BMC Geriatrics最新文献

{"title":"Construction of an evaluation indicator system for humanistic care quality in nursing homes.","authors":"Chenglei Wu, Sisi Zhang, Huiqi Chen, Jing Yu, Jingru Song, Yanan Shi, Qin Shen","doi":"10.1186/s12877-026-07623-3","DOIUrl":"https://doi.org/10.1186/s12877-026-07623-3","url":null,"abstract":"<p><strong>Background: </strong>The implementation of humanistic care services in nursing homes is of great importance for improving the quality of life of older people, enhancing their sense of self-worth, and meeting their spiritual and psychological needs. However, there is currently a lack of standardized criteria and validated tools for the systematic assessment of the quality of humanistic care in nursing homes. Therefore, the aim of this study was to develop a comprehensive indicator system for evaluating the quality of humanistic care in nursing homes.</p><p><strong>Methods: </strong>Guided by the Quality Caring Model and Maslow's hierarchy of needs theory as the theoretical framework, an initial evaluation indicator system was developed through a literature review and semi-structured interviews. Based on the preliminary indicator system, an expert consultation questionnaire was designed, and two rounds of Delphi expert consultation were conducted with 32 experts from relevant fields to further refine and optimize the evaluation indicator system by integrating expert opinions. Subsequently, the Analytic Hierarchy Process was applied to determine the weight of each indicator, and consistency testing was performed.</p><p><strong>Results: </strong>The effective recovery rates of the two rounds of expert consultation questionnaires were 94.12% and 100.00%, respectively, and the expert authority coefficients were 0.850 and 0.859. The Kendall's coefficients of concordance for the two rounds of expert consultation were 0.167 and 0.269, respectively (P < 0.001). Ultimately, a quality evaluation indicator system for humanistic care in nursing homes was established, comprising 3 primary-level indicators, 10 secondary-level indicators, and 38 tertiary-level indicators.</p><p><strong>Conclusion: </strong>The quality evaluation indicator system for humanistic care in nursing homes developed in this study demonstrates a certain degree of scientific rigor and rationality. It can provide a theoretical reference for promoting the standardization of humanistic care processes and the systematization of quality management in nursing homes in China, and offers a systematic framework for the subsequent evaluation and improvement of the quality of humanistic care.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855611","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":"Implicit rationing of nursing care in Turkish public nursing homes and rehabilitation centres: a cross-sectional analysis.","authors":"Şirin Özkan, Zeynep Acar, Güven Özkaya, Franziska Zúñiga, Lisa Geyskens, Mieke Deschodt","doi":"10.1186/s12877-026-07576-7","DOIUrl":"https://doi.org/10.1186/s12877-026-07576-7","url":null,"abstract":"<p><strong>Background: </strong>Implicit rationing of nursing care refers to situations in which healthcare workers must delay, postpone, or omit required nursing activities due to limited resources. İmplicit rationing of nursing care is particularly important in nursing homes, where it is associated with poorer resident outcomes, increased adverse events, preventable hospitalisations, and negative consequences for care providers such as emotional exhaustion and job dissatisfaction. This study aimed to describe the prevalence and types of implicit rationing of nursing care in public nursing homes and rehabilitation centers (NHRC) in Türkiye, and to analyse its associations with nurses' and geriatric care workers' professional experience, work experience in the institution, and geriatric care training level.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in six NHRCs across different provinces in Türkiye. The Basel Extent of Rationing of Nursing Care for Nursing Homes (BERNCA-NH) instrument was used to assess the frequency of implicit rationing of nursing care. Categorical variables were summarised with frequencies and percentages, continuous variables with means and standard deviations, and responses to the open-ended question were analysed using qualitative content analysis.</p><p><strong>Results: </strong>Of the 489 eligible nurses and geriatric care workers, 280 (57%) participated in the study. Rationing of nursing care rates ranged from 9.3% to 51.9% across different activities. Assisting with eating or drinking was the least rationed activity, while social care activities, such as \"cultural activity for residents with contact outside of the nursing home\", were rationed the most. Significant associations were found between implicit rationing of activities and characteristics such as total professional experience, working experience at the same institution, and level of geriatric care training. The main reasons for implicit rationing included tasks out of professional scope, heavy workloads, insufficient staffing, and low motivation.