Geriatrics最新文献

{"title":"Polypharmacy in Older Adults: A Narrative Review of Clinical Risks, Deprescribing Strategies, and Interdisciplinary Management.","authors":"Himat Hussein Mamand, Nóra Rozmann, Miklós Sugár, Ahmed Lateef Abed Alkhaqani, Saya Hama, Bence Raposa","doi":"10.3390/geriatrics11040096","DOIUrl":"10.3390/geriatrics11040096","url":null,"abstract":"<p><p><b>Background/Objective</b>: Polypharmacy, conventionally defined as the concurrent use of five or more medications, has emerged as a critical public health challenge in aging populations worldwide. Polypharmacy in older adults, driven by multimorbidity and age-related physiological changes, increases the risk of adverse drug reactions, drug interactions, falls, cognitive impairment, non-adherence, and preventable hospitalization. This study aims to provide a structured narrative synthesis of the current evidence on the incidence, risk factors, and clinical management of polypharmacy in elderly patients, with particular emphasis on deprescribing strategies, interdisciplinary care models, patient education, and digital clinical decision support technologies. <b>Methods</b>: A structured narrative literature review was conducted across PubMed, Scopus, and Web of Science using Boolean combinations of MeSH and free text terms including 'polypharmacy,' 'elderly,' 'deprescribing,' and 'medication review.' Eligible sources were peer-reviewed primary studies published between January 2016 and June 2026 that enrolled adults aged ≥65 years and reported validated prescribing review approaches, such as the STOPP/START criteria. The review drew on 40 primary studies spanning randomized controlled trials (RCTs) and observational, qualitative, and mixed-methods designs, which were interpreted and synthesized narratively across the principal thematic domains of polypharmacy management. <b>Results</b>: Polypharmacy was independently and consistently associated with DDIs, preventable hospitalizations, and functional decline across diverse clinical settings. Pharmacist-led medication reviews and interdisciplinary, team-based interventions produced the most robust improvements in prescribing appropriateness and meaningful reductions in potentially inappropriate medications (PIMs). Electronic clinical decision support systems (CDSSs) have demonstrated measurable benefits for safe deprescribing at scale, although usability limitations, incomplete workflow integration, and clinician resistance are significant implementation obstacles. <b>Conclusions</b>: Effective management of polypharmacy in older adults requires a multicomponent, patient-centered strategy that integrates evidence-based deprescribing algorithms, principally the STOPP/START criteria, sustained interdisciplinary collaboration, structured patient education, and technology-assisted decision support.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827463","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 Multimodal Exercise Intervention on Single- and Dual-Task Gait Performance in Older Patients with Open-Angle Glaucoma: A Pilot Study.","authors":"Constantin W Freitag, Martin Behrens, Robert Bielitzki, Tom Behrendt, Khaldoon O Al-Nosairy, Cynthia Moffack Djuloun, Francie H Stolle, Hagen Thieme, Michael B Hoffmann, Lutz Schega","doi":"10.3390/geriatrics11040095","DOIUrl":"10.3390/geriatrics11040095","url":null,"abstract":"<p><p><b>Background/Objectives</b>: To investigate the effects of a 12-week multimodal intervention (MMI [resistance + motor-cognitive dual-task training]) versus a unimodal intervention (UMI [resistance training]) on gait and cognitive performance in people with glaucoma during single-task (ST) and dual-task (DT) walking. <b>Methods</b>: In this randomized controlled pilot study, fifteen glaucoma patients (MMI: <i>n</i> = 8, UMI: <i>n</i> = 7) completed 24 supervised intervention sessions over 12 weeks. Spatio-temporal gait parameters (stride length, gait velocity, minimum toe clearance [MTC], and their respective coefficient of variance [CoV]) were assessed using inertial measurement units (sampling frequency 100 Hz) during ST and DT walking. During DT walking, the participants performed three cognitive tasks: reaction time task, N-Back task, and letter fluency task. Each cognitive task was performed with two levels of difficulty. Repeated measures analysis of covariance (TIME × INTERVENTION × CONDITION) was conducted to analyze the data. <b>Results</b>: No significant group or time effects were observed for ST walking or cognitive performance. Independent of intervention, dual-task costs (DTC) improved for MTC (<i>p</i> = 0.188, ηp2 = 0.205) and MTC_CoV (<i>p</i> = 0.021, ηp2 = 0.713) over time. UMI showed greater improvements over time than MMI for DTC MTC (<i>p</i> = 0.168, ηp2 = 0.223) and DTC MTC_CoV (<i>p</i> = 0.047, ηp2 = 0.407). <b>Conclusions</b>: This pilot study indicated that both MMI and UMI decreased DTC MTC and DTC MTCCoV in glaucoma patients, with probably higher effects after UMI. These preliminary findings must be interpreted with caution due to the small sample size, but the provided effect size measures and sample size calculations can be used for future randomized controlled trials to verify and extend these results.