European Geriatric Medicine最新文献

{"title":"Characteristics of fall recurrence among persistent, quasi-persistent, and transient fallers: a 3-year analysis from the SCOPE study.","authors":"Itshak Melzer, Ellen Freiberger, Sabine Britting, Fabrizia Lattanzio, Andrea Corsonello, Yehudit Melzer, Rada Artzi-Medvedick, Regina Roller-Wirnsberger, Gerhard Wirnsberger, Francesco Mattace-Raso, Lisanne Tap, Pedro Gil, Francesc Formiga, Rafael Moreno-González, Tomasz Kostka, Agnieszka Guligowska, Johan Arnlov, Axel C Carlsson, Paolo Fabbietti, Robert Kob","doi":"10.1007/s41999-026-01555-2","DOIUrl":"10.1007/s41999-026-01555-2","url":null,"abstract":"<p><strong>Methods: </strong>To address the substantial disability and healthcare burden associated with falls in older adults, the aim of this study is to use a new 3-year operationalization of fall occurrence profiles to identify factors linked with persistent falling. Data were obtained from the multicenter SCOPE study, which followed 2461 community-dwelling adults (median age 80.0 and IQR 6.0; 56.1% women) across seven European countries, with assessments at baseline and after 1 and 2 years. Variables included demographics, comorbidities, medication use, functional status, mood, quality of life, and kidney function. Fall-related data included number, location, cause, and consequences. Participants were classified as Persistent-Fallers (falls at all three timepoints), Quasi Persistent-Fallers (falls in two), and Transient-Fallers (one fall episode). Logistic regression assessed predictors of being Persistent-Fallers vs. Transient-Fallers, and vs. Quasi Persistent-Fallers.</p><p><strong>Results: </strong>Across the study, 894 falls occurred in Persistent-Fallers (n = 137), 919 in Quasi-Persistent Fallers (n = 299), and 695 in Transient-Fallers (n = 524). Most falls occur outdoors and during ambulation. Persistent-Fallers showed poorer physical performance, worse health, and higher proportion of indoor falls. Transient-Fallers were more likely to fall outdoors but sustain a higher risk of fractures per fall. Quasi-Persistent Fallers displayed intermediate characteristics. In fully adjusted models, higher comorbidity burden, presence of lower urinary tract symptoms and poorer self-rated health were significantly associated with persistent falling.</p><p><strong>Conclusions: </strong>This study reveals distinct faller profiles. Persistent-Fallers reflect frailty and linked to overall medical burden and functional decline; Transient-Fallers are generally healthier, fall outdoors more often, and their falls more often lead to fractures, possibly due to lower risk awareness falls; Quasi-Persistent Fallers exhibit characteristics that fall between those of the other two groups.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2223-2233"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-care quadriceps muscle ultrasound as a predictor of postoperative delirium in older adults: a prospective cohort study.","authors":"Zihuan Xu, Gaolin Qiu, Tingting Peng, Qiuyu Liu, Qiuling Du, Wenxin Zhang, Yahui Xu, Xuesheng Liu, Panpan Fang","doi":"10.1007/s41999-026-01499-7","DOIUrl":"10.1007/s41999-026-01499-7","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium (POD) is a common neurological complication in older patients. Frailty is an independent risk factor for POD, and sarcopenia has been increasingly linked to cognitive decline through the emerging concept of the brain-muscle axis. This study aimed to evaluate the predictive value of preoperative point-of-care ultrasound (POCUS) measurements of the quadriceps and vastus intermedius muscles for POD.</p><p><strong>Methods: </strong>In this prospective observational study, 236 patients aged ≥ 65 years [median (IQR): 72 (69-76)] scheduled for major non-cardiac surgery were enrolled. The POCUS was used to quantitate preoperative quadriceps femoris muscle thickness (QF-MT). POD was assessed daily until postoperative day 7 using the 3-Minute Diagnostic Interview for CAM-defined Delirium (3D-CAM) or the CAM-ICU. Univariate and multivariate logistic regression analyses were performed to identify key factors associated with POD. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive efficacy of ultrasonic parameters.</p><p><strong>Results: </strong>POD occurred in 33 patients (14.0%). Multivariate analysis identified advanced age (OR: 1.182, 95% CI 1.054-1.328, p = 0.005), preoperative frailty (OR: 3.226, 95% CI 1.120-9.287, p = 0.030), and lower QF-MT (OR: 0.006, 95% CI 0.000-0.073, p < 0.010) as independent predictors. ROC analysis showed that QF-MT alone had an AUC of 0.843 (95% CI 0.773-0.913) for predicting POD, which increased to 0.916 (95% CI 0.868-0.964) when combined with age.</p><p><strong>Conclusion: </strong>Preoperative POCUS assessment of QF-MT is a promising tool for predicting POD in older adult patients. Its integration into preoperative risk stratification could facilitate the early identification of high-risk patients.