Gerontology最新文献

{"title":"Delirium in Hospitalized Trauma Surgery Patients Cared by Geriatric Trauma Co-Management and Standard Care: A Propensity Score-Matched Analysis.","authors":"Eli Wolfgang, Joao Filipe Gonclaves Monteiro, Mitchell Wice, Mriganka Singh, Carla Tricia Williams, Nadia Mujahid, Rohit Tyagi, Andrew Stephen, Stephanie Lueckel, Lynn McNicoll, Stefan Gravenstein, Iva Neupane","doi":"10.1159/000553239","DOIUrl":"https://doi.org/10.1159/000553239","url":null,"abstract":"<p><strong>Introduction: </strong>Delirium is common in hospitalized older adults and is associated with higher morbidity and mortality in this population. Our geriatric trauma co-management (GTC) program integrates a geriatrician in the trauma team, with a focus on team-based, interdisciplinary care coordination to mitigate geriatric syndromes, including delirium.</p><p><strong>Methods: </strong>We analyzed 12,631 patients aged 65 and older admitted to the trauma surgery team at a level-1 trauma center from 2017 to 2024. We perform a 1:1 ratio matching of propensity scores. The primary outcome was delirium incidence, defined by acute encephalopathy, positive Confusion Assessment Method (CAM) score, or new use of antipsychotic medicine between GTC and usual standard care (UC). The secondary outcomes included discharge disposition, in-hospital falls, intensive care unit (ICU) length of stay (LOS), mortality, and 30-day readmission. Chi-square and Students's t tests were used for bivariate analyses. Multivariate linear or logistic regression analyses were used for outcomes. When applicable, the analyses were adjusted.</p><p><strong>Results: </strong>The propensity score-matched cohort included 1,318 patients (659 GTC; 659 UC). Mean age was 82.1 ± 8.1 years, 45% were male. GTC patients had a 37% higher likelihood of being discharged to SNF (1.37 [1.04-1.79]). The mean ICU LOS was higher in the GTC group (3.9 ± 5.7 days vs. 2.3 ± 3.7 days, adjusted p = 0.002), but there were no significant differences in mean LOS, in-hospital falls, in-hospital mortality, discharge to hospice or death during hospitalization, death within 30 days after discharge, or 30-day readmissions. For the prespecified composite delirium outcome, GTC patients had higher documented delirium (51.9%) compared with 28.1% for UC patients (2.50 [1.88-3.34]). Secondary exploratory analyses of individual delirium definitions showed higher rates of acute encephalopathy occurred in 7.6% of GTC patients versus 1.2% of UC patients (OR 14.80, 95% CI [4.82-45.45]; p < 0.0001). Positive CAM score was documented in 42.6% of GTC patients compared with 11.1% of UC patients (4.68 [3.23-6.78]; p < 0.0001). Positive CAM score and/or new use of antipsychotic medicine occurred in 27.2% of GTC patients versus 22.2% of UC patients (1.38 [1.02-1.87]; p = 0.038). In contrast, new antipsychotic alone was more common in UC (15.8% vs. 7.9%, p < 0.05). Among patients with a positive CAM score, GTC patients had lower in-hospital mortality compared with UC (8.2% vs. 18.4%; OR 0.40, 95% CI: 0.17-0.95; p < 0.05).</p><p><strong>Conclusion: </strong>GTC in older trauma patients helps identify delirium and potentially reduces the need for antipsychotics and improves mortality. A randomized controlled trial is needed to verify these findings.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-13"},"PeriodicalIF":3.1,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wearable-Derived Digital Biomarkers for Mobility Assessment and Risk Stratification in Older Adults: A Scoping Review.","authors":"Dhika Dharmansyah, Laili Rahayuwati, Iqbal Pramukti, Kuswandewi Mutyara","doi":"10.1159/ger/acxag001","DOIUrl":"10.1159/ger/acxag001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The global population aged ≥60 years will reach 2.1 billion by 2050. Mobility decline is a critical precursor of disability, hospitalization, and mortality in older adults, yet clinic-based assessments may have limited ecological validity and miss subtle deteriorations observable only under free-living conditions. Wearable technology offers continuous objective monitoring through digital biomarkers that may enable earlier intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To systematically map current evidence on digital biomarkers derived from wearable technology for mobility assessment and risk stratification in older adults (≥60 years), examining biomarker types, sensor devices, validation approaches, clinical applications, and evidence gaps. Evidence was stratified descriptively across cross-sectional mobility impairment, fall/frailty risk stratification, and longitudinal/prognostic decline.