European Geriatric Medicine最新文献

{"title":"Multimorbidity, polypharmacy and frailty in critically ill older adults.","authors":"Lorène Zerah, Lorenz Van der Linden, James D van Oppen","doi":"10.1007/s41999-026-01491-1","DOIUrl":"https://doi.org/10.1007/s41999-026-01491-1","url":null,"abstract":"<p><strong>Purpose: </strong>Population ageing has transformed intensive care unit (ICU) populations, with older adults increasingly presenting with multimorbidity, polypharmacy, and frailty. This review aims to examine how these interrelated constructs shape vulnerability to critical illness and influence clinical decision-making and outcomes in geriatric critical care.</p><p><strong>Methods: </strong>We conducted a narrative review of the literature focussing on the interactions between multimorbidity, polypharmacy, and frailty in critically ill older adults, and their implications for medication-related harm and care delivery across the ICU trajectory.</p><p><strong>Results: </strong>Multimorbidity drives clinical complexity and prescribing burden, contributing to high rates of polypharmacy. Polypharmacy is associated with adverse drug events, functional decline, and mortality. Frailty modifies risk through altered pharmacokinetics, heightened susceptibility to treatment-related harm, and the depletion of adaptive capacity that characterises the syndrome. These factors interact dynamically during critical illness, particularly at transitions of care, where medication-related harm is most likely to occur.</p><p><strong>Conclusion: </strong>In older ICU patients, multimorbidity, polypharmacy, and frailty interconnect and interact to shape both risk and recovery. Recognising frailty supports more nuanced, patient-centred decision-making beyond survival alone. Integrating medication stewardship strategies, including reconciliation, deprescribing, and multidisciplinary review, offers a practical approach to reducing harm and improving outcomes that matter to older patients.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845123","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":"Exploring educational needs on frailty outside geriatrics: a survey of European Union of Medical Specialists' bodies.","authors":"Román Romero Ortuño, Sara Solis López, M Cristina Polidori, Tahir Masud, Michael Vassallo, Marianne van Iersel, Jūratė Macijauskienė, Eva Topinková, Maria Nuotio, Rozemarijn L Van Bruchem-Visser, Maria Victoria Farré Mercadé, Mario Barbagallo","doi":"10.1007/s41999-026-01469-z","DOIUrl":"https://doi.org/10.1007/s41999-026-01469-z","url":null,"abstract":"<p><strong>Purpose: </strong>Frailty in older adults is associated with increased vulnerability, poorer outcomes, and greater healthcare utilisation. To inform future inter-specialty educational initiatives, a survey across UEMS bodies was conducted.</p><p><strong>Methods: </strong>An online survey was disseminated between July and November 2025 via the UEMS Coordination team to all sections, divisions, multidisciplinary joint committees, and thematic federations. Eligible respondents were specialists not certified in Geriatric Medicine who provide care to older adults (≥ 65 years).</p><p><strong>Results: </strong>Of 416 respondents, 283 were non-geriatric specialists caring for older people. They encompassed 40 specialties (40% surgical, 33% medical, 15% emergency/critical care, 12% imaging/laboratory) across 39 countries (91% EU/EEA/UK). Respondents were predominantly late career (63%), university-hospital-based (73%), and 44% were female. Most (83%) reported no formal geriatric training. While the perceived importance of frailty was high (mean 8.0 out of 10), 56% believed frailty is generally or inevitably worsening over time. Although 68% were aware of at least one validated frailty tool, 36% never used such tools, most commonly due to lack of familiarity or time constraints. Confidence in managing frailty was low (mean 4.7/10), and only 29% felt frailty is adequately addressed within their clinical setting. Nearly all respondents agreed that non-geriatric specialists should have basic competencies in frailty (90%) and 86% supported including a frailty appendix in relevant European Training Requirements.</p><p><strong>Discussion: </strong>Non-geriatric specialists recognise the clinical importance of frailty, but report limited confidence and insufficient structured training. These findings underscore the need for accessible, standardised, inter-specialty frailty education to support high-quality care for older adults.