European Geriatric Medicine最新文献

{"title":"Intensive care under uncertainty: a qualitative study of how older patients and their relatives wish to contribute to decision-making.","authors":"Gabriele Leonie Schwarz, Britt Ågot Sjøbø, Elisabeth Skaar, Ingrid Miljeteig, Reidar Kvåle, Hans Flaatten, Karen E A Burns, Paul K J Han, Margrethe Schaufel","doi":"10.1007/s41999-026-01523-w","DOIUrl":"10.1007/s41999-026-01523-w","url":null,"abstract":"<p><strong>Purpose: </strong>Given the importance of shared decision-making in critical illness in advanced age, we aimed to explore how very old patients and their next of kin envision their contribution to the decision-making process.</p><p><strong>Methods: </strong>From November 2021 to March 2023, we conducted a survey among Norwegian outpatients aged 80 and over and their next of kin. We studied their perspectives on hypothetical scenarios of acute, life-threatening illness warranting admission to the intensive care unit (ICU). In this sub-study, we conducted cross-case thematic analysis of free-text responses addressing patients' and next-of-kins' participation in shared decision-making.</p><p><strong>Results: </strong>Of 202 very old and 153 next-of-kin respondents, 210 participants provided 339 free-text comments relevant to this research question. Vi identified five main categories, describing how participants wished to contribute to the decision process: (1) Seeking scientific knowledge, (2) Contributing personal knowledge, (3) Tailoring care to the heterogeneity of older age, (4) Improving the process of decision-making, and (5) Strengthening security. Applying a framework for medical uncertainty and uncertainty tolerance, we found that all five of them comprised ways of coping with or adapting to the multidimensional uncertainty characterising clinical decisions when very old patients fall critically ill.</p><p><strong>Conclusion: </strong>These findings highlight the need to include patients' and family members' personal knowledge in clinical decision-making, and to facilitate the presence of next of kin when very old patients require critical care.</p><p><strong>Trail registration: </strong>ClinicalTrails.gov NCT05149040 (October 31, 2021).</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1735-1746"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279603","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":"Perceptions of care home residents, families and staff about wearable devices: a scoping review.","authors":"Ana Swain-Velasco, Kirsty Hynes, Susan D Shenkin, Maria Drummond","doi":"10.1007/s41999-026-01550-7","DOIUrl":"10.1007/s41999-026-01550-7","url":null,"abstract":"<p><strong>Purpose: </strong>This scoping review explores perceptions of care home residents, staff and family members on the use of wearable devices-e.g. smartwatches, fall-detection devices, sensor-enabled clothing-in care homes, on the acceptability, perceived value, and implementation considerations.</p><p><strong>Methods: </strong>We searched six databases. Two reviewers independently screened studies. Eligible studies reported stakeholders' perceptions wearable devices used by older adults (65 +)§ in care homes. We followed PRISMA-ScR guidelines. Protocol registered on Open Science Framework ( https://doi.org/10.17605/OSF.IO/EJZ3S ). Key data were extracted and narratively summarised, then analysed using a deductive and inductive framework based on the research aims.</p><p><strong>Results: </strong>Of 620 studies, 12 were included. Studies were mostly qualitative and varied in size (n = 4-178) using a wide range of wearables: activity/sleep trackers (N = 4); wireless monitoring (N = 3); incontinence pad sensors (i = 2); posture-improving sensors (N = 1); pressure injury prevention (N = 1); contact tracing (N = 1).Familiarity and aesthetics, including the potential of stigmatisation, influenced acceptability for residents and passive devices were deemed more suitable in cognitive impairment. Perceived value included reassurance for residents and family members. Devices could improve quality of life. Staff considered the potential impact on workload, and cost as potential implementation considerations.</p><p><strong>Conclusion: </strong>There is limited literature on wearable device use in care homes, despite the rapid expansion of technology in this setting. Future research should focus on familiar devices that are not stigmatising, and are easy to use, with co-creation approaches and longer evaluation.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2323-2336"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425705","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":"Prevalence of pre-frailty and frailty and their association with postoperative hospital days in older adults referred for elective orthopaedic surgery.","authors":"Marie Linderup Funck, Lotte Sejr Kirring, Anne Mette Schmidt, Inger Markussen Gryet, Morten Fenger-Grøn, Peter Vedsted, Merete Gregersen","doi":"10.1007/s41999-026-01515-w","DOIUrl":"10.1007/s41999-026-01515-w","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate the prevalence of pre-frailty and frailty among older persons referred for elective orthopaedic surgery and determine whether frailty was associated with the occurrence of postoperative complications, measured as the number of days spent in the hospital within 90 days after surgery.