Aging Clinical and Experimental Research最新文献

{"title":"Chronological age and failure to rescue after colorectal cancer surgery: A multicentre cohort study","authors":"Tomasz Cwaliński,&nbsp;Michał Kazanowski,&nbsp;Jacek Piątkowski,&nbsp;Maciej Ciesielski,&nbsp;Marcin Januszkiewicz,&nbsp;Zuzanna Bigus,&nbsp;Patryk Kaczor,&nbsp;Bartosz Kapturkiewicz,&nbsp;Paweł Lesiak,&nbsp;Sergii Girnyi,&nbsp;Damian Nowiński,&nbsp;Piotr Kurek,&nbsp;Marek Jackowski,&nbsp;Marek Bębenek,&nbsp;Mateusz Jagielski,&nbsp;Luigi Marano","doi":"10.1007/s40520-026-03508-y","DOIUrl":"10.1007/s40520-026-03508-y","url":null,"abstract":"<div><h3>Background</h3><p>Whether advancing chronological age is associated more strongly with serious postoperative events or with survival after an event remains uncertain.</p><h3>Aims</h3><p>To compare the association of chronological age with major postoperative events and failure to rescue after colorectal cancer surgery.</p><h3>Methods</h3><p>We analyzed 1,124 adults treated at five Polish centers between January 2022 and August 2025. Major events were Clavien–Dindo ≥grade IIIa; failure to rescue was cumulative 90-day death after such an event. Chronological age was analysed per 10-year increase. Multivariable logistic regression examined major events and Firth regression examined failure to rescue.</p><h3>Results</h3><p>Major events occurred in 145 patients; failure to rescue was evaluable in 134 and occurred in 24. Chronological age was not associated with major events (adjusted odds ratio per decade 1.09, 95% confidence interval 0.89–1.33) or nonfatal major morbidity. Failure-to-rescue odds increased per decade (odds ratio 2.02, 95% confidence interval 1.21–3.63); model-standardized probabilities were 11.1% at age 65 and 32.5% at age 85 years. Sensitivity analyses were directionally consistent, but the interval included no association when every model-eligible missing post-event outcome was assigned to death.</p><h3>Discussion</h3><p>The chronological-age gradient was concentrated in survival after a serious event. Frailty and physiological reserve were not measured; reduced reserve remains a plausible explanation rather than a demonstrated mechanism.</p><h3>Conclusions</h3><p>Chronological age may help identify patients who warrant intensified postoperative surveillance and early escalation, while formal geriatric and frailty assessment remains necessary to characterize biological vulnerability.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-026-03508-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149132632","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":"Cognitive frailty and hip fracture: methodological considerations for community screening","authors":"Lianhua Sheng","doi":"10.1007/s40520-026-03496-z","DOIUrl":"10.1007/s40520-026-03496-z","url":null,"abstract":"","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872642","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":"Food insecurity and mortality in older adults: a prospective reconstruction","authors":"Quvonch Tursunov,&nbsp;Lim Maksim,&nbsp;Barnokhon Badridinova,&nbsp;Feruza Abdumalikova,&nbsp;Hamideh R. Babaloo","doi":"10.1007/s40520-026-03482-5","DOIUrl":"10.1007/s40520-026-03482-5","url":null,"abstract":"<div><p>Food insecurity is increasingly recognised as a public health concern among older adults, yet the mechanisms linking it to mortality remain unclear. Gianfredi and colleagues recently examined this association using data from the English Longitudinal Study of Ageing (ELSA), reporting that food insecurity was associated with a 41% higher risk of all‑cause mortality and a 126% higher risk of premature mortality (before age 75). While the study addresses an important question using a large, nationally representative cohort, four methodological considerations warrant careful attention before these findings can be interpreted as evidence of a causal relationship. Four methodological considerations, premature mortality definition, unmeasured nutritional status, mediator adjustment, and absent diet quality assessment, warrant careful attention before causal interpretation. Future studies should adopt sensitivity analyses for premature mortality thresholds, measure nutritional status directly, distinguish confounders from mediators using directed acyclic graphs, and assess diet quality using validated indices. Until these methodological gaps are addressed, the evidence that food insecurity causally influences mortality in older adults remains inconclusive.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811800","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":"Rethinking dementia prevention: what the new WHO guidelines get right (and what they left behind)","authors":"Nicola Veronese,&nbsp;Stefania Maggi","doi":"10.1007/s40520-026-03470-9","DOIUrl":"10.1007/s40520-026-03470-9","url":null,"abstract":"","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-026-03470-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148615145","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":"Comment on “swedish massage versus hip strengthening exercises for pain and function in older adults with knee osteoarthritis: a randomized controlled trial”","authors":"Sahil Kumar,&nbsp;Sandeep Pattnaik","doi":"10.1007/s40520-026-03418-z","DOIUrl":"10.1007/s40520-026-03418-z","url":null,"abstract":"<div><p>The results of the randomised