Elena Levati, Maria Beatrice Zazzara, Angela Iurlaro, Emanuele Marzetti, Riccardo Calvani, Marco Pahor, Anna Picca, Matteo Tosato, Francesco Landi, Roberto Bernabei, Graziano Onder
{"title":"Lifestyle interventions and medication burden in older adults: insights from the Lifestyle Intervention and Independence for Elders (LIFE) and the Sarcopenia and Physical fRailty iN older people: multi-componenT Treatment strategies (SPRINTT) trials.","authors":"Elena Levati, Maria Beatrice Zazzara, Angela Iurlaro, Emanuele Marzetti, Riccardo Calvani, Marco Pahor, Anna Picca, Matteo Tosato, Francesco Landi, Roberto Bernabei, Graziano Onder","doi":"10.1007/s41999-025-01266-0","DOIUrl":"https://doi.org/10.1007/s41999-025-01266-0","url":null,"abstract":"<p><strong>Purpose: </strong>Polypharmacy is a growing public health problem and implementing strategies to reduce its prevalence is considered a research and clinical priority. Healthy lifestyle impacts the onset and progression of chronic conditions. Yet, there is limited understanding of how this effect influences medication use. The aim of the study was to assess the impact of lifestyle interventions on use of medications for treatment of common chronic conditions.</p><p><strong>Methods: </strong>We performed a secondary analyses from two randomized clinical trials: the Lifestyle Interventions and Independence for Elders Study (LIFE) and the Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies (SPRINTT) trials. LIFE study enrolled community-dwelling men and women aged 70 to 89 years old who were physically inactive and had reduced physical function recruited in eight centers in the United States. SPRINTT enrolled community-dwelling men and women aged 70 years or older with physical frailty and sarcopenia recruited in 16 clinical sites in Europe. Active intervention groups consisted of a physical activity program in LIFE and a multicomponent intervention based on physical activity with technological support and nutritional counselling/dietary intervention in SPRINTT. The main outcome measure was the change in cardiovascular, diabetes, mood and anxiety, and chronic pain medication use as measured by daily dose per day (DDD/day).</p><p><strong>Results: </strong>A total of 1519 LIFE participants (752 intervention vs 767 control group, mean age 78.9 years; 67.3% women) and 1,208 SPRINTT participants (602 intervention vs 606 control group, mean age 78.8 years; 72.8% women) were evaluated. For both studies, no significant difference was observed in the median number of DDDs at baseline and follow-up assessments for any of the medication classes considered. Longitudinal analysis performed using linear mixed models revealed no significant association between DDDs/day and lifestyle interventions, with the only exception of an increase in DDD/day of pain medications in the intervention group of SPRINTT (β = 0.16; CI 0.06-0.26 at 6 months; β = 0.12; CI 0.01-0.22 at 12 months; β = 0.12; CI 0.01-0.22 at 18 months).</p><p><strong>Conclusion: </strong>Lifestyle interventions did not significantly impact on burden of medications used to treat chronic conditions in frail older adults. This finding does not undermine the beneficial effects of these interventions on health outcomes, but highlights the need for specifically designed trials to determine their effect on reducing polypharmacy.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT01072500 (LIFE) and NCT02582138 (SPRINTT).</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643992","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":"What's behind delirium: is there a specific role for medications?","authors":"Alessia Beccacece, Olafur Samuelsson, Freyja Jónsdóttir, Massimiliano Fedecostante, Adalsteinn Gudmundsson, Antonio Cherubini","doi":"10.1007/s41999-025-01269-x","DOIUrl":"https://doi.org/10.1007/s41999-025-01269-x","url":null,"abstract":"<p><strong>Purpose: </strong>Delirium in nursing home (NH) residents is typically multifactorial and complex. This narrative review aims to synthesize the current literature on medications that are identified as predisposing and precipitating factors for delirium in older adults in NHs.</p><p><strong>Methods: </strong>A comprehensive PubMed search was carried out to identify English-language publications up to March 2025. Studies were included if they explored the role of medications in inducing delirium in NH residents aged 65 years and older.</p><p><strong>Results: </strong>While there is substantial evidence linking medications to delirium, the number of studies evaluating their effects in the NH setting is notably limited. Several studies conducted in NHs confirmed the association between anticholinergic drugs and delirium. Antipsychotic medications and benzodiazepines may increase the risk of delirium onset. However, the studies conducted in NHs are insufficient to make definitive recommendations due to the small sample sizes and conflicting results. Other classes of medications have been recognized as potential delirium triggers in other healthcare settings, but existing evidence in NHs is either limited or absent.