European Geriatric Medicine最新文献

{"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}

{"title":"Towards a typology of medical care in European long-term care homes.","authors":"Martin Aasbrenn, Anna Björg Jónsdóttir, Emil Lundgren, Roope Jaatinen, Wilco Achterberg, Adam L Gordon","doi":"10.1007/s41999-026-01467-1","DOIUrl":"https://doi.org/10.1007/s41999-026-01467-1","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to describe the range of ways in which medical care for older people living in care homes across Europe is provided and to group these, using similarities and differences in current practice, into categories-a typology-that would enable future collaboration between countries.</p><p><strong>Methods: </strong>A questionnaire-based survey comprising a mixture of closed and open questions was distributed in October 2025 to graduates of the European Academy for Medicine of Ageing (EAMA) course.</p><p><strong>Results: </strong>Respondents from 19 countries answered the survey. Waiting time for a care home placement was two months or more in 68% of countries. Median survival after moving to a care home ranged from 1.3 to 3.4 years. Digitalized medical records were available in most care homes, but were usually not synchronized with hospital or GP records. Nurses were available around the clock, while doctors came on predetermined days or per request. The residents' medical care was broadly grouped into three categories: Specialist-led, structured admission systems, GP-led care with strong admission gatekeeping and predominantly GP-led with less formal admission process.</p><p><strong>Conclusions: </strong>There was a substantial heterogeneity of the care home settings across the 19 countries studied. The way that residents received care can be broadly grouped into three categories. These represented a continuum from highly involved, highly specialised models of medical care to less-specialized medical models that more closely resemble the routine primary care received by citizens living in their own homes.</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":"147678127","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":"Intensive care admissions in older adults: are we moving from ageism to ableism?","authors":"Laura Moïsi, Bénédicte Lombart, Valérie Bellamy, Fabrice Gzil, Jean-Christophe Mino","doi":"10.1007/s41999-026-01468-0","DOIUrl":"https://doi.org/10.1007/s41999-026-01468-0","url":null,"abstract":"<p><strong>Purpose: </strong>Across Europe, the proportion of older adults is increasing, raising complex questions regarding intensive care unit (ICU) admission decisions in late life. As chronological age is no longer recommended alone as an ICU admission criterion, functional independence and frailty have gradually helped refine medical assessment of older adults and guiding decisions. We aimed to study chronological age's influence in ICU admission decisions and if and how functional independence and frailty scales are currently used in France.</p><p><strong>Methods: </strong>We conducted a qualitative study using semi-structured interviews of geriatricians, emergency physicians, and intensivists. Physicians' decision-making practices in critical situations were discussed. Data were analyzed using inductive thematic analysis within a constructivist and empirical ethics framework.</p><p><strong>Results: </strong>We interviewed 15 geriatricians, 8 emergency physicians, and 9 intensivists. Chronological age continued to influence ICU admission decisions through references to life expectancy. Functional independence and frailty scales (ADL/IADL and CFS) were used to assess premorbid status, estimate prognosis, and facilitate interprofessional communication. However, scales sometimes functioned as decision-making shortcuts, reduced deliberation, and risked reinforcing self-fulfilling prophecies. Scores were also used to justify implicit value judgments, valuing functionally independent and fit patients and judging others to be less worthy of ICU admission.</p><p><strong>Conclusion: </strong>Chronological age continues to shape ICU admission decisions for older adults despite increasing reliance on functional independence and frailty scales. Though these provide structured decision-making support, their use may inadvertently embed normative assumptions about aging and functional independence. Greater reflexivity is needed to ensure patient-centered robust decision-making for older adults in critical care.</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":"147678151","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":"Healthcare professionals consensus on purpose, content and frequency of physical activity for older adults during the non-weight-bearing rehabilitation: an iterative consensus study.","authors":"Elma van Garderen, Mandy Visser, Wilco P Achterberg","doi":"10.1007/s41999-026-01463-5","DOIUrl":"https://doi.org/10.1007/s41999-026-01463-5","url":null,"abstract":"<p><strong>Background: </strong>Among older adults who are temporarily restricted from weight-bearing on a lower extremity, inactivity is prevalent, and there is limited evidence-based guidance available regarding physical activity programs for older adults with such restrictions. However, healthcare professionals do have ample experience working with those patients. This study explored their experiences and aimed to reach consensus among healthcare professionals on the purpose, desired content, and frequency of physical activity for older adults during non-weight-bearing rehabilitation.