controlled trial by Asgarimoghadam et al. (2026) on the use of Swedish massage and hip-strengthening exercises in older adults with knee osteoarthritis are quite informative regarding non-pharmacological management strategies. Although both interventions showed remarkable outcomes in alleviating pain and enhancing function and range of movement compared with the control, a few methodological issues should be considered. The lack of participant blinding with the use of subjective outcome measures is a potential risk of performance bias. Also, the sample size used is not very large, which raises doubts about the lack of statistical power to identify the differences between two active interventions contributing to an increased risk of a Type II error. The large screening-to-enrollment ratio also constrains the external validity of the results to more widespread clinical groups. The future research by addressing these limitations in prospective research with sound trial design, big sample size and enhanced external validity will go a long way to improve the evidence base associated with clinical decision-making in the geriatric rehabilitation field.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-026-03418-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148615069","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":"Stroke burden and associated predictors in Ghana: a Bayesian analysis of the WHO study on global ageing and adult health","authors":"Abdul-Karim Iddrisu,&nbsp;Adam Mohammed","doi":"10.1007/s40520-026-03462-9","DOIUrl":"10.1007/s40520-026-03462-9","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Stroke is a major public health concern in sub-Saharan Africa, including Ghana. Although its clinical and demographic risk factors are well established globally, nationally representative evidence on stroke prevalence and associated factors in Ghana remains limited. Also, previous research using WHO SAGE Wave 1 data has examined stroke prevalence and associated factors among older adults in Ghana; however, important methodological gaps remain, particularly regarding the explicit consideration of the complex survey design and unobserved cluster-level heterogeneity.&lt;/p&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;p&gt;This study examined the prevalence and risk factors of stroke among adults in Ghana.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;Data were obtained from the World Health Organization’s Study on Global AGEing and Adult Health (WHO SAGE, Wave 1), comprising 5,066 Ghanaian participants, including individuals aged 50 years and older and a comparative group aged 18–49 years. Descriptive statistics and chi-square tests were used to assess variable distributions and bivariate associations with stroke. Given the hierarchical and complex survey structure of the data, with individuals nested within primary sampling units (PSUs), survey multivariable logistic regression was applied to estimate adjusted associations, while Bayesian multilevel logistic regression models were fitted to account for cluster-level random variation and improve estimate stability. Analyses were conducted in R (v4.5.1) using the survey and R-INLA packages, with statistical significance set at &lt;i&gt;p&lt;/i&gt; &lt; 0.05.&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;The two models produced consistent findings, with the Bayesian multilevel model offering the most stable and precise estimates after accounting for cluster-level heterogeneity at the PSU level and the within-cluster dependence among sampled individuals. Cluster-level heterogeneity was negligible (ICC = 0.0001; 95% CrI: 0.0000–0.0005), indicating minimal residual variation in stroke across PSUs. The Bayesian multilevel logistic regression analysis identified several significant predictors of stroke. Individuals who had ever attended school had higher odds of stroke compared to those who had not (aOR = 1.48, 95% CrI: 1.00-2.21). Obesity (aOR = 1.68, 95% CrI: 1.05–2.70), arthritis (aOR = 1.74, 95% CrI: 1.08–2.79), diabetes (aOR = 2.67, 95% CrI: 1.53–4.66), and hypertension (aOR = 3.46, 95% CrI: 2.28–5.23) were all associated with increased odds of stroke. Participants aged 50 years and above also had higher odds compared to younger adults (aOR = 2.76, 95% CrI: 1.18–6.44), whereas engagement in vigorous work-related physical activity was associated with reduced odds of stroke (aOR = 0.60, 95% CrI: 0.38–0.95).&lt;/p&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;Public health strategies should emphasize physical activity, healthy diets, weight control, and improved management of chronic diseases. These efforts align with the sustainable development goal 3 (SDG 3); Good Health and Well-being, particularl","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-026-03462-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519648","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":"Frailty, physiological reserve, and surgical resilience: toward a dynamic stress–recovery model","authors":"Rafal Cudnik,&nbsp;Mirko Barone,&nbsp;Luigi Marano,&nbsp;Simone Gargarella,&nbsp;Ruslan Duka,&nbsp;Robert Molchanov,&nbsp;Sergii Girnyi,&nbsp;Tomasz Cwalinski,&nbsp;Mahmoud Al-Balas,&nbsp;Yogesh Vashist,&nbsp;Lorenzo Cobianchi,&nbsp;Silvia Malerba,&nbsp;Francesco Paolo Prete,&nbsp;Mario Testini,&nbsp;Valentin Calu,&nbsp;Archil Aladashvili,&nbsp;Kamal Mahawar,&nbsp;Arda Isik,&nbsp;Virginia Boccardi","doi":"10.1007/s40520-026-03461-w","DOIUrl":"10.1007/s40520-026-03461-w","url":null,"abstract":"<div><h3>Background</h3><p>Chronological age remains widely used in perioperative decision-making but incompletely captures the biological heterogeneity that influences postoperative outcomes. Frailty has substantially advanced surgical risk assessment by shifting attention from age toward multidimensional vulnerability and diminished physiological reserve. Nevertheless, patients with similar frailty profiles often experience markedly different recovery trajectories, suggesting that baseline vulnerability alone may not fully explain postoperative adaptation.