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845132","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":"Hospital at home for older patients with heart failure: an observational study of the GIROT experience.","authors":"Francesca Verga, Samuele Baldasseroni, Matteo Bulgaresi, Riccardo Barucci, Ilaria Del Lungo, Irene Taverni, Silvia Tognelli, Chiara Bandinelli, Giulia Rivasi, Enrico Mossello, Guglielmo Bonaccorsi, Andrea Ungar, Enrico Benvenuti","doi":"10.1007/s41999-026-01492-0","DOIUrl":"https://doi.org/10.1007/s41999-026-01492-0","url":null,"abstract":"<p><strong>Purpose: </strong>Heart failure (HF) is a leading cause of hospitalization in older adults and is associated with frequent readmissions within 30 days after discharge. GIROT (Gruppo Intervento Rapido Ospedale-Territorio) model, an example of Hospital at Home (HaH) model, provides home-based care for older patients with acute conditions. This study aimed to compare hospital admissions in the 30-day and 6-month periods before and after GIROT referral.</p><p><strong>Methods: </strong>This retrospective observational study included patients ≥ 65 years with HF, referred to GIROT between March 2022 and April 2024. Given the lack of a control group, an intra-patient comparison of the number of hospital admissions in the 30-day and 6-month periods before and after GIROT referral was performed using the Wilcoxon signed-rank test. Predictors of all-cause 6-month mortality were investigated using multivariate logistic regression.</p><p><strong>Results: </strong>Among 157 included participants (mean age 89; female 63.1%, 75% with moderate-to-severe disability), the number of hospital admissions decreased from a median of 1.0 to 0.0 at 1 month and from 1.0 to 0.0 at 6 months (both p < 0.001, Wilcoxon signed-rank test). Six-month mortality rate was 47%, with severe disability at the end of GIROT service period emerging as the independent predictor (OR 1.42, 95% CI 1.17-1.69). Patient and caregiver satisfaction was high (84%).</p><p><strong>Conclusion: </strong>The GIROT HaH model was associated with a reduction in hospital admissions in the 1 and 6 months following the intervention in old patients with HF. Functional status, rather than comorbidities, independently predicted 6-month mortality. Further prospective studies including control groups are needed to better assess the effectiveness of this model.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845061","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":"Circulating PBX1 and age-related sarcopenia phenotypes: metabolic mediation analyses in a community-based study.","authors":"Xiangyuan Meng, Zhenhu Zhao, Shuhua Mao, Jianing Yu, Yuqin Liu, Xingxiang Yang, Xin Zhang, Ruihan Guo, Shuran Yang, Zhuoshuai Liang, Fengdan Wang, Lanchao Sun, Hui Zhao, Jinyu Liu, Tianlin Gao","doi":"10.1007/s41999-026-01488-w","DOIUrl":"https://doi.org/10.1007/s41999-026-01488-w","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether circulating PBX1 is associated with AWGS2019-defined sarcopenia phenotypes in older adults, and whether alanine-related metabolites mediate the PBX1-ASMI association.</p><p><strong>Methods: </strong>We enrolled 324 adults aged 60 years or older from Licha Town, Qingdao, China (2022-2023) and classified sarcopenia using AWGS 2019. Plasma PBX1 was quantified by ELISA, and targeted plasma metabolite profiling was performed by LC-MS/MS. Primary outcomes were appendicular skeletal muscle mass index (ASMI), 6-m gait speed, and maximal handgrip strength. Independent associations were estimated using multivariable linear regression. Mediation models quantified indirect statistical components of the PBX1-ASMI association through prespecified metabolites (alanine and the lactic acid/alanine ratio) with bootstrap confidence intervals. ROC analyses assessed discrimination for sarcopenia and severe sarcopenia.</p><p><strong>Results: </strong>Higher plasma PBX1 was independently associated with greater ASMI, faster gait speed, and stronger handgrip strength (all P < 0.001). PBX1 was positively associated with alanine and inversely associated with the lactic acid/alanine ratio. Alanine and the lactic acid/alanine ratio accounted for 10.79% (P = 0.017) and 10.11% (P = 0.002) of the PBX1-ASMI association, respectively; indirect components for gait speed and handgrip strength were not statistically significant. PBX1 discriminated sarcopenia (AUC 0.748) and severe sarcopenia (AUC 0.771), with high negative predictive value for severe sarcopenia at Youden-optimal thresholds.