European Geriatric Medicine最新文献

{"title":"Enhancing the accuracy of bioimpedance-derived appendicular skeletal muscle mass in aged adults through machine learning.","authors":"Bruno Micael Zanforlini, Nicolò Biasetton, Alessandro Perencin, Giorgia Longo, Elena Barzizza, Chiara Curreri, Anna Bertocco, Chiara Ceolin, Giuseppe Sergi, Luigi Salmaso, Marina De Rui","doi":"10.1007/s41999-026-01592-x","DOIUrl":"https://doi.org/10.1007/s41999-026-01592-x","url":null,"abstract":"<p><strong>Purpose: </strong>Appendicular Skeletal Muscle Mass (ASMM) estimation via Bioelectrical Impedance Analysis (BIA) is a high-quality and bedside-accessible method. However, its accuracy is limited in comorbid populations, and determining the degree of error at the bedside remains a challenge. This study evaluates the application of Machine Learning (ML) algorithms as a decision-support layer to identify patients for whom the BIA-derived ASMM value is accurate.</p><p><strong>Methods: </strong>This cross-sectional study included 701 participants aged ≥65 years (550 healthy subjects, 151 outpatients). ASMM measured by Dual-Energy X-ray Absorptiometry served as the reference. An absolute error ≤1.14 kg (the original equation's standard error) defined accurate estimation. Five algorithms-Extreme Gradient Boosting, Support Vector Machine (SVM), Random Forest, Logistic regression, and Neural Networks-were trained using three hierarchical sets of predictors: (1) anthropometric and bioimpedance variables, (2) model 1 plus handgrip strength, and (3) model 2 plus anthropometric circumferences (arm, waist, and calf) and knee height.</p><p><strong>Results: </strong>Estimation error was minimal in healthy subjects but markedly higher in outpatients (median absolute difference 0.81 vs. 2.37 kg, p<0.001). Accurate estimates dropped from 62.4% in healthy individuals to 25.2% in outpatients. Discriminative performance improved progressively with each predictor set. In Set 3, SVM achieved the highest cross-validation Area Under the Curve (0.813) and a test AUC of 0.867, with an accuracy of 0.70.</p><p><strong>Conclusions: </strong>Integrating ML into BIA-based muscle assessment enables clinicians to quantify the reliability of individual ASMM estimates, even in patients with comorbidities. This approach provides a standardized framework for accepting or rejecting bedside estimations, enhancing clinical decision-making.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851853","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 survey among geriatricians on geriatric oncology and geriatric surgical oncology models in Europe.","authors":"Paula Sobrini-Morillo, Isabelle Moens, Alfonso Cruz-Jentoft, Andrea Sebastiano Ciccone, Jugdeep K Dhesi, Nicolas M Gonzalez-Senac, Marije Hamaker, Cecilia Lund, Francesco Mattace-Raso, Nina Neuendorff, Siri Rostoft, David Shipway, Giuseppe Dario Testa, Anja Velghe, Harmke A Polinder-Bos","doi":"10.1007/s41999-026-01575-y","DOIUrl":"https://doi.org/10.1007/s41999-026-01575-y","url":null,"abstract":"<p><strong>Purpose: </strong>To provide an up-to-date overview of geriatricians' involvement in oncological and onco-surgical care for older adults across Europe.</p><p><strong>Methods: </strong>An anonymous 35-item online survey was distributed via (inter)national societies between 10 April and 23 May 2025. The responses were summarized, and associations between comprehensive geriatric assessment (CGA) outputs, participation in oncological multidisciplinary team (MDT) meetings, and involvement in treatment decision-making were explored.</p><p><strong>Results: </strong>A total of 2160 responses were received from 37 countries. Further analysis included 395 geriatrician/internal medicine respondents with > 25% survey completion from 34 countries. Of them, 19% reported no formal geriatric oncology model; the most common approaches were referral based on clinical judgment (43%) and a two-step pathway (42%). Frailty screening-guided referral occurred in 63%, with the G8 (50%) and Clinical Frailty Scale (32%) being the most commonly used. Among respondents, 30% reported routine MDT attendance, and 20% reported involvement in treatment decisions. In exploratory analyses, routine MDT participation was associated with active treatment decision-making (aOR 6.01, 95% CI 3.08-11.7), CGA-based recommendations addressing both geriatric domains and oncological treatment (aOR 5.81, 95% CI 3.16-10.7), and positive feedback from oncology/surgery teams (aOR 3.75, 95% CI 1.96-7.14; all p < 0.001). Only 39% of respondents were involved in inpatient surgical oncology care, with liaison models predominating (37%).</p><p><strong>Conclusion: </strong>Geriatric oncology and geriatric surgical oncology remain unevenly implemented across Europe. Standardized pathways, training, and MDT integration may improve equity of care for older adults with cancer.