European Geriatric Medicine最新文献

{"title":"Predictors of change in sleep disturbance in Canadian long-term care facilities: a longitudinal analysis based on interRAI assessments.","authors":"Nasir Wabe, Lisa Geyskens, Jae Yoon Yi, Edoardo Varratta, Alcina Matos Queirós, Luke Andrew Turcotte, Andrew Costa, John P Hirdes","doi":"10.1007/s41999-025-01302-z","DOIUrl":"https://doi.org/10.1007/s41999-025-01302-z","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep disturbance is prevalent in long-term care facilities (LTCFs), yet there is limited understanding of individual factors predicting changes in sleep within these populations. Our objective was to determine predictors of sleep disturbance in LTCFs and investigate variation in prevalence across facilities in two Canadian provinces-New Brunswick and Saskatchewan.</p><p><strong>Method: </strong>This retrospective longitudinal cohort study used interRAI comprehensive health assessment data from 2016 to 2021, encompassing 21,394 older adults aged ≥ 65 years across 228 LTCFs. Generalised estimating equations were used to determine predictors of sleep disturbance, with separate models for new and resolved sleep disturbance. Funnel plots were employed to assess facility-level variation, with facilities exceeding the 99.8th percentile control limit identified as outliers.</p><p><strong>Results: </strong>The overall prevalence of sleep disturbance was 21.7%, with rates ranging from 3 to 56% across facilities, and 8% of facilities showing outlying rates. Nine predictors were significantly associated with the onset of new sleep disturbance, including being a male, being newly admitted, cognitive impairment, pain, daytime sleeping, chronic obstructive pulmonary disease, coronary heart disease, antipsychotics use, and sedative-hypnotics use. Significant predictors of resolved sleep disturbance were stroke, polypharmacy, and being newly admitted. Conversely, lower odds of resolved sleep disturbance were observed among daytime sleepers and residents taking sedative-hypnotics.</p><p><strong>Conclusion: </strong>This study underscores the high prevalence and variation of sleep disturbance in LTCFs, highlighting potential modifiable risk factors for improvement. Further research is needed to explore the interplay of institutional, environmental, and individual factors to develop targeted interventions that enhance the quality of care in LTCFs.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030763","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":"Chronic pain and decline in activities of daily living among community-dwelling older adults: a systematic review of longitudinal studies.","authors":"Arisa Kawashima, Ayane Komatsu, Xueying Jin, Hiroyuki Shimada, Hidenori Arai, Tami Saito","doi":"10.1007/s41999-025-01299-5","DOIUrl":"https://doi.org/10.1007/s41999-025-01299-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the longitudinal association between chronic pain and decline in activity of daily living (ADL) among community-dwelling older adults aged ≥ 60 years.</p><p><strong>Methods: </strong>In this systematic review of prospective longitudinal studies with narrative synthesis, a comprehensive literature search was conducted using PubMed and Embase using free-text words and MeSH terms on February 3, 2025. Longitudinal studies that quantitatively assessed ADL at two or more time points and pain at least once were included. Interventional studies, qualitative research, and non-English publications were excluded. Titles, abstracts, and full texts were screened by multiple independent reviewers based on the eligibility criteria. The included studies' methodological quality was evaluated using the Study Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.</p><p><strong>Results: </strong>Seven studies (9,786 participants) met the inclusion criteria. These prospective cohort studies suggest that chronic musculoskeletal pain, particularly knee or back pain, is associated with declines in basic ADL, instrumental ADL, lower extremity physical function, and mobility disability. Most studies evaluated pain based on frequency, severity, or impact on function, whereas one study used the number of pain sites. The reported effect sizes varied, with adjusted odds ratios for ADL decline ranging from 1.31 to 2.38 and hazard ratios from 1.49 to 3.47. Meta-analysis was not feasible because of the heterogeneity in the measures used to assess pain and ADL.</p><p><strong>Conclusions: </strong>This review indicates that chronic pain is associated with ADL decline in community-dwelling older adults. Regular pain assessment and appropriate management may help maintain ADL in this population.