</p><p><strong>Conclusion: </strong>Determining which medications that trigger delirium is complicated by the presence of numerous confounding factors among NH residents, including cognitive impairment, frailty, multimorbidity, polypharmacy, acute medical conditions, pain, end-of-life care, and organizational factors that can interact and amplify the risk. More research is necessary to establish the role of medications in the etiology of delirium in this population.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Muscle mass adjustment for body size: is using a ratio doing the job? A cross-sectional study in two samples of older adults.","authors":"Marjolein Visser, Minoru Yamada, Hidenori Arai","doi":"10.1007/s41999-025-01263-3","DOIUrl":"https://doi.org/10.1007/s41999-025-01263-3","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this cross-sectional study was to investigate the prevalence of low muscle mass using different ratios, across categories of BMI in older adults.</p><p><strong>Methods: </strong>Muscle mass estimates obtained by DXA, CT, and BIA from two samples of older adults were used (the Health, Aging, and Body composition study, USA and the MUSCLE study, Japan). For each muscle mass estimate, three ratios were calculated: muscle mass divided by body height squared, muscle mass divided by body weight, and muscle mass divided by body mass index. The prevalence of low muscle mass (ratio < 20th percentile of the sample) was determined across BMI categories.</p><p><strong>Results: </strong>For all three ratios, the prevalence of low muscle mass was dependent on BMI. These findings were consistent for the different body composition methods, men and women, and for the two data samples.</p><p><strong>Conclusion: </strong>Regardless of the muscle mass-body size ratio being used, cut-off values for low muscle mass need to be BMI-specific.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585403","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}
Addinah Sharifuddin, Nur Izzah Suhaili, Amanda Goh, Muhamad Danial Bin Zulkifli, Kejal Hasmukharay, Terence Ong
{"title":"Discharge transition programme to reduce readmission to hospital among older people: a feasibility study.","authors":"Addinah Sharifuddin, Nur Izzah Suhaili, Amanda Goh, Muhamad Danial Bin Zulkifli, Kejal Hasmukharay, Terence Ong","doi":"10.1007/s41999-025-01265-1","DOIUrl":"https://doi.org/10.1007/s41999-025-01265-1","url":null,"abstract":"<p><strong>Purpose: </strong>Supporting discharge from hospital may reduce readmission among older people. This was a feasibility study of a discharge transition programme which utilised a combination of a discharge transition coordinator, a self-reporting questionnaire of health and care needs, and a telecommunication messaging service.</p><p><strong>Methods: </strong>Older people admitted to an acute geriatric medicine ward of a university hospital were eligible to participate. Those recruited completed an online questionnaire of their health status twice a week for 2 weeks. They could highlight queries in-between questionnaires via text messages up to 28-days post-discharge. The coordinator would facilitate any health queries between the participant and the medical team. Data were collected on their demographics, clinical details, questionnaire completion, and outcomes at day 28.</p><p><strong>Results: </strong>One hundred thirty participants (130) were recruited. 71.8% of those eligible were recruited. 69/130 (53.1%) participants were women and their mean age was 81.9 years. They were frail (Clinical Frailty Scale ≥ 4, 90.8%), multimorbid ≥ 3, 72.3%) and had multiple acute medical diagnoses on admission (≥ 2 diagnoses, 89.2%). One hundred four participants (80.0%) returned home with family support. One hundred and seven, 107 (82.3%), completed at least one questionnaire. Fifty-one (39.2%) reported their health status all four times. On average, ten additional queries arose weekly via the messaging service. Concerns included changes in consciousness, reduced oral intake, mobility limitations, and medication uncertainties. 26/130 (20.0%) were readmitted and 9 (6.9%) died within 28 days of their discharge. Most expressed a positive satisfactory response with the programme.</p><p><strong>Conclusion: </strong>This study provided insight into what is required before performing an adequately powered clinical trial to evaluate its impact on reducing readmission among older people.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585402","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}
