Archives of gerontology and geriatrics最新文献

{"title":"An overview of care coordination elements for older adults with long-term care needs: A narrative review","authors":"Natasha Grande de França ,&nbsp;Philipe de Souto Barreto ,&nbsp;Hyobum Jang ,&nbsp;Matteo Cesari ,&nbsp;Yves Rolland","doi":"10.1016/j.archger.2025.106077","DOIUrl":"10.1016/j.archger.2025.106077","url":null,"abstract":"<div><h3>Aims</h3><div>Care coordination is crucial in long-term care (LTC) as it contributes to patient-centered, high-value, and high-quality care. This review presents an overview of how care coordination for older adults with long-term needs is described in the literature.</div></div><div><h3>Methods</h3><div>This narrative review focused on older adults receiving LTC in institutional settings and the community. A comprehensive and structured search was conducted in PubMed in January 2025 using a combination of key and indexed terms related to care coordination, long-term care, and older adults.</div></div><div><h3>Results</h3><div>We retained 56 articles published between 1988 and 2024. Most of the information was from North American programs designed for community-dwelling older persons. Description of care coordination is lacking in middle and low-income countries, with limited information on institutional settings. Coordination is commonly performed by a designated health or social worker, responsible for assessing, developing, and monitoring the care plan with the support of a multidisciplinary team (not always including a geriatrician) and electronic health records. Care coordination can be challenging to translate into practice, mainly due to limited time availability and a lack of specific training. Communication across care settings and among the staff is frequently fragmented, partial, and unstandardized.</div></div><div><h3>Conclusions</h3><div>Care systems for older persons living in the community seem to apply fundamental elements of care coordination. However, their implementation in real life is challenging. The current information on care coordination is not well-documented at the global level, especially in LTC facilities, highlighting the need for more attention to this aspect of care.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106077"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464806","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":"Exercise upregulates Mitsugumin 53 and ameliorates behavioral deficits and mitochondrial biogenesis in a sporadic Alzheimer's disease model in rats","authors":"Muaz Belviranlı,&nbsp;Nilsel Okudan,&nbsp;Tuğba Sezer","doi":"10.1016/j.archger.2025.106078","DOIUrl":"10.1016/j.archger.2025.106078","url":null,"abstract":"<div><div>Chronic physical exercise is a promising non-pharmacological strategy to mitigate the progression of Alzheimer's disease (AD), yet the underlying molecular mechanisms remain incompletely understood. This study investigated the effects of chronic treadmill exercise on behavioral deficits and key molecular pathways in a d-galactose and AlCl₃-induced rat model of sporadic AD. Animals were assigned to control, AD, exercise and AD + exercise (AE) groups for a ten-week intervention. Behavioral assessments included the elevated plus maze and Morris Water Maze, followed by molecular and biochemical analyses (RT-qPCR, ELISA) of the hippocampus, skeletal muscle, and plasma. Our results demonstrate that the AD model induced profound cognitive impairments, diminished locomotor activity, heightened anxiety-like behavior, and elevated plasma tau levels. These pathological changes were accompanied by a significant downregulation of the AMPK/SIRT1/PGC-1α mitochondrial biogenesis pathway and, notably, a marked suppression of the membrane repair protein Mitsugumin 53 (MG53) in both the hippocampus and skeletal muscle. The physical exercise regimen successfully ameliorated these behavioral deficits and normalized plasma tau. Mechanistically, physical exercise potently upregulated the AMPK/PGC-1α/FNDC5/BDNF axis in both central and peripheral tissues. Crucially, this study reveals for the first time that physical exercise also triggers a robust upregulation of MG53 at both the gene and protein levels in the brain, muscle, and circulation. These findings identify the physical exercise-induced mobilization of MG53 as a novel and powerful neuroprotective mechanism, linking systemic cellular repair capacity to the enhancement of cognitive resilience against AD.