Australasian Journal on Ageing最新文献

{"title":"How Frailty Is Considered, Measured and Managed in Clinical Practice, Quality Improvement and Research in Australia: Insights From a National Survey.","authors":"Wei Jin Wong, Melissa Baysari, Fiona Blyth, Danijela Gnjidic, Lisa Kouladjian O'Donnell, Susan Kurrle, Richard I Lindley, Vasi Naganathan, Mitchell Sarkies, Anita Sharma, Janani Thillainadesan, Diana Trickett, Constance Vogler, Sarah N Hilmer","doi":"10.1111/ajag.70189","DOIUrl":"10.1111/ajag.70189","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the extent to which frailty is currently considered, measured and managed in clinical practice, quality improvement and research in Australia.</p><p><strong>Methods: </strong>A cross-sectional electronic survey was developed and promoted to clinicians, health service managers and researchers involved in the provision or study of health care for older people across Australia (August 2024 to March 2025).</p><p><strong>Results: </strong>Of the 155 responses analysed, 88% (n = 136) were from clinicians. Over half of the respondents, 57% (n = 55/97) reported that frailty screening occurred regularly in their health service. Screening was performed by clinicians with allied health, nursing and medical backgrounds, with the Clinical Frailty Scale (CFS) the tool reported most commonly (61%). Free text responses indicated that although frailty screening often informed individual clinical care, system-level models of care to manage people who were screened as frail were rare. Respondents viewed management of frailty as the most important research area (management 41%, prevention 34%, screening 25%). Free text responses on priority research questions highlighted knowledge and implementation gaps in all domains. Of those who responded to the question on research (n = 154), 75% indicated that there was no ongoing research on frailty in their health service and 43% indicated willingness to be involved in frailty research.</p><p><strong>Conclusions: </strong>Frailty screening in practice was reported by over half of the respondents, with opportunities identified to implement models of care for patients with frailty. There is an appetite for further research on frailty in health services across Australia, with management of frailty a priority.</p>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 2","pages":"e70189"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13297020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Planning for Māori Futures: A Scoping Review of Experiences, Priorities and Opportunities for Culturally Informed and Appropriate Aged Care Design.","authors":"Joanna F Hikaka, Tuakana August, Melisa Duque, Ngaire Kerse","doi":"10.1111/ajag.70147","DOIUrl":"10.1111/ajag.70147","url":null,"abstract":"<p><strong>Objectives: </strong>Developing models of aged care that align with Māori aspirations has been identified as a national priority in a recent report by the New Zealand (NZ) Aged Care Commissioner. We aimed to identify key considerations useful for informing Māori aged care and to identify known gaps and proposed solutions, which could be prioritised in health and social service design, delivery and implementation, and for investigation in future research.</p><p><strong>Methods: </strong>We undertook a critical review of peer-reviewed academic and grey literature to identify relevant studies. Studies were grouped into three pre-defined areas: components and values of care models; physical spaces of care; and infrastructures of care.</p><p><strong>Results: </strong>We included 45 articles that focussed on diverse areas including broad experiences of older age, quality of life and well-being, frailty, housing and aged residential care. Findings relating to care models highlighted the aspiration for holistic care models that supported maintaining independence and included meaningful activities. Connection to place and community was important within physical spaces of care and a cross-sectoral approach that allowed for connected and informed decision-making and appropriate resourcing was an important infrastructure consideration.</p><p><strong>Conclusions: </strong>By identifying relevant knowledge relating to models, physical spaces and infrastructures of care, this review provides an evidence base for future health and social service development and identifies gaps in knowledge, which require further research.</p>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 2","pages":"e70147"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Dynapaenic Abdominal Obesity and Fall Risk in Middle-Aged and Older Chinese Adults.","authors":"Feng Lin, Ning Wang","doi":"10.1111/ajag.70188","DOIUrl":"10.1111/ajag.70188","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to examine the relationship between dynapaenic abdominal obesity (D/AO) and fall risk in Chinese middle-aged and older adults.</p><p><strong>Methods: </strong>We analysed data from 9364 participants in the China Health and Retirement Longitudinal Study (CHARLS 2011-2018). Participants were categorised into four groups: non-dynapaenia and non-abdominal obesity (ND/NAO), only abdominal obesity (ND/AO), only dynapaenia (D/NAO), and D/AO. Cox regression, sensitivity, subgroup and geographic analyses were conducted.</p><p><strong>Results: </strong>During follow-up, 2989 falls were reported. After full adjustment, D/NAO and D/AO significantly increased fall risk by 44% (HR = 1.44, 95% CI: 1.25-1.65) and 28% (HR = 1.28, 95% CI: 1.05-1.57), respectively. Stratified analysis revealed significant sex differences: among males, the association between D/AO and fall risk was most pronounced (HR = 2.26, 95% CI: 1.58-3.23); among females, the risk was primarily driven by D/NAO (HR = 1.32, 95% CI: 1.07-1.62). Diabetes significantly interacted with D/AO status (p < 0.05), intensifying the risk. Geographically, Northeast China exhibited high D/AO-associated fall risk despite having the optimal baseline muscle strength.