</p><p><strong>Trial registration number: </strong>ChiCTR2500106607.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2143-2154"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935059","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 safety, acceptability, and effectiveness of home-based 'exercise snacking' for improving physical function of older adults: a systematic review.","authors":"Mohammad Mahdi Eidiyan-Kakhki, Hamid Rajabi, Sadegh Amani-Shalamzari, Pezhman Motamedi","doi":"10.1007/s41999-026-01529-4","DOIUrl":"10.1007/s41999-026-01529-4","url":null,"abstract":"<p><strong>Background: </strong>Exercise snacking has emerged as a new method of training to improve physical function in older adults. However, the safety, acceptability, and effectiveness of home-based exercise snacking interventions in this population have not been specifically or systematically evaluated.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed/MEDLINE, Scopus, and Web of Science from database inception to May 1, 2026. Randomized controlled trials, quasi-experimental studies, and controlled before-and-after studies investigating home-based exercise snacking interventions in adults aged 60 years and older were included. Eligible interventions consisted of multiple short bouts (1-10 min) of structured exercise performed at least twice daily at home. Outcomes related to physical function, safety, and acceptability were extracted. Risk of bias was assessed using the Cochrane RoB2 tool for randomized trials and the Joanna Briggs Institute checklist for quasi-experimental studies.</p><p><strong>Results: </strong>Eight studies (n = 317 participants), primarily conducted in the United Kingdom, China, Korea, and Australia, met the inclusion criteria. Improvements in physical function outcomes-including lower limb strength, balance, and functional mobility-were generally reported compared to baseline or control conditions. Adherence and acceptability were high, ranging from approximately 80 to 115%. Values exceeding 100% reflected participants completing more exercise sessions than prescribed in some studies. Metabolic outcomes were infrequently reported; one study observed reductions in fasting glucose following the intervention, with no significant differences between exercise modalities. Reported adverse events were rare and minor. However, the evidence base remains limited, with relatively few robust studies and modest sample sizes.</p><p><strong>Conclusions: </strong>Home-based exercise snacking may represent a safe, feasible, and acceptable intervention to improve physical function in older adults. However, the current evidence base remains limited. Larger, well-designed trials are needed to confirm its effectiveness, safety, and long-term adherence.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1873-1888"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254139","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":"Health care professional perspectives on vision screening in older adults who attend hospital following a fall: a focus group study.","authors":"Aishah Baig, Kate Radford, Alison Cowley, Jignasa Mehta, Adam L Gordon","doi":"10.1007/s41999-026-01486-y","DOIUrl":"10.1007/s41999-026-01486-y","url":null,"abstract":"<p><strong>Background: </strong>The assessment and management of impaired vision is included in falls prevention guidance. However, implementation is inconsistent. We conducted focus groups to explore the perspectives of Health Care Professionals (HCP) on vision screening in older adults attending acute hospitals following a fall.</p><p><strong>Methods: </strong>A focus group study was undertaken with HCPs from a single-acute hospital trust. Semi-structured topic guides were informed by the Consolidated Framework for Implementation Research (CFIR). Transcripts were first inductively then deductively coded using CFIR constructs. Demographic data were collected and summarized.</p><p><strong>Results: </strong>Five focus groups were conducted with 19 HCPs overall. Six interconnecting themes were identified, mapped to 14 CFIR constructs, relating to barriers and facilitators to vision screening. Barriers encompassed: lack of training, referral networks to manage impaired vision and prioritization of task-focused, rather than person-centered care, in the acute setting. Facilitators included: perceived mission alignment, adequate training, tools, guidance on roles, responsibilities and management pathways, integration of eye care professionals in multi-disciplinary falls care and time in job plans.