European Geriatric Medicine最新文献

{"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}

{"title":"The \"healthy\" chronic disease patient: intrinsic capacity and functional ability beyond disease counts.","authors":"Stefano Cacciatore","doi":"10.1007/s41999-026-01546-3","DOIUrl":"10.1007/s41999-026-01546-3","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2395-2396"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387856","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":"Prognostic performance of Asian Working Group for Sarcopenia 2025 Constructs for activities of daily living at discharge after stroke: a head-to-head validation.","authors":"Yoshihiro Yoshimura, Hidetaka Wakabayashi, Ayaka Matsumoto, Fumihiko Nagano, Sayuri Shimazu, Kouki Yoneda","doi":"10.1007/s41999-026-01554-3","DOIUrl":"10.1007/s41999-026-01554-3","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the prognostic performance of the Asian Working Group for Sarcopenia (AWGS) 2025 diagnostic constructs-specifically height- versus body mass index (BMI)-indexed muscle mass-for discriminating functional outcomes in patients with stroke.</p><p><strong>Methods: </strong>From a cohort of 1246 consecutive post-acute stroke admissions, we analyzed 864 inpatients (median age 76 years; 47.2% women) who met the inclusion criteria. Sarcopenia was classified according to AWGS 2025 criteria: possible sarcopenia (low handgrip strength) and confirmed sarcopenia (low strength plus low skeletal muscle mass). Skeletal muscle mass was indexed by height-squared (SMI/height2) and BMI (SMI/BMI). Multivariable linear regression analysis, stratified by age (50-64 vs. ≥ 65 years) and sex, assessed the associations with the Functional Independence Measure motor subscale (FIM-motor) at discharge.</p><p><strong>Results: </strong>Confirmed sarcopenia defined by SMI/height² was independently and consistently associated with lower discharge FIM-motor scores across all age and sex strata (men ≥ 65 years: B - 3.51, P = 0.038; women ≥ 65 years: B - 3.08, P = 0.024; men 50-64 years: B - 4.59, P = 0.044; women 50-64 years: B - 9.19, P = 0.045). In contrast, SMI/BMI-based definitions showed poor prognostic utility, with no significant associations in men. Possible sarcopenia demonstrated limited, inconsistent associations.</p><p><strong>Conclusion: </strong>AWGS 2025 confirmed sarcopenia utilizing height-indexed muscle mass provided superior prognostic discrimination for discharge ADL compared with BMI-indexed or possible sarcopenia constructs in post-stroke inpatients. These findings support prioritizing height-indexed confirmed sarcopenia for functional risk stratification in this setting.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2187-2196"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399803","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":"Bridging the gap in delirium management: a European comparison of geriatric practices.","authors":"Alessandra Coin, Silvia Sturani, Christian Pozzi, Maela Caudal, Duygu Erbas Sacar, Massimiliano Fedecostante, Maria Cristina Ferrara, Antonio Cherubini, Alessandro Morandi, Gulistan Bahat, Giuseppe Bellelli, Suzanne Timmons","doi":"10.1007/s41999-026-01527-6","DOIUrl":"10.1007/s41999-026-01527-6","url":null,"abstract":"<p><strong>Aim: </strong>To compare diagnostic and therapeutic approaches to delirium across European countries with well-established (WE) versus less-developed (LE) geriatric medicine (GM), to identify similarities, differences and potential gaps in care.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among European geriatricians via the European Geriatric Medicine Society and professional networks from July 2023 to March 2024. Responses on delirium diagnosis and management were analyzed quantitatively, with comparisons between WE and LDGM countries.</p><p><strong>Results: </strong>Of 196 hospital-based respondents, 79.1% were from WEGM countries and 20.9% from LDGM countries. Structured delirium screening was significantly more common in WEGM nations, especially in geriatric (88.4% vs 43.9%, p < 0.001) and orthopedic wards. Non-pharmacological strategies-such as hydration support (76.8% vs 52.5%, p = 0.002) and family involvement (81.5% vs 60.4%, p = 0.005)-were also more frequently used. Conversely, physical restraints were more commonly employed in LDGM countries (70.7% vs 41.4%, p < 0.001), as were pharmacological treatments, such as trazodone and quetiapine.</p><p><strong>Conclusion: </strong>Marked differences exist in delirium management across Europe, which may be linked at least in part to GM development, although confounding factors may exist, and causality cannot be assumed. WEGM countries appear to prioritize structured screening and non-pharmacological interventions, whereas LDGM countries rely more on pharmacological treatments. These findings highlight the need for standardized European guidelines to ensure equitable delirium care.