</p><p><strong>Conclusions: </strong>Implicit rationing of nursing care remains a challenge in NHRCs in Türkiye. To reduce the implicit rationing of nursing care, the roles and responsibilities of care workers with different training levels may need clearer definition in nursing homes, and their competencies can be enhanced through in-service training programs.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855654","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":"Vancomycin-induced acute kidney injury in older Chinese patients: a multicenter retrospective cohort study.","authors":"Ying Zhang, Yuzhu Wang, Sunhui Zhou, Chengchun Zuo, Xingyun Hou, Jie Li, Xiaoqiang Ding, Qianzhou Lv, Xiaoyu Li, Kunming Pan","doi":"10.1186/s12877-026-07596-3","DOIUrl":"https://doi.org/10.1186/s12877-026-07596-3","url":null,"abstract":"<p><strong>Background: </strong>Vancomycin-associated nephrotoxicity remains a major clinical concern, yet evidence in older patients is limited and largely derived from small single-center studies. This multicenter study aimed to evaluate the incidence, risk factors, and outcomes of vancomycin-induced acute kidney injury (VI-AKI).</p><p><strong>Methods: </strong>In this retrospective cohort study, patients aged ≥ 65 years who received vancomycin at three tertiary hospitals in Shanghai between 2009 and 2024 were included. AKI was defined according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Multivariable logistic regression was performed to identify independent risk factors. The primary outcome was VI-AKI incidence; secondary outcomes included renal recovery and all-cause mortality. A predefined subgroup analysis assessed the association between vancomycin trough concentrations and VI-AKI in patients undergoing therapeutic drug monitoring (TDM).</p><p><strong>Results: </strong>Among 3,762 patients, VI-AKI occurred in 640 (17.0%). Independent risk factors included age > 75 years, heart failure, baseline renal insufficiency, multiple organ failure, hypoproteinemia, intensive care unit admission, sepsis, vancomycin dose > 2 g/day, and concomitant use of aminoglycosides or piperacillin-tazobactam (all P < 0.05). Complete renal recovery occurred in 21.9% of patients and was less likely in those with stage 3 AKI (OR 0.43, P = 0.012), while acetylcysteine use was associated with a higher likelihood of recovery (OR 2.42, P = 0.009). In the TDM subgroup (n = 433), VI-AKI incidence was 25.9%, and trough concentrations ≥ 17.3 mg/L were independently associated with increased risk (OR 3.02, P < 0.001).</p><p><strong>Conclusion: </strong>VI-AKI is common in older adults receiving vancomycin and is associated with multiple clinical and treatment-related factors. The low rate of renal recovery underscores the need for early risk stratification and optimized therapeutic drug monitoring in this population.</p><p><strong>Trial registration: </strong>This clinical trial was registered in the Chinese Clinical Trial Registry (ChiCTR) with the identifier ChiCTR2400094474 on 23 December 2024.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833399","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":"Unconventional multi-morbidity patterns in older adults: results from 39,172 Chinese health examination population at primary healthcare centers.","authors":"Kangjun Wu, Yujian Lu, Anping Liu, Yuefang Wang, Xiandong Shen","doi":"10.1186/s12877-026-07387-w","DOIUrl":"https://doi.org/10.1186/s12877-026-07387-w","url":null,"abstract":"<p><strong>Background: </strong>Multi-morbidity is prevalent among the elderly, yet specific co-occurrence patterns remain unclear. While prior studies have predominantly focused on cardiometabolic disease clusters, this study aimed to explore the proportion of recorded diagnoses of common diseases and identify unconventional multi-morbidity patterns among older adults at primary healthcare settings using electronic health records.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using data from regional health information platform in eastern China. Participants aged ≥ 65 years who underwent at least one health examination at primary healthcare setting in 2022 were included. Association rule mining integrated with the hypertext-induced topic search framework was employed to identify disease co-occurrence patterns, weighting participants and diseases based on network connectivity. Twelve common diseases were analyzed, stratified by sex and age.