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851820","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":"Communication strategies amongst healthcare professionals, patients and caregivers in Hospital-at-Home Admission Avoidance models for acutely ill older adults: a scoping review.","authors":"Anne Hedegaard Arndt, Merete Gregersen, Linda Huibers, Viola Burau, Maria Lundsby Jensen, Anna Dalsgaard Thorsen, Lone Winther Lietzen","doi":"10.1007/s41999-026-01593-w","DOIUrl":"https://doi.org/10.1007/s41999-026-01593-w","url":null,"abstract":"<p><strong>Purpose: </strong>Hospital-at-Home Admission Avoidance (HaH-AA) provides hospital-level treatment at home as an alternative to hospital admission. Communication is key to safe, coordinated care for older adults, many of whom live with frailty. This review aimed to identify and map communication strategies and healthcare professionals involved in HaH-AA models for acutely ill older adults whilst charting reported frailty measures and frailty-related characteristics.</p><p><strong>Methods: </strong>This scoping review followed the Arksey and O'Malley framework. Four databases were searched to July 2025 to identify studies describing communication strategies in HaH-AA models for acutely ill older adults. A Communication Strategy Framework guided data extraction across three domains: face-to-face, technology- and organisational-mediated communication. Frailty measures and frailty-related characteristics were extracted when available.</p><p><strong>Results: </strong>Twenty-eight papers describing fifteen HaH-AA models were included. Face-to-face communication was described in all models for initial assessment and follow-up, delivered by nurses and physicians on-site, by nurses with remote physician input, or by nurses alone. Technology-mediated communication was described in 12 models as virtual visits (telephone or video), remote monitoring in 7 models using automated or manual methods. Organisationally mediated communication strategies were described across all models and included shared documentation and coordination mechanisms centred on four themes: standardised protocols, structured communication processes, dedicated coordination roles and shared training initiatives. Frailty-related reporting was heterogeneous; most studies reported frailty measures and frailty-related characteristics, but only four reported validated frailty measures.</p><p><strong>Conclusion: </strong>Communication strategies were not examined as a primary research focus, resulting in heterogeneous descriptions and limited clinical guidance. HaH-AA research should explicitly address communication for acutely ill older adults, including those living with frailty.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814500","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":"Preoperative antithrombotic use is associated with delayed mobilization and plural blood transfusions following hip fracture surgery: a case-control study.","authors":"Henrik Nupponen, Hanna Pajulammi, Anssi Korppi, Esa Jämsen","doi":"10.1007/s41999-026-01581-0","DOIUrl":"https://doi.org/10.1007/s41999-026-01581-0","url":null,"abstract":"<p><strong>Purpose: </strong>Early surgical treatment is important to allow a prompt start for rehabilitation after hip fracture. In patients using antithrombotic drugs, the surgery is often delayed, but it is unclear how this affects early post-operative recovery.</p><p><strong>Methods: </strong>The course of treatment and early post-operative outcomes of hip fracture patients, aged ≥ 70 years, using either warfarin, direct oral anticoagulants (DOACs), or adenosine diphosphate. (ADP) inhibitors were compared to age- and sex-matched controls not using such drugs, operated during the same observation period at the same hospital. All data were retrospectively collected from electronic medical records.</p><p><strong>Results: </strong>306 patients (53% of all operations; mean age 87 years, 63% females) were included. Patients using DOACs or ADP inhibitors had their operation later than controls and warfarin users (2 and 2.5 days, respectively, compared to 1 day after admission; p < 0.001). Antithrombotic use was also associated with later mobilization (cases 2nd vs. controls 1st post-operative day; p = 0.004) and greater use of red blood cell (RBC) transfusions (14% of warfarin, 26% of DOAC, and 10% of ADP inhibitor users received ≥ 2 units of RBCs, compared to 5% of controls; p = 0.003). After adjustment for comorbidities, cognition, mobility, and disability, antithrombotic use was associated with RBC transfusions and use of DOACs with delayed surgery and RBC transfusions. There were no differences in 30-day mortality.</p><p><strong>Conclusion: </strong>Preoperative use of antithrombotic drugs may delay mobilization and increase the need for RBC transfusions after hip fracture surgery. Delayed surgery and mobilization may lead to worse rehabilitation outcome.