Age and ageing最新文献

{"title":"Learning from the early adoption of an evidence-based Falls Management Exercise Programme (FaME) in Ireland","authors":"Ruth McCullagh, Dawn Skelton, N Frances Horgan, Eidin Ni She, Katherine Thackeray, Caroline Eldridge, Leanne Ahern, Eibhlis Cahalane, Vanda Cummins, Edel Brennan","doi":"10.1093/ageing/afaf318.006","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.006","url":null,"abstract":"Background The Falls Management Exercise (FaME) programme is a group-based strength and balance intervention shown to reduce falls and support physical activity and independence in older adults, with lasting effects. A key component is teaching participants how to get up from the floor, reducing fear and ambulance calls. Although UK studies highlight implementation challenges, FaME remains effective across populations. With Ireland’s over-65 population projected to exceed one million within a decade and injury costs set to surpass €2 billion, community-based falls prevention is urgently needed. In 2022, the AFFINITY project funded the training of 120 instructors to deliver FaME nationally. FaME Ireland now aims to assess early adoption, focusing on service integration, programme acceptability, and sustainability. Methods To evaluate early adoption, all FaME-trained instructors were surveyed on their delivery experiences. The HSE Change Guide, an experience-based co-design and action research approach, is being applied at three early-adopter sites reflecting varied contexts. Interviews, observations, and co-design workshops explored delivery, access, sustainability, and post-programme physical activity. Results Survey response rate was 67% (n=103), with good geographic coverage. Just over half reported delivering FaME, though some faced long waiting lists. Strong demand and positive participant feedback enabled uptake, but barriers included funding, venue shortages, and limited referral systems. Participants valued improved confidence and social connection, but access, awareness, and follow-on options were limited. Instructor job insecurity and short-term funding threatened sustainability. Local workshops proposed solutions including increased awareness, better referral pathways, and stronger networks. Conclusion FaME is valued and impactful, but early implementation reveals service gaps. To scale effectively, improved referral systems, long-term funding, and workforce support are needed. Upcoming HSE restructuring presents an opportunity to embed FaME nationally and enhance older adults’ independence and wellbeing.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"11 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146160119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Motivators to Conducting Research with Long-Term Care Facility Residents with Dementia in Ireland","authors":"JP Connelly, Iracema Leroi, Nicole Muller, Valerie Smith","doi":"10.1093/ageing/afaf318.142","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.142","url":null,"abstract":"Background The number of long-term care facility (LTCF) residents with dementia (RwD) in Ireland is projected to rise significantly over the next two decades. With an increasingly complex and high-dependency resident profile, LTCFs face mounting pressures to uphold care standards. Innovative, evidence-based solutions are urgently needed; however, recruiting LTCFs and RwD into research remains a persistent challenge. This study explored key barriers and facilitators to conducting research with this vulnerable population. Methods A pragmatic, mixed-methods approach was employed, comprising a national survey (n = 200) and follow-up interviews (n = 18) with LTCF managers, directors of nursing, care staff, residents with dementia, and family caregivers. Patient and Public Involvement (PPI) was embedded throughout the research process. Results Key challenges across participants included inaccessible or complex study language and distrust of the researcher. Challenges identified for care staff specifically, included time constraints and disruption to daily routines. Motivators for participation included access to useful information, belief in the value of research, and clearly articulated study aims. Professional development was a strong motivator for care staff. Financial incentives were not identified as a strong motivator across participant groups. Conclusion By identifying key challenges and motivators to recruitment of LTCFs and RwD to research, these findings will inform more efficient, targeted and cost-effective design of targeted interventions to better address the specialised needs of RwD.