</p><p><strong>Conclusion: </strong>Circulating PBX1 is independently associated with preserved muscle mass and function in older adults. PBX1 warrants external validation and longitudinal evaluation as a clinically informative correlate and candidate adjunctive biomarker for sarcopenia risk stratification.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822817","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":"Caring for older adults in the Emergency Department: a Delphi-based national consensus by the Academy of Emergency Medicine and Care and the Italian Society of Gerontology and Geriatrics.","authors":"Maria Cristina Ferrara, Eleonora Cucini, Martina Marelli, Antonella Zambon, Andrea Ungar, Lorenzo Ghiadoni, Antonio Cherubini, Michele Cosimo Santoro, Alessandra Marengoni, Ciro Paolillo, Ivo Casagranda, Giuseppe Bellelli","doi":"10.1007/s41999-026-01462-6","DOIUrl":"https://doi.org/10.1007/s41999-026-01462-6","url":null,"abstract":"<p><strong>Purpose: </strong>The number of older adults attending Emergency Departments (EDs) is increasing rapidly in Italy. This trend poses substantial challenges to services that are not structured to address multidimensional needs. Despite the availability of international guidance, implementation of geriatric emergency care models remains inconsistent in Italy. This study aimed to establish a national, inter-specialty expert consensus on priorities for improving geriatric emergency care.</p><p><strong>Methods: </strong>A two-round Delphi process was conducted involving 32 experts (16 geriatricians and 16 emergency physicians) from two Italian Academic Societies: the Academy of Emergency Medicine and Care, and the Italian Society of Gerontology and Geriatrics. Participants rated 50 items, grouped into 10 statements covering triage, infrastructure, organization, clinical priorities, and care models, using a 5-point Likert scale. Consensus was defined as ≥ 80% agreement or disagreement for each item.</p><p><strong>Results: </strong>Consensus was achieved for 37 of 50 items (74%). Panelists agreed on the need for early identification of frailty and delirium, environmental adaptations within EDs, and multidisciplinary management in ED Observation Units. Disagreement was observed regarding triage models for older adults, the mode of geriatrician involvement in the ED (on-site vs on-call), and staff perceptions on the appropriateness of ED use by older adults.</p><p><strong>Conclusion: </strong>This national consensus defines priorities for geriatric emergency care in Italy, while highlighting inter-specialty areas of disagreement. The findings provide a basis for strengthening clinicians' ability to address complex needs and informing the development of geriatric-oriented ED pathways and policies.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822842","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":"Current practices and challenges in orthogeriatrics: findings from a European six-center survey.","authors":"Ferrara Maria Cristina, Bonnici Maria, Alves Mariana, Jaatinen Roope, Schlotmann Julia, Prada Ana Gabriela, De Breucker Sandra, Münzer Thomas","doi":"10.1007/s41999-026-01479-x","DOIUrl":"https://doi.org/10.1007/s41999-026-01479-x","url":null,"abstract":"<p><strong>Purpose: </strong>To describe reported orthogeriatric pathways and shared gaps across six European hospital units managing older adults with hip fractures, as a baseline for a quality-improvement (QI) project.</p><p><strong>Methods: </strong>We conducted a cross-sectional online survey among healthcare professionals involved in orthogeriatric care in six units in Portugal, Finland, Germany, Romania, Italy, and Malta. The questionnaire explored prompt geriatric assessment in the emergency department, pain management, delirium assessment, urinary catheter policies, nutritional management, multidisciplinary team organization, osteoporosis treatment, and fall-prevention referral.</p><p><strong>Results: </strong>A total of 163 professionals completed the survey. Timely admission to the orthogeriatric unit, early mobilization, and nutritional management were commonly reported, while urinary catheter policies, osteoporosis treatment, and fall-prevention referrals were infrequently reported across units.