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Following Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines, we searched four databases (Scopus, PubMed/MEDLINE, Web of Science Core Collection, and IEEE Xplore) from 1 January 2019 to 31 March 2026. The protocol was prospectively registered (OSF; https://doi.org/10.17605/OSF.IO/PABFT). Two independent reviewers conducted screening and data extraction; disagreements were resolved by a third reviewer. A narrative synthesis was employed. Formal risk-of-bias assessment was not undertaken, consistent with JBI scoping-review methodology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From 3,345 identified records, 97 primary empirical studies met inclusion criteria after removing 2,796 duplicates and applying predefined eligibility (Cohen's κ = 0.86 title/abstract; κ = 0.88 full-text). Seven biomarker categories were identified (non-mutually exclusive; percentages sum to &gt;100%): gait spatiotemporal parameters (38.1%), daily-life mobility metrics (24.7%), frailty-related biomarkers (18.6%), cognitive-physical dual biomarkers (15.5%), circadian rhythm parameters (12.4%), gait dynamics/complexity (9.3%), and consumer device metrics (8.2%). Validation performance, where comparable, ranged from ICC 0.70-0.98 (reliability vs reference systems) and AUC 0.73-0.94 for fall/frailty discrimination; these are study-specific, not pooled estimates. Among circadian biomarkers, one large registry study (UK Biobank age-stratified analysis) reported a CosinorAge hazard ratio of 1.58 per year for all-cause mortality (95% CI 1.52-1.64), warranting prospective validation in dedicated older-adult cohorts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Wearable-derived digital biomarkers show promising, study-specific criterion and discriminative validity for mobility assessment and fall/frailty risk stratification in older adults across multiple clinical domains; however, direct longitudinal evidence for detecting mobility decline remains limited and heterogeneous. Evidence consistency and maturity vary across biomarker domains an","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time- versus Step-Based Physical Activity Metrics for Disability Incidence in Older Adults.","authors":"Takahiro Shimoda, Osamu Katayama, Ryo Yamaguchi, Chika Nakajima, Ayuka Kawakami, Daiki Yamagiwa, Shoma Akaida, Hiroyuki Shimada","doi":"10.1159/000553408","DOIUrl":"10.1159/000553408","url":null,"abstract":"<p><strong>Introduction: </strong>The recommended target durations for moderate-to-vigorous physical activity (MVPA) to promote health have been established; however, evidence supporting the use of step counts as a measure of physical activity remains limited. We aimed to compare the predictive ability of MVPA and step counts for incident disability among community-dwelling older adults.</p><p><strong>Methods: </strong>This prospective cohort study included a total of 8,664 community-dwelling older adults from a community-based setting. MVPA and step counts were measured using an accelerometer. Disability incidence and mortality rates were prospectively assessed over 60 months. Inverse probability weighting-adjusted receiver operating characteristic curve analysis was used to evaluate the predictive ability of MVPA and step counts for disability incidence, while adjusting for covariates.</p><p><strong>Results: </strong>A total of 1,373 (15.8%) patients developed an incidental disability within 60 months. In the inverse probability weighting analysis based on the covariate model, the areas under the curve for MVPA and step counts were 0.572 (95% confidence intervals [CI], 0.542-0.603) and 0.565 (95% CI, 0.537-0.596), respectively.</p><p><strong>Conclusion: </strong>Among community-dwelling older adults, step counts and MVPA showed comparable associations and predictive performance for incident disability after adjustment for background risk factors. Our findings support the use of step counts as a measure of physical activity in this population.