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827393","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":"Role Captivity in Former Dementia Caregivers: Constrained Choice, Role Engulfment and Caregiver Wellbeing in Ageing Care.","authors":"Barbara Plagg, Heidi Flarer, Petra Wlasak, Adolf Engl, Doris Hager von Strobele-Prainsack, Klaus Eisendle, Giuliano Piccoliori","doi":"10.3390/geriatrics11040094","DOIUrl":"10.3390/geriatrics11040094","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Family caregiving for people living with dementia is central to ageing and long-term care, but it is not only a practical arrangement but also a relational and structurally shaped experience. Care may be grounded in affection, responsibility, and connection, while still becoming difficult to refuse, share, or limit. Although caregiver burden is well documented, less is known about how former caregivers retrospectively appraise the caregiving role after active care has ended. This study examined role captivity among former family caregivers, focusing on constrained choice, subjective role engulfment, perceived support, and caregiver wellbeing. <b>Methods:</b> A retrospective cross-sectional mixed-methods survey was conducted among 180 former family caregivers of people living with dementia in Northern Italy. Quantitative analyses examined associations between role-captivity-related indicators and retrospective caregiving outcomes. Open-ended responses were analysed using theory-informed qualitative content analysis. <b>Results:</b> Constrained choice at caregiving uptake was reported by 22.2% of participants, and 56.1% met the criterion for subjective role engulfment. Overall, 60.0% would provide family care again, while only 28.3% would be willing to receive family care themselves. One in five reported caregiving-related health problems. In multivariable models, constrained choice was associated with lower willingness to provide care again (OR = 0.27, <i>p</i> = 0.002) and less positive retrospective appraisal (OR = 0.35, <i>p</i> = 0.036). Subjective role engulfment was independently associated with less positive appraisal (OR = 0.36, <i>p</i> = 0.008), while perceived support was associated with positive appraisal (OR = 6.31, <i>p</i> < 0.001) and perceived processing (OR = 2.68, <i>p</i> = 0.013). Qualitative findings showed that caregiving was often remembered as meaningful and relationally important, yet difficult to refuse, progressively all-consuming, and shaped by structural and informational barriers. <b>Conclusions:</b> Retrospective appraisal of family dementia caregiving depends not only on care demands, but also on whether care was experienced as chosen, bounded, shared, and supported. Role captivity helps identify when relationally meaningful care becomes difficult to sustain and highlights the need for caregiver-sensitive dementia care that protects agency, role boundaries, and access to timely support.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827470","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":"Understanding Factors Contributing to Vitality in Older Adults: A Qualitative Descriptive Study.","authors":"Ilana I Logvinov, Jennifer Crook, Donna Neff, Cindy Tofthagen, Victoria Loerzel","doi":"10.3390/geriatrics11040093","DOIUrl":"10.3390/geriatrics11040093","url":null,"abstract":"<p><p><b>Background</b>: By 2030, nearly one-quarter of the U.S. population will be over age 65, emphasizing the need to understand factors that promote healthy aging. Vitality is often reduced to physical indicators in clinical frameworks, overlooking its multidimensional nature. <b>Methods:</b> This qualitative descriptive study explored how independently living older adults define and experience vitality, focusing on physical, emotional, cognitive, and social dimensions. Guided by Self-Determination Theory, semi-structured interviews were conducted with 10 participants aged 61-83 years purposively recruited from community and faith-based settings in Northeast Florida. <b>Results</b>: Thematic analysis revealed four interconnected themes: (1) <i>Make Adjustments, Keep Going</i>; (2) <i>Being Mentally Jubilant</i>; (3) <i>Bonds that Keep Me Going</i>; and (4) <i>Thriving Amid Uncertainty</i>. <b>Conclusions</b>: Findings suggest that participants perceived vitality as a dynamic, multidimensional process shaped by adaptation, purpose, and connection rather than physical health alone. These insights underscore the need for holistic approaches to vitality assessment and interventions that support autonomy, competence, and relatedness in later life.