</p><p><strong>Results: </strong>There were 39,172 individuals enrolled in this study. Significant sex and age differences were found in most diseases, with hypertension, hyperlipidemia, cataract and other diseases accounting for 56.48%, 36.02%, 21.33% and 13%-20% of the overall proportion of recorded diagnoses. A total of 58 association rules met the predefined thresholds among the whole population. Beyond cardiometabolic clusters (hypertension or hyperlipidemia co-occurrence), we identified strong associations within inflammatory diseases (osteoporosis and arthritis) and between gastrointestinal conditions and sleep disorders (chronic gastritis, constipation, and sleep disorder). Patterns were consistent across sex and age subgroups.</p><p><strong>Conclusion: </strong>Multi-morbidity patterns in Chinese older adults extend beyond traditional cardiovascular risks to include inflammatory and gut-sleep clusters. These findings suggest the potential value of considering cluster-based care pathways and may inform the integration of sleep screening into gastrointestinal management in primary healthcare settings.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833420","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":"Determinants of malnutrition in older hospitalized patients: a prospective multicenter study with the DoMAP model.","authors":"Maryam Pourhassan, Stefan Pfannkuch, Kiril Stoev, Maria Schnepper, Isabel Levermann, Baigang Wang, Chantal Giehl, Ulrike Trampisch, Lukas Funk, Ilse Gehrke, Wolfried Schröer, Dorothee Volkert, Rainer Wirth","doi":"10.1186/s12877-026-07612-6","DOIUrl":"10.1186/s12877-026-07612-6","url":null,"abstract":"<p><strong>Background: </strong>Few studies have assessed the full spectrum of potential causes of malnutrition in older hospitalized patients using a standardized framework. Applying the \"Determinants of Malnutrition in Aged Persons\" (DoMAP) model, this study aimed to quantify the prevalence of specified determinants and compare their distribution between malnourished and non-malnourished patients, thereby identifying the most important determinants.</p><p><strong>Methods: </strong>This multicenter, cross-sectional, prospective, observational study was conducted in three geriatric acute care hospital units. Malnutrition was diagnosed using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Potential causes of malnutrition were assessed using the DoMAP model. This study was registered in the German Clinical Trials Register with the DRKS-ID: DRKS00030850 on December 14, 2022.</p><p><strong>Results: </strong>A total of 556 patients (mean age 82.5 ± 6.6 years; 67% women) were included. Malnourished patients exhibited a significantly higher prevalence of most determinants compared to non-malnourished patients, particularly low intake (89 vs. 49%), poor appetite (68 vs. 25%), inflammation (31 vs. 19%), gastrointestinal disease (29 vs. 11%), inflammatory disease (32 vs. 19%), and hospitalization (62 vs. 47%). The mean total determinants count was significantly higher in malnourished participants (12.5 ± 5.3) than in non-malnourished ones (10.1 ± 4.0; p < 0.001). Regression analysis revealed low intake as the strongest determinant at Level1; poor appetite, at Level2; gastrointestinal disease and oral pain at Level3, and anorexia of aging and hospitalization at Level4.</p><p><strong>Conclusion: </strong>The DoMAP model provides a structured framework for capturing the diverse etiologies of malnutrition in older patients. This study emphasizes the multifactorial nature of malnutrition in hospitalized patients, with low intake and poor appetite emerging as predominant drivers.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13154458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of AI-based conversational and socially assistive agents in older adults: a systematic review and meta-analysis.","authors":"Wenling Gou, Florian Lefebvre, Tongping Yang, Robin Recours, Jing Yang","doi":"10.1186/s12877-026-07418-6","DOIUrl":"https://doi.org/10.1186/s12877-026-07418-6","url":null,"abstract":"<p><strong>Background: </strong>Depression and loneliness are highly prevalent among older adults, yet access to timely and adequate mental health care remains limited in this population. Artificial intelligence-based conversational and socially assistive agents have emerged as a potentially scalable and cost-effective intervention; however, their effectiveness in alleviating depression and loneliness among older adults has not been comprehensively established. This systematic review and meta-analysis aimed to synthesize evidence from randomized controlled trials (RCTs) examining the effects of AI-based conversational and socially assistive agent interventions on depressive symptoms and loneliness in older adults.</p><p><strong>Methods: </strong>A systematic search of five electronic databases was conducted from inception to November 15, 2025, to identify RCTs evaluating AI-based conversational and socially assistive agent interventions targeting depression and/or loneliness in older adults. Random-effects meta-analyses were performed using standardized mean differences. Statistical heterogeneity was assessed using the I² statistic and further explored through subgroup analyses. Risk of bias was evaluated using the Cochrane Risk of Bias 2 tool, and the certainty of evidence was appraised using the GRADE framework.