</p><p><strong>Methods: </strong>A three-phase iterative design was followed. Phase one consisted of focus group discussions with healthcare professionals. In phase two, panel discussions were used to extract relevant information from phase one. The relevant information was used as statements in phase three, a Delphi consensus study aimed to reach consensus among healthcare professionals.</p><p><strong>Results: </strong>In total, 76 healthcare professionals participated in the first Delphi round. 47 consensus statements, based on the first two phases, were grouped under eight themes derived from the focus group and panel discussions. Consensus was reached on 38 of 47 statements in round one. In round two, 51 participants reviewed eight revised or new statements, of which six reached consensus. The final two statements that did not reach consensus were revised based on the participants' comments and expert feedback.</p><p><strong>Conclusion: </strong>This study provides a consensus-based foundation for developing physical activity interventions for older adults during non-weight-bearing rehabilitation. Although there was broad agreement on most statements, participants emphasized the importance of tailoring interventions to each patient's individual condition, abilities, and goals.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663295","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":"Age and neutrophil counts at the time of diagnosis of polymyalgia rheumatica: are they useful or confounding factors in the geriatrician's clinical practice?","authors":"Ciro Manzo","doi":"10.1007/s41999-026-01460-8","DOIUrl":"https://doi.org/10.1007/s41999-026-01460-8","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647182","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 three-biomarker panel for frailty prediction and risk stratification in institutionalized older adults: a multicenter validation study.","authors":"Amr Ali Mohamed Abdelgawwad El-Sehrawy, Ismail Abdelhameed Abadia Ali Kandi, Mansuor A Alanazi, Saud S Alharbi, Sultan Mohammed Alanazi, Mona Y Alqassim, Amal A Abdulbaqi, Amro Elbaz","doi":"10.1007/s41999-026-01438-6","DOIUrl":"https://doi.org/10.1007/s41999-026-01438-6","url":null,"abstract":"<p><strong>Purpose: </strong>Frailty affects between 20 and 75% of residents in long-term care facilities; however, there is a notable absence of objective biological assessment tools for proactive risk stratification.</p><p><strong>Methods: </strong>To address this gap, we examined inflammatory and metabolic biomarkers using a validated 52-item Frailty Index in a cohort of 292 older adults residing in institutions. Each participant completed an assessment of the Frailty Index and underwent quantification of 12 inflammatory and metabolic-nutritional biomarkers that encompass the pathways of inflammation, proteostasis, and metabolic dysregulation.</p><p><strong>Results: </strong>In a study of 292 institutionalized older adults (mean age 82.6 ± 6.7 years, 68.8% female, 58.6% frail), a simplified three-biomarker panel-interleukin-6 (IL-6), prealbumin, and high-sensitivity C-reactive protein (hs-CRP)-demonstrated excellent predictive accuracy. A simplified three-biomarker panel-interleukin-6 (IL-6), prealbumin, and high-sensitivity C-reactive protein (hs-CRP)achieved excellent diagnostic accuracy (area under curve (AUC) = 0.861, 95% confidence interval (CI) 0.801-0.915), with 81.2% sensitivity and 85.4% specificity for This parsimonious panel retained 96.5% of the predictive performance of the full 12-biomarker model while using only routinely available laboratory tests.</p><p><strong>Conclusion: </strong>Taken together, these results underscore the potential of inflammatory and metabolic biomarkers for the early identification of high-risk residents, thereby supporting personalized nursing care. Integrating biomarker-guided stratification may facilitate the targeted allocation of nutritional support, physical therapy, and inflammatory management, potentially preventing 30-40% of frailty progression.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647246","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":"Muscle loss must be interpreted in the context of fluid imbalance: a dual-parameter model predicts functional outcomes after acute stroke.","authors":"Kota Amakasu, Tatsuro Inoue, Araki Saito, Natsumi Kamada, Akiko Brown, Akari Kasai, Mei Furusawa, Sota Kobayashi, Yumiko Watanabe","doi":"10.1007/s41999-026-01464-4","DOIUrl":"https://doi.org/10.1007/s41999-026-01464-4","url":null,"abstract":"<p><strong>Aim: </strong>To examine whether the coexistence of elevated extracellular water-to-total body water ratio (ECW/TBW) and low appendicular lean soft tissue index (ALSTI), a combined fluid-muscle phenotype, predicted poorer functional independence at hospital discharge.