European Geriatric Medicine最新文献

{"title":"Toward standardized geriatric-neurosurgical co-management: the transnational GENEUS project.","authors":"Mariana Alves, Diogo Roque, Sofia Duque, Gabor Abellan van Kan, Nicolas Martinez Velilla, Eric Schmidt","doi":"10.1007/s41999-026-01475-1","DOIUrl":"https://doi.org/10.1007/s41999-026-01475-1","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787253","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":"Delirium and in-hospital falls in older adults: factors associated with fall occurrence and number of falls.","authors":"Justine Falciola, Christophe Graf, Aline Mendes","doi":"10.1007/s41999-026-01482-2","DOIUrl":"https://doi.org/10.1007/s41999-026-01482-2","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the association between delirium and in-hospital falls in older adults, including fall occurrence and number of falls, and to assess whether fall-related factors differ according to delirium status.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients aged ≥ 65 years hospitalized in acute geriatric units between 2022 and 2024. Delirium was identified using ICD-10 codes, Confusion Assessment Method (CAM) documentation, and physician-entered diagnoses. Fall occurrence (≥ 1 fall) was analysed using multivariable logistic regression and number of falls using negative binomial regression. Analyses were stratified according to delirium status.</p><p><strong>Results: </strong>Among 12,866 hospitalizations, 1751 patients (13.6%) experienced at least one in-hospital fall. Delirium occurred in 2889 patients (22.5%) and was independently associated with fall occurrence (OR 1.51, 95% CI 1.32-1.72). Male sex (OR 1.56, 95% CI 1.39-1.74), Parkinson's disease (OR 1.52, 95% CI 1.23-1.89), and antipsychotic exposure were also associated with falls. Baseline functional status showed a significant interaction with delirium status (p = 0.0002): higher functional independence was associated with lower fall risk in patients without delirium (OR per 10-point FIM increase 0.91, 95% CI 0.89-0.94), but not in those with delirium (OR 0.99, 95% CI 0.95-1.03). Delirium was also independently associated with a higher fall count (IRR 1.47, 95% CI 1.31-1.66).</p><p><strong>Conclusion: </strong>Delirium is independently associated with both the occurrence and number of in-hospital falls. Once delirium develops, fall risk appears to reflect a state of acute neurocognitive instability in which baseline functional status loses much of its discriminative value for risk stratification.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729877","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":"Geriatrician telephone support for emergency medical dispatchers: safe alternatives for older patients at high risk of short-term emergency department visits.","authors":"Xavier Dubucs, Léa Colomar, Orhiane Dabasse, Yves Rolland, Sandrine Charpentier, Sophie Elmalem, Sara Vienne-Noyes, Zara Steinmeyer, Charles Henri Houze-Cerfon, Vincent Bounes, Pierre Roucolle, Laurent Balardy, Hélène Villars","doi":"10.1007/s41999-026-01483-1","DOIUrl":"https://doi.org/10.1007/s41999-026-01483-1","url":null,"abstract":"<p><strong>Aim: </strong>For older patients at presumed high risk of short-term emergency department visits but without immediate hospital needs, we aim to describe a system that provides geriatrician telephone support to emergency medical dispatchers, offering a safe alternative to emergency department referral.</p><p><strong>Findings: </strong>Providing geriatrician telephone support to emergency medical dispatchers could offer an alternative to referring certain older patients at presumed high risk of a short-term emergency department visit. Among older patients for whom an emergency department referral was not initially recommended, some experienced early unplanned hospital visits, highlighting the need to develop and strengthen reactive alternatives to emergency department referral.</p><p><strong>Message: </strong>Collaboration between emergency medical dispatchers and on-phone geriatricians could provide a safe alternative to emergency department referrals for older patients at presumed high risk of short-term ED visits.</p><p><strong>Purpose: </strong>To describe a system enabling Emergency Medical Dispatchers (EMD) to access direct geriatrician telephone support (SCAS: Senior Care Access System) with the purpose of providing alternatives to Emergency Department (ED) referral for older patients at presumed high risk of short-term ED visits.