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning Classification of Frailty Using Wearable-Derived Sleep Metrics in Community-Dwelling Older Adults.","authors":"Kyuenam Park, Sihyun Kim","doi":"10.1159/000553496","DOIUrl":"10.1159/000553496","url":null,"abstract":"<p><strong>Introduction: </strong>Frailty is a multifactorial geriatric syndrome, and sleep disturbances have emerged as a potential contributing factor. However, conventional statistical approaches may not adequately capture the complex and nonlinear patterns inherent in wearable-derived sleep data. This study evaluated the feasibility of machine learning (ML) models for classifying frailty using objectively measured sleep features in older adults under free-living conditions.</p><p><strong>Methods: </strong>This cross-sectional study included 90 community-dwelling adults aged ≥65 years. Participants were classified as robust or pre-frail/frail using the Fried frailty phenotype. Sleep data were collected via a wrist-worn device, and sleep stage, duration, and interaction features were extracted. Five ML models (random forest, gradient boosting, categorical boosting, extreme gradient boosting, and logistic regression) were developed, and model performance on an independent test dataset was evaluated using accuracy, F1 score, receiver operating characteristic area under the curve (ROC-AUC), precision-recall area under the curve (PR-AUC), sensitivity, specificity, and Matthews correlation coefficient. Shapley additive explanation (SHAP) analysis was applied to enhance model interpretability.</p><p><strong>Results: </strong>Among the evaluated models, random forest showed the best overall performance, achieving the highest ROC-AUC of 0.892 and PR-AUC of 0.894. SHAP analysis identified age, cognitive function, rapid eye movement sleep, sleep duration, and interaction features reflecting sleep characteristics as important contributors to frailty classification.</p><p><strong>Conclusion: </strong>Wearable-derived sleep monitoring combined with interpretable ML may provide a feasible and noninvasive approach for early frailty risk identification in older adults. Sleep features, together with age and cognitive function, may serve as meaningful indicators of frailty risk in older adults.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-13"},"PeriodicalIF":3.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-COVID-19 Condition Diagnosis among Older People: Findings from Swedish National Register Data.","authors":"Zhongsong Zhang, Minh Tuan Hoang, Jonas W Wastesson, Kristina Johnell","doi":"10.1159/000553601","DOIUrl":"10.1159/000553601","url":null,"abstract":"<p><strong>Introduction: </strong>Post-COVID-19 condition (PCC) denotes the persistence of symptoms following Severe Acute Respiratory Syndrome Coronavirus 2 infection. PCC poses a large disease burden worldwide. We aimed to explore the epidemiological characteristics of clinically diagnosed PCC among older people aged ≥65 years in Sweden and to establish a machine learning tool to predict PCC risk.</p><p><strong>Methods: </strong>This nationwide register-based study employed a cross-sectional design. Prevalence of PCC diagnosis recorded in hospital and specialized outpatient care settings among older people aged ≥65 years in Sweden was calculated. Logistic regression models were employed to assess the associations between various factors and PCC diagnosed in hospital and specialized outpatient care. A prediction model based on extreme gradient boosting was constructed based on selected features.</p><p><strong>Results: </strong>Of 236,943 older people aged ≥65 years who were diagnosed with COVID-19, 2.5% of them were diagnosed with PCC in hospital or specialized outpatient care. The odds of PCC diagnosed in hospital and specialized outpatient care in women were lower (odds ratio [OR] = 0.78, 95% confidence interval [CI]: 0.73-0.82). The odds decreased for each additional year of age (OR = 0.98, 95% CI: 0.98-0.98). Higher odds of PCC were found in people with higher Charlson Comorbidity Index and who used more types of medication. The odds of PCC were the lowest for infections during Omicron-predominant period (OR = 0.09, 95% CI: 0.08-0.10). The predicted PCC risk was generally higher among individuals aged 65-74 years with higher comorbidity burden, with more types of medication use, and during early variant-dominant periods.</p><p><strong>Conclusion: </strong>In summary, the prevalence of PCC diagnosis among older people in Sweden was relatively low when restricted to hospital and specialized outpatient care. A higher burden of comorbidities and more types of medication use were associated with increased odds of PCC diagnosed in hospital and specialized outpatient care. Register-based predictive models may help identify older people at higher risk of PCC.