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016521","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":"Emergency one-stage endoscopic treatment in the older adults with acute cholangitis with choledocholithiasis: a propensity score-matched analysis.","authors":"Yang Zhou, Yuanyuan Li, Aijing Zhu, Shuaijing Huang, Yan Liang, Chunxiao Yue, Xiaoyu Bai, Yadong Feng","doi":"10.1007/s41999-025-01296-8","DOIUrl":"https://doi.org/10.1007/s41999-025-01296-8","url":null,"abstract":"<p><strong>Purpose: </strong>Current opinions on endoscopic retrograde cholangiopancreatography (ERCP) safety in older patients are contentious. This study aimed to assess emergency one-stage endoscopic treatment for choledocholithiasis-related cholangitis in older adults.</p><p><strong>Methods: </strong>Patients with choledocholithiasis related cholangitis from January 2019 to July 2023 were recruited. A propensity score (PS) framework was then used to evaluate clinical outcomes after ERCP in patients over 80 years of age.</p><p><strong>Results: </strong>Inclusion criteria yielded 374 patients, with 120 pairs matched via PS (median age: 85.1 years; 49.2% male in the older group). There was no significant difference in in-hospital mortality between the older adult ERCP group and the control group (2.5% vs. 0%, P = 0.081), whereas intensive care unit (ICU) admissions were higher (38.3% vs. 17.5%, P < 0.001) and length of hospital stay (LOHS) were longer (10 days vs. 8.5 days, P < 0.001). Multivariate analysis revealed that factors affecting LOHS included procalcitonin (PCT), creatinine (Cr), age, and adverse events related to post-ERCP. The independent factor rising ICU admission was age. Subgroup analysis revealed early ERCP reduced antibiotic use and hospitalization in older patients. Severe acute cholangitis (SAC) increased antibiotic use duration and 30-day mortality, while comorbidities raised ICU admission rates, ICU duration, and antibiotic use.</p><p><strong>Conclusion: </strong>One-stage endoscopic treatment is safe and effective for older patients, with higher age linked to increased ICU admissions. Early ERCP benefits hospital outcomes, feasible even in severe SAC or comorbid conditions.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976145","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 falls prevention in older adults: a critical appraisal of the 2022 world falls guidelines.","authors":"Hanadi Al Hamad, Brijesh Sathian","doi":"10.1007/s41999-025-01298-6","DOIUrl":"10.1007/s41999-025-01298-6","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976108","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":"Closer than ever before: insights into parallel ageing of older people and their even older parents from the cinematic genius of no home movie.","authors":"Neasa Fitzpatrick, Desmond O'Neill","doi":"10.1007/s41999-025-01291-z","DOIUrl":"https://doi.org/10.1007/s41999-025-01291-z","url":null,"abstract":"<p><strong>Introduction: </strong>Ageing is an increasingly popular subject in modern cinema, as prominent directors contend with the advancing age of both themselves and their parents. Within cultural gerontology and medical humanities, cinema provides unique insights into the heterogeneous experience of ageing, often surpassing what is possible with other methods of qualitative analysis.</p><p><strong>Methods: </strong>We analyse 65-year-old Chantal Ackerman's final film No Home Movie, a documentary following her 86-year-old mother, Natalia, in the last phase of her life. We assess Ackerman's depiction of her mother at this age and how this relates to Ackerman's own attitudes towards ageing. Through this, we examine the modern cultural phenomenon of children and parents existing simultaneously in the 'older demographic', the effect this may have on parent-child relationships, and how this is represented in No Home Movie.</p><p><strong>Results: </strong>No Home Movie reveals Ackerman's fascination, admiration and also apprehension of living into extended old age. We obtain a first-hand account of Natalia's experience of ageing, revealing a certain tranquillity and contentment, even amidst a more restricted life. Chantal and Natalia's relationship is fluid and dynamic, their roles oscillating between that care-giver and care-receiver, but most commonly expressed as a friendship of peers.</p><p><strong>Conclusions: </strong>Cinema is a rich area for interpretation and interrogation around the topic of ageing. This paper on No Home Movie is an example of how the study of cinema can contribute to ageing scholarship. No Home Movie highlights the unique joys and challenges of intergenerational relationships in the setting of our growing longevity.