Geriatrics最新文献

{"title":"Premorbid Personality in Alzheimer's Disease and Caregiver Well-Being: The Role of Extraversion.","authors":"Jordina Muñoz-Padros, Quintí Foguet-Boreu, Emma Puigoriol-Juvanteny, Maite Garolera","doi":"10.3390/geriatrics11040108","DOIUrl":"10.3390/geriatrics11040108","url":null,"abstract":"<p><p><b>Objectives:</b> To examine the association between premorbid personality in people with Alzheimer's disease and caregiver well-being, while accounting for caregiver personality, sociodemographic characteristics, and behavioural and psychological symptoms of dementia. <b>Methods:</b> This cross-sectional observational study included 56 dyads consisting of people with mild-to-moderate Alzheimer's disease and their informal caregiver. Caregiver well-being was operationalised using a continuous index derived from a principal component analysis integrating depressive and anxiety symptoms, burden, loneliness, perceived social support, quality of life and happiness. Caregiver personality and the premorbid personality of people with Alzheimer's disease (assessed retrospectively by an informant) were assessed according to the Big Five model. Behavioural and psychological symptoms of dementia were assessed using the Neuropsychiatric Inventory. Associations were examined using correlation analyses and hierarchical multiple linear regression models. <b>Results:</b> Caregivers had a mean age of 55.2 years (SD = 11.0), and 82.1% were women. Higher premorbid extraversion of people with Alzheimer's disease was significantly associated with better caregiver well-being (β = 0.123; <i>p</i> < 0.05), and this association remained significant after adjustment for caregiver personality and other covariates. The final model explained 57.3% of the variance in caregiver well-being (R² = 0.573; <i>p</i> < 0.001). <b>Conclusions:</b> Premorbid extraversion of people with Alzheimer's disease was independently associated with caregiver well-being. These findings suggest that personality characteristics of both may be relevant for understanding caregiver well-being within a relational perspective of caregiving.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827540","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":"Navigating Support for Informal Caregivers of Older Migrants with Dementia in The Netherlands: Insights from Patient Journey Mapping.","authors":"Margaret von Faber, Suzan van der Pas","doi":"10.3390/geriatrics11040105","DOIUrl":"10.3390/geriatrics11040105","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The aim of the study is to determine factors that affect informal caregivers' ability to care for older migrants with dementia, with a broad aim of providing a framework for improving regional formal support. We used patient journey mapping as a method to identify experiences of informal caregivers. <b>Methods</b>: The study took place in three phases. In the first phase, the content of the patient journey was outlined, and semi-structured interviews were conducted with 14 informal caregivers of people with dementia and a migrant background. In the second phase, results of the interviews were discussed in workshops with professionals. In the third phase, professionals worked together on a plan for improving care and support. <b>Results</b>: Besides positive experiences with care and support, informal caregivers expressed the need for knowledge and training, timely information as well as practical culturally sensitive care and support. Professionals expressed a need for more knowledge of culturally sensitive issues and conversation techniques. They also indicated the need for more integrated care and the ability to offer practical solutions for informal caregivers. As a final result, a multidisciplinary programme on improving knowledge, information for clients, informal caregivers and professionals, use of key figures, culturally sensitive support, a multidisciplinary care path and education for future professionals was launched for the region. <b>Conclusions</b>: A patient journey is a valuable method to pinpoint problems and needs of informal caregivers as well as professionals. It provides a foundation for multidisciplinary communication and collaboration to improve care and support.