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-16"},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Body Shape Index Shows Stronger Associations with Falls than BMI among Older Adults: Evidence from the NHATS Cohort.","authors":"Zhenxuan Ma, Indrakshi Roy","doi":"10.1159/000553364","DOIUrl":"10.1159/000553364","url":null,"abstract":"<p><strong>Introduction: </strong>Falls are a major public health concern among older adults, leading to injuries, loss of independence, and increased mortality. A body shape index (ABSI), which integrates waist circumference with height and weight, may better characterize abdominal adiposity than body mass index (BMI). To our knowledge, this is the first study to examine the association between ABSI and fall risk in older adults using data from the National Health and Aging Trends Study (NHATS).</p><p><strong>Methods: </strong>We analyzed data from NHATS, a nationally representative cohort of US Medicare beneficiaries aged ≥65 years. Baseline anthropometric data (height, weight, waist circumference) from round 1 were linked to 12-month fall outcomes in round 2. Exposures were BMI and ABSI. Survey-weighted logistic regression models estimated associations between each measure and fall outcomes, adjusting for sociodemographic and health-related covariates.</p><p><strong>Results: </strong>In adjusted models, ABSI was significantly associated with both any fall (odds ratio [OR] = 1.15, 95% confidence interval [CI]: 1.04-1.27; p = 0.009) and multiple falls (OR = 1.20, 95% CI: 1.03-1.39; p = 0.018). BMI showed weaker and less consistent associations (any fall: OR = 1.02, 95% CI: 1.00-1.03; p = 0.030; multiple falls: OR = 1.01, 95% CI: 0.995-1.03; p = 0.158). Associations were stronger among adults aged ≥80 years and those with multimorbidity or conditions such as arthritis, hypertension, or diabetes.</p><p><strong>Conclusion: </strong>ABSI may be a more sensitive anthropometric measure than BMI for identifying older adults at risk for falls, underscoring its potential to improve geriatric fall-risk assessment and prevention strategies.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-12"},"PeriodicalIF":3.1,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148445758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leisure Activities in Very Old Age: Prevalence and Links to Well-Being in (Near-)Centenarians.","authors":"Melanie Stahlmann, Daniela S Jopp, Christina Röcke, Charikleia Lampraki, Kathrin Boerner","doi":"10.1159/000553222","DOIUrl":"10.1159/000553222","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined leisure activity engagement among (near-)centenarians and its association with two aspects of well-being: life satisfaction and purpose in life. We analyzed specific activity types and their combinations, as well as three activity parameters: the total number of activities, the variety of different higher-order activity types, and the distribution of activities across these types (i.e., activity diversity).</p><p><strong>Methods: </strong>We pooled data from two comparable studies conducted in the USA and Germany, yielding a final sample of N = 134 participants aged 96-107 years. Activity engagement was assessed using open-ended questions, with responses coded into 12 activity types further used to compute the activity parameters.</p><p><strong>Results: </strong>Centenarians' common activities included watching TV, social activities, and experiential activities (e.g., reading). The assessed general activity parameters - number, variety, and diversity of activities - were not related to well-being. Life satisfaction correlated positively with physical and experiential activities and negatively with developmental activities (e.g., visiting a museum). Purpose in life was positively linked to experiential activities. Specific engagement patterns of these activity types, rather than overall activity levels, best predicted well-being outcomes.</p><p><strong>Conclusion: </strong>Our results contrast prior findings from younger-old samples, suggesting that the relevance of activity types for well-being may shift in very late life. This supports theories emphasizing emotionally meaningful and less demanding activities as more beneficial with increasing age. Findings underline the need for interventions that enable personally relevant forms of engagement to support life satisfaction and purpose in the oldest olds.