</p><h3>Methods</h3><p>This narrative conceptual review was developed through a targeted search of PubMed/MEDLINE, Scopus, and Google Scholar, focusing on frailty, physiological reserve, physical resilience, intrinsic capacity, prehabilitation, and postoperative recovery. Peer-reviewed clinical studies, reviews, and conceptual frameworks from geroscience and perioperative medicine were synthesized to develop an integrated model of surgical resilience.</p><h3>Results</h3><p>Emerging evidence indicates that frailty and resilience represent related but distinct constructs. Frailty primarily identifies vulnerability before stress exposure, whereas resilience reflects the dynamic capacity to withstand, adapt to, and recover from physiological perturbation. Recent perioperative studies suggest that postoperative outcomes are influenced not only by baseline reserve but also by the interaction between reserve, surgical stress exposure, and recovery capacity. Within this framework, skeletal muscle function, nutritional status, cognition, inflammatory burden, and functional independence appear to contribute to an individual’s adaptive potential. Surgery represents a uniquely informative human model through which stress–response biology and recovery trajectories can be studied longitudinally.</p><h3>Conclusions</h3><p>We propose surgical physiological resilience as a dynamic stress–recovery phenotype emerging from the interaction among three interconnected domains: baseline reserve, surgical stress load, and recovery capacity. This framework extends current frailty-based approaches by incorporating longitudinal adaptation and recoverability after surgical stress. Reframing perioperative medicine around resilience may support trajectory-based risk stratification, targeted prehabilitation strategies, longitudinal functional monitoring, and the future development of a dynamic Surgical Resilience Index capable of capturing postoperative heterogeneity more accurately than chronological age or static vulnerability measures alone.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-026-03461-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148534945","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":"Biological age-acceleration in relation to muscle mass, strength and function: findings from the Hertfordshire Cohort Study","authors":"Faidra Laskou,&nbsp;Leo D. Westbury,&nbsp;Negusse Kitaba,&nbsp;John W. Holloway,&nbsp;Elaine M. Dennison,&nbsp;Nicholas R. Fuggle","doi":"10.1007/s40520-026-03457-6","DOIUrl":"10.1007/s40520-026-03457-6","url":null,"abstract":"<div><h3>Introduction</h3><p>Sarcopenia, the accelerated loss of muscle mass, strength and function with age, is associated with adverse health outcomes. DNA methylation accumulates across life and methylation clocks (which provide a measure of biological age) could potentially be used to predict individuals at high sarcopenia risk. In this study, we examined biological age-acceleration measures in relation to sarcopenia components.</p><h3>Methods</h3><p>Overall, 331 participants from the UK community-dwelling Hertfordshire Cohort Study were analysed. At baseline (1998–2004), participants underwent health assessments and provided blood samples. At follow-up (2011-12), appendicular lean mass (ALM) index was ascertained using DXA; muscle strength by grip dynamometry; and gait speed over 8ft (2.44 m). DNA was extracted from peripheral blood leukocytes and DNA methylation at CpG sites was measured using the Infinium Human Methylation Beadchip array. Methylation clock measures were ascertained, and examined in relation to grip strength, gait speed and ALM index using linear regression, and in relation to a sarcopenia score (number of sarcopenia components) using Poisson regression. Baseline age, follow-up time, height and BMI were included as adjustments.</p><h3>Results</h3><p>At baseline, mean (SD) age was 65.1 (2.8) years. Among males, greater age-acceleration was related to lower grip strength; the standard deviation (SD) difference in grip strength per SD increase in age-acceleration was − 0.16 (-0.32, -0.01) for Principal Component (PC) PhenoAge and − 0.16 (-0.31, -0.01) for bAge. Associations regarding grip strength among females, and for gait speed and ALM index among both males and females were weak. The multiplicative increase in sarcopenia score per SD increase in age-acceleration among females was 1.23 (1.04, 1.45) for PCHorvath1, and 1.20 (1.02, 1.41) for PCHorvath2 (<i>p</i> = 0.02 for both associations).</p><h3>Conclusions</h3><p>Greater age-acceleration was related to lower grip strength among males only, and associations regarding gait speed and ALM index were weak among both sexes. Greater baseline biological age-acceleration was related to a higher sarcopenia score among females. These findings require further investigation in larger cohorts.