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827453","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":"Muscle Matters: Dietary Supplement Use and Sarcopenia Risk.","authors":"Francesco Saverio Ragusa, Anna Licata, Pascal R Titone, Alessandro D'Aleo, Gerlando Speziale, Laura Vernuccio, Maurizio Soresi, Giovanna Di Bella, Lydia Giannitrapani, Nicola Veronese, Ligia J Dominguez, Mario Barbagallo","doi":"10.3390/geriatrics11040092","DOIUrl":"10.3390/geriatrics11040092","url":null,"abstract":"<p><p><b>Background:</b> The association between dietary supplement use and risk of sarcopenia in older adults remains poorly investigated. The primary objective of this study was to investigate the association between risk of sarcopenia and supplement use in older adults. <b>Methods:</b> A cross-sectional study was conducted to analyze the association between supplement use and risk of sarcopenia, assessed by the SARC-F questionnaire, in older outpatients. The associations between risk of sarcopenia and dietary supplement use were examined through logistic regression models. <b>Results:</b> A total of 162 participants were included in this study. Among supplement users (92 patients), 55.4% were identified as being at risk of sarcopenia (SARC-F ≥ 4). Regarding SARC-F components, dietary supplement users exhibited significantly higher median scores for walking assistance (median 1 vs. 0, <i>p</i> = 0.004) and rising from a chair (median 1 vs. 0, <i>p</i> = 0.04) compared to non-users. Individuals at risk were significantly more likely to use dietary supplements compared with those not at risk (OR 1.98, 95% CI 1. 05-3.76; <i>p</i> = 0.034), and this association remained significant after adjustment for confounders, such as sex, age, study, and marital status (OR 2.35, 95% CI 1.21-4.72; <i>p</i> = 0.013). Cognitive decline was the most frequently reported reason for supplement use in both groups. <b>Conclusions:</b> Dietary supplement use is highly prevalent among older adults and independently associated with sarcopenia risk, particularly tracking with functional limitations. Rather than a causal factor, supplementation may serve as a surrogate indicator of overall clinical vulnerability. These findings underscore the importance of assessing muscle health in older supplement users.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578429","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 Role of Subjective Vitality Among Older Adults from a Self-Determination Theory Perspective: A Scoping Review.","authors":"James Dawe, Christina M Frederick, Sara Manganelli, Elisa Cavicchiolo, Fabio Alivernini, Giulia Raimondi","doi":"10.3390/geriatrics11040091","DOIUrl":"10.3390/geriatrics11040091","url":null,"abstract":"<p><p><b>Background:</b> Aging involves several social, psychological, and biological changes, including changes in perceived energy. Within Self-Determination Theory, Subjective Vitality refers to the experience of having energy available to the self. Despite its relevance for older adults, no review has mapped how Subjective Vitality has been studied in this population. This scoping review aimed to map the literature on Subjective Vitality in older adults and identify gaps in the evidence base. <b>Method:</b> Following Joanna Briggs Institute guidance, five electronic databases were searched for peer-reviewed quantitative articles published between 1997 and 2026 in which Subjective Vitality was assessed in samples with a mean age of 65 years or older. Of the 1915 records identified, 11 reports were included, corresponding to eight independent samples. <b>Results:</b> Studies were conducted in a limited number of countries, predominantly Western, and showed substantial heterogeneity across research domains. Subjective Vitality was most often assessed using the Subjective Vitality Scale, although different versions and response formats were used, and psychometric or adaptation evidence specific to older adults was limited. Potential antecedents and mechanisms included basic psychological need satisfaction, autonomy support, autonomous regulation, intrinsic goals, flow, social contacts, ego integrity, and meaning in life. Intervention studies suggested that leisure education and endurance training may support Subjective Vitality, although evidence remains limited. <b>Conclusions:</b> Future studies should use clearer sampling procedures, validated and well-reported measures, and stronger longitudinal and intervention designs capable of testing temporal and causal relationships.