</p><p><strong>Methods: </strong>Between April 1 and July 31, 2022, we consecutively included individuals aged 65 years or older who were referred for elective shoulder, knee, hip, or spine surgery at a centre for elective surgery. Health status was assessed preoperatively using the record-based Multidimensional Prognostic Index, based on data extracted from the electronic medical record by a geriatrician. Postoperative hospital data were obtained from the Business Intelligence Data Warehouse of the Central Denmark Region.</p><p><strong>Results: </strong>A total of 519 persons were included, with a mean age of 75.2 years (SD 5.9), and 56% were females. The majority of the persons were referred for elective hip (41%) or knee (37%) arthroplasty. Preoperatively, 26% of the persons were classified as pre-frail and 4% as moderately frail, while none were severely frail. Pre-frailty and moderate frailty were associated with a greater number of hospital days within 90 days post-surgery compared with non-frail persons.</p><p><strong>Conclusion: </strong>More than one in four older persons aged 65 + referred for elective orthopaedic surgery are pre-frail or moderate frail. Identifying this vulnerability is essential for optimizing care across healthcare settings and professions, with the goal of preventing postoperative complications.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2277-2284"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201042","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":"Older people will be left behind by generic AI.","authors":"Simon P Mooijaart, Bram M A van Dijk, Marco R Spruit","doi":"10.1007/s41999-026-01506-x","DOIUrl":"10.1007/s41999-026-01506-x","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1829-1831"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983960","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":"A shocking cinematographic reflection on ageism: The Ballad of Narayama.","authors":"Andrea Ticinesi","doi":"10.1007/s41999-026-01525-8","DOIUrl":"10.1007/s41999-026-01525-8","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2389-2390"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254170","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":"The two gazes of geriatrics: art, identity, and the ageing body.","authors":"Vangipuram Sai Shreya, Vangipuram Harshil Sai","doi":"10.1007/s41999-026-01556-1","DOIUrl":"10.1007/s41999-026-01556-1","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2391-2393"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537495","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":"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":"1693-1700"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562279/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"User requirements for an emotion-intelligent autonomous care robot in long-term care.","authors":"Marije Harmsen, Esmee Adam, Ellen Ricke, Hanneke J A Smaling","doi":"10.1007/s41999-026-01532-9","DOIUrl":"10.1007/s41999-026-01532-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To identify user requirements and stakeholders perspectives for the development and implementation of an autonomous emotion-intelligent robot in long-term care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;The to-be-developed emotion-intelligent robot must meet the user requirements regarding prerequisites, functional capabilities, and physical appearance to enhance acceptance in long-term care. While the emotion-intelligent robot was seen as promising for companionship and for providing structure to care recipients, concerns about loss of personalized 'warm' care and reliability underscore the need for targeted education and phased implementation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Message: &lt;/strong&gt;Autonomous emotion-intelligent robots may add value to daily long-term care practice for geriatric clinicians by complementing human care through enhanced independence, companionship, and person-centered support, provided successful adoption is ensured through attention to user requirements, ethical considerations, and clear communication, education, and phased integration strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Growing care demands in long-term care (LTC), driven by aging populations and staff shortages, challenge the delivery of person‑centered care. Autonomous emotion intelligent (EI) robots, socially assistive robots that independently perform tasks and make context-aware decisions tailored to user needs, may address these challenges by supporting daily care. This study identified key user requirements for the development and future implementation of an EI robot in LTC, exploring expectations of care recipients, family caregivers, and healthcare professionals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A qualitative design with 13 focus groups and 20 interviews was employed. Data were collected in two iterative rounds. Thematic analysis was used for the analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants were 4 people with dementia (mean age: 83.0 years), 7 people with intellectual disabilities (mean age: 32.9 years), 14 family caregivers (mean age: 63.3 years), and 32 HCPs (mean age: 38.6 years). The user requirements were clustered into three themes: (1) prerequisites (e.g., robustness, ease-of-use), (2) functional requirements (e.g., provide companionship, stimulate independence), and (3) physical appearance (e.g., user-specific customization, simple interface). Participants generally viewed the EI robot positively for its potential to provide companionship and structure to care recipients, but raised concerns about loss of 'warm' human care and its reliability. Participants indicated that successful implementation would require clear communication, targeted education, and a structured, step-by-step rollout.