Francesca Mancinetti, Dionysios Xenos, Michelantonio De Fano, Alessio Mazzieri, Sara Ercolani, Patrizia Mecocci, Francesca Porcellati, Virginia Boccardi
{"title":"Switching from insulin injections to degludec/liraglutide in older frail persons: 6-month body composition remodelling.","authors":"Francesca Mancinetti, Dionysios Xenos, Michelantonio De Fano, Alessio Mazzieri, Sara Ercolani, Patrizia Mecocci, Francesca Porcellati, Virginia Boccardi","doi":"10.1007/s41999-025-01271-3","DOIUrl":"https://doi.org/10.1007/s41999-025-01271-3","url":null,"abstract":"<p><strong>Purpose: </strong>Managing T2DM in older frail adults is challenging, as age-related sarcopenia and insulin resistance may be worsened by traditional insulin regimens. IDegLira, a fixed-ratio combination of insulin degludec and liraglutide, may simplify therapy and improve body composition.</p><p><strong>Methods: </strong>This retrospective analysis of 36 (18 women/18 men) frail insulin-treated older adults (mean age 79.6 ± 5.8 years) from the STOP (Simplifying Treatment in Older People) study assessed the impact of switching to once-daily IDegLira. Body composition was measured via bioelectrical impedance analysis (BIA) at baseline and 6 months, and changes were evaluated using adjusted mixed models for repeated measures.</p><p><strong>Results: </strong>Total insulin dose dropped from 34.52 to 24.30 U/day, and bolus insulin was nearly discontinued, while IDegLira was up titrated from 15.66 to 22.41 units/day. After 6 months on IDegLira, body composition controlling for multiple covariates improved significantly: fat-free mass (+ 3.17 kg/m), body cell mass (+ 7.82 kg/m), phase angle (+ 1.75°), and basal metabolic rate (+ 217.6 kcal) all increased (p < 0.001), while fat mass, total body water, and extracellular water decreased (p < 0.001). Weight and BMI were also reduced (-2.6 kg and -0.95 kg/m<sup>2</sup>, p < 0.001). Glycemic control improved with a favorable trend in reduction in HbA1c (7.29% to 7.05%, p = 0.089), while insulin resistance (METS-IR) declined significantly (42.39 to 32.84, p < 0.0001).</p><p><strong>Conclusion: </strong>Switching frail older adults with T2DM to IDegLira improved body composition, metabolic parameters, and reduced insulin needs, filling a critical gap in BIA-based evidence for this population and supporting its use as a safer, simplified alternative to complex insulin regimens.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585404","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}
Julie Merche, Henri Thonon, François-Xavier Sibille, Julie Gabriel, Elise Simonin, Didier Schoevaerdts, Thérèse Van Durme, Marie de Saint-Hubert
{"title":"Avoidable emergency department admissions among nursing home residents - insights from a retrospective study.","authors":"Julie Merche, Henri Thonon, François-Xavier Sibille, Julie Gabriel, Elise Simonin, Didier Schoevaerdts, Thérèse Van Durme, Marie de Saint-Hubert","doi":"10.1007/s41999-025-01264-2","DOIUrl":"https://doi.org/10.1007/s41999-025-01264-2","url":null,"abstract":"<p><strong>Purpose: </strong>The number of nursing home residents (NHRs) admitted to emergency departments (EDs) is steadily increasing. Some of these admissions have been identified as potentially avoidable. This study aims to quantify avoidable admissions at a Belgian hospital and identify factors associated with these admissions. A retrospective assessment tool is also proposed for the rapid identification of avoidable admissions.</p><p><strong>Methods: </strong>One-year retrospective descriptive study of NHR admissions to the ED of a Belgian university hospital. The avoidability of each admission was assessed using a retrospective assessment tool and independently assessed by two geriatricians based on clinical judgment. The sensitivity and specificity of the tool were measured against clinical judgment as the reference standard.</p><p><strong>Results: </strong>A total of 246 NHRs visited the ED, accounting for 327 admissions. Based on clinical judgment, 22.6% of admissions were deemed potentially avoidable. Direct costs were estimated. The retrospective assessment tool identified a rate of 14.1% (specificity: 98.4% and sensitivity: 56.8%). The most common presenting complaints for avoidable admissions were falls (26.1%), minor catheter-related issues (13.5%), and wounds (8.1%). No significant differences were observed in population and NH characteristics between avoidable and non-avoidable admissions.</p><p><strong>Conclusion: </strong>We identified approximately one in five ED admissions among NHRs as potentially avoidable. This work also presents a specific tool enabling identification and quantification of avoidable admissions. Detecting the most common \"avoidable\" presenting complaints and diagnoses associated with avoidable admissions presents potential opportunities to explore alternative care solutions within nursing homes.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561728","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}