</p><p><strong>Conclusions: </strong>This survey highlights elements of shared routine care and common actionable gaps, providing a baseline for targeted QI projects in orthogeriatric care, especially in secondary fracture prevention.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822872","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":"Geriatric critical care assessment: key considerations.","authors":"James D van Oppen, Ben Bloom, Simon Conroy","doi":"10.1007/s41999-026-01478-y","DOIUrl":"https://doi.org/10.1007/s41999-026-01478-y","url":null,"abstract":"<p><p>Frailty, multimorbidity, and altered physiology each and together shape the presentation, management, and outcomes for older people with critical illness. This narrative review of the field argues that the structures and processes of geriatric critical care must align with the outcomes that matter to older people living with frailty. This extends the scope of consideration beyond assumptions which may necessarily be restorative or curative, to focus on those interventions which are most achievable and desirable. Frailty is a stronger predictor of mortality, functional decline, and health-related quality of life than age alone. Yet frailty screening changes nothing, unless there is a corresponding change in clinical approach. We review the ABCDE-Frailty framework, operationalising frailty-attuned assessment in standard emergency evaluation using the 5Ms: Mind, Mobility, Medications, Multicomplexity, and Matters most. Person-centred decision-making, incorporating shared value- and goal-based understanding, provides the ethical and clinical foundation for proportionate treatment in critical situations. Avoiding non-beneficial intervention is not therapeutic nihilism but rather its opposite: care directed towards dignity, function, and the outcomes people themselves would choose. A paradigm shift is required, from survival-centred to person-centred, frailty-attuned geriatric critical care.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822870","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":"Microvascular health and frailty: nailfold capillaroscopy as a window into aging.","authors":"Arzu Nevin Dagdemir, Pinar Akyuz Dagli, Gulsah Soyturk, Rana Tuna Dogrul, Zeynep Sahiner, Cemile Peker, Hande Selvi Oztorun, Yuksel Maras, Sukran Erten, Gunes Eken, Kamile Silay","doi":"10.1007/s41999-026-01494-y","DOIUrl":"https://doi.org/10.1007/s41999-026-01494-y","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a prevalent geriatric syndrome characterized by diminished physiological reserves and increased vulnerability to stressors. Microvascular dysfunction and inflammaging have been proposed as key biological mechanisms underlying frailty; however, objective and practical vascular biomarkers remain limited. Nailfold capillaroscopy (NFC), a non-invasive imaging method that visualizes microcirculatory architecture, may offer novel insight into the vascular component of frailty. This study aimed to investigate the association between frailty and NFC findings in older adults.</p><p><strong>Methods: </strong>This cross-sectional study evaluated 102 individuals aged 65 years or older (mean age 78.7 ± 8.1 years; 67% female) who underwent a comprehensive geriatric assessment. Frailty was assessed using the Clinical Frailty Scale (CFS) and the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (FRAIL) scale. NFC was performed on eight fingers following standardized protocols. A total NFC score was derived from capillary density, giant capillaries, microhemorrhages, neoangiogenesis, tortuosity, and additional morphological features. Receiver operating characteristic (ROC) curve analysis was used to determine discriminatory performance, while multivariable logistic regression identified independent predictors of frailty.</p><p><strong>Results: </strong>Frail participants exhibited significantly reduced capillary density and higher frequencies of giant capillaries, microhemorrhages, morphological abnormalities, neoangiogenesis, and tortuosity (all p < 0.001). An NFC score ≥ 5 was associated with frailty, with an area under the ROC curve of 0.68.