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"98 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146160211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Realist Evaluation of a Seven Day Community Rehabilitation Unit","authors":"Lisa Murphy, Freda Browne, Helen Toohey, Jennifer Kinsella, Michael Connolly","doi":"10.1093/ageing/afaf318.021","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.021","url":null,"abstract":"Background The Community Rehabilitation Unit (CRU) at Our Lady’s Hospice & Care Services is an 18-bed inpatient facility for those aged 65+. The unit bridges the gap between acute care and community living by providing tailored rehabilitation programmes to optimise patient function. Established as a five-day service it expanded to seven days in 2020. Research on community rehabilitation inpatient services for frail older adults is limited internationally. Methods This study set out to investigate how the CRU works for patients and in what circumstances it works best and why? The objectives included developing explanatory theories, identifying perceptions of processes, resources, mechanisms and determining areas for service improvement. Phase1: a literature review, analysis of anonymised data from 200 admissions, 19 internal documents and an Expert Panel (n=7) to develop initial programme theory. Phase 2: testing and refining these theories through stakeholder focus groups/interviews (n=10) and patient interviews (n=4). Phase 3: final theory refinement and approval by the Expert Panel (n=4). Results The primary patient profile were admitted from home (94%) with mobility issues (54%) being the main reason, followed by general rehabilitation (27%). The seven-day service was positively evaluated by stakeholders and patients, although some internal feedback mentioned 'quiet weekends. The seven-day service enabled the admission of more complex patients. The CRU's location and grounds were appreciated. Resources fostered autonomy, while limited bathrooms posed challenges. Socialisation positively impacted patient motivation, as did staff. While rehabilitation focused on patient-set goals, this was not consistently documented in nursing assessments. Conclusion The CRU service was positively received and areas for improvement were identified. Reviewing PAS data to better capture admission details and reasons for admission is recommended. Formalising a philosophy of care, including a nursing-care model, to reflect person-centred, goal-oriented rehabilitation is crucial. Maintaining the seven-day service and enhancing weekend social activities are recommended to reinforce its benefits.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"16 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146160215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of an acute emergency department and outpatient frailty service on reducing re-attendance rates in patients aged over 75","authors":"Jennifer Bruton, Odharna Ní Dhomhnallaín, Eman Berier, Lisa Kennedy, Patricia Kelly, Sandra Carey, Joanna McGlynn, Teresa Donnelly","doi":"10.1093/ageing/afaf318.170","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.170","url":null,"abstract":"Background This level 3 hospital has a frailty pathway in place since 2016, consisting of a frailty team within the emergency department (ED) and an outpatient hub. Patients that are seen by the frailty team in ED, undergo a comprehensive geriatric assessment by a specialist multidisciplinary team, and if suitable for discharge are followed up within 1-2 weeks by the outpatient team. Two principle objectives of the frailty pathway is to minimise ED length of stay and admission avoidance in this vulnerable cohort. This audit examines the likelihood of re-attendance to ED in patients over 75 years if seen by a frailty team. Methods Data were collected using hospital IPMS software examining all attendances in January 2025. Data were then analysed to focus on the audit objective. Results In January 2025, 731 people over the age of 75 attended this level-3 hospital ED, of which 402 (55%) were classified as being frail at triage. 179 (24.5%) of this patient cohort re-attended the ED during the course of January. Of this group, 52 (7.1%) of all attendees re-presented within 7 days, 29 (4%) within 14 days and 19 (2.6%) within 30 days. The ED frailty team saw 183 (25%) of overall attendees, of which 72% were frail. Within this cohort of patients, the total number of re-attendances was 9 (4.9%), with 3(33.3%) re-presenting within 7 days, 4(44.4%) within 14 days and 2(22.2%) within 30 days. Conclusion Patients over 75 years of age attending this level-3 emergency department were less likely to re-attend within 30 days if seen by the frailty team on arrival (4.9% vs 7.1%). Prompt intervention by a specialist multidisciplinary geriatric team in ED, with early interval outpatient follow-up, has a protective influence against repeat hospital presentations.