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819915","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":"Coexisting malnutrition risk, frailty, and probable sarcopenia are associated with previous-year falls in community-dwelling older adults: a retrospective cross-sectional real-world evidence study.","authors":"Ezgi Pinar, Tugba Erdogan, Emine Asci Civelek, Ozge Can Ceylan, Sirin Zelal Sahin Tirnova, Zeynep Fetullahoglu, Damla Gul Cetin, Serdar Ozkok, Mehmet Akif Karan, Gulistan Bahat","doi":"10.1007/s41999-026-01590-z","DOIUrl":"https://doi.org/10.1007/s41999-026-01590-z","url":null,"abstract":"<p><strong>Background: </strong>Falls in older adults are associated with disability, hospitalization, and mortality. Although frailty, malnutrition, and sarcopenia have individually been linked to falls, their combined association with previous-year fall history remains unclear. This study investigated the associations of these conditions and the number of coexisting conditions with self-reported falls during the previous year among community-dwelling older adults attending a geriatric outpatient clinic.</p><p><strong>Methods: </strong>This retrospective cross-sectional real-world evidence study included 1219 adults aged ≥65 years attending a tertiary geriatric outpatient clinic between 2012 and 2024 who underwent comprehensive geriatric assessment. Frailty was assessed using the FRAIL scale, malnutrition risk using the Mini Nutritional Assessment-Short Form, and probable sarcopenia according to population-specific low handgrip strength based on European Working Group on Sarcopenia in Older People criteria. History of falls was assessed by asking participants whether they had experienced at least one fall during the previous 12 months and was analyzed as a binary outcome. The number of coexisting conditions was categorized as 0, 1, 2, or 3. Multivariable logistic regression models were adjusted for age, sex, and body mass index. A complete-case sensitivity analysis in the subgroup with complete data (n=557) was additionally adjusted for cognitive impairment, depressive symptoms, and polypharmacy.</p><p><strong>Results: </strong>Mean age was 75.5±6.8 years, 68.3% were female, and 40.3% reported at least one fall during the previous year. Frailty, malnutrition risk, and probable sarcopenia were present in 19.8%, 26.9%, and 42.2% of participants, respectively. Frailty (OR 1.40, 95% CI 1.02-1.92) and malnutrition risk (OR 1.70, 95% CI 1.28-2.26) were associated with previous-year fall history, whereas probable sarcopenia was not (OR 1.28, 95% CI 0.98-1.68). Taking participants with none of the three conditions as the reference group, the adjusted odds of reporting a previous-year fall were higher among those with one condition (OR 1.43, 95% CI 1.09-1.88), two conditions (OR 2.22, 95% CI 1.56-3.16), and three conditions (OR 2.41, 95% CI 1.34-4.34); p for trend <0.001. Participants with two or three conditions had higher odds of reporting a previous-year fall than those with zero or one condition (OR 1.94, 95% CI 1.44-2.63). This association remained significant in the complete-case sensitivity analysis involving 557 participants (OR 1.66, 95% CI 1.06-2.60).</p><p><strong>Conclusions: </strong>Malnutrition risk and frailty were associated with previous-year fall history, whereas the association with probable sarcopenia was attenuated after multivariable adjustment. A greater number of coexisting conditions was associated with progressively higher odds of reporting a previous-year fall.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800543","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":"Integrated rehabilitation and ambulatory recovery in older adults with hip fracture according to muscle strength and sarcopenia status: a secondary analysis of a randomized controlled trial.","authors":"Seung-Kyu Lim, Jae-Young Lim","doi":"10.1007/s41999-026-01587-8","DOIUrl":"https://doi.org/10.1007/s41999-026-01587-8","url":null,"abstract":"<p><strong>Purpose: </strong>Sarcopenia and impaired muscle strength are common in older adults with hip fractures and are strongly associated with poor functional recovery. Although integrated multidisciplinary rehabilitation improves outcomes after hip fracture, whether its benefits differ according to baseline muscle strength or sarcopenia severity remains unclear. This study aimed to examine whether the functional benefits of Fragility Fracture Integrated Rehabilitation Management (FIRM) vary according to sarcopenia status and handgrip strength (HGS) in older adults after hip fracture surgery.</p><p><strong>Methods: </strong>This was a secondary analysis of a multicenter randomized controlled trial comparing FIRM with conventional rehabilitation in adults aged ≥ 65 years undergoing hip fracture surgery. The primary outcome was independent ambulation at 12 months. Sarcopenia was classified using three approaches: sarcopenia versus non-sarcopenia, a three-level classification (non-sarcopenia, possible sarcopenia, and sarcopenia), and low versus normal HGS. Logistic regression models, including treatment, sarcopenia status, and their interactions, were fitted with sequential adjustments for relevant covariates.