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976083","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":"Th1/Th2 immune regulation and functional resilience in older adults following severe COVID-19: a prospective cohort study.","authors":"Daniela Cataneo-Piña, Leslie Chávez-Galán, Ranferi Ocaña-Guzmán, José Alberto Ávila-Funes, Tamas Fulop, Ivette Buendia-Roldan","doi":"10.1007/s41999-025-01293-x","DOIUrl":"https://doi.org/10.1007/s41999-025-01293-x","url":null,"abstract":"<p><strong>Background: </strong>Older adults recovering from severe COVID-19 exhibit heterogeneous trajectories, ranging from persistent frailty to full functional recovery. The biological mechanisms underpinning resilience in this population remain poorly defined. This study aimed to investigate the association between Th1/Th2 immune regulation and functional resilience, defined as improvement in frailty status, among older survivors of severe COVID-19.</p><p><strong>Methods: </strong>We conducted a prospective study at a tertiary respiratory center in Mexico. Twenty-four patients aged 65 or older with a history of severe COVID-19 were assessed at 4 and 12 months post-discharge. Frailty was evaluated using a validated phenotype adapted for the Mexican population. Peripheral blood mononuclear cells (PBMCs) were analyzed by flow cytometry to quantify CD4+ T cell subsets, cytokine production (IFN-γ, TNF, and IL-10), and the expression of T-bet, GATA-3, and TIM-3.</p><p><strong>Results: </strong>Thirteen participants showed improved frailty status over 12 months. Resilient patients exhibited a higher Th1/Th2 (T-bet/GATA-3) ratio at 4 months post-discharge and increased IFN-γ and TNF production at 12 months. TIM-3 expression on CD4+ cells and circulating levels were also elevated in the resilient group.</p><p><strong>Conclusions: </strong>A Th1-skewed immune profile early after recovery and sustained proinflammatory cytokine activity are associated with resilience in older adults following severe COVID-19. These findings offer insight into immune mechanisms that may support functional recovery in aging populations.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976077","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":"Comorbidities and comorbidity burden in patients with neurocognitive disorders: findings from the MEMORA Cohort Study.","authors":"Mohamed Nour Temedda, Antoine Garnier-Crussard, Claire Moutet, Christelle Mouchoux, Virginie Dauphinot","doi":"10.1007/s41999-025-01288-8","DOIUrl":"https://doi.org/10.1007/s41999-025-01288-8","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to compare comorbidities' prevalence and the comorbidity burden as measured by comorbidity indices according to the stages and the etiological diagnoses of neurocognitive disorders (NCD). This study aimed also to examine how comorbidities and comorbidity indices were associated with both stages and etiologies of NCD.</p><p><strong>Methods: </strong>This is a cross-sectional study including participants from the MEMORA real-life cohort, aged ≥ 60 years. Patients had to be in either MCI or dementia stage, with the following etiological diagnoses of NCD: AD, VD (vascular dementia), mixed dementia (MD), dementia with Lewy bodies, frontotemporal dementia and Parkinson's disease. Three comorbidity indices were used to measure comorbidity burden: the Charlson comorbidity index, the multimorbidity-weighted index (MWI) and the health-related quality of life comorbidity index (HRQOL-CI). Prevalence of comorbidities involved in the calculation of at least one comorbidity index were reported. The associations between comorbidities/comorbidity indices and groups were assessed using binary and multinomial logistic regressions.</p><p><strong>Results: </strong>Overall, 3470 patients (66.9% dementia; 50.9% AD) were included. The most frequent comorbidities were hypertension (50.2%), depression (28.0%) and hypercholesterolemia (22.6%). The MWI and the HRQOL-CI were associated with increased odds of dementia (vs. MCI). Upon stratifying population according to the etiological diagnoses of NCD, the highest mean of the three comorbidity indices were found in patients with VD and MD.</p><p><strong>Conclusion: </strong>Comorbidities and comorbidity burden vary according to the stage and etiological diagnoses of NCD. Future studies should consider the stage and the etiological diagnoses, when studying the effect of the comorbidity burden on the progression of NCD.