</p><p><strong>Conclusions: </strong>HCPs were motivated to vision screen and felt it aligned with person-centered falls care, however there were individual-, structural-, and organization-level barriers related to staff capability and opportunity to implement vision screening in the acute setting. Multi-component and multi-level interventions and implementation strategies are needed to integrate eye care professionals into the falls multi-disciplinary team, engage supportive leaders, develop an effective vision screening assessment, define roles, responsibilities, and management pathways, and organize individual training and time allocation for staff to perform screening.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2247-2261"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of medical intermediate care unit use in critically ill very old patients in France.","authors":"Adrien Migeon, Julien Demiselle, Lucile Godillon, Victoire Leroy, Leslie Grammatico-Guillon, Antoine Guillon","doi":"10.1007/s41999-026-01495-x","DOIUrl":"10.1007/s41999-026-01495-x","url":null,"abstract":"<p><strong>Purpose: </strong>The growing population of adults aged ≥ 80 represents major challenges for critical care. Intermediate care units (IMCUs) offer a level that could bridge the gap between ICU and standard ward, but information is lacking regarding IMCU use for older critically ill patients. This study aimed to characterize critical-care trajectories involving IMCU use among older critically ill patients at a national level.</p><p><strong>Methods: </strong>A nationwide retrospective cohort study was conducted in France, including all patients hospitalized in medical critical care in 2018. Patients were categorized as young (18-64), old (65-79), and very old adults (≥ 80). Trajectories between critical care units and general wards were visualized using Sankey diagrams. Overall survival was represented with Kaplan-Meier curves according to trajectory patterns.</p><p><strong>Results: </strong>Of 439,213 individuals admitted to medical critical care, 28.2% were aged ≥ 80. Among patients aged ≥ 80 admitted to an ICU, a step-up strategy (IMCU before ICU) was used in 12% of patients, and a step-down strategy (ICU followed by IMCU) in 23%. The step-up strategy was associated with high mortality in critical care (46.6%, compared to 33.9% for patients admitted directly to an ICU). Step-down patients had an extended critical care length of stay; however, those discharged from critical care via step-down strategy showed a lower cumulative mortality at one year (RR 0.86).</p><p><strong>Conclusion: </strong>IMCUs play a central role in the management of very old critically ill patients. The potential benefit of IMCU care for older adults transitioning out of the ICU should be evaluated in prospective clinical trials.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1793-1802"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarker-defined congestion profiles in very old adults with acute heart failure: beyond ejection fraction classification.","authors":"Pau Llàcer, François Croset, Alberto Pérez Nieva, Jorge Campos, Marina García Melero, Carlos Pérez, Marina Vergara, Paul Cevallos Castro, Juanes Oyuela Rodriguez, Cristina Fernández, María Pumares, Martín Fabregate, Beatriz Del Hoyo, Esteban Pérez Pisón, Luis Manzano","doi":"10.1007/s41999-026-01505-y","DOIUrl":"10.1007/s41999-026-01505-y","url":null,"abstract":"<p><strong>Background: </strong>Congestion is the main driver of worsening acute heart failure, yet its manifestation in very old adults and its relationship with prognosis remains incompletely understood. Traditional classification based on left ventricular ejection fraction (LVEF) may not adequately capture the biological heterogeneity of congestion in this population. We aimed to characterize patient subgroups defined by BNP and CA125 constellations, to characterize their clinical and echocardiographic features, and to evaluate their prognostic implications. As a secondary objective, we explored their relationship with conventional LVEF categories.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including 830 consecutive patients hospitalized with acute heart failure. Congestion was assessed using clinical signs, echocardiography, biomarkers (BNP and CA125), and point-of-care ultrasound. Outcomes included heart failure rehospitalization and all-cause mortality over a median follow-up of 310 days (IQR 62-543). Multivariable Cox regression models were used.</p><p><strong>Results: </strong>The median age was 87 years, and 65.6% were women. Four patient subgroups were defined by BNP and CA125 constellations, showing distinct clinical and echocardiographic profiles. Mortality increased progressively across phenotypes, with combined elevation of BNP and CA125 independently associated with higher risk of death (HR 1.48; p = 0.008). Isolated CA125 elevation was associated with increased rehospitalization risk (HR 1.45; p = 0.031). In contrast, LVEF categories showed limited prognostic discrimination.