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106078"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464804","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":"Bidirectional transitions of frailty states in middle-aged and older adults: Findings from two longitudinal cohorts studies","authors":"Sutong Wang ,&nbsp;Lin Wang ,&nbsp;Yongcheng Wang ,&nbsp;Xiaoyu Su ,&nbsp;Feihu Zhang ,&nbsp;Shuli Zong ,&nbsp;Lei Qi ,&nbsp;Yuehua Jiang ,&nbsp;Jifu He ,&nbsp;Xiao Li","doi":"10.1016/j.archger.2025.106085","DOIUrl":"10.1016/j.archger.2025.106085","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to characterize frailty dynamics in older adults by applying multi-state Markov models (MSMs) to English Longitudinal Study of Ageing (ELSA) and the China Health and Retirement Longitudinal Study (CHARLS) data to estimate transition intensities.</div></div><div><h3>Methods</h3><div>Data from ELSA (2004–2012) and CHARLS (2011–2018) cohorts were analyzed using MSMs. Frailty was assessed using the Frailty Index (FI), and covariates like age, sex, marital status, physical activity, and economic status were included. Transition probabilities between frailty states were estimated, and subgroup analyses were performed to assess the influence of covariates on frailty transitions.</div></div><div><h3>Results</h3><div>A total of 8 187 participants from ELSA, and 9 171 participants from CHARLS were included in the analysis. In ELSA, the transition intensity from pre-frail to robust (0.226, 95 % CI 0.217–0.234) exceeded that from pre-frail to frail (0.105, 95 % CI 0.099–0.111), whereas in CHARLS a different pattern was observed. In the covariate analysis, we found that age, marital status, loneliness, physical activity, current drinking status, and economic status exerted both common and cohort-specific effects on frailty transitions in ELSA and CHARLS, with age and marital status influencing bidirectional frailty transitions in both cohorts.</div></div><div><h3>Conclusion</h3><div>Frailty is reversible, especially in the pre-frail stage. Transition intensities and influencing factors vary across older adult cohorts in different countries, and beyond age, marital support, physical activity quality, and economic status significantly shape frailty trajectories and should be incorporated into public health policy design.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106085"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575002","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":"Cognitive decline before and after incident depression: Evidence from three international prospective cohorts","authors":"Xiaoyu Qian ,&nbsp;Congdi Wang ,&nbsp;Xueman Zhao ,&nbsp;Min Jin ,&nbsp;Yonghao Xiao ,&nbsp;Ziwang Zhou ,&nbsp;Feifei Jia","doi":"10.1016/j.archger.2025.106086","DOIUrl":"10.1016/j.archger.2025.106086","url":null,"abstract":"<div><h3>Background</h3><div>Depression and cognitive decline frequently co-occur in late life, potentially reflecting shared biological, psychological, or social pathways. However, their temporal relationship remains unclear. Understanding how cognitive deterioration and depression unfold over time may inform prevention and intervention strategies.</div></div><div><h3>Methods</h3><div>This cohort study analyzed 40,167 older adults without baseline depression from CHARLS, HRS, and SHARE (2010–2021). Depressive symptoms were assessed using validated scales. Cognitive function was assessed across memory, executive function, and orientation, and standardized as z-scores. Linear mixed models estimated cognitive trajectories before, at, and after depression onset.</div></div><div><h3>Results</h3><div>Across 401,017.8 person-years, 10530 participants developed depression. Compared with non-depressed individuals, those with depression onset showed faster cognitive decline before onset, acute decline at onset, and accelerated decline thereafter across all cognitive domains (P &lt;0.001).</div></div><div><h3>Discussion</h3><div>Cognitive decline precedes, accompanies, and accelerates after the onset of depression among older adults. These findings suggest that cognitive impairment may be an early signal associated with depression risk, highlighting the importance of routine cognitive monitoring in preventive mental health strategies.