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1933-1943"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354318","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":"Efficacy of treatment for subacromial pain in older adults: a systematic review and meta-analysis with GRADE recommendations.","authors":"Gabriel de Castro Mariz, Diego Mendes Xavier, Micaelen Mara Ferreira Barroso, Alessandra de Carvalho Bastone, Arthur Nascimento Arrieiro, Vinicius Cunha de Oliveira, Murilo Xavier de Oliveira","doi":"10.1007/s41999-026-01511-0","DOIUrl":"10.1007/s41999-026-01511-0","url":null,"abstract":"<p><p>Subacromial pain is a prevalent musculoskeletal condition that impairs shoulder function, particularly in older adults. It is often associated with tendinopathy, bursitis, and biomechanical dysfunction, leading to limitations in daily activities and decreased quality of life. Despite its clinical relevance, studies targeting individuals aged 60 years and older are scarce. The aim of this review was to systematically synthesize the evidence from randomized controlled trials (RCTs) evaluating the effectiveness of conservative treatments for subacromial pain in adults aged 60 years and older.</p><p><strong>Methods: </strong>This review followed the Cochrane and PRISMA guidelines and was registered in PROSPERO (CRD42024591488). Six databases were searched without restrictions. Eligible RCTs compared therapeutic interventions to minimal intervention controls and reported outcomes on pain and/or disability. Risk of bias was assessed using the PEDro scale, and the certainty of evidence was rated using the GRADE approach. Meta-analyses were performed using random-effects models.</p><p><strong>Results: </strong>Out of 6,198 records, four RCTs met the inclusion criteria. Interventions included resistance training, cycle ergometer exercise, dry needling, and osteopathic manipulative treatment. The meta-analysis of three trials showed a statistically significant pooled effect for pain reduction (MD = -1.60; 95% CI: -3.16 to -0.04); however, two studies (resistance training and cycle ergometer) demonstrated significant individual benefits. The overall certainty of evidence ranged from low to high. No study assessed disability using validated upper limb-specific instruments.</p><p><strong>Conclusions: </strong>Although some interventions demonstrated positive effects on pain, the overall evidence for conservative treatments in older adults with subacromial pain is limited. Further high-quality trials are needed, focusing on functional outcomes and long-term benefits.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2155-2162"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057858","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":"Perceptions of frail older adults and professionals on adherence to a multidomain community programme to prevent disability: a descriptive qualitative study of + AGIL Barcelona.","authors":"Mercè Sitjà-Rabert, Sebastián Nazar-González, Lluvi Farré Montalà, Júlia Ollé-Gonzalez, Luís Soto-Bagaria, Laura Mónica Pérez, Sonia Baró Sabaté, Olga Güibas-Roura, Paula Espí-Vallvé, Andrea González, Marco Inzitari, Aida Ribera, Olga Canet-Vélez","doi":"10.1007/s41999-026-01484-0","DOIUrl":"10.1007/s41999-026-01484-0","url":null,"abstract":"<p><strong>Purpose: </strong>Sustained adherence is essential for the effectiveness of community-based multidomain interventions aimed at preventing disability in older adults with initial frailty. This study explores the perspectives of older adults and primary care professionals involved in the + AGIL Barcelona programme to understand the factors that facilitate or hinder sustained adherence and provide evidence for improving its implementation and scalability.</p><p><strong>Methods: </strong>A qualitative descriptive study was conducted in three primary care centres in Barcelona implementing the + AGIL programme. Participants were purposively selected to ensure information-rich perspectives. Six homogeneous focus groups were conducted with older adults meeting criteria for initial frailty (n = 22; mean age 82 years) and primary care professionals (n = 18), facilitated by two experienced qualitative researchers. Discussions were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis. Rigour was ensured through independent coding, reflexive discussion, consensus, and data saturation confirmation.</p><p><strong>Results: </strong>Adherence emerged as a multidimensional and context-dependent process shaped by professional, personal, and community-related factors. Empathetic communication, individualised exercise prescription, and group cohesion acted as key facilitators for motivation, autonomy, and the adoption of new healthy routines. Conversely, caregiving responsibilities, socioeconomic vulnerability, and limited access to community resources hindered the maintenance of behaviours over time. Organisational continuity and stronger healthcare-community coordination were perceived as essential for sustainability.</p><p><strong>Conclusion: </strong>Adherence to multidomain interventions depends not only on programme content but also on delivery processes and contextual embedding within participants' lived realities. Strengthening behavioural support and healthcare-community integration is vital to enhance long-term sustainability and scalability in primary care settings.