</p><p><strong>Conclusions: </strong>In very old adults hospitalized with acute heart failure, combined elevation of BNP and CA125 was independently associated with increased mortality, while isolated CA125 elevation was associated with higher rehospitalization risk. LVEF was not independently associated with either outcome. These findings suggest that integrating BNP and CA125 may complement conventional LVEF classification for risk stratification in this population.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2073-2085"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of cardiovascular fall risk assessment and managment in Dutch fall clinics comparing current practice to guideline recommendations.","authors":"A C Pronk, R Schroten, L J Seppala, E P van Poelgeest, B A Damoiseaux-Volman, J A H R Claassen, F Mattace-Raso, S C de Ruiter, J O Daal, L A R Zwart, T N Bongers, G S Spronk, S M Driessen, N van der Velde","doi":"10.1007/s41999-026-01481-3","DOIUrl":"10.1007/s41999-026-01481-3","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disorders are important fall risk factors, especially in unexplained recurrent falls. According to (international) guidelines, a standard workup of cardiovascular fall risk factors is indicated; however, its implementations is lagging. This study aimed to map the daily practice of cardiovascular fall risk assessment and management in Dutch fall clinics, comparing guideline recommendations (work-as-imagined) with actual practice (work-as-done), and to identify barriers to implementation.</p><p><strong>Methods: </strong>The functional resonance analysis method (FRAM) was used to visualize work-as-imagined and work-as-done. Input for work-as-imagined was the Dutch guideline on fall prevention, which follows the ESC syncope guideline recommendations where applicable. Work-as done and barriers for guideline implementation were derived from semi-structured interviews with Dutch fall clinic professionals.</p><p><strong>Results: </strong>Fourteen participants from eight fall clinics participated. Work-as-done related to the initial assessment of cardiovascular fall risk factors (e.g., ECG recording), was in line with work-as-imagined and implemented across the participating fall clinics. For the implementation of further cardiovascular assessments (e.g., head-up tilt testing), significant variability was observed across fall clinics, resulting in four different work-as-done FRAM models. The variations were mainly driven by the following barriers: unavailability of staff, gaps in knowledge, lack of expertise, and lack of resources.</p><p><strong>Conclusion: </strong>This study highlights important discrepancies between recommended cardiovascular fall risk assessment protocols and current practices in Dutch fall clinics. A structured care pathway could help standardize and optimize cardiovascular fall risk practices. Addressing the identified barriers to implementation and development in standardized care pathways could facilitate the implementation of the care pathway and optimize cardiovascular fall prevention practices in older adults.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2235-2246"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why do residents choose to specialize in geriatric medicine?","authors":"Magdalena Linge Martín, Gema Somoza Fernández, Nicolas M Gonzalez-Senac, Amaya Capón Sáez, Jesús Mateos-Nozal, Alfonso J Cruz-Jentoft, Francisco José Tarazona Santalbina, José Antonio Serra-Rexach","doi":"10.1007/s41999-026-01544-5","DOIUrl":"10.1007/s41999-026-01544-5","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the most common factors influencing the selection of Geriatric Medicine as a specialty among medical residents, and to assess whether receiving specific exposure to Geriatric Medicine during training influences these factors.</p><p><strong>Methods: </strong>A qualitative descriptive study was carried out using intentional sampling, involving anonymous completion of a questionnaire distributed to accredited Spanish Geriatric Medicine teaching units during the 2023/2024 academic year.</p><p><strong>Results: </strong>A total of 129 medical residents participated in the survey. Eighty-nine per cent were already familiar with the specialty and 46% had received theoretical and practical Geriatric Medicine training during medical school. The most frequently reported factors were affinity with older persons (95%), communication with patients and families (90%), multidisciplinary work (86%), clinical complexity of older adult patients (84%), multimorbidity (82%), and relationships with older relatives (76%). Participants who had received complete training in Geriatric Medicine (46%) were more likely to have considered Geriatrics as a potential specialty (75% vs. 54%, p = 0.02). The clinical complexity of the older adult patients was significantly more relevant among those with complete Geriatric training (92% vs. 77%, p = 0.027).</p><p><strong>Conclusion: </strong>Interest in Geriatric Medicine is shaped by a combination of personal motivations and factors directly related to the specialty and the characteristics of the older adult population. Comprehensive training in Geriatric Medicine has the potential to transform commonly perceived barriers into rewarding aspects of the field.