Helena A Ferris, Mary E Walsh, Niamh A Merriman, Louise Brent, Pamela Hickey, Niamh O ' Regan, Tara Coughlan, Roman Romero-Ortuno
{"title":"Identifying frailty in acutely hospitalised patients with hip fracture: are the clinical frailty scale and irish hip fracture database frailty index comparable for predicting adverse outcomes?","authors":"Helena A Ferris, Mary E Walsh, Niamh A Merriman, Louise Brent, Pamela Hickey, Niamh O ' Regan, Tara Coughlan, Roman Romero-Ortuno","doi":"10.1007/s41999-025-01268-y","DOIUrl":"https://doi.org/10.1007/s41999-025-01268-y","url":null,"abstract":"<p><strong>Purpose: </strong>Frail older adults are at increased risk of adverse outcomes after hip fracture. We compared the Clinical Frailty Scale (CFS) and the Irish Hip Fracture Database Frailty Index (IHFD FI) in predicting hospital outcomes.</p><p><strong>Methods: </strong>A secondary analysis of national clinical audit data from two trauma units was conducted. The CFS and IHFD FI were derived from routinely collected data. Multivariable logistic regression assessed the predictive value of age, sex, ASA grade, plus either frailty tool for the following outcomes: delirium (positive 4AT and/or clinical diagnosis), inpatient mortality, prolonged length of stay (LOS ≥ 30 days) and discharge home within 14 days. Predictive performance was evaluated using area under the curve (AUC).</p><p><strong>Results: </strong>The study included 1,388 patients discharged between 1st January 2022 and 31st December 2023 (mean age 80.0, 68.4% female). Delirium occurred in 39.1%, inpatient mortality in 5.2%, prolonged LOS in 22.2% and 33.6% were discharged home within 14 days. CFS data were available for 84.4% and IHFD FI for 86.5%. When added to age, sex and ASA, the CFS outperformed the IHFD FI for predicting delirium (AUC 0.816 vs. 0.790), while the IHFD FI was better for mortality (AUC 0.778 vs. 0.744). Both tools performed similarly for prolonged LOS and discharge home.</p><p><strong>Conclusion: </strong>Both the CFS and IHFD FI were predictive of outcomes. However, the CFS demonstrated superior predictive value for delirium during admission. Prospective collection of the CFS is recommended to enhance the identification of patients at risk of delirium and to support timely clinical interventions.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555529","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}
Riikka T Niskanen, Hanneke A H Wijnhoven, Kaisu H Pitkälä, Marjolein Visser, Hannu Kautiainen, Merja H Suominen, Satu K Jyväkorpi
{"title":"Association of personalized dietary advice aiming to increase protein intake with macronutrient intake of community-dwelling older adults: a secondary analysis of the PROMISS RCT.","authors":"Riikka T Niskanen, Hanneke A H Wijnhoven, Kaisu H Pitkälä, Marjolein Visser, Hannu Kautiainen, Merja H Suominen, Satu K Jyväkorpi","doi":"10.1007/s41999-025-01267-z","DOIUrl":"https://doi.org/10.1007/s41999-025-01267-z","url":null,"abstract":"<p><strong>Purpose: </strong>The PROMISS randomized-controlled trial (RCT) showed that personalized dietary advice, regarding, for instance, protein-enriched food products, increased protein intake among community-dwelling older adults with a low habitual protein intake. This secondary analysis evaluates how the dietary advice aimed solely at increasing protein intake affects the intake of other (macro)nutrients, saturated fat, sugars, and dietary fiber.</p><p><strong>Methods: </strong>Community-dwelling older adults (n = 260, mean age 75 years, 53% women) in Finland and the Netherlands with a habitual protein intake < 1.0 g/kg adjusted body weight/day were included in this secondary analysis. The two intervention groups (n = 175) received personalized dietary advice for 6 months to increase protein intake. The control group (n = 85) received no intervention. Nutrient intake was evaluated with 24 h recalls and a 3-day food record at baseline and follow-up.</p><p><strong>Results: </strong>Macronutrient intake at baseline was similar across groups. In addition to an increase in protein, the intervention groups showed a significant increase in carbohydrate intake relative to the control group, with no change in the intake of total fat, saturated fat, sugars, or dietary fiber. An increase in energy intake was associated with an increase in protein intake [r = .55 (95% CI 0.46-0.63)] but not with relative weight gain [r = 0.03 (95% CI - 0.09 to 0.16)].</p><p><strong>Conclusion: </strong>Dietary advice to increase protein intake increased also the intake of carbohydrates, but intakes of fiber, sugars, and (saturated) fat remained at baseline levels.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545776","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}