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our findings highlight a core tension between the desire for autonomy-enhancing support and concerns about relational quality, trustworthiness, and ethical boundaries. Addressing this tension will be essential for re","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2041-2055"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297104","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":"Mealtime irregularity is associated with higher serum growth differentiation factor-15 levels in older adults: the explanatory role of dietary quality.","authors":"Kaori Kinoshita, Yosuke Osuka, Georg von Fingerhut, Kazuhiro Yoshiura, Noriko Hori, Shosuke Satake, Shigenobu Shibata, Hidenori Arai","doi":"10.1007/s41999-026-01524-9","DOIUrl":"10.1007/s41999-026-01524-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined the association between mealtime irregularity and Growth Differentiation Factor-15 (GDF-15)-a potential biomarker of biological aging-and evaluated whether this association could be explained by poor dietary quality among community-dwelling older adults.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from 378 disability-free adults aged ≥ 65 years from the Higashiura Study. Eating habits (regular vs. irregular) were assessed during the interviews. Dietary quality was evaluated using nutrient density scores from the Nutrient-Rich Food Index, calculated from 3-day dietary records. The association among mealtime irregularity, dietary quality, and serum GDF-15 levels was examined using mediation analysis after adjusting for age, sex, comorbidities, sleep duration, physical activity, smoking status, employment status, and total energy intake.</p><p><strong>Results: </strong>Participants with irregular mealtimes were significantly younger than those with regular mealtimes (mean ± standard deviation: 73.3 ± 4.6 vs. 75.1 ± 5.6 years, p = 0.014) and had higher serum GDF-15 levels (least-squares means, 95% confidence interval [CI]: 1161.4, 1063.4-1270.2 vs. 1028.0, 988.4-1068.9 pg/mL, p = 0.009). In the mediation analysis, lower nutrient density partially explained the association between mealtime irregularity and higher GDF-15 levels (β, 95% CI: total effect: 0.053, 0.0078-0.0977; direct effect: 0.046, 0.0004-0.0898; indirect effect: 0.008, 0.0001-0.0205; mediation proportion: 14.5%).</p><p><strong>Conclusion: </strong>Although participants with irregular mealtimes were significantly younger than those with regular mealtimes, they showed higher levels of biological aging markers. Dietary quality partially accounted for this association. These findings suggest that dietary quality may be an important consideration for older adults with irregular mealtimes.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2175-2185"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260290","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":"Utilization patterns of hypodermoclysis and association with staffing levels in long-term care: a cross-sectional multicenter study in France.","authors":"Nicolas Deniau, Oceane Lelong, Christine Forasassi, Frédéric Behar, Anthony Meziere","doi":"10.1007/s41999-026-01496-w","DOIUrl":"10.1007/s41999-026-01496-w","url":null,"abstract":"<p><strong>Purpose: </strong>To describe utilization patterns of hypodermoclysis in long-term care (LTC) (primary objective), and to explore institutional factors associated with hypodermoclysis use in LTC (secondary objective); as hypodermoclysis is used to manage low-intake dehydration among institutionalized older adults.</p><p><strong>Methods: </strong>Cross-sectional multicenter study based on a single day. Data collected by questionnaire addressed to geriatricians of LTC units affiliated with the Assistance Publique-Hôpitaux de Paris, France. Descriptive statistics summarized utilization patterns of hypodermoclysis. A multivariable logistic regression was performed to explore the association between institutional factors and the likelihood of receiving hypodermoclysis.</p><p><strong>Results: </strong>Among 748 residents (median age: 86; 68% female), 21% were receiving hypodermoclysis, with prevalence varying significatively across centers (14-36%). Hypodermoclysis had been prescribed for a median duration of 95 days on the study day. It most commonly involved dextrose solution, prescribed at 500 mL per day. Factors independently associated with increased hypodermoclysis use included lower nursing assistant staffing, higher nurse staffing, and lower physician staffing.</p><p><strong>Conclusion: </strong>Findings reveal heterogeneous use of hypodermoclysis in LTC, often at low volumes and over prolonged periods. Given the association between staffing levels and hypodermoclysis use, strengthened interprofessional engagement and collaboration may be needed to optimize hydration practices.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2057-2065"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864737","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}