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2351-2363"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148177110","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":"Prevalence and correlates of e-cigarette use among older adults aged 60 years and over.","authors":"Yusuff Adebayo Adebisi, Anas Ali Alhur, Isaac Olushola Ogunkola, Najim Z Alshahrani, Don Eliseo Lucero-Prisno, Usman A Adeniran, Giulio Geraci, Venera Tomaselli, Riccardo Polosa","doi":"10.1007/s41999-026-01539-2","DOIUrl":"10.1007/s41999-026-01539-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;E-cigarette use has increased substantially in the general population, yet evidence on use among older adults remains limited. Older adults bear a disproportionate burden of smoking-related morbidity and, in some populations, have shown persistently high smoking prevalence relative to younger age groups. Understanding the prevalence and correlates of e-cigarette use in this population is essential to inform targeted tobacco control and harm reduction strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a pooled cross-sectional analysis of 13,297 adults aged 60 years and over (mean age 71.4 years; 54.3% female) from seven waves (2017-2024, excluding 2020) of the Scottish Health Survey (SHeS), a nationally representative household survey. Current e-cigarette use was the primary outcome. Survey-weighted logistic regression was used to estimate crude and adjusted odds ratios for the association between current e-cigarette use and sociodemographic, behavioural, and health-related covariates, accounting for the complex survey design.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The weighted prevalence of current e-cigarette use among older adults was 4.5% (95% CI: 4.1-4.9). Prevalence remained broadly stable across survey years, ranging from 2.16% (95% CI: 1.43-3.25) in 2021 to 5.55% (95% CI: 4.43-6.93) in 2023. E-cigarette use was overwhelmingly concentrated among those with a smoking history: current smokers (adjusted OR 18.78, 95% CI: 11.79-29.92, p &lt; 0.001) and ex-smokers (adjusted OR 20.17, 95% CI: 13.10-31.06, p &lt; 0.001) had markedly elevated odds compared with never smokers. E-cigarette use declined sharply with advancing age: compared with the 60-64 reference group, adjusted odds were lower at ages 65-69 (OR 0.61, 95% CI: 0.47-0.79, p &lt; 0.001), 70-74 (OR 0.44, 95% CI: 0.33-0.58, p &lt; 0.001), 75-79 (OR 0.19, 95% CI: 0.13-0.29, p &lt; 0.001), and 80 and over (OR 0.11, 95% CI: 0.06-0.19, p &lt; 0.001). Residence in less deprived areas was associated with lower odds of use compared with the most deprived quintile: fourth quintile (OR 0.49, 95% CI: 0.34-0.70, p &lt; 0.001) and least deprived (OR 0.41, 95% CI: 0.27-0.61, p &lt; 0.001). Respondents reporting fair (OR 1.32, 95% CI: 1.03-1.70, p = 0.028) or bad/very bad self-rated health (OR 1.73, 95% CI: 1.31-2.27, p &lt; 0.001) had higher odds than those in very good or good health. Being divorced was independently associated with current use (OR 1.65, 95% CI: 1.22-2.23, p = 0.001). Sex and alcohol consumption were not significant correlates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;E-cigarette use among Scottish older adults was low but non-trivial and was strongly patterned by smoking history. The concentration of use among current and former smokers suggests that e-cigarette use in this age group occurs mainly among people with prior exposure to combustible tobacco, although the cross-sectional design cannot determine whether use reflects cessation, substitution, experimentation, or persistent dual ","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2109-2121"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347077","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":"Hospital at home for older patients with heart failure: an observational study of the GIROT experience.","authors":"Francesca Verga, Samuele Baldasseroni, Matteo Bulgaresi, Riccardo Barucci, Ilaria Del Lungo, Irene Taverni, Silvia Tognelli, Chiara Bandinelli, Giulia Rivasi, Enrico Mossello, Guglielmo Bonaccorsi, Andrea Ungar, Enrico Benvenuti","doi":"10.1007/s41999-026-01492-0","DOIUrl":"10.1007/s41999-026-01492-0","url":null,"abstract":"<p><strong>Purpose: </strong>Heart failure (HF) is a leading cause of hospitalization in older adults and is associated with frequent readmissions within 30 days after discharge. GIROT (Gruppo Intervento Rapido Ospedale-Territorio) model, an example of Hospital at Home (HaH) model, provides home-based care for older patients with acute conditions. This study aimed to compare hospital admissions in the 30-day and 6-month periods before and after GIROT referral.</p><p><strong>Methods: </strong>This retrospective observational study included patients ≥ 65 years with HF, referred to GIROT between March 2022 and April 2024. Given the lack of a control group, an intra-patient comparison of the number of hospital admissions in the 30-day and 6-month periods before and after GIROT referral was performed using the Wilcoxon signed-rank test. Predictors of all-cause 6-month mortality were investigated using multivariate logistic regression.</p><p><strong>Results: </strong>Among 157 included participants (mean age 89; female 63.1%, 75% with moderate-to-severe disability), the number of hospital admissions decreased from a median of 1.0 to 0.0 at 1 month and from 1.0 to 0.0 at 6 months (both p < 0.001, Wilcoxon signed-rank test). Six-month mortality rate was 47%, with severe disability at the end of GIROT service period emerging as the independent predictor (OR 1.42, 95% CI 1.17-1.69). Patient and caregiver satisfaction was high (84%).</p><p><strong>Conclusion: </strong>The GIROT HaH model was associated with a reduction in hospital admissions in the 1 and 6 months following the intervention in old patients with HF. Functional status, rather than comorbidities, independently predicted 6-month mortality. Further prospective studies including control groups are needed to better assess the effectiveness of this model.