</p><p><strong>Results: </strong>Of the 203 randomized participants, 119 (58.6%) completed the 12-month follow-up. Treatment-by-sarcopenia interactions were not statistically significant. Stratum-specific analyses suggested a pattern of greater functional improvement with FIRM than with conventional rehabilitation, particularly among participants with low HGS and, to a lesser extent, those with sarcopenia. In the fully adjusted models, FIRM was associated with greater improvement in independent ambulation among participants with low HGS (odds ratio, 4.25; risk difference, + 34.7%; P = 0.014).</p><p><strong>Conclusions: </strong>Integrated rehabilitation may provide greater functional benefits than conventional rehabilitation in older adults with hip fractures, particularly among those with low muscle strength. However, given the lack of statistically significant interaction effects and the attenuation of the observed associations in the fully adjusted models, these findings should be interpreted as exploratory.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800540","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 survey of medical student education in dementia and delirium in Europe.","authors":"Mary Faherty, Catriona Curtin, Lauren O'Mahony, Tomas Welsh, Jos Tournoy, Pinar Soysal, Shibley Rahman, Hanna-Maria Roitto, Maria Cristina Ferrara, James Fisher, Yaohua Chen, Suzanne Timmons","doi":"10.1007/s41999-026-01572-1","DOIUrl":"https://doi.org/10.1007/s41999-026-01572-1","url":null,"abstract":"<p><strong>Purpose: </strong>Knowledge of dementia and delirium is essential for all clinicians. This survey aims to map the teaching of these two topics in European medical school curricula, in terms of content, linked learning, and pedagogical approach.</p><p><strong>Methods: </strong>A bespoke online survey was circulated to educators within universities providing medical student programmes (direct entry or graduate entry) across Europe, championed by the European Geriatric Medicine Society (EuGMS) Special Interest Group members and contacts sourced through institutions' websites. Responses (2024-2025) were limited to one per course.</p><p><strong>Results: </strong>The final dataset comprised 64 courses across 62 universities, from 17 countries. Dementia and delirium featured in 95% of curricula, taught separately in about half of instances. Typical teaching time was 3-4 h for dementia and 1-2 h for delirium, concentrated in later course years, and mainly involving geriatricians. Fewer than one-in-four courses incorporated interprofessional learning, most commonly with nursing; involving people with lived experience was rare. Young-onset dementia and decision-making capacity and supports were absent in > 25% of courses, while medications for cognitive and non-cognitive symptoms of dementia were absent in 19% and 13%, respectively. Content gaps for both dementia and delirium included local or national guidelines, communication strategies, and environmental design. Patient-student interaction in the clinical environment pre-graduation was not universal (72-73%), with gaps reported in nine countries.</p><p><strong>Conclusion: </strong>While dementia and delirium are broadly included in participating European institutions' medical student curricula, limited teaching time, infrequent interprofessional and experiential learning, and significant content gaps highlight the need for greater consistency and comprehensiveness to meet future healthcare needs.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800596","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":"Nonspecific symptoms explain functional limitations in older adults better than disease-specific symptoms.","authors":"Sandra L Wezeman, René J F Melis, Cillian Hourican, Rick Quax, Thomas M Gill, Marcel G M Olde Rikkert, Geeske Peeters","doi":"10.1007/s41999-026-01583-y","DOIUrl":"https://doi.org/10.1007/s41999-026-01583-y","url":null,"abstract":"<p><strong>Purpose: </strong>Older adults often have multiple diseases and age-related physiologic changes that may present with nonspecific symptoms such as fatigue or dizziness. Identifying symptoms that are most strongly associated with functioning may guide symptom management. This study examined the association of nonspecific and disease-specific symptoms with functional limitations in community-dwelling older adults over a 23-year period.</p><p><strong>Methods: </strong>Data were from the Precipitating Events Project, a longitudinal cohort study, involving 754 adults aged 70 and older [mean (standard deviation) age of 78.9 (5.3) years, 64.6% female] from South Central Connecticut, USA. During monthly telephone interviews, 20 symptoms and limitations in 13 daily activities were assessed. Associations were cross-sectionally and longitudinally tested using trends in proportions (Z-scores) and generalized estimating equations models.