or remembering (41.1% vs. 23.2%, <i>p</i> < 0.0001) and difficulty doing errands alone (27.11% vs. 23.67%, <i>p</i> = 0.00), but less likely to report difficulty walking or climbing stairs (34.3% vs. 47.6%, <i>p</i> < 0.0001). Additionally, younger adults with stroke reported significantly more poor mental health days (10.81 vs. 5.76, <i>p</i> < 0.0001) than older adults. In adjusted models, being out of work or out of the labor force was consistently associated with greater odds of functional limitations (e.g., OR for activity difficulty = 2.07, 95% CI: 1.56-2.75) and higher counts of poor mental and physical health days. Younger stroke survivors who were out of the labor force had significantly greater odds of difficulty concentrating (OR = 2.02, 95% CI: 1.17-3.48) and increased days of poor mental (IRR = 1.27, 95% CI: 1.19-1.70) and physical health (IRR = 1.26, 95% CI: 1.19-1.53). <b>Conclusions:</b> These findings highlight the intersection of age and employment on stroke outcomes. Younger stroke survivors face unique and disproportionate challenges in functional and mental health.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503662","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":"Risk Stratification for In-Hospital Mortality in Alzheimer's Disease Using Interpretable Regression and Explainable AI.","authors":"Tursun Alkam, Ebrahim Tarshizi, Andrew H Van Benschoten","doi":"10.3390/geriatrics11020023","DOIUrl":"10.3390/geriatrics11020023","url":null,"abstract":"<p><strong>Background: </strong>Older adults with Alzheimer's disease (AD) face a heightened risk of adverse hospital outcomes, including mortality. However, early identification of high-risk patients remains a challenge. While regression models provide interpretable associations, they may miss non-linear interactions that machine learning can uncover.</p><p><strong>Objective: </strong>To identify key predictors of in-hospital mortality among AD patients using both survey-weighted logistic regression and explainable machine learning.</p><p><strong>Methods: </strong>We analyzed hospitalizations among AD patients aged ≥60 in the 2017 Nationwide Inpatient Sample (NIS). The outcome was in-hospital death. Predictors included demographics, hospital variables, and 15 comorbidities. Logistic regression used survey weighting to generate nationally representative inference; XGBoost incorporated NIS discharge weights as sample weights during 5-fold hospital-grouped cross-validation and used the same weights in performance evaluation. Missing-value imputation and feature scaling were performed within the cross-validation pipelines to prevent data leakage. Model performance was assessed using AUROC, AUPRC, Brier score, and log loss. Feature importance was assessed using adjusted odds ratios and SHapley Additive exPlanations (SHAP). A sensitivity analysis excluded palliative care and DNR status and was re-evaluated under the same grouped cross-validation.</p><p><strong>Results: </strong>In the full model, logistic regression achieved AUROC 0.879 and AUPRC 0.310, while XGBoost achieved AUROC 0.887 and AUPRC 0.324. Palliative care (aOR 6.19), acute respiratory failure (aOR 5.15), DNR status (aOR 2.20), and sepsis (aOR 2.26) were the strongest logistic predictors. SHAP analysis corroborated these findings and additionally emphasized dysphagia, malnutrition, and pressure ulcers. In sensitivity analysis excluding palliative care and DNR status, logistic regression performance declined (AUROC 0.806; AUPRC 0.206), while XGBoost performed similarly (AUROC 0.811; AUPRC 0.206). SHAP corroborated the dominant signals from end-of-life documentation and acute organ failure in the full model; in the restricted model (excluding DNR and palliative care), SHAP highlighted physiologic and frailty-related features (e.g., dysphagia, malnutrition, aspiration risk) that may be more actionable when end-of-life documentation is absent.</p><p><strong>Conclusions: </strong>Combining regression with explainable machine learning enables robust mortality risk stratification in hospitalized AD patients. Restricted models excluding end-of-life indicators provide actionable risk signals when such documentation is absent, while the full model may better support resource allocation and goals-of-care workflows.