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827392","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":"Long-Term Physical Activity Patterns and Risk of Future Frailty: A Systematic Review and Age-Stratified Meta-Analysis.","authors":"Danai Sgouropoulou, Maria-Iosifina Kasdagli, Demosthenes B Panagiotakos, Petros P Sfikakis, Evrydiki Kravvariti","doi":"10.3390/geriatrics11040104","DOIUrl":"10.3390/geriatrics11040104","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Physical activity (PA) interventions have the potential to delay or reverse frailty in older people, and previous meta-analyses have shown that PA reduces frailty risk. However, introduction and maintenance of PA during midlife might be more impactful as a public health intervention to reduce frailty at the population level. This study aimed to evaluate the impact of longitudinal PA patterns on future frailty risk and to examine whether it is modified by age of onset before vs. after 60 years. <b>Methods</b>: We conducted a systematic review and meta-analysis of prospective population-based cohort studies evaluating the effect of longitudinal PA trajectories on frailty risk of community-dwelling adults below and above 60 years at baseline. Risk ratios (RRs) from studies eligible for quantitative synthesis were pooled using random-effects meta-analysis. Results: Ten studies involving 111,714 participants from Europe, Asia, and North America were included in the systematic review and six in the meta-analysis. Relative to long-term physical inactivity, persistent PA trajectory was associated with 44% reduced risk of frailty (RR = 0.56, 95% CI:0.42-0.76) with moderate certainty, while inclining trajectories were associated with a 38% reduced risk (RR = 0.62, 95% CI: 0.57-0.68) with low certainty. <b>Results</b>: were similar for populations > 60 and <60 years at baseline. <b>Conclusions</b>: Sustained or increasing PA patterns over time are associated with lower risk of future frailty. These findings warrant further implementation studies to quantify the impact of public health policies promoting physically active lifestyles in midlife on the burden of frailty in aging populations.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827418","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":"Autoimmune Oral Mucosal Diseases in Older Patients: An Overview of Early Recognition and Management in the Primary Care Setting.","authors":"Anahita Gupta, Donna A Culton","doi":"10.3390/geriatrics11040102","DOIUrl":"10.3390/geriatrics11040102","url":null,"abstract":"<p><p>Autoimmune oral mucosal diseases, including pemphigus vulgaris, mucous membrane pemphigoid, and oral lichen planus, are important yet frequently underrecognized causes of morbidity in older adults. These conditions often initially present with nonspecific symptoms such as persistent oral pain, erosions, ulcerations, or gingival inflammation, contributing to delays in diagnosis and treatment. Primary care clinicians and geriatricians are uniquely positioned to identify these diseases early and facilitate timely referral for diagnostic confirmation and initiation of therapy. This review provides a practical overview of the clinical presentation, diagnostic evaluation, and initial management of pemphigus vulgaris, mucous membrane pemphigoid, and oral lichen planus and highlights features that should raise suspicion for an autoimmune oral process. In addition to disease-specific therapies, supportive care measures including pain control, oral hygiene counseling, nutritional support, and mental health screening are essential to reducing morbidity and improving quality of life. Special consideration should be given to challenges disproportionately affecting older adults, including frailty, polypharmacy, and social barriers to care. Through timely recognition and a multidisciplinary, patient-centered approach, clinicians can improve outcomes and support the quality of life of this patient population.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827252","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":"Lost in Translation: Interprofessional Variability in Understanding Pro Re Nata (PRN) Prescribing in Geriatric Practice-A Prospective Observational Study.","authors":"Pauline Ripoche, Thomas Rodier, Marine Grangé, Dany Vythilingum, Zohra Mekerta, Aude Tarré, Patrick Hindlet, Laurent Lechowski, Hugues Michelon","doi":"10.3390/geriatrics11040103","DOIUrl":"10.3390/geriatrics11040103","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Medication safety is a critical concern in older adults due to age-related vulnerability, multimorbidity, and polypharmacy. Pro Re Nata (PRN, \"as needed\") prescribing is common in geriatric care but may be interpreted inconsistently across healthcare professionals, potentially increasing the risk of medication errors. This study aimed to evaluate PRN prescribing patterns in hospitalized older adults and assess interprofessional perceptions of the clarity and appropriateness of PRN prescribing for conditions. <b>Methods:</b> We conducted a prospective, single-day observational study in a French geriatric university hospital, including all patients aged ≥65 years with at least one medication prescription. PRN prescriptions were extracted from electronic medical records and independently assessed by a pharmacist, nurse, and