</p><p><strong>Results: </strong>The three strongest trends in proportions with functional limitations were for the nonspecific symptoms: 'memory problems' (Z-score 60.9), 'arm or leg weakness' (58.5), and 'fatigue' (54.7). The lowest z-scores were for the disease-specific symptoms 'cold or flu symptoms' (12.3), 'decreased eyesight' (17.8), and 'chest pain' (19.9). The three nonspecific symptoms: 'fall' [regression coefficient b = 1.40, confidence interval (CI) 1.28-1.52], 'arm or leg weakness' (b = 1.13, CI 1.02-1.23), and 'dizziness' (b = 1.12, CI 1.04-1.20) had the strongest cross-sectional associations with functional limitations. In longitudinal models with a 1-month time lag, these associations attenuated.</p><p><strong>Conclusion: </strong>Nonspecific symptoms had stronger associations with functional limitations than disease-specific symptoms, underscoring the importance of addressing nonspecific symptoms in older adults. The presence of cross-sectional, but not longitudinal, associations likely reflects an immediate rather than sustained impact on functioning.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800615","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":"Supporting geriatric thinking and management: adaptation of the Geriatrics 5Ms to Danish healthcare context.","authors":"Lone Winther Lietzen, Rune Dall Jensen, Ryan Z Chippendale, Anna Skovsbo Vamdrup-Andersen, Karen Andersen-Ranberg, Lene Holst Andersen","doi":"10.1007/s41999-026-01576-x","DOIUrl":"https://doi.org/10.1007/s41999-026-01576-x","url":null,"abstract":"<p><strong>Purpose: </strong>Coordinated, person-centred care for older adults is often challenged by multimorbidity, functional decline, and fragmented care trajectories. While Comprehensive Geriatric Assessment (CGA) remains the gold standard, its implementation outside specialised geriatric settings is limited. The Geriatrics 5Ms framework (mind, mobility, medications, multicomplexity, and matters most) offers a structured and accessible alternative. We aimed to adapt the Geriatrics 5Ms to the Danish healthcare context.</p><p><strong>Methods: </strong>Using Moore et al.'s ADAPT guidance, we conducted an iterative adaptation process involving academics, clinicians, and patient representatives. The framework was professionally translated and refined through expert workshops and ad hoc consultations. Evaluation activities included focus groups, individual interviews, structured feedback from health professions education and primary and secondary care. Findings informed iterative revisions and development of a core content list to support implementation.</p><p><strong>Results: </strong>Direct transfer of the original Geriatrics 5Ms was not feasible due to organisational differences and cross-sectoral responsibilities in Danish healthcare. Adaptation resulted in a shift from a physician-centred decision-support tool to an interprofessional reference framework with simplified language and strong emphasis on everyday functioning, care transitions, and shared decision-making. Stakeholders valued the structured, person-centred approach and the potential for a shared cross-sectoral language but highlighted the need for context-specific versions and clear implementation strategies.</p><p><strong>Conclusion: </strong>Stakeholders perceived the Danish adaptation of the Geriatrics 5Ms as relevant and potentially feasible across sectors. Future efforts should focus on structured context-sensitive implementation and education research to ensure sustainable integration into routine clinical practice.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761849","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 motion of resistance: radical autonomy and the medicalization of the mundane in Shoojit Sircar's Piku.","authors":"Samikhya Dash, Soumya Jose","doi":"10.1007/s41999-026-01588-7","DOIUrl":"https://doi.org/10.1007/s41999-026-01588-7","url":null,"abstract":"<p><p>This article evaluates Shoojit Sircar's Piku [1] within the geriatric medical canon, examining its subversion of traditional aging tropes that equate old age with inevitable decline, loss of autonomy, and passive dependency. Centered on the protagonist Bhashkor Banerjee's chronic constipation, the narrative explores the medicalization of the mundane, where both bowel motion and bodily movement become intertwined sites through which elderly agency is negotiated. Through a gerontological lens, the film portrays the domestic space as a site of conflict between the autonomy of the aging subject and the ethical demands of caregiving. By analyzing Bhashkor's refusal to be governed-manifested in a cross-country road trip and his reclamation of physical agency via a bicycle ride in Kolkata-this study identifies a shift from the conventional senescence-as-loss narrative. It argues that Piku reimagines ageing through the interdependence of bodily autonomy, mobility, and caregiving, offering a reimagined framework for filial maturity that privileges the elderly subject's right to pleasure, agency, and negotiated care over clinical safety.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759853","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}