</p><p><strong>Methods: </strong>This prospective study was conducted at the EMD of Toulouse University Hospital. EMD could contact the SCAS for patients aged 75 or older who were presumed to be at high risk of a short-term ED visit but did not require an immediate ED referral. The primary outcome was the alternative to ED referral decided by the SCAS, which included telephone advice, geriatric consultation, geriatric day hospital admission, admission to post-acute care and rehabilitation, or direct admission to an acute geriatric unit. Secondary outcomes were i) alternative follow-up destinations and ii) early unplanned hospital visits (ED visit or unplanned hospital admission within 7 days following the SCAS call).</p><p><strong>Results: </strong>A total of 364 patients were included between September 1, 2023 and February 28, 2025. The mean age of the patients was 87.5 years (± 8.3), and 40.1% were male. The primary reason for the call was altered general health status (30.8%), followed by falls (17.9%). An alternative to ED referral was proposed for 287/364 patients (78.8%). Among the 117 patients for whom the SCAS decided no ED referral or admission to an acute geriatric unit, 32 (27.4%) patients experienced an early unplanned hospital visit within a median delay of 3 days.</p><p><strong>Conclusion: </strong>Our study suggests that geriatrician telephone support for EMD could offer an alternative to ED referral for older patients with presumed high risk of short-term ED visit.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729953","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 multidomain sleep-brain vulnerability index predicts delirium and long-term cognitive decline in hospitalized older adults.","authors":"Shengjie Pan, Gang Wang","doi":"10.1007/s41999-026-01480-4","DOIUrl":"https://doi.org/10.1007/s41999-026-01480-4","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a frequent complication among hospitalized older adults and is associated with prolonged recovery, increased mortality, and long-term cognitive decline. However, traditional risk models rely largely on baseline clinical characteristics and often fail to capture dynamic physiologic vulnerability during hospitalization. We therefore aimed to develop a multidomain physiologic index integrating sleep, circadian, autonomic, and environmental disturbances to improve delirium risk prediction.</p><p><strong>Methods: </strong>In this prospective cohort study, 600 hospitalized adults aged ≥ 60 years admitted to surgical wards or intensive care units in a tertiary hospital were enrolled. Participants underwent multimodal monitoring including actigraphy, heart rate variability, and bedside noise-light sensors; 96 also completed overnight EEG. Eighteen physiologic and environmental variables were standardised and reduced using principal component analysis. The first component, reflecting sleep fragmentation, circadian instability, autonomic imbalance, and environmental load, was prespecified as the Sleep-Brain Vulnerability Index (SBVI). Delirium was assessed daily, and cognition at baseline, 3 months, and 12 months. Associations between SBVI and outcomes were examined using multivariable logistic, Cox, and linear mixed-effects models.</p><p><strong>Results: </strong>Delirium occurred in 148 participants (24.7%). Higher SBVI was independently associated with delirium (adjusted OR per SD 1.94; 95% CI 1.48-2.56) and showed graded risk across tertiles (12.3%, 23.7%, 39.8%). Adding SBVI to a clinical model improved discrimination (AUC 0.72 to 0.81). SBVI predicted slower discharge (HR 0.86; 95% CI 0.80-0.93) and greater 12-month cognitive decline (β - 0.47 MoCA points per SD; 95% CI - 0.70 to - 0.25). EEG analyses showed reduced slow-wave activity among individuals with higher SBVI.</p><p><strong>Conclusions: </strong>SBVI provides a multidomain physiologic measure that predicts delirium, recovery, and long-term cognitive decline in hospitalized older adults. Because its components can be obtained using feasible bedside monitoring, SBVI may enable early identification of vulnerable patients and support targeted geriatric interventions.