</p><p><strong>Conclusion: </strong>Microvascular abnormalities detected through NFC are strongly associated with frailty in older adults. An NFC threshold of ≥ 5 may serve as a practical, non-invasive indicator of elevated frailty risk. These findings support the potential value of incorporating NFC into geriatric assessment, and prospective studies are needed to clarify its prognostic and clinical utility.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787301","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":"Association between oral frailty and a laboratory-based frailty index in older adults.","authors":"Shuzo Miyahara, Keisuke Maeda, Koki Kawamura, Shosuke Satake, Hiroyasu Akatsu, Hidenori Arai","doi":"10.1007/s41999-026-01489-9","DOIUrl":"https://doi.org/10.1007/s41999-026-01489-9","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the association between oral frailty and laboratory-based Frailty Index (FI-lab) in older adults.</p><p><strong>Methods: </strong>This cross-sectional study included patients aged ≥ 65 years who attended a frailty outpatient clinic. Oral frailty was assessed using the Oral Frailty five-item checklist. The FI-lab was constructed from 31 laboratory parameters, with frailty defined as an FI-lab value > 0.21. The association between oral frailty and FI-lab-defined frailty was examined using multivariable logistic regression analysis.</p><p><strong>Results: </strong>Among the 486 patients, the mean age was 77.9 ± 6.3 years, and 63.6% were women. The prevalence of oral frailty was 49.6%, and the median FI-lab value was 0.16. Oral frailty was significantly associated with FI-lab-defined frailty after adjustment for age, sex, and comorbidities (odds ratio 1.52, 95% confidence interval 1.01-2.29).</p><p><strong>Conclusion: </strong>Oral frailty is associated with FI-lab-defined frailty, suggesting a relationship between oral function and latent physiological vulnerability, as captured by the FI-lab.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787263","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":"Rethinking sarcopenia: a conceptual shift towards a muscle health continuum.","authors":"Stany Perkisas, Kristoffer K Brockhattingen, Ester López Jiménez, Michael O Harris-Love, Sophie Bastijns, Anne-Marie De Cock, Femke Ariën, Chun Yuen Johnny Chung, Lynn Longueville, Karen Andersen-Ranberg, Siri Aas Smedemark, Pedro Abizanda Soler","doi":"10.1007/s41999-026-01485-z","DOIUrl":"https://doi.org/10.1007/s41999-026-01485-z","url":null,"abstract":"<p><strong>Purpose: </strong>Current guideline-based approaches to sarcopenia are operationalised around thresholds of muscle mass, strength, and performance, which limit the opportunities for early/preventive intervention. This view insufficiently reflects skeletal muscle as a multifunctional organ and fails to capture its dynamic and heterogeneous nature. The objective of this manuscript is to place sarcopenia within this muscle health continuum.</p><p><strong>Methods: </strong>Expert discussions were conducted to identify conceptual limitations in existing approaches and to explore opportunities for improvement. These discussions were complemented by a narrative review of the literature, forming an integrative conceptual framework.</p><p><strong>Results: </strong>A six-stage muscle health continuum is proposed in which sarcopenia is positioned as an advanced, pathological state rather than a binary diagnosis. Conceptual definitions of muscle health and muscle failure are introduced, alongside causal factors as potential targets for treatment as well as an aetiological stratification into subtypes. The framework is aligned with the International Classification of Functioning, Disability and Health to contextualise muscle dysfunction in terms of functioning and disability. To enhance diagnostic resolution and treatment monitoring, the concept of muscle profile analysis is introduced, supporting the use of direct muscle visualisation techniques such as ultrasound, computed tomography, and magnetic resonance imaging.</p><p><strong>Conclusion: </strong>Positioning sarcopenia within a broader muscle health continuum reframes it from a late-stage geriatric diagnosis into a condition embedded within a lifelong trajectory. This conceptual shift hopes to kindle discussions about earlier assessment, preventive strategies, and individualised interventions, laying the foundation for future research, clinical innovation, and guideline evolution aimed at improving patient outcomes.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787298","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}