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"2099-2107"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845061","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":"Impact of virtual reality versus conventional balance training on balance function and fear of falling in older adults: a single blinded, randomized controlled trial.","authors":"Alireza Shamsoddini, Moslem Cheraghifard","doi":"10.1007/s41999-026-01493-z","DOIUrl":"10.1007/s41999-026-01493-z","url":null,"abstract":"<p><strong>Purpose: </strong>Balance issues and the fear of falling are among the primary factors contributing to falls in older people, leading to injury and a decline in quality of life.</p><p><strong>Methods: </strong>A single-blind, randomized, controlled trial was conducted involving 34 older adult participants (17 males and 17 females). The participants in the virtual reality group performed exercises using Kinect and a balance board, while those in the conventional interventions group performed balance exercises. The participants received interventions twice weekly for six weeks, each lasting 50 min. Fear of falling and balance performance were assessed using the Falls Efficacy Scale, Activities-specific Balance Confidence Scale, Berg Balance Scale, Time Up and Go Test, and Functional Reach Test. Evaluations were conducted at three time points: pre-intervention, post-intervention, and follow-up. The participants' motivation levels were also evaluated using the Intrinsic Motivation Inventory.</p><p><strong>Results: </strong>A total of 34 older adults (mean age 71.3 ± 5.4 years) completed the study. For the primary outcomes, a significant group-by-time interaction was found for both the Falls Efficacy Scale (FES-I, p = 0.04) and the Berg Balance Scale (BBS, p < 0.001). Post-intervention, the virtual reality (VR) group showed a significant reduction in fear of falling (mean change in FES-I: -4.2 points, p < 0.001), whereas the conventional group did not. Both groups demonstrated significant and sustained improvements in balance on the BBS from baseline to follow-up (VR group mean change: + 6.1 points; Conventional group mean change: + 4.3 points; both p < 0.001), with no significant difference between the groups. Functional mobility also improved significantly in both groups over time (Timed Up and Go, p < 0.001). Furthermore, the VR group reported significantly higher motivation scores, specifically in enjoyment (p < 0.001) and perceived competence (p < 0.001), compared to the conventional group.</p><p><strong>Conclusion: </strong>Virtual reality interventions were associated with reduced fear of falling, enhanced confidence in balance abilities, increased participants' engagement in the intervention process, and offered more favorable experiences of balance interventions within the older population. However, causal pathways cannot be established from this study, and the findings should be interpreted considering the limited sample size.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1889-1900"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139509","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 under uncertainty: a qualitative study of how older patients and their relatives wish to contribute to decision-making.","authors":"Gabriele Leonie Schwarz, Britt Ågot Sjøbø, Elisabeth Skaar, Ingrid Miljeteig, Reidar Kvåle, Hans Flaatten, Karen E A Burns, Paul K J Han, Margrethe Schaufel","doi":"10.1007/s41999-026-01523-w","DOIUrl":"10.1007/s41999-026-01523-w","url":null,"abstract":"<p><strong>Purpose: </strong>Given the importance of shared decision-making in critical illness in advanced age, we aimed to explore how very old patients and their next of kin envision their contribution to the decision-making process.</p><p><strong>Methods: </strong>From November 2021 to March 2023, we conducted a survey among Norwegian outpatients aged 80 and over and their next of kin. We studied their perspectives on hypothetical scenarios of acute, life-threatening illness warranting admission to the intensive care unit (ICU). In this sub-study, we conducted cross-case thematic analysis of free-text responses addressing patients' and next-of-kins' participation in shared decision-making.</p><p><strong>Results: </strong>Of 202 very old and 153 next-of-kin respondents, 210 participants provided 339 free-text comments relevant to this research question. Vi identified five main categories, describing how participants wished to contribute to the decision process: (1) Seeking scientific knowledge, (2) Contributing personal knowledge, (3) Tailoring care to the heterogeneity of older age, (4) Improving the process of decision-making, and (5) Strengthening security. Applying a framework for medical uncertainty and uncertainty tolerance, we found that all five of them comprised ways of coping with or adapting to the multidimensional uncertainty characterising clinical decisions when very old patients fall critically ill.</p><p><strong>Conclusion: </strong>These findings highlight the need to include patients' and family members' personal knowledge in clinical decision-making, and to facilitate the presence of next of kin when very old patients require critical care.</p><p><strong>Trail registration: </strong>ClinicalTrails.gov NCT05149040 (October 31, 2021).</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1735-1746"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279603","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}