</p><p><strong>Findings: </strong>The coexistence of high ECW/TBW and low ALSTI was associated with poorer functional independence at hospital discharge, whereas low ALSTI alone was not.</p><p><strong>Message: </strong>The interpretation of ALSTI in patients with acute stroke should consider ECW/TBW and that ALSTI with ECW/TBW is clinically useful in predicting prognosis.</p><p><strong>Purpose: </strong>We aimed to examine whether the coexistence of elevated extracellular water-to-total body water ratio (ECW/TBW) and low appendicular lean soft tissue index (ALSTI), a combined fluid-muscle phenotype, predicted poorer functional independence at hospital discharge.</p><p><strong>Methods: </strong>Patients aged ≥65 years with an acute stroke between 2021 and 2024 were included. Baseline body composition was measured using bioelectrical impedance analysis within one week of rehabilitation initiation. High ECW/TBW was defined as ≥0.400, and low ALSTI as <7.0 kg/m² for males and <5.7 kg/m² for females. Functional independence at discharge was assessed using the modified Rankin Scale (mRS), with scores of 0-2 defined as independent and 3-6 defined as non-independent. Multivariate logistic regression analysis was used to examine the effects of the coexistence of high ECW/TBW and low ALSTI on functional independence.</p><p><strong>Results: </strong>In total, 560 patients were included in the analysis. The number of patients with high ECW/TBW and low ALSTI was 227 (49.4%). Multivariate logistic regression analysis showed that the coexistence of high ECW/TBW and low ALSTI at baseline was a significant associated with non-independence at discharge (odds ratio (OR) = 3.82, 95% confidence interval (CI) 2.00-7.32, P < 0.001), but low ALSTI alone was not (OR = 1.73, 95% CI 0.92-3.22, P = 0.086).</p><p><strong>Conclusions: </strong>Baseline coexistence of high ECW/TBW and low ALSTI, highlighting the importance of considering fluid imbalance in addition to muscle mass, was associated with for non-independence at hospital discharge in patients with acute stroke.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624223","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":"Functional recovery in older adults following mild traumatic brain injury: a systematic review.","authors":"Lucas Tze Peng Tan, Claire Yi Jia Lim, Jin Hean Koh, Gobinathan Chandran, Li Feng Tan, Reshma A Merchant","doi":"10.1007/s41999-025-01326-5","DOIUrl":"10.1007/s41999-025-01326-5","url":null,"abstract":"<p><strong>Aim: </strong>To determine the domain-specific functional, psychological, and cognitive recovery outcomes in older adults aged ≥ 65 years after mild traumatic brain injury.</p><p><strong>Findings: </strong>Across 18 studies (3549 participants), fewer than half of the older adults regained full functional independence by 6 months, and many had persistent mood symptoms and cognitive deficits up to 1 year. Global tools such as the GOSE reveal wide measurement heterogeneity and an under-recognized burden.</p><p><strong>Message: </strong>Mild traumatic brain injury is seldom \"mild\" in older adults. Geriatrics-tailored, multidimensional assessment and follow-up could improve rehabilitation and guide practice.</p><p><strong>Purpose: </strong>Mild traumatic brain injury (mTBI) in older adults is increasingly common and associated with long-term functional, psychological, and cognitive impairment, especially in those with frailty and multimorbidity. Traditional outcome measures may underestimate the long-term burden in this patient population. This systematic review synthesizes current evidence on domain-specific functional recovery outcomes in older adults with mTBI with emphasis on physical function, depression, and cognition.</p><p><strong>Methods: </strong>A systematic search of Medline/PubMed, Embase, and Cochrane Library was conducted through 6 October 2024. Observational studies reporting functional outcomes in older adults ≥ 65 years post-mTBI were included. Study quality was assessed using the Quality of Prognostic Studies (QUIPS) tool.</p><p><strong>Results: </strong>Eighteen studies (three thousand five hundred forty-nine participants) were included. Persistent impairments in activity and participation were observed in up to 66% at 6 months post-injury. Approximately 24% experienced at least mild depression, and 9% had moderate-to-severe anxiety. Cognitive recovery was heterogeneous, with residual deficits in processing speed, memory, and executive function. Standard global measures such as GOSE frequently failed to detect domain-specific impairments, especially in psychosocial and cognitive domains.</p><p><strong>Conclusion: </strong>Older adults with mTBI frequently experience prolonged and incomplete recovery across multiple domains, which often goes undetected by traditional outcome measures. Given the multidimensional burden observed, comprehensive geriatric assessment and interdisciplinary follow-up could help align care to patient needs. Future research should include adults aged ≥ 80 years, adopt multidimensional tools, and extend follow-up to better guide tailored rehabilitation strategies.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"507-523"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287505","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}