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578345","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":"Pre-Pandemic- and During-COVID-19 Anxiety and Depression Symptoms and Health-Related Quality of Life Were Similar in Injured Older Adults Enrolled in a Clinical Trial.","authors":"Damaris Ortiz, Anthony J Perkins, Sujuan Gao, Nicholas Adam Sergiwa, Emma Holler, Ashley D Meagher, Sanjay Mohanty, Dustin D French, Sue Lasiter, Babar Khan, Malaz Boustani, Ben Zarzaur","doi":"10.3390/geriatrics11040090","DOIUrl":"10.3390/geriatrics11040090","url":null,"abstract":"<p><p><b>Introduction:</b> The Trauma Medical Home (TMH) randomized clinical trial tested the efficacy of a collaborative care intervention on the biopsychosocial recovery of older injured adults compared to usual care. Study enrollment occurred between 11 October 2017 and 13 October 2021 and study operations were impacted by the COVID-19 pandemic. It is important to measure the potential effects of COVID-19 on research study participants to ensure accurate reporting of results. The purpose of this secondary analysis was to compare depression and anxiety symptoms and health-related quality of life in older adults at TMH study enrollment pre-COVID-19 and during COVID-19. We hypothesized that those enrolled during COVID-19 would have worse symptoms and quality of life. <b>Methods:</b> This study was a secondary analysis of data from a multicenter randomized clinical trial (R01AG052493-01A1) TMH, that examined the ability of a collaborative care model to enhance the recovery of older injured adults compared to usual care. It was hypothesized that the TMH intervention would improve biopsychosocial recovery for injured older adults compared to usual care. The enrollment periods pre-COVID-19 and during COVID-19 were compared. Chi-square tests and Wilcoxon Rank Sum tests, then multivariable linear and logistic regressions were completed with SF-36 component scores and depression (PHQ-9) and anxiety (GAD-7) scores as the dependent variables, respectively. <b>Results:</b> A total of 429 participants were analyzed. There was no significant difference in anxiety and depression symptoms between the pre-COVID-19 and during-COVID-19 enrollment periods. Perceived limitations due to physical health problems were worse for those enrolled during COVID-19 (adjusted β = -9.8, 95% CI -18.3 to -1.4), but other health-related quality of life measures were similar between the two groups. <b>Conclusions:</b> These findings support the conclusion that the negative psychological impacts of the pandemic are likely due to individual factors other than age or COVID-19. These results suggest a high degree of psychological resiliency in older adults under stress. Future research should focus on the potential effects of socioeconomic status, demographic background, and level of physical functioning on psychological outcomes.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578381","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":"Uncovering Patient-Reported and Observed Barriers and Facilitators to Sufficient Dietary Intake in Acutely Admitted Older Adults: Insights from a Nutritional Trial.","authors":"Olivia Bornæs, Rikke Lundsgaard Nielsen, Ove Andersen, David Peick Sonne, Ingrid Poulsen, Mette Merete Pedersen, Aino Leegaard Andersen","doi":"10.3390/geriatrics11040089","DOIUrl":"10.3390/geriatrics11040089","url":null,"abstract":"<p><p><b>Background and Aims</b>: Insufficient dietary intake is common among hospitalized older (≥65 years) adults with or at risk of malnutrition. Identifying barriers and facilitators is essential for improving nutritional care in this population. This study aimed to identify the most frequently reported and observed barriers and facilitators linked to the achievement of estimated dietary requirements during a nutritional intervention. <b>Methods</b>: This descriptive, inductive qualitative content analysis used data from the intervention group (<i>n</i> = 65) of the OptiNAM trial (NCT03741283), a randomized controlled trial evaluating a multidisciplinary nutritional intervention among acutely admitted older adults at Copenhagen University Hospital, Hvidovre. A total of 23 of the 65 participants were hospitalized for ≥24 h, allowing dietary intake to be assessed by a dietitian using validated 24 h dietary records, supplemented by dietitian-conducted 24 h recalls when records were unavailable. Individual energy and protein requirements were estimated, and intake was validated and recorded. Meaning units were derived from free-text data from patient interviews or observations during patient interviews that were linked to dietary intake and categorized as barriers or facilitators depending on whether dietary intake was below or above the estimated requirements. <b>Results</b>: In acutely admitted older adults with malnutrition or malnutrition risk receiving a nutritional intervention during hospitalization, poor appetite was the most frequently reported barrier to sufficient dietary intake (73.9%), followed by disliking the food (39.1%). In contrast, intrinsic motivation (69.6%), good appetite (34.8%), and support from relatives (30.4%) were the most commonly reported facilitators. <b>Conclusions</b>: Appetite, hospital meals, motivation, and support from relatives play central roles in achieving sufficient dietary intake among acutely admitted older adults with or at risk of malnutrition receiving a nutritional intervention.