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106086"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590270","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":"Social vulnerability increases the risk of death differently in men and women: longitudinal analysis over 15 years in the Paquid Study","authors":"Camille Ouvrard ,&nbsp;Ivane Koumetio Jiatsa ,&nbsp;Antoine Gbessemehlan ,&nbsp;Yvanna Simon ,&nbsp;Luc Letenneur ,&nbsp;Jean-François Dartigues ,&nbsp;Melissa K Andrew ,&nbsp;Hélène Amieva ,&nbsp;Karine Pérès","doi":"10.1016/j.archger.2025.106079","DOIUrl":"10.1016/j.archger.2025.106079","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Social vulnerability (SV) is a multidimensional construct associated with adverse health outcomes, including mortality. However, little is known about how SV differentially affects older men and women.</div></div><div><h3>Research design and methods</h3><div>We analyzed data from 3695 community-dwelling older adults from the Paquid cohort, followed for 15 years. SV was assessed using a 26-item SV Index (SVI), categorized into low, moderate, and high levels. Delayed-entry Cox models stratified by gender were used to estimate mortality risk, adjusting for disability, history of ischemic heart disease, dyspnea, diabetes, and cognitive impairment. Associations between SV subdimensions and mortality were also examined separately by gender.</div></div><div><h3>Results</h3><div>Women accumulated more social deficits than men (40 % vs. 21 % with high SV). High SV was associated with a 21–25 % increased mortality risk in both genders. However, moderate SV is significantly associated with an increased mortality risk only in men (adjusted Hazard Ratio = 1.25, 95 % CI: 1.09–1.44 vs. aHR = 0.96, 95 % CI: 0.81–1.13 in women). Among subdimensions, low socioeconomic status and poor leisure activity engagement were the strongest mortality predictors in men–even at moderate levels (result marginally significant for leisure activities, <em>p</em> = 0.073). In women, poor engagement in leisure activities and negative psychological experience were the main predictors of mortality; low socioeconomic status (SES) showed a trend-level association (<em>p</em> = 0.045).</div></div><div><h3>Discussion and implications</h3><div>Despite greater SV, women seem to withstand moderate social deficits better than men. These findings highlight the need for further studies to explain gender differences and develop gender-sensitive public health interventions.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106079"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518340","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":"SGLT2 inhibitors versus DPP-4 inhibitors and dementia risk in type 2 diabetes: A meta-analysis of cohort studies","authors":"Zhaoshuang Zhong ,&nbsp;Shijie Zhao ,&nbsp;Wei He ,&nbsp;Rongmei Li ,&nbsp;Shuyue Xia","doi":"10.1016/j.archger.2025.106065","DOIUrl":"10.1016/j.archger.2025.106065","url":null,"abstract":"<div><h3>Background</h3><div>Sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown neuroprotective potential. This meta-analysis aimed to compare the effects of SGLT2 inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors on dementia risk in patients with type 2 diabetes mellitus (T2DM).</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science was conducted from inception through May 2025. Cohort studies comparing dementia incidence in T2DM patients treated with SGLT2 inhibitors versus DPP-4 inhibitors were included. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Data were pooled using a random-effects model in STATA 12.0, with incidence rate ratios (IRRs) and 95 % confidence intervals (CIs) calculated for dementia outcomes.</div></div><div><h3>Results</h3><div>Eight cohort studies (1275,257 participants) were analyzed. SGLT2 inhibitor use was associated with a 33 % lower risk of all-cause dementia compared to DPP-4 inhibitors (I² = 0.0 %, <em>P</em> = 0.816; IRR = 0.666; 95 % CI: 0.484–0.918; <em>P</em> &lt; 0.05). Subgroup analyses indicated non-significant risk reductions for Alzheimer’s disease (I² = 0.0 %, <em>P</em> = 0.994; IRR = 0.654; 95 % CI: 0.352–1.212; <em>P</em> = 0.177) and vascular dementia (I² = 0.0 %, <em>P</em> = 0.971; IRR = 0.573; 95 % CI: 0.204–1.605; <em>P</em> = 0.289).</div></div><div><h3>Conclusions</h3><div>SGLT2 inhibitors are associated with a significantly reduced risk of all-cause dementia in T2DM patients compared to DPP-4 inhibitors. While trends favoring SGLT2 inhibitors were observed for dementia subtypes, further long-term studies are needed to confirm these associations.