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718566","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":"Short-term safety and reactogenicity of same-day COVID-19 and influenza vaccination in very old, community-dwelling adults.","authors":"Robin Šín, Alena Lochmannová, Gizell Green, Miroslav Kubiska","doi":"10.1007/s41999-026-01477-z","DOIUrl":"https://doi.org/10.1007/s41999-026-01477-z","url":null,"abstract":"<p><strong>Purpose: </strong>To assess short-term safety after routine same-day seasonal influenza and COVID-19 vaccination in community-dwelling adults aged 65 years and older, predominantly very old, and to identify factors associated with adverse events within 48 h.</p><p><strong>Methods: </strong>We conducted a prospective observational cohort study in a hospital-based infectious diseases department and a collaborating outpatient clinic in the Czech Republic, enrolling adults aged 65 years and older vaccinated between 1 September and 30 November 2025. Participants completed 48 h symptom diaries and measured body temperature at 24 and 48 h. We compared local reactions between vaccine injection sites within individuals and used regression models to examine demographic and clinical correlates of adverse events and the predictive value of 24 h temperature.</p><p><strong>Results: </strong>The cohort included 169 participants, 75.1% of whom were women, with a mean age of 84.3 years and substantial multimorbidity. Within 48 h, 44.4% reported at least one adverse event, most reactions were mild, and no participant had fever at 48 h. Local reactions were more frequent at the COVID-19 than the influenza injection site. Higher comorbidity count predicted any adverse event (odds ratio 1.3, 95% CI 1.0-1.6), and prior COVID-19 infection predicted systemic adverse events (odds ratio 2.2, 95% CI 1.1-4.4). Higher body temperature at 24 h was associated with higher counts of total, systemic, and local adverse events at 48 h, with the strongest association observed for systemic symptoms (β = 0.4, p < 0.001).</p><p><strong>Conclusion: </strong>Same-day influenza and COVID-19 vaccination was generally well tolerated in very old, medically complex adults, supporting coadministration with anticipatory counselling for those with higher comorbidity burden or prior COVID-19 infection.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718569","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":"Beyond specialty silos: geriatrics as a core competency for all physicians in an aging Europe.","authors":"Fiona Ecarnot, Jean-Pierre Michel","doi":"10.1007/s41999-026-01471-5","DOIUrl":"https://doi.org/10.1007/s41999-026-01471-5","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700543","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":"Risk of 30-day all-cause mortality in octogenarians with non-variceal upper gastrointestinal bleeding: a multinational analysis.","authors":"Do Han Kim, Jose A Porres, Donghyun Ko, Denisa Costea, Sharon I Narvaez, Luis M Nieto, Frank J Lukens, Pedro Palacios Argueta, Ben M W Illigens, Tiago L Cerqueira, Paul T Kröner","doi":"10.1007/s41999-026-01472-4","DOIUrl":"https://doi.org/10.1007/s41999-026-01472-4","url":null,"abstract":"<p><strong>Background: </strong>Studies show declining non-variceal upper gastrointestinal bleeding (NVUGIB) incidence and hospitalization, likely due to novel pharmacological and endoscopic therapies. However, data on mortality and outcomes in octogenarians with NVUGIB remain limited.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the TriNetX platform, identifying adults NVUGIB between January 1, 2014, and May 18, 2025. Patients with gastroesophageal variceal bleeding were excluded. Two age cohorts (> 80 years and 18-65 years) were 1:1 propensity matched according to sex, demographics, comorbidities, and medications. The primary outcome was risk of all-cause mortality. Secondary outcomes included in-hospital and procedure-related outcomes. Cox-proportional hazards models estimated hazard ratios (HR) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>117,695 octogenarians (mean [SD] age, 81.4 [5.3] year; 59,524 [50.6%] female) were matched with 117,695 patients < 65 years (mean [SD] age, 44.9 [13.6] year; 60,044 [51.0%] female). The octogenarian cohort had significantly higher all-cause mortality (HR, 2.73; 95% CI 2.60-2.87), acute kidney injury (HR, 1.61; 95% CI 1.56-1.66), mechanical ventilation (HR, 1.17; 95% CI 1.12-1.23), hypovolemic shock (HR, 1.54; 95% CI 1.40-1.70), and intensive care unit admission (HR, 1.10; 95% CI 1.06-1.13) compared to those aged under 65 years. Subgroup analysis comparing the timing of endoscopy and its effect on mortality showed increased all-cause mortality in octogenarians with NVUGIB and early endoscopy (HR, 2.04; 95% CI 1.81-2.30).