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578323","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":"Daily Step Count Is Associated with Frailty Status in Veterans Presenting for Major Operations.","authors":"Jessica Y Rove, Yi Su, Jennifer E Stevens-Lapsley, Hillary D Lum, Thomas N Robinson","doi":"10.3390/geriatrics11040088","DOIUrl":"10.3390/geriatrics11040088","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Frailty is an under-recognized preoperative risk factor for poor surgical outcomes. Recovery of preoperative ambulation levels one month after surgery represents an important patient-centered outcome. The purpose of this study was to (1) identify a preoperative daily step count threshold associated with frailty, and (2) characterize the one-month ambulation recovery (steps/day) of older adults (≥60 years) with and without frailty following major elective inpatient operations. <b>Methods</b>: This single-center observational pilot study included older adults undergoing elective inpatient operations at a Veterans Affairs Hospital. Frailty was assessed before surgery. Ambulation (steps/day) was measured continuously from ≥3 full days before surgery, to at least 28 days after surgery, using a wrist-worn accelerometer. Sensitivity analysis identified a step count threshold associated with frailty. The primary outcome was the percentage of daily steps recovered at 28 days. <b>Results</b>: The average age of participants (<i>n</i> = 109) was 69 years, and 37.6% (41/109) were identified as prefrail or frail. Preoperative steps/day were lower in the frail cohort (3322.00 [2654.70, 5483.20] versus 4993.95 [3540.90, 6599.97], <i>p</i> < 0.05). Sensitivity analysis showed 4137 steps/day to be associated with preoperative frailty, and this remained significant in multivariate analysis. At 28 days, the percentage of daily steps recovered did not differ between groups (72.57% [49.15, 92.06] overall). <b>Conclusions</b>: Preoperative frailty is associated with lower daily step counts (<4137 steps/day), identifying individuals at increased likelihood of frailty in this older Veteran cohort undergoing major surgery. The median daily step count, regardless of frailty status, was <5000 steps/day, consistent with a sedentary lifestyle, and likely too low to show a difference in one-month ambulation recovery. This finding underscores the need to explore walking interventions in older Veterans awaiting surgery.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578395","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":"Bias and Beliefs: Age Discrimination, Perceived Control over Cognitive Aging, and Executive Functioning in Caregiving Grandparents.","authors":"Maia A McLin, Laura A Shillingsburg, Amara L Mason, Kourtney Mia Barfield, Danielle Kristen Nadorff","doi":"10.3390/geriatrics11040087","DOIUrl":"10.3390/geriatrics11040087","url":null,"abstract":"<p><p><b>Background:</b> Caregiving grandparents face unique stressors that may affect cognitive health. Discrimination is associated with poorer cognitive performance, whereas stronger perceived control over cognitive aging is associated with better performance. This study examined how everyday discrimination and perceived control over cognitive aging relate to executive function in caregiving grandparents. <b>Methods:</b> Using cross-sectional data from the Midlife in the United States study (MIDUS 3), we analyzed 1326 grandparents (166 caregiving and 1160 non-caregiving) with complete data on all study measures. Everyday discrimination, perceived control over cognitive aging, and executive function were assessed with self-report surveys and telephone-based cognitive assessments. Mediation and moderated mediation models were estimated with covariates. <b>Results:</b> Perceived control over cognitive aging mediated the relation between discrimination and executive function, and this mediation was moderated by caregiving status. Among non-caregivers, stronger perceived control was associated with a weaker negative relation between discrimination and executive function. This protective pattern was not observed among caregiving grandparents. The moderation was attenuated to nonsignificance when an expanded covariate set was added, so it should be considered preliminary. <b>Conclusions:</b> The demands of caregiving may lessen the influence of control beliefs on cognitive performance. Because the design is cross-sectional, these results describe statistical rather than temporal mediation. The findings support targeted interventions for this vulnerable population, although they warrant further investigation.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"11 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578411","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}