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-14"},"PeriodicalIF":3.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nature-based Virtual Reality for Depression in Alzheimer's Disease: Protocol of a Pilot Randomized Controlled Trial.","authors":"Harmehr Sekhon, Ashnie Sukhu, Pascal Fallavollita, Séan McLoone, Sanjeev Kumar, Benoit H Mulsant, Heather Brooks, Bassam Khoury, Amie M Preston, Ipsit Vahia, Julia Chabot, Sofia Nene, Wei Wang, Helen Noble, Tarek K Rajji, Eric E Brown","doi":"10.1159/000553254","DOIUrl":"https://doi.org/10.1159/000553254","url":null,"abstract":"<p><strong>Introduction: </strong>Alzheimer's disease (AD) is the most common form of dementia. Depression is common in AD, with limited evidence for efficacy of pharmacotherapy. Limited in-home non-pharmacological treatments for depression in AD underscore a need for novel in-home treatments. Virtual reality (VR) is an immersive audiovisual technology, which has been used in different clinical contexts. Exposure to nature can improve mental health, including the behavioural and psychological symptoms of dementia (BPSD). To our knowledge, in-home VR use has not been assessed in AD with depression (AD-D). This study aims to assess the feasibility of an in-home nature VR (N-VR) exposure versus an active non-immersive control intervention for individuals with AD-D.</p><p><strong>Methods: </strong>This is a pilot, parallel group, assessor-blinded, randomized controlled trial, assessing a N-VR for AD-D. Participants (n=50) with AD-D are randomized (1:1) to N-VR vs. an active control intervention of nature-based videos. All participants receive the intervention as 15-min sessions delivered twice a week, for 4 weeks. Assessments are conducted remotely by assessors (via WebEx) blinded to randomized assignment at baseline, after each session, and within 7 days of completing the 4-week course to assess tolerability, feasibility, and acceptability. Participants also have the option to participate in a focus group at the end of the study.</p><p><strong>Data analysis: </strong>Measures of feasibility, tolerability and acceptability, and preliminary clinical outcomes will be compared between the VR and control groups in intention-to-treat analyses. Qualitative data from the focus group is thematically analyzed. Relevant participant characteristics (e.g., age, sex, baseline clinical characteristics) will be described across groups and may be considered in exploratory or sensitivity analyses, recognizing the limited statistical power of this pilot study.</p><p><strong>Discussion: </strong>If successful, this study has the potential to establish feasibility of remote VR for individuals with AD-D.</p><p><strong>Clinical trials: </strong>NCT06732128 For the reporting of the RCT, the Consolidated Standards of Reporting Trials (CONSORT) has been used.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-18"},"PeriodicalIF":3.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Same-Day Discharge in Primary Total Joint Arthroplasty in Octogenarians: A Case Series and Narrative Review of Optimization Strategies and Perioperative Outcomes.","authors":"Jonathan Liu, Simbarashe J Peresuh, Sandi Caus, Jeffrey Okewunmi, Christopher J Lama, Phillip Schmitt, Michel A Arcand, Valentin Antoci, Mriganka Singh, Eric Cohen","doi":"10.1159/000553197","DOIUrl":"10.1159/000553197","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The demand for total joint arthroplasty (TJA) continues to rise in an aging population, and evaluating the safety and outcomes of these procedures in octogenarians has become increasingly important. While advanced age is associated with increased medical complexity, including frailty, polypharmacy, and higher perioperative risk, growing evidence supports favorable outcomes of TJA in octogenarians, when patient selection and perioperative care are appropriately tailored. This study aimed to evaluate short-term perioperative outcomes among octogenarians undergoing planned same-day discharge after elective primary hip or knee arthroplasty and to contextualize these findings within optimization strategies for older surgical patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective case series of octogenarian patients who underwent elective primary total hip, total knee, or unicompartmental knee arthroplasty at a single orthopedic institution (2020-2023). Demographics, perioperative