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503505","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":"Interdisciplinary Strategies for Improving Oral Health in Older Adults: A Comprehensive Review.","authors":"Joanna Cheuk Yan Hui, Lindsey Lingxi Hu, Alice Kit Ying Chan, Chun Hung Chu","doi":"10.3390/geriatrics11010022","DOIUrl":"10.3390/geriatrics11010022","url":null,"abstract":"<p><p>Oral health in older adults is a critical component of overall well-being requiring integrated, interdisciplinary approaches to address its complex interplay of medical, functional, and psychosocial challenges. The aim of this is to examine strategies to enhance interdisciplinary collaboration among dental professionals, physicians, nurses, nutritionists, and caregivers to improve oral health outcomes in aging populations. Older adults commonly face dental problems such as periodontal disease which can be exacerbated by polypharmacy, systemic diseases, and barriers to accessing care. These multifaceted needs necessitate coordinated efforts across dentistry, geriatric medicine, nursing, and social support systems. Strategies of effective interdisciplinary care include: (1) Medical-dental integration, enabling physicians to screen for oral health issues during routine assessments; (2) Nursing and caregiver engagement in daily oral hygiene support and early problem identification; (3) Nutritional interventions tailored to address chewing difficulties and prevent malnutrition; (4) Social support systems to improve access to affordable care; and (5) Technology-driven solutions such as tele-dentistry to enhance communication, early detection, and care coordination. Despite these opportunities, systemic barriers persist, including fragmented healthcare systems, financial constraints, workforce shortages, cultural biases, and technological gaps. Progress requires commitment from policymakers, healthcare institutions, and health care professionals to prioritize geriatric oral health as a public health imperative. In conclusion, interdisciplinary collaboration enhances older adults' oral-systemic health via cross-sector policies and healthcare workforce education. Implementing these strategies can mitigate oral health disparities, reduce the burden of chronic diseases, and improve quality of life for aging populations through holistic, patient-centered care.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12940609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289831","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":"Temporal Prognostic Factors in Elderly Patients with Acute Heart Failure: A Cohort Study from a Spanish Emergency Department.","authors":"Itziar Ostolaza Tazón, Héctor Alonso Valle, Pedro Muñoz Cacho","doi":"10.3390/geriatrics11010021","DOIUrl":"10.3390/geriatrics11010021","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Acute heart failure (AHF) is a common cause of hospitalization in older adults, associated with high morbidity and mortality. In this population, frailty, comorbidity, and functional variability significantly influence prognosis. This study evaluated short-term (30-day) and long-term (1-year) mortality predictors in elderly patients with AHF treated in the emergency department (HED), considering clinical variables, comorbidities, and precipitating factors (PFs). <b>Materials and Methods:</b> An observational cohort study was conducted based on a secondary analysis of older patients with AHF included in the Epidemiology of Acute Heart Failure in Emergency Departments (EAHFE) registry, treated at Hospital Universitario Marqués de Valdecilla (HUMV) between 2007 and 2022. Clinical, laboratory, and PF-related variables were collected. The primary outcome was all-cause mortality at 30 days and 1 year. Univariate and multivariate logistic regression analyses were performed. <b>Results:</b> A total of 548 patients were included (mean age: 80.7 years), of whom 78.6% required hospitalization, mainly in the Internal Medicine department. Mortality was 11.1% at 30 days and 29.9% at 1 year. Age, valvular heart disease, dementia, and elevated creatinine levels were independently associated with higher mortality. Hypoxemia and low-output symptoms were linked to short-term mortality, while NYHA class III and anemia were associated with long-term mortality. Among PFs, acute coronary syndrome (ACS) was related to worse short-term outcomes, whereas rapid atrial fibrillation (AF) was inversely associated with long-term mortality. <b>Conclusions:</b> The prognostic relevance of risk factors differs between short- and long-term outcomes in older patients with AHF. Incorporating clinical characteristics and PFs into risk stratification models may support individualized management and guide follow-up strategies tailored to the geriatric profile. This multidimensional approach is essential to improve clinical decision-making and outcomes in a highly vulnerable population.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12940665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289791","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}