Irene Mansutti, Chiara Muzzana, Vanessa Vater, Pia Urfer Dettwiler, Alvisa Palese, Dietmar Ausserhofer, Wolfgang Hasemann
{"title":"Delirium in nursing homes and long-term care facilities: findings of a scoping review of detection tools.","authors":"Irene Mansutti, Chiara Muzzana, Vanessa Vater, Pia Urfer Dettwiler, Alvisa Palese, Dietmar Ausserhofer, Wolfgang Hasemann","doi":"10.1007/s41999-025-01250-8","DOIUrl":"https://doi.org/10.1007/s41999-025-01250-8","url":null,"abstract":"<p><strong>Background: </strong>The detection of delirium among residents in nursing homes (NH) and long-term care (LTC) facilities remains challenging due to overlapping symptoms with dementia, limited staff training, and variability in assessment tools. This scoping review aimed to identify delirium detection tools and their properties as used for research purposes in these settings.</p><p><strong>Methods: </strong>The methodology was guided by Arksey and O'Malley and Levac et al. Medline, Embase, CINAHL, PsycINFO, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials were searched for original research studies.</p><p><strong>Results: </strong>A total of 58 studies met the inclusion criteria, with most conducted in the USA (37.9%) and Europe. We identified 25 delirium detection tools, with the Confusion Assessment Method long form (43.1%), the Neelon and Champagne Confusion Scale (10.3%), the Nursing Home Confusion Assessment Method (10.3%), the short Confusion Assessment Method and its modifications (8.6%), the Delirium Index (6.8%), the Delirium Rating Scale-Revised-98 (6.8%), and the 4A's Test (5.1%) as the most frequently used. Only 14 tools have undergone validity and reliability testing in NH/LTC settings, with the Delirium Observation Screening Scale showing the highest diagnostic accuracy. Ten tools showed full concordance regarding the three delirium domains: cognitive domain, higher-level thinking domain, and circadian domain. The Delirium Diagnostic Tool-Provisional (DDT-Pro) required no more than three items.</p><p><strong>Discussion: </strong>This review highlights the lack of standardized delirium detection in NH/LTC settings. Future research should focus on providing evidence based on validity and reliability of existing tools, integrating delirium screening and assessment into routine care as part of delirium prevention and management, and training NH/LTC staff.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530682","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}
Simon A Moyes, Vanessa Selak, Lindsay Plank, Joanna Hikaka, Ngaire Kerse
{"title":"Sarcopenia and mortality in Indigenous and non-Indigenous New Zealand octogenarians-the LiLACS NZ cohort study.","authors":"Simon A Moyes, Vanessa Selak, Lindsay Plank, Joanna Hikaka, Ngaire Kerse","doi":"10.1007/s41999-025-01261-5","DOIUrl":"https://doi.org/10.1007/s41999-025-01261-5","url":null,"abstract":"<p><strong>Purpose: </strong>As the population is ageing, age-related vulnerability to chronic infirmity has become of greater concern. Sarcopenia, low muscle strength and mass, is a major contributor to infirmity. Both sarcopenia and hand grip strength (HGS) are known to predict mortality in older people. This paper investigates the impact of ethnicity on this relationship in New Zealand octogenarians.</p><p><strong>Methods: </strong>This study used data from Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ), which recruited 421 Māori and 516 non-Māori with follow-up mortality data for over twelve years and had a median survival period of 6.02 years, 251 Māori and 374 non-Māori had sufficient data to be included in modelling. Survival analysis (Cox regression) assessed the association between HGS or probable sarcopenia (defined using HGS) and mortality, separately by ethnicity (Māori, non-Māori) and sex.</p><p><strong>Results: </strong>Hand grip strength was a predictor of mortality for non-Māori men (age-adjusted hazard ratio, aHR, per 1 kg increase in HGS, 0.93, 95% CI: 0.91-0.96) but not for women or Māori men. Probable sarcopenia was associated with an increased hazard of mortality among all groups, but the effect was statistically significant for non-Māori (men 1.97, 1.39-2.79; women 1.49, 1.08-2.06) and not Māori (men 1.55, 0.97-2.48; women 1.36, 0.79-2.34).</p><p><strong>Conclusion: </strong>Hand grip strength, either as a continuous variable or to identify probable sarcopenia, remains an important indicator with high clinical utility in advanced age. However, its utility may need to be re-examined for Indigenous populations.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530683","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}