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"7 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146160216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Awareness Of Adult Safeguarding Practices In Acute Hospitals: A Survey Of HSE Dublin And South East Hospital Network Staff","authors":"Sarah Donnelly, Sinead McGarry, Amanda Casey, Sinead Brennan, Lorna Montgomery, Tim Hanly, Tim Lynch","doi":"10.1093/ageing/afaf318.129","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.129","url":null,"abstract":"Background The investigation of, and interventions on, the alleged or suspected abuse of older people has become an important feature of professional practice in Ireland. This implies important organisational responsibilities in ensuring that adult safeguarding responsibilities are delivered in ways that ensure positive outcomes for all stakeholders. Many factors can influence staff responses to concerns in acute care contexts. These can relate to awareness of the many forms of abuse and reporting obligations, attitudes to adult safeguarding and understanding the impact of abuse. Acute hospitals offer unique opportunities to identify and intervene in abusive situations and to offer support to those at risk. This study set out to explore the awareness and attitudes towards safeguarding practices of staff in the HSE Dublin and Southeast Acute Hospital Network. Methods A quantitative, descriptive study design was adopted, which utilised a cross-sectional online survey of hospital staff from the 10 participating hospitals. This generated 230 responses from a variety of hospital staff, including nurses, doctors and health and social care professionals Results Findings indicate that acute care staff have varying levels of awareness of different categories of abuse. 32% of respondents reported being ‘very confident’ in recognising suspected harm, abuse or neglect of an adult patient, with 36% of respondents reporting being ‘somewhat confident in reporting abuse. Barriers to identification and reporting included a lack of time, lack of confidence in skills and the victim being confused/cognitively impaired. 61% of respondents reported being ‘extremely confident’ or ‘very confident’ that their organisation would handle concerns about abuse carried out by a staff member in accordance with safeguarding policy. Conclusion Many staff in acute care contexts lack confidence and knowledge in detecting and reporting the abuse of adults at risk. This study clearly indicates the need for further adult safeguarding training and the need for quality improvement initiatives.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"18 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146160294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Converging Competencies: Commonalities and Alignments in Higher Specialist Training Curricula for Psychiatry, Neurology, and Geriatric Medicine in Ireland","authors":"Roman Romero-Ortuno, Declan Mc Loughlin, Orla Hardiman","doi":"10.1093/ageing/afaf318.088","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.088","url":null,"abstract":"Background Older adults commonly present with overlapping psychiatric, cognitive, and neurological conditions, requiring care that spans multiple specialties. In Ireland, Higher Specialist Training (HST) in Psychiatry, Neurology, and Geriatric Medicine has traditionally followed independent pathways. However, as the population ages and clinical complexity increases, integrated competencies and collaborative practice are essential. This study explored the extent to which current Irish HST curricula are aligned in their approach to ageing-related care. Methods A qualitative content analysis was conducted on the 2024 Irish HST curricula for Psychiatry (College of Psychiatrists of Ireland), Neurology, and Geriatric Medicine (Royal College of Physicians of Ireland). Learning outcomes and structural elements were reviewed, with a focus on interdisciplinary competencies, shared clinical placements, and integration in service design and delivery. Specific cross-references between specialties were mapped and analysed. Results The 2024 HST curricula in Psychiatry, Neurology, and Geriatric Medicine share an outcomes-based structure and emphasise communication, ethics, capacity assessment, and multidisciplinary care. Geriatric Medicine includes outcomes on managing psychiatric and neurological conditions, recommending placements in Psychiatry of Later Life and Neurology Movement Disorder services. Neurology requires collaboration with other specialties, including Psychiatry and Geriatrics. Psychiatry of Old Age training mandates geriatric and neurological competencies, with substantial time in relevant placements. All three curricula emphasise cognitive assessment, risk management, and integrated care, reflecting strong alignment in preparing trainees for complex ageing-related presentations. Conclusion There is significant alignment across the HST curricula in Psychiatry, Neurology, and Geriatric Medicine in Ireland, with deliberate cross-specialty placements and shared competencies in cognitive, neuropsychiatric, and functional assessment. These synergies provide a strong foundation for more integrated training models that better reflect the interdisciplinary needs of an ageing population. Structured joint modules or shared rotations could enhance workforce readiness and improve care quality for older adults. Units that offer co-location of training opportunities may provide advantages for trainees.