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976125","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":"Ageing and the lifespan through the eyes of Caspar David Friedrich.","authors":"Desmond O'Neill","doi":"10.1007/s41999-025-01290-0","DOIUrl":"https://doi.org/10.1007/s41999-025-01290-0","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976135","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":"Diagnostic test accuracy of screening tools for the detection of neurocognitive disorders in older adults post-trauma in acute care settings: a systematic review.","authors":"Niamh A Merriman, Mary E Walsh, Helena Ferris, Eithne Sexton, Niamh O'Regan, Rose S Penfold, Marie Carrigan, Tara Coughlan, Lorna Gurren, Jodie Adams, Chris Reidy, Arveen Jeyaseelan, Patrick Doyle, Mubashra Ashraf, Tomás Ó Flatharta, Siofra Hearne, Jane Gaffey, Louise Brent, Pamela Hickey, Catherine Blake","doi":"10.1007/s41999-025-01287-9","DOIUrl":"https://doi.org/10.1007/s41999-025-01287-9","url":null,"abstract":"<p><strong>Purpose: </strong>Neurocognitive disorders (NCDs), including delirium, cognitive impairment, or dementia, are prevalent in older patients with physical trauma in acute care settings. Identifying NCDs in these patients can enhance care decisions to improve outcomes. This study aimed to identify the diagnostic accuracy of screening tools for NCDs in older patients with trauma in acute care settings.</p><p><strong>Methods: </strong>Electronic databases (MEDLINE, Embase, CINAHL, PsycInfo, Cochrane Library) were searched from inception to 01 March 2024. Inclusion criteria were: older adults (≥ 60 years); admitted to acute care setting following physical trauma; diagnostic accuracy study of a screening tool for (1) delirium and/or (2) cognitive impairment or dementia against a reference standard of a clinical diagnosis (standard diagnostic criteria or validated tool). Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A narrative synthesis was conducted. Methodological heterogeneity between the studies precluded meta-analysis.</p><p><strong>Results: </strong>Five studies examining five different screening tools for delirium in older adults, all with hip fracture, were included. Studies reported wide variance in sensitivity (76.9-91.8) and specificity (54.5-99). Prevalence of detected delirium varied widely across studies (6.7-31.5%). All studies had a high or unclear risk of bias in at least one domain. No studies were found to examine the diagnostic accuracy of screening tools for cognitive impairment in older patients with trauma.</p><p><strong>Conclusion: </strong>This systematic review highlights the dearth of studies validating screening tools for NCDs in older patients following trauma in acute care settings.</p><p><strong>Prospero registration number: </strong>CRD42024518730.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876407","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 sarcopenia and hypercoagulability in elderly patients with chronic obstructive pulmonary disease.","authors":"Huijun Tian, Yanwei Cheng, Lijie Qin, Peirong Zhang, Yun Li, Bingwei Liang","doi":"10.1007/s41999-025-01289-7","DOIUrl":"https://doi.org/10.1007/s41999-025-01289-7","url":null,"abstract":"<p><strong>Purpose: </strong>Blood hypercoagulability is associated with poor prognosis in elderly patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to explore whether sarcopenia, a common disease among the elderly, could promote the hypercoagulable state in such patients.</p><p><strong>Methods: </strong>Elderly patients with stable-phase COPD were divided into the sarcopenia group (n = 192) and the non-sarcopenia group (n = 264). Sarcopenia was diagnosed according to the criteria for risk assessment, muscle mass measurement, muscle strength evaluation, and muscle function assessment. All patients were followed up for 18 months, and the acute exacerbation of COPD was recorded. The characteristics of COPD, coagulation function, and potential confounding factors during the stable and acute exacerbation phases were collected. Multivariate logistic or linear regression was used for data analysis.</p><p><strong>Results: </strong>Compared with the non-sarcopenia group, the levels of PLT and AT-III in patients of the sarcopenia group were significantly lower, while the levels of PAR, PT, APTT, FIB, and D-dimer were significantly higher during both the stable phase and the acute exacerbation phase of COPD. More importantly, compared with the non-sarcopenia group, the deterioration amplitudes of most coagulation indicators in patients of the sarcopenia group were significantly greater during the process of COPD developing from the stable phase to the acute exacerbation phase.</p><p><strong>Conclusion: </strong>There is a significant correlation between sarcopenia and blood hypercoagulability in elderly patients with COPD. Sarcopenia seemingly has the potential to be a risk factor for the blood hypercoagulable state in such patients, but further verification is still needed.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876395","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}