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106065"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460889","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":"Meaning in life and Parkinson’s disease: Evidence from a 17-year study across 14 countries","authors":"Selin Karakose ,&nbsp;Antonio Terracciano ,&nbsp;Martina Luchetti ,&nbsp;Yannick Stephan ,&nbsp;Angelina R. Sutin","doi":"10.1016/j.archger.2025.106062","DOIUrl":"10.1016/j.archger.2025.106062","url":null,"abstract":"<div><h3>Background</h3><div>Meaning in life is associated consistently with a reduced risk of incident Alzheimer’s disease and related dementias. It also changes across the disease continuum. Less work has examined the association between meaning in life and Parkinson’s disease and the natural history of meaning with onset of Parkinson’s disease has yet to be evaluated. This study examines the prospective association between meaning in life and incident Parkinson’s disease and evaluates changes in meaning in life prior and after onset of Parkinson’s disease.</div></div><div><h3>Methods</h3><div>This prospective cohort study used assessments of meaning in life and incident Parkinson’s disease from 2004 to 2022 in the Survey of Health, Ageing and Retirement in Europe. Meaning in life was measured with a single-item measure from the Control, Autonomy, Self-realization and Pleasure scale. Parkinson’s disease was self/proxy-reported doctor diagnosis up to 2022.</div></div><div><h3>Results</h3><div>Accounting for age, sex, and education, greater meaning in life was associated with lower risk of developing incident Parkinson’s disease over up to 17 years follow-up. This association was accounted for behavioral, clinical, and psychological factors. Accounting for demographic differences and normative changes that occur in meaning, meaning in life did not decline significantly before the onset of Parkinson’s disease but showed a significant and accelerated decline following disease onset.</div></div><div><h3>Conclusions</h3><div>Behavioral, clinical, and psychological risk factors accounted for the association between meaning in life and risk of Parkinson’s disease. Meaning in life levels remained stable before Parkinson’s disease’s onset but declined significantly afterward, paralleling the worsening of psychological outcomes in Parkinson’s disease.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106062"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145384574","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":"An explainable machine learning model for comorbidity risk stratification in patients with fractures admitted to the intensive care unit: a multicenter study","authors":"Xuelong Liang ,&nbsp;Weijie Zhao ,&nbsp;Weigui Liufu ,&nbsp;Jiale Qian ,&nbsp;Nantian Xiang ,&nbsp;Xinzhe Zhang ,&nbsp;Jihui Zhou ,&nbsp;Hongwang Cui","doi":"10.1016/j.archger.2025.106082","DOIUrl":"10.1016/j.archger.2025.106082","url":null,"abstract":"<div><h3>Background</h3><div>Among traumatic-fracture patients admitted to intensive care units (ICUs), those with substantial chronic comorbidities recover more slowly and die more often than their counterparts without such conditions. The age-adjusted Charlson Comorbidity Index (aCCI) quantifies this burden, yet clinicians still lack a tool that can identify—at the point of ICU admission—which fracture patients are likely to have a high aCCI. To fill this gap, we used a large electronic health-record repository to develop and externally validate an interpretable machine-learning model that predicts severe comorbidity burden in this population.</div></div><div><h3>Methods</h3><div>We extracted 3 763 adult fracture cases from MIMIC-IV (2008–2019) and split them 3:1 into training and internal validation sets. High comorbidity (aCCI ≥ 7) was defined as the optimal cut-off derived from one-year survival analysis. Nine key predictors emerged from the intersection of LASSO, SVM-RFE, and random-forest importance. Eleven candidate algorithms underwent grid-search hyperparameter tuning with 10-fold cross-validation, and their performance was compared to identify the optimal model, while SHAP clarified model logic. External validation in two Chinese tertiary centres (<em>n</em> = 558) confirmed generalisability, and the final model was deployed as a bedside Shiny calculator.</div></div><div><h3>Results</h3><div>XGBoost achieved the best internal discrimination (AUROC = 0.84; AUPRC = 0.76) and exhibited excellent calibration and net benefit across clinically relevant thresholds. In external validation, AUROC values were 0.88 (Hainan) and 0.83 (Guangdong). The interactive calculator delivers patient-specific risk explanations in real time.</div></div><div><h3>Conclusions</h3><div>An XGBoost-based, SHAP-interpretable model accurately predicts high aCCI in ICU fracture patients and generalises across institutions. The readily accessible web tool can help clinicians identify high-risk individuals early, personalise management, and allocate resources more efficiently.