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"32 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146160298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More Than Heartburn: A Case of PPI-Induced Hypomagnesemia","authors":"Tala Abdullatif, Abdirahman Mohamed, Nouman Niaz, Swraj Singla, Esraa Siddig Hashim Ismail, Jethen Maharaj, Daniel Power, Jai Deep, Ahmed Gabr, Margaret O'Connor","doi":"10.1093/ageing/afaf318.135","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.135","url":null,"abstract":"Background Proton pump inhibitors (PPIs) are widely used for the treatment of acid-related gastrointestinal conditions. Although generally well-tolerated, long-term PPI use has been associated with hypomagnesemia, a potentially life-threatening electrolyte disturbance. We report a case of severe hypomagnesemia secondary to prolonged PPI therapy, highlighting the clinical presentation, diagnostic workup, and the pathophysiological mechanisms involved. Methods A 70-year-old male presented with generalized fatigue, muscle cramps, and recurrent episodes of palpitations. Laboratory investigations revealed a serum magnesium level of 0.3 mmol/L (reference range: 0.7–1.0 mmol/L), with associated hypocalcaemia and mild hypokalaemia. The patient had been taking pantoprazole 40 mg daily for over four years for gastroesophageal reflux disease. Potential alternative causes, including gastrointestinal losses, renal magnesium wasting, and the use of diuretics or other hypomagnesemia-associated medications, were systematically excluded. Magnesium supplementation resulted in only transient improvements until the PPI was discontinued. Upon cessation of pantoprazole, serum magnesium normalised after 5 weeks without further supplementation, confirming PPI-induced hypomagnesemia. Results The pathogenesis of PPI-induced hypomagnesemia is not entirely understood, but evidence suggests impaired active and passive intestinal magnesium absorption via the transient receptor potential melastatin 6 and 7 (TRPM6/7) ion channels. Prolonged PPI use may interfere with luminal pH, reducing TRPM6/7 function. The condition may go unrecognized until significant symptoms develop and can recur with re-challenge. Conclusion Clinicians should be aware of the risk of hypomagnesemia in patients on long-term PPI therapy, especially those presenting with neuromuscular or cardiac symptoms. Routine monitoring of serum magnesium should be considered in at-risk individuals, and alternative acid suppression therapies should be evaluated when appropriate. Early identification and discontinuation of the causative agent can lead to resolution of the deficiency and reduce the risk of further complications.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"301 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146160405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and Mortality Risk Factors in Adults Hospitalised with RSV: A Descriptive Cohort Study in an Ageing Population","authors":"Louise Ward, Nathan Scanlon, Katherine Finan, Ciara Gough","doi":"10.1093/ageing/afaf318.164","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.164","url":null,"abstract":"Background Respiratory syncytial virus (RSV) is increasingly recognised as a significant cause of morbidity in older adults. However, real-world outcome data in this population remains limited. This retrospective observational study explores mortality, hospital course, and clinical predictors of outcome in a cohort of RSV-positive inpatients. Methods Data was collected for 89 adult inpatients (mean age 71.5 years; range 19–100) with laboratory-confirmed RSV infection admitted over a single winter season. Key outcomes included 30-, 60-, and 90-day mortality, length of stay (LOS), ICU admission, respiratory support, and antibiotic use. Kaplan-Meier survival analysis was performed, though limited by low event numbers. Results Overall 90-day mortality was 6.1%, with most deaths occurring within 10–20 days of admission. Non-survivors were significantly older (mean age 83.8 vs. 70.9 years), had longer LOS (median 8 vs. 3.5 days), and were more likely to require respiratory support and ICU care. ICU admission occurred in only 2.2% of patients. Antibiotic use was common (57.3%), with Co-Amoxiclav being most prescribed. Patients receiving antibiotics or advanced respiratory support (Airvo, BiPAP) had longer LOS (median 13–18 days). Thirty-day readmission occurred in 11.2% of discharged patients. Conclusion This cohort of RSV-positive inpatients demonstrated low short-term mortality despite advanced age and comorbidity. Mortality risk appeared highest in older patients requiring ICU-level care or respiratory support. Given the increasing burden of RSV in older adults, this study supports the need for preventative strategies, improved risk stratification, and resource planning—particularly as RSV vaccines and monoclonal therapies become more widely available.