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-026-03457-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148496943","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":"Machine learning–based prediction of hospital-associated complications after tibial fracture surgery in older patients: a nationwide Japanese database study","authors":"Akio Shimizu,&nbsp;Ryota Sakamoto,&nbsp;Hirofumi Nagayama,&nbsp;Ryo Momosaki","doi":"10.1007/s40520-026-03460-x","DOIUrl":"10.1007/s40520-026-03460-x","url":null,"abstract":"<div><h3>Background</h3><p>Older adults requiring emergency surgery for acute tibial fractures are vulnerable to hospital-associated complications (HACs), but admission-time risk stratification tools are lacking. We aimed to characterize HACs and develop both an ensemble prediction model and a simplified bedside risk score.</p><h3>Methods</h3><p>This retrospective cohort study used the Japanese Diagnosis Procedure Combination database provided by JMDC Inc. Patients aged ≥ 65 years emergently admitted for tibial fracture (ICD-10: S82, 2014–2025) who underwent surgery within 5 days, with stay &gt; 5 days, were included. The primary outcome was composite HACs during index hospitalization. Missing data were handled with multiple imputation. A Super Learner ensemble was developed and evaluated on held-out test data, and a simplified scorecard was derived using analysis of variance (ANOVA)-based feature selection and Weight-of-Evidence transformation.</p><h3>Results</h3><p>Among 53,186 admissions, 5,193 met eligibility criteria. HACs occurred in 851 patients (16.4%), most commonly delirium (7.5%) and falls/trauma (5.7%). The Super Learner achieved a test-set area under the receiver operating characteristic curve (AUC) of 0.740 (95% CI 0.707–0.772), higher than conventional linear logistic regression (0.724). The most influential predictors were Hospital Frailty Risk Score, dementia, Barthel Index, comorbidity burden, and days to surgery. The simplified 7-variable scorecard achieved a test-set AUC of 0.736 (95% CI 0.703–0.769), stratifying patients into five risk groups (HAC rate: 3.45%–38.64%).</p><h3>Conclusions</h3><p>HAC risk after emergency tibial fracture surgery in older adults was driven primarily by geriatric vulnerability rather than fracture-specific factors. A simplified admission-time score may support targeted prevention, pending external validation.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-026-03460-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468324","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":"Current evidence on the core components of the geriatric rehabilitation process: a systematic review","authors":"Martin Skoumal,&nbsp;Martina Honegger,&nbsp;Stefan Grund,&nbsp;Petra Benzinger,&nbsp;Stefan Bachmann,&nbsp;Thomas Münzer,&nbsp;Stefan Goetz,&nbsp;Thomas E. Dorner,&nbsp;Christoph Pertinatsch,&nbsp;Britta Neubacher,&nbsp;Christof Kadane,&nbsp;Sonja Lindner-Rabl,&nbsp;Regina Roller-Wirnsberger","doi":"10.1007/s40520-026-03450-z","DOIUrl":"10.1007/s40520-026-03450-z","url":null,"abstract":"<div><h3>Background</h3><p>Geriatric rehabilitation (GR) is a key component of integrated care for older persons with multimorbidity, yet its fundamental care process and core components that enable effective GR remain poorly defined and highly variable.</p><h3>Methods</h3><p>We conducted a systematic review (Registration ID: PROSPERO 2025 CRD42025642761) to identify and synthesise evidence on core components of the GR care process. Medline, CINAHL, Cochrane and Embase were searched to 31 January 2025. Randomised controlled trials (RCTs) and controlled prospective cohort studies involving multimorbid geriatric patients undergoing multidisciplinary GR programmes were included. Study quality was assessed using the JBI critical appraisal tool.</p><h3>Results</h3><p>Thirty-six studies (31 RCTs and 5 controlled prospective cohort studies), comprising 10,647 patients, met the inclusion criteria. Studies represented a broad range of GR service types. Substantial heterogeneity was observed in reported care processes, including terminology, team composition, workflow, contextual factors, and assessment methods, with over 90 different tools used. Comprehensive geriatric assessment (CGA) was rarely reported, patients with moderate to severe dementia were frequently excluded, and no study described the entire GR care process in a holistic manner.</p><h3>Discussion</h3><p>Current evidence shows substantial heterogeneity and fragmentation in the description and implementation of the GR care process, with variable depth of implementation, team structures and assessments. The lack of reproducible process structures and clearly defined core components limits comparability, implementation, and evaluation.</p><h3>Conclusion</h3><p>Future research should adopt study designs spanning the full GR pathway across settings, incorporate standardised process indicators, a toolbox of CGA and goal-setting instruments and evaluate outcomes aligned with the biopsychosocial principles of the ICF.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-026-03450-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148443834","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}