physician for clarity and appropriateness. Descriptive statistics summarized PRN use, chi-square tests assessed interprofessional differences, and multivariate logistic regression identified predictors of appropriate PRN wording. <b>Results:</b> Among 316 patients, 1035 PRN prescriptions were analyzed, representing 24.5% of all medication entries. Only 51.3% (n = 531) were deemed appropriate by all evaluators. Significant differences in interpretation were observed across professional groups (<i>p</i> < 0.001 for most pairwise comparisons). PRN prescriptions were most frequent in long-term care units and primarily involved gastrointestinal agents, analgesics, and psychotropic medications. Multivariate analysis showed that hospitalization in long-term care (OR = 4.17; 95% CI 2.48-7.03) or rehabilitation units (OR = 2.07; 95% CI 1.22-3.53) with a higher number of prescriptions administered under a therapeutic protocol PRN (OR = 2.27; 95% CI 1.39-3.63) were independently associated with appropriate wording, while a higher total number of PRN prescriptions reduced appropriateness (OR = 0.87; 95% CI 0.82-0.94). <b>Conclusions:</b> PRN prescribing is frequent in hospitalized older adults and often involves high-risk or potentially inappropriate medications. Substantial interprofessional variability in the interpretation of PRN medication wording requires appropriate, standardized, and clinical PRN guidelines to improve medication safety and reduce potential adverse events in geriatric practice.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827414","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 over Numbers: Pharmacological Burden and Scalable Medication Review in Older Adults.","authors":"Michał Pstrągowski, Dawid Hachlica, Łukasz Izbicki","doi":"10.3390/geriatrics11040100","DOIUrl":"10.3390/geriatrics11040100","url":null,"abstract":"<p><p>Polypharmacy in older adults is common, rising and inconsistently defined, and it is widely treated as a problem of how many medicines a person takes. This non-systematic narrative review argues that its harm depends more on the appropriateness of the regimen and the pharmacological burden the regimen imposes, with the number of drugs a partly confounded marker rather than the principal cause. Drawing on evidence published mainly since 2020, it traces the shift from counting medicines to weighting them; the prescribing cascade as a patterned and detectable source of inappropriate use; the explicit criteria (Beers, STOPP/START, EURO-FORTA) and implicit measures (the Medication Appropriateness and Drug Burden indices) that give appropriateness operational form; and the evidence that deprescribing is feasible and generally safe, although its benefit is conditional and depends on how it is done. Because these criteria can be applied to medication lists held in routine data, potentially inappropriate prescribing can increasingly be identified beyond the single encounter and at population scale, even as automated tools remain unreliable at judging whether a flagged criterion applies to the individual patient. The review concludes that medication review should prioritise appropriateness and the individual benefit-risk balance rather than the medication count, and that detection can increasingly be scaled even though the clinical decision and the patient's agreement cannot.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827308","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":"Factors Associated with 30-Day Non-Return to Pre-Hospital Residence in Older Patients Hospitalized with Pneumonia or Lower Respiratory Tract Infection: The Role of Serum Albumin and Early Treatment Failure.","authors":"Akira Goto, Takayoshi Hozuki, Akihiro Matsumura, Hiroaki Mita, Norikazu Iwata, Emiko Tsuda, Ikumi Ebisu, Kazumi Yonekura, Susumu Kikuchi, Masahiro Nakamura, Yukinari Yoshida, Yuji Hinoda, Hiroo Yuasa, Yasuo Kato","doi":"10.3390/geriatrics11040101","DOIUrl":"10.3390/geriatrics11040101","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Return to the pre-hospital residence is a meaningful patient-centered outcome after hospitalization for pneumonia or lower respiratory tract infection (LRTI). We examined factors associated with 30-day non-return, including prespecified baseline characteristics, the initial empirical antimicrobial therapy pattern, and initial treatment failure within 7 days. <b>Methods:</b> This retrospective observational study included 126 consecutive patients aged ≥65 years admitted with pneumonia or LRTI to a community-based general hospital in Japan. Patients who died within 48 h were excluded. Three multivariable logistic regression models were fitted: Model 1 evaluated prespecified baseline characteristics; Models 2 and 3 added the initial empirical antimicrobial therapy pattern