</p><p><strong>Conclusions: </strong>Both D/NAO and D/AO are important risk factors for falls in middle-aged and older adults. The effect of abdominal obesity on fall risk differs significantly by sex and diabetes status, demonstrating a notable synergistic pathogenic effect. Fall prevention strategies should focus on comprehensive body composition management. In particular, for men and individuals with diabetes, greater emphasis should be placed on muscle strength training and the control of central obesity. For high-risk regions (e.g., Northeast China), in addition to physiological interventions, multidimensional public health prevention strategies should be developed that take into account local environments.</p>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 2","pages":"e70188"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Falls as Sentinel Signals of Transitional Vulnerability in Older Adults.","authors":"Yalcin Golcuk","doi":"10.1111/ajag.70198","DOIUrl":"https://doi.org/10.1111/ajag.70198","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 2","pages":"e70198"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Is Inclusive Occupational Therapy for People Living With Dementia? Lessons From Collaborative Workshops With Diverse Communities.","authors":"Sally Day, Kate Laver, Kylie Radford, Yun-Hee Jeon, Rhonda Smith, Patricia Laranjeira, Grahame Smith, Gail Daylight, Gwenda Darling, Lee-Fay Low","doi":"10.1111/ajag.70199","DOIUrl":"10.1111/ajag.70199","url":null,"abstract":"<p><strong>Objective: </strong>Occupational therapy interventions for people living with dementia have been shown to have positive outcomes for the person and family carers. However, people from culturally diverse communities and Aboriginal and Torres Strait Islander peoples are largely missing from research studies. People with dementia from these communities have unique needs, and they can experience health inequity. The aim of this study was to use inclusive methods to explore key factors contributing to and identify potential adaptations required for culturally inclusive and acceptable occupational therapy interventions for people living with dementia.</p><p><strong>Methods: </strong>We adopted best practice research methodology for working with people living with dementia from diverse communities. We conducted three collaborative workshops using co-design techniques. Attendees discussed a hypothetical vignette using group problem-solving. Findings were mapped to the key cultural adaptation framework elements using content analysis.</p><p><strong>Results: </strong>Twenty-one people from diverse communities with living experience of dementia attended one of three collaborative workshops. Participants were accepting of occupational therapy intervention components. Priority areas for delivering inclusive interventions were knowing the person, establishing a therapeutic relationship and expressing cultural humility.</p><p><strong>Conclusion: </strong>The therapist themselves is the key factor that supports the delivery of inclusive interventions. They should be aware of and be responsive to the cultural needs of diverse communities, adjust their therapeutic approach and be prepared to offer flexibility. Working in partnership fostered successful research collaboration, showcasing how people living with dementia from diverse communities can be supported to contribute to research and potentially influence 'higher order' healthcare issues.</p>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 2","pages":"e70199"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 a Multidimensional Occupational Therapy Environmental Checklist for People Experiencing Delirium During Hospital Admission: A Quasi-Experimental Study.","authors":"Sharon Neale, Erin McKnight, Renee Dixon, Danielle Hitch","doi":"10.1111/ajag.70165","DOIUrl":"10.1111/ajag.70165","url":null,"abstract":"<p><strong>Objective: </strong>Delirium, an acute medical emergency, significantly impacts older adults, increasing morbidity, mortality and healthcare costs (estimated at $8.8 billion annually in Australia). Environmental modifications in hospital wards are underexplored despite their potential to mitigate delirium's effects. This study evaluated a multidimensional occupational therapy environmental checklist's impact on functional and service outcomes for hospitalised delirium patients compared to standard care.</p><p><strong>Methods: </strong>A quasi-experimental design was employed, collecting pre- and post-intervention data from 100 electronic medical records (50 comparison, 50 intervention) on a Geriatric Evaluation and Management ward in Melbourne, Australia. The checklist, implemented by occupational therapists and allied health assistants, targeted orientation, object accessibility, daily routines and safety. Outcomes included length of stay, adverse events (e.g., falls, pressure injuries) and Functional Independence Measure (FIM) scores. Descriptive statistics, t-tests and χ² tests were conducted using SPSS Statistics 28 (p < 0.05).</p><p><strong>Results: </strong>The intervention group showed a 27% reduction in total adverse events (comparison: n = 37; intervention: n = 27) and significantly higher FIM scores at discharge (motor: t = -2.38, p = 0.02; cognitive: t = -2.62, p = 0.01; total: t = -3.24, p < 0.001). However, length of stay (comparison: M = 28.2 days; intervention: M = 29.36 days; t = -0.20, p = 0.84) and adverse event rates (χ² = 1.48, p = 0.22) did not differ significantly. The intervention group had a higher fall admission rate (36% vs. 2%; χ² = 20.38, p < 0.001).