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1923-1931"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425756","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":"Multimorbidity, polypharmacy and frailty in critically ill older adults.","authors":"Lorène Zerah, Lorenz Van der Linden, James D van Oppen","doi":"10.1007/s41999-026-01491-1","DOIUrl":"10.1007/s41999-026-01491-1","url":null,"abstract":"<p><strong>Purpose: </strong>Population ageing has transformed intensive care unit (ICU) populations, with older adults increasingly presenting with multimorbidity, polypharmacy, and frailty. This review aims to examine how these interrelated constructs shape vulnerability to critical illness and influence clinical decision-making and outcomes in geriatric critical care.</p><p><strong>Methods: </strong>We conducted a narrative review of the literature focussing on the interactions between multimorbidity, polypharmacy, and frailty in critically ill older adults, and their implications for medication-related harm and care delivery across the ICU trajectory.</p><p><strong>Results: </strong>Multimorbidity drives clinical complexity and prescribing burden, contributing to high rates of polypharmacy. Polypharmacy is associated with adverse drug events, functional decline, and mortality. Frailty modifies risk through altered pharmacokinetics, heightened susceptibility to treatment-related harm, and the depletion of adaptive capacity that characterises the syndrome. These factors interact dynamically during critical illness, particularly at transitions of care, where medication-related harm is most likely to occur.</p><p><strong>Conclusion: </strong>In older ICU patients, multimorbidity, polypharmacy, and frailty interconnect and interact to shape both risk and recovery. Recognising frailty supports more nuanced, patient-centred decision-making beyond survival alone. Integrating medication stewardship strategies, including reconciliation, deprescribing, and multidisciplinary review, offers a practical approach to reducing harm and improving outcomes that matter to older patients.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1713-1722"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845123","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":"Circulating PBX1 and age-related sarcopenia phenotypes: metabolic mediation analyses in a community-based study.","authors":"Xiangyuan Meng, Zhenhu Zhao, Shuhua Mao, Jianing Yu, Yuqin Liu, Xingxiang Yang, Xin Zhang, Ruihan Guo, Shuran Yang, Zhuoshuai Liang, Fengdan Wang, Lanchao Sun, Hui Zhao, Jinyu Liu, Tianlin Gao","doi":"10.1007/s41999-026-01488-w","DOIUrl":"10.1007/s41999-026-01488-w","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether circulating PBX1 is associated with AWGS2019-defined sarcopenia phenotypes in older adults, and whether alanine-related metabolites mediate the PBX1-ASMI association.</p><p><strong>Methods: </strong>We enrolled 324 adults aged 60 years or older from Licha Town, Qingdao, China (2022-2023) and classified sarcopenia using AWGS 2019. Plasma PBX1 was quantified by ELISA, and targeted plasma metabolite profiling was performed by LC-MS/MS. Primary outcomes were appendicular skeletal muscle mass index (ASMI), 6-m gait speed, and maximal handgrip strength. Independent associations were estimated using multivariable linear regression. Mediation models quantified indirect statistical components of the PBX1-ASMI association through prespecified metabolites (alanine and the lactic acid/alanine ratio) with bootstrap confidence intervals. ROC analyses assessed discrimination for sarcopenia and severe sarcopenia.</p><p><strong>Results: </strong>Higher plasma PBX1 was independently associated with greater ASMI, faster gait speed, and stronger handgrip strength (all P < 0.001). PBX1 was positively associated with alanine and inversely associated with the lactic acid/alanine ratio. Alanine and the lactic acid/alanine ratio accounted for 10.79% (P = 0.017) and 10.11% (P = 0.002) of the PBX1-ASMI association, respectively; indirect components for gait speed and handgrip strength were not statistically significant. PBX1 discriminated sarcopenia (AUC 0.748) and severe sarcopenia (AUC 0.771), with high negative predictive value for severe sarcopenia at Youden-optimal thresholds.</p><p><strong>Conclusion: </strong>Circulating PBX1 is independently associated with preserved muscle mass and function in older adults. PBX1 warrants external validation and longitudinal evaluation as a clinically informative correlate and candidate adjunctive biomarker for sarcopenia risk stratification.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2197-2210"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822817","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}