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"28 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146160551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital admissions due to adverse drug reactions and adverse drug events in older adults: A systematic review","authors":"Nicole Cosgrave, Juliane Frydenlund, Francis Beirne, Stuart Lee, Iman Faez, Caitriona Cahir, David Williams","doi":"10.1093/ageing/afaf318.020","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.020","url":null,"abstract":"Background Adverse drug events (ADEs) and adverse drug reactions (ADRs) are consistently reported to be the cause of up to 30% of hospital admissions in older adults resulting in significant morbidity and mortality with an added health economic burden. We wish to systematically review the literature to establish the frequency of ADRs and ADEs as a cause of hospitalization with a secondary aim of determining the implicated drugs and risk factors. Methods Standard databases and citations were searched (2015 to 2024) and studies specifically assessing ADR and ADE prevalence and risk factors in older adults were included. The systematic review was registered in PROSPERO (CRD42024613426). The Joanna Briggs Institute (JBI) criteria was used to assess quality, and the risk of bias was determined using the ‘risk of bias in non-randomised studies – of exposure’ (ROBINS-E). A narrative synthesis approach was used to present the findings. Results Eight studies met the inclusion criteria and underwent further evaluation and quality assessment. The prevalence of ADRs was reported to be 3.3% to 23.1% and the reported prevalence of ADEs ranged from 11.75% to 18%. The median age of those included ranged from 77 to 86 years. Falls (19.4-20.9%), hypotension (7.6-33.5%), delirium (7.3-12.9%) and bleeding (8-30.2%) were the most encountered ADR/ADEs with anti-thrombotics (11.5-30.2%) diuretics (14.7-30.2%) and renin-angiotensin-aldosterone system (RAAS) inhibitors (7.5-8.9%) accounting for the highest proportion of ADR/ADE causative agents. Only two studies performed logistic regression analysis to establish risk factors for ADE/ADRs. Conclusion This review has limitations stemming from the heterogeneity in the included studies and the exclusion of grey literature. However, ADRs and ADEs remain a significant cause of hospital admissions in older adults despite their reported preventability. Future research into methods for risk assessment and prevention of ADEs and ADRs is urgently needed to address this significant health burden for older adults.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"98 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146160552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance-Based Measures of Executive Function through Instrumental Activities of Daily Living: Systematic Review for early detection of Mild Cognitive Impairment","authors":"Noelle Downey, Bart Daly, Tim Dukelow, Denis Curtin, Irene Hartigan","doi":"10.1093/ageing/afaf318.076","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.076","url":null,"abstract":"Background Subtle impairments in instrumental activities of daily living (IADLs) and executive dysfunction are key features in the early stages of cognitive decline and mild cognitive impairment (MCI). Higher level cognitive functions, such as planning and decision-making, are essential for complex IADLs including driving and managing finances. Early detection of MCI enables timely intervention and planning. While traditional cognitive assessments and carer or self-reporting questionnaires provide valuable insights, performance-based IADL measures may offer greater ecological validity and earlier detection of subtle functional deficits. This systematic review aimed to (i) examine existing evidence on performance-based measures that assess executive function through IADL activities in older adults and (ii) evaluate their effectiveness in identifying MCI. Methods From an initial 378 peer reviewed articles, fifteen studies met the predefined inclusion criteria, and underwent full-text analysis. Two reviewers independently, screened studies and conducted quality assessments using the Mixed Methods Appraisal Tool. Eligible studies involved quantitative evaluations of IADL performance in community-dwelling older adults, with a focus on executive function and MCI. Results Tools such as the PASS, STAM, Home-MET, DAFS-R, and FUCAS effectively differentiated individuals with MCI from cognitively healthy peers These assessments showed moderate to strong correlations with executive function like planning, inhibition, set shifting and working memory. Error analysis during task performance also offered insight into their functional ability. Financial management, medication use, and multi-step planning were particularly sensitive indicators. However, limitations included methodological variability, high education levels and under representation of non-amnestic MCI subtypes. Conclusion Performance-based IADL tools show promise for the early identification of MCI by offering ecologically valid insights into executive dysfunction and moving beyond traditional assessments to reflect real-world cognitive demands, while also aligning with person-centred care by focusing on meaningful, everyday abilities and challenges.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"133 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146160363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}