</p><p><strong>Conclusions: </strong>The checklist enhances functional recovery in older adults with delirium, reducing adverse events. Larger, multi-site studies are needed to confirm efficacy and generalisability, supporting occupational therapy's role in delirium management.</p>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 2","pages":"e70165"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycaemic Control, Blood Pressure and Lifestyle Behaviours in Relation to Sarcopenia Among Older Adults in Korea: A Population-Based Cross-Sectional Study.","authors":"Kyeongmin Jang","doi":"10.1111/ajag.70174","DOIUrl":"10.1111/ajag.70174","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to estimate the prevalence of sarcopenia and examine its associations with glycaemic control, blood pressure and lifestyle behaviours among older adults in Korea.</p><p><strong>Methods: </strong>We conducted a secondary analysis of the 2023 Korea National Health and Nutrition Examination Survey that included 1394 adults aged 65 years or older. Sarcopenia followed Asian Working Group for Sarcopenia 2019 criteria (low appendicular skeletal muscle mass index and low handgrip strength). Complex-sample descriptive tests and multivariable logistic regression identified independent correlates adjusting for sociodemographic, behavioural and clinical covariates. Blood pressure was measured per standard protocol; fasting glucose and haemoglobin A1c (HbA1c) were assayed in a central laboratory.</p><p><strong>Results: </strong>Sarcopenia prevalence was 14% (n = 199). Age 76 years or older (OR 3.19, 95% CI 2.27-4.49) and poor glycaemic control (HbA1c ≥ 7.0%; OR 1.89, 95% CI 1.16-3.08) were associated with higher odds of sarcopenia. Protective factors included body mass index ≥ 25 kg/m² (OR 0.32, 95% CI 0.21-0.48), meeting the World Health Organization physical activity guideline (OR 0.50, 95% CI 0.28-0.90) and alcohol consumption in the past year (OR 0.58, 95% CI 0.41-0.82). Hypertension diagnosis and smoking were not significant. Diastolic, but not systolic, blood pressure was lower among participants with sarcopenia.</p><p><strong>Conclusions: </strong>In a nationally representative Korean sample, sarcopenia was common and linked to modifiable factors-glycaemic control and physical activity. Findings support integrating HbA1c monitoring, resistance and aerobic exercise promotion, and nutrition counselling into community and primary care to reduce sarcopenia risk and support healthy ageing.</p>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 2","pages":"e70174"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fifty Years of Ageing Research: From Evidence to Impact.","authors":"Tracy Comans","doi":"10.1111/ajag.70194","DOIUrl":"https://doi.org/10.1111/ajag.70194","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 2","pages":"e70194"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three Additional Considerations for Interpreting HbA1c in Frail Older Adults With Diabetes.","authors":"Ping Yan, Xuejin Yu, Wei Zhou","doi":"10.1111/ajag.70196","DOIUrl":"https://doi.org/10.1111/ajag.70196","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 2","pages":"e70196"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Factors Mediate the Relationship Between Olfactory Function and Cognitive Frailty in Older Adults: A Structural Equation Modelling.","authors":"Li-Jun Chen, Chung-Ying Lin, Chieh-Ying Chou, Yu-Chi Liao, Yi-Ying Tsai, Esther En-Shu Kuo, Fang-Wen Hu","doi":"10.1111/ajag.70178","DOIUrl":"10.1111/ajag.70178","url":null,"abstract":"<p><strong>Objective: </strong>With the trend of population ageing, cognitive frailty in older adults is an increasingly pressing public health issue. Identifying early-stage risk factors has become a key priority for researchers with the goal of preventing disability. This study aimed to test a conceptual model and elucidate the pathways leading to cognitive frailty using Structural Equation Modelling (SEM).</p><p><strong>Methods: </strong>We conducted a cross-sectional design with data from outpatient departments within a tertiary medical centre in southern Taiwan. Participants (n = 208) were aged 65 years or older and able to communicate independently with the researchers. Demographic factors, extant health conditions, and psychosocial factors were collected. Structural Equation Modelling (SEM) was used to construct a path model.</p><p><strong>Results: </strong>Olfactory function was significantly positively correlated with nutritional status and significantly negatively correlated with depressive symptoms, resilience, and cognitive frailty. Nutritional status was significantly negatively correlated with sarcopenia. Resilience was significantly positively correlated with social support but negatively correlated with sarcopenia. Sarcopenia was significantly positively correlated with cognitive frailty. Social support was significantly negatively correlated with cognitive frailty. Despite these associations, in this model, only one specific serial indirect pathway-via resilience and social support-demonstrated a statistically significant mediating effect between olfactory function and cognitive frailty.</p><p><strong>Conclusions: </strong>The findings suggest that the association between olfactory function and cognitive frailty may involve a limited, pathway-specific serial mediation through resilience and social support. Clinically, this pathway may help to inform the early identification of older adults with olfactory impairment who may benefit from targeted supportive strategies aimed at strengthening resilience and social support.</p>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 2","pages":"e70178"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13156806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}