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106082"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552264","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":"Actions to control the fear of falling in older people: An umbrella review","authors":"Ana Rita Capela Oliveira ,&nbsp;Carla Maria Pintado Magueja ,&nbsp;Armando Manuel Gonçalves de Almeida","doi":"10.1016/j.archger.2025.106087","DOIUrl":"10.1016/j.archger.2025.106087","url":null,"abstract":"<div><h3>Background</h3><div>Fear of falling in older adults is a multifactorial psychological condition associated with the degree of confidence in performing activities of daily living without falling, leading to reduced physical activity, quality of life, and life satisfaction, and resulting in social isolation.</div></div><div><h3>Purpose</h3><div>This study aimed to summarize and evaluate effective actions to control fear of falling in older adults.</div></div><div><h3>Method</h3><div>An umbrella review of interventions that control fear of falling in people aged ≥60 years was conducted, in accordance with JBI and PRISMA guidelines. The search was conducted in six electronic databases: CINAHL, Web of Science, MEDLINE, Scopus, Cochrane Reviews, and JBI Databases, during the period from February to April 2024.</div></div><div><h3>Results</h3><div>Of a total of 706 references identified, 25 met the eligibility criteria. Of those included, eleven studies are systematic review, three studies are meta-analysis, and eleven studies are systematic review with meta-analysis. Five types of action to control fear of falling with therapeutic potential were identified: Physical and functional therapy; Cognitive Behavioral Therapy; Combined strategies; Multifactorial preventive programs; Technological interventions.</div></div><div><h3>Conclusions</h3><div>The results of this umbrella review indicate that holistic exercises (Tai Chi, Yoga, Pilates) are the most effective in mitigating fear of falling in older adults. Interventions that incorporate multimodal approaches also appear to be beneficial. The combination of physical and cognitive actions is widely recognized as effective and long-lasting. Longitudinal studies are needed to assess the effectiveness of actions over time.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106087"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607843","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":"Non-pharmacological interventions for preventing delirium in older adults in intensive care units: a systematic review and network meta-analysis","authors":"Hu Lizi,&nbsp;Wang Qingyuan,&nbsp;Wang Shuyao,&nbsp;Wang Dan,&nbsp;Hua Kang","doi":"10.1016/j.archger.2025.106075","DOIUrl":"10.1016/j.archger.2025.106075","url":null,"abstract":"<div><h3>Objective</h3><div>This study compares the effects of non-pharmacological interventions on delirium incidence and other outcomes in elderly patients in ICU.</div></div><div><h3>Methods</h3><div>A comprehensive search of eight electronic databases to identify randomized controlled trials (RCTs). The search covered studies from the inception to June 2024. Two reviewers independently screened titles and abstracts according to pre-defined inclusion and exclusion criteria. The analysis was conducted using Stata (version 15.0).</div></div><div><h3>Results</h3><div>A total of 38 studies involving 7229 critically ill patients and 12 interventions were included. While the network meta-analysis results suggest that nurse-led cluster nursing is the superior intervention for reducing delirium incidence (SUCRA=80.5 %), delirium duration (SUCRA=92.2 %), and mechanical ventilation duration (SUCRA=84.4 %) in elderly patients, it’s important to note that physical exercise (SUCRA=92.9 %) and cluster care (SUCRA=82.4 %) also demonstrated significant effects in decreasing ICU stay duration. However, these findings should be approached with caution.</div></div><div><h3>Conclusion</h3><div>Our findings indicated that nurse-led cluster nursing showed reliable performance in managing outcome indicators of delirium in the elderly. Our study provides important evidence for clinical medical staff to optimize intensive care programs, but the results should be interpreted with caution.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106075"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518338","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}