</p><p><strong>Conclusion: </strong>Through this multicenter retrospective study, we demonstrate that octogenarians with NVUGIB have a 2.7-fold higher risk of all-cause mortality. This study emphasizes the importance of early diagnosis, aggressive management, and risk stratification to improve outcomes in this population.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693344","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":"Beyond percutaneous endoscopic gastrostomy: a broader view of nutritional care in older adults.","authors":"Ola Sultan, Benjamin H L Harris, Louis J Koizia","doi":"10.1007/s41999-026-01474-2","DOIUrl":"https://doi.org/10.1007/s41999-026-01474-2","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678124","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":"Reply to the letter to the editor \"beyond percutaneous endoscopic gastrostomy: a broader view of nutritional care in older adults \" by Ola Sultan, Benjamin HL Harris and Louis J Koizia regarding our publication \"longitudinal trends of percutaneous endoscopic gastrostomy in geriatric hospital units in Germany \".","authors":"Rainer Wirth","doi":"10.1007/s41999-026-01476-0","DOIUrl":"https://doi.org/10.1007/s41999-026-01476-0","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678062","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 combined association of STOPPFall medication use and orthostatic blood pressure abnormalities with future falls and fractures in community-dwelling older people.","authors":"Kate Doyle, Siobhan Scarlett, Silvin P Knight, Frank Moriarty, Amanda Lavan, Robert Briggs, Rose-Anne Kenny","doi":"10.1007/s41999-026-01473-3","DOIUrl":"https://doi.org/10.1007/s41999-026-01473-3","url":null,"abstract":"<p><strong>Purpose: </strong>STOPPFall(Screening Tool of Older Persons Prescriptions in older adults with high fall risk) defines fall-risk-increasing drugs(FRIDs) associated with orthostatic hypotension(OH)/falls. This study assesses the association between the cumulative effect of STOPPFall medications and OH, on future falls/fractures, over 4-year follow-up among community-dwelling older people ≥ 65 years using The Irish Longitudinal Study on Ageing(TILDA) data.</p><p><strong>Methods: </strong>STOPPFall medications were recorded at Wave1. Orthostatic blood pressure(BP) was measured by active stand using a Finometer at Wave1, recording delayed BP recovery(drop in systolicBP(sBP) ≥ 20 mmHg and/or diastolicBP ≥ 10 mmHg from baseline at 30 s post-stand) and \"any OH\"(same BP drop at any of 30,60,90,120 s post-stand). Falls/fractures were self-reported. Logistic regression models using interaction terms generated odds ratios(ORs) assessing the association between the interaction of STOPPFall medications and delayed BP recovery/any OH at baseline, and falls(including injurious/unexplained falls) and all fractures at follow-up.</p><p><strong>Results: </strong>1390 participants were included, mean age at baseline 71.0 years, 51% female. One STOPPFall medication was prescribed in 27%(372/1390) participants, 11%(147/1390) were prescribed ≥ 2STOPPFall medications. Over 40% participants fell during follow-up(592/1390,42.6%), 12%(160/1390) sustained fractures. The cumulative effect of ≥ 2STOPPFall medications and delayed BP recovery was independently associated with all falls[OR1.93(95%CI1.04-3.59);p = 0.036], injurious falls[OR2.97(95%CI1.55-5.68);p = 0.001] and all fractures[OR3.50(95%CI1.66-7.41);p = 0.001]. Prescription of ≥ 2STOPPFall medications and any OH was independently associated with all falls[OR1.98(95%CI1.11-3.54);p = 0.021], injurious falls[OR2.25(95%CI1.21-4.20);p = 0.011] and all fractures[OR2.81(95%CI1.34-5.90);p = 0.006].</p><p><strong>Conclusion: </strong>Prescription of ≥ 2 STOPPFall medications and delayed BP recovery, and prescription of ≥ 2 STOPPFall medications and any OH, was associated with all falls, injurious falls and all fractures. This highlights the importance of multidomain interventions during multifactorial falls assessments.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678099","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}