and initial treatment failure within 7 days, respectively. Initial treatment failure was treated as a post-baseline marker of an unfavorable early clinical course. <b>Results:</b> The median age was 89.0 years, and 56 patients (44.4%) returned to their pre-hospital residence within 30 days. Higher serum albumin was associated with lower adjusted odds of non-return across all models (OR range, 0.365-0.407 per 1 g/dL increase). Initial treatment failure was associated with higher adjusted odds of non-return (OR, 3.296; 95% CI, 1.095-9.923), whereas the initial empirical antimicrobial therapy pattern showed no statistically significant overall association (global <i>p</i> = 0.859). The principal findings were materially unchanged in sensitivity analyses addressing early deaths and the treatment-failure definition. However, in other supportive analyses, the associations remained directionally consistent but were attenuated and no longer statistically significant in the analysis restricted to 30-day survivors; in addition, the serum albumin association in Model 3 did not retain statistical significance in some leave-one-out analyses. <b>Conclusions:</b> Higher serum albumin at admission was associated with lower odds of 30-day non-return, whereas initial treatment failure was associated with higher odds. Initial treatment failure should be interpreted as a post-baseline marker of an unfavorable early clinical course rather than as an independent baseline predictor. No statistically significant association with the initial empirical antimicrobial therapy pattern was detected. These findings do not establish causality.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827367","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":"Perspectives of Healthcare Providers and Managers on Older Adults' Transition to a Long-Term Care Facility in the Côte-Nord Region of Quebec.","authors":"Mélanie Le Berre, Fanny Leblanc, Mathieu Hotton, Marie-Pierre Gagnon, Félix Pageau, Émilie Dionne, Marie-Soleil Hardy, Maxime Sasseville, Samira Amil, Manon Cody, Louise Bertrand, André Côté, Maude Laberge","doi":"10.3390/geriatrics11040099","DOIUrl":"10.3390/geriatrics11040099","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Older adults' transitions to long-term care facilities (LTCFs) are complex. In Quebec, Canada, recent policies promoted LTCFs as living environments. The Life Story questionnaire was suggested as one tool to support this shift. In addition, rural regions may face specific barriers to successful transitions to LTCFs. The Côte-Nord region, with a vast territory and a low population density, offers a distinctly rural setting. The objective of this study was therefore to describe healthcare providers' and managers' perceptions of the use of the Life Story questionnaire during the transition to an LTCF in the Côte-Nord region of Quebec, and gain a deeper understanding of the factors influencing its implementation in this context. <b>Methods</b>: A qualitative study was conducted. Semi-structured interviews were audio-recorded, transcribed and analyzed using a descriptive interpretive methodology. <b>Results</b>: Participants highlighted social workers' central role in completing the questionnaire and discussed its use by team members. They valued the tool for supporting individualized care and emotional well-being. They also identified barriers and facilitators at institutional, inter-institutional and organizational levels. Barriers included staff turnover and the difficulty of establishing a wide cultural shift. Facilitators included institutional support, consistent access to completed questionnaires, stable teams, interprofessional collaboration and inter-institutional collaboration. Participants finally offered some recommendations to spread the practice and foster a more consistent use across settings. <b>Conclusions</b>: The Life Story questionnaire appeared to support policy priorities and may be particularly valuable when completed prior to LTCF admission. Further research could explore its impact on specific indicators.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827528","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 Cachexia Defined by the Asian Working Group for Cachexia Criteria and One-Year Post-Discharge Mortality in Older Adults with Acute Decompensated Heart Failure.","authors":"Daisuke Suzuki, Toshimi Sato, Yuichiro Sasamoto, Shun Monoe, Keita Kaneko, Shinichiro Morishita","doi":"10.3390/geriatrics11040098","DOIUrl":"10.3390/geriatrics11040098","url":null,"abstract":"<p><p><b>Background</b>: Cachexia is a well-known clinically important condition in older adults with heart failure, but evidence regarding cachexia defined by the Asian Working Group for Cachexia (AWGC) criteria in those with acute decompensated heart