metrics, and 90-day outcomes were collected from the electronic health records and institutional surgical database. In parallel, a narrative review of the literature was performed to contextualize these findings within current optimization strategies for elderly arthroplasty patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Fifteen patients met the inclusion criteria, with a mean age of 81.6 years, and 5 patients were female. The mean body mass index was 25.7 ± 2.3 kg/m2. Most patients were categorized as American Society of Anesthesiologists (ASA) II (n = 12), with ASA III (n = 2) and ASA I (n = 1). The median Charlson comorbidity index was 4. The most frequent comorbidities were hypertension (n = 10), diabetes mellitus (n = 3), and coronary/cardiovascular disease (n = 1). Procedures included either hip or knee arthroplasties with 8 total knee arthroplasties, 6 total hip arthroplasties, and 1 unicompartmental knee arthroplasty. The mean estimated blood loss was 100 ± 58 mL, and the mean operative time was 72 ± 19 min. All patients were discharged on the day of surgery, with a mean discharge time from the facility of approximately 4 h. There were no intraoperative complications and no readmissions within 30 or 90 days, and no perioperative adverse events were observed. Literature review highlights the value of geriatric comanagement, individualized anesthetic planning, early mobilization, and standardized discharge processes in reducing complications such as delirium, infection, and prolonged hospitalization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Primary same-day TJA can be safely and effectively performed in selected octogenarian patients when guided by comprehensive preoperative assessment and multidisciplinary perioperative care. This case series reinforces growing evidence that age alone should not preclude surgical intervention. Our findings contribute to an evolving understanding of evidence-based, age-inclusive arthroplasty practi","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-9"},"PeriodicalIF":3.1,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148328698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essentialist Beliefs About Aging Moderate the Link between Physical Functioning and Subjective Well-Being in a Geriatric Sample of Older Adults.","authors":"Elisabeth Dobkowitz, Aline Schönenberg, Tino Prell, David Weiss","doi":"10.1159/000552827","DOIUrl":"10.1159/000552827","url":null,"abstract":"<p><strong>Introduction: </strong>This study tests the moderating role of essentialist beliefs about aging (i.e., perceptions of aging as a fixed versus malleable process) in the relationship between physical functioning and subjective well-being distinguishing between (a) overall quality of life and (b) health satisfaction among older adults in clinical care. We propose that essentialist beliefs serve as adaptive, palliative cognitions that help maintain high subjective well-being despite health challenges.</p><p><strong>Methods: </strong>Hospitalized multimorbid older adults in Germany (N = 102; 67-96 years) completed measures of essentialist beliefs about aging, quality of life and health satisfaction. Physical functioning was assessed using the Barthel-Index. Hierarchical multiple regression analyses tested whether essentialist beliefs moderated the association between physical functioning and subjective well-being.</p><p><strong>Results: </strong>Essentialist beliefs significantly moderated the association between physical functioning and both indicators of subjective well-being. For quality of life, stronger essentialist beliefs were linked to more positive evaluations under poor physical functioning, whereas more flexible beliefs were associated with lower quality of life. In contrast, for health satisfaction, more flexible beliefs were associated with a stronger link between physical functioning and health satisfaction, while essentialist beliefs weakened this association. These effects were particularly evident at lower levels of physical functioning.</p><p><strong>Conclusion: </strong>These findings highlight the domain-specific role of aging beliefs and suggest that essentialist beliefs may serve as a psychological buffer under conditions of physical decline, while more malleable beliefs promote condition-congruent evaluations of health.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-7"},"PeriodicalIF":3.1,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}