failure (ADHF) remains limited. <b>Methods</b>: This prospective observational study included 78 patients aged 65 years or older who were hospitalized for ADHF. Cachexia on admission was diagnosed using the AWGC criteria. The primary outcome was all-cause mortality within one year after discharge and the secondary outcome was all-cause readmission within the same period. <b>Results</b>: Cachexia was diagnosed in 26 patients (33.3%). Compared with the patients without cachexia, those with cachexia were older and had a lower body mass index, poorer nutritional status, and reduced physical function. Cachexia was associated with a significantly higher risk of all-cause mortality after discharge. In the adjusted Cox proportional hazards model, cachexia remained significantly associated with all-cause mortality within one year after discharge (HR, 3.04), whereas no significant association was observed with all-cause readmission. <b>Conclusions</b>: Among older adults hospitalized for ADHF, AWGC-defined cachexia on admission was associated with increased all-cause mortality within one year after discharge. Although these findings suggest that AWGC-defined cachexia may be useful for identifying a clinically vulnerable phenotype, they should be interpreted as exploratory and confirmed in larger multicenter studies.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827272","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":"Regional Geriatric Trauma Advice for Older Patients with Chronic Subdural Haematoma-A Novel Service for Multi-Disciplinary Decision-Making.","authors":"Frances Rickard, Rebecca Hutchins, David Shipway, Adam Williams, Anthony Cox, Alex Mortimer","doi":"10.3390/geriatrics11040097","DOIUrl":"10.3390/geriatrics11040097","url":null,"abstract":"<p><p><b>Background:</b> Chronic subdural haematoma (cSDH) is one of the most common neurocranial conditions in older adults and is increasing in incidence. Conservatively managed patients are typically older, frailer, and more comorbid than surgical candidates, yet specialist geriatrician input into their management is rarely formalised. Potential for geographic inequity in hub-and-spoke neurosurgical networks within the UK compounds this challenge. We describe a service evaluation of a novel regional geriatric trauma advice service providing specialist trauma geriatrician input into cSDH management alongside the neurosurgical team, across a single UK Neurosurgical Network. To the authors' knowledge, this is the first of its kind in the UK. Prior to this service 'normal' care within our region was no routine specialist medical input. <b>Methods:</b> A service evaluation of all referrals received by the North Bristol National Health Service (NHS) Trust geriatric trauma team between July 2024 and March 2026 was performed by the authors. Referrals were discussed within a multidisciplinary team including geriatric trauma, interventional neuroradiology and neurosurgery. Individuals' demographic data, advice types, management enhancement, intervention outcomes and mortality were recorded and analysed descriptively. Management enhancement was defined as a definitive management decision that resulted in either an action or an active decision not to act. <b>Results:</b> Ninety referrals were included. Median age was 83 years (IQR 77-88) and median Clinical Frailty Scale (CFS) score was 4, with 50% classified as frail (CFS 4-8). Referrals were received from five satellite NHS trusts and the community. Three-quarters (75.6%) required multiple concurrent advice types; Middle Meningeal Artery Embolisation (MMAE) suitability (93.3%) and antithrombotic management (51.1%) were the most frequent. Specialist geriatrician input enhanced management in 97.8% of cases. Forty percent of conservatively managed patients were converted to active intervention, most commonly standalone MMAE (50%). Of district general hospital patient referrals, 40.3% were conveyed to the neurosurgical centre following geriatric trauma review. Mortality was comparatively lower at multiple time points when compared to existing UK data for conservatively managed patients. <b>Conclusions:</b> A regional virtual geriatric trauma advice service for older adults with cSDH is feasible and is associated with enhanced management of this cohort, potentially improving access to treatment. Combining neurosurgical, neurointerventional and geriatrician expertise through a structured multi-disciplinary team (MDT) approach addresses the clinical complexity of this patient group and the potential geographic inequity of hub-and-spoke networks. Further research is needed to investigate the impact of routine geriatrician input into cSDH care.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827478","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}