</p><p><strong>Results: </strong>Eight RCTs comprising 611 participants met the inclusion criteria. Compared with control conditions, AI-based conversational and socially assistive agent interventions were associated with a statistically significant reduction in depressive symptoms (Hedges' g = - 0.25, 95% CI - 0.48 to - 0.02; I² = 10.7%). In contrast, no significant effect was observed for loneliness, and substantial heterogeneity was detected across studies (Hedges' g = - 0.67, 95% CI - 2.57 to 1.23; I² = 89%). Subgroup analyses suggested that interventions with a cognitive focus yielded more consistent effects than companionship-focused approaches, while no clear differences were observed between home-based and institutional settings.</p><p><strong>Conclusions: </strong>AI-based conversational and socially assistive agent interventions appear to be effective in reducing depressive symptoms among older adults, whereas current evidence does not support a significant effect on loneliness. The effectiveness of these interventions may depend on their theoretical orientation and implementation characteristics. AI-based conversational and socially assistive agents may serve as a promising adjunct to conventional mental health care for older adults; however, further high-quality trials are needed to clarify their role in addressing loneliness and to optimize intervention design.</p><p><strong>Protocol registration: </strong>The protocol for this systematic review was registered in International Prospective Register of Systematic Reviews (PROSPERO identifier: CRD420261283098).</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833393","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":"Perceptions of nursing home staff, residents and relatives on the quality of person-centered care in Spain nursing homes across the COVID-19 Pandemic.","authors":"Pau Moreno-Martin, Rosa Noell-Boix, Iván Sánchez-Martínez, Javier Jerez-Roig, Xavier Gómez-Batiste, Jaume-Miquel March-Amengual","doi":"10.1186/s12877-026-07298-w","DOIUrl":"https://doi.org/10.1186/s12877-026-07298-w","url":null,"abstract":"<p><strong>Background: </strong>Person-Centered Care (PCC) has become established as an essential model in geriatric care, promoting the dignity, autonomy, and well-being of residents. However, the COVID-19 pandemic posed an unprecedented challenge to its implementation in nursing homes (NH), affecting both the quality of care and human relationships. This study analyzes the perceptions of residents, relatives, professionals, and directors regarding PCC before, during, and after the pandemic in Catalonia (Spain).</p><p><strong>Methods: </strong>A multicenter cross-sectional study was conducted in 30 NH across the 10 healthcare regions of Catalonia. Validated PCC in Gerontology Services model questionnaires were administered to 335 participants, including residents, relatives, professionals, and directors. Each item was retrospectively assessed at three time points: before, during, and after the pandemic. Descriptive, staffing, and pandemic-related variables from the facilities were collected. Statistical analyses included descriptive statistics, nonparametric tests for group comparisons, and bivariate associations assessed using Spearman's rank correlation coefficients.</p><p><strong>Results: </strong>During the COVID-19 pandemic, PCC scores dropped sharply-from 176 pre-pandemic to 136 during the crisis- before partially recovering to 171 post-pandemic, underscoring the substantial impact of the health emergency. Larger NHs and those with more months in \"red code\" experienced greater losses in PCC scores during the pandemic, while homes with a higher proportion of resident transfers showed smaller decreases. Additionally, NHs with a higher physician-to-resident ratio experienced larger decreases in PCC scores during the pandemic, while NHs that suffered greater losses in PCC scores tended to show greater post-pandemic recovery.</p><p><strong>Conclusion: </strong>This study confirms that PCC is particularly vulnerable during health crises such as the COVID-19 pandemic. The findings highlight the need for flexible organizational structures, adequate resources, and strong ethical guidance to ensure the sustainability of the PCC model and underscore the importance of contingency plans that maintain PCC without compromising residents' safety, dignity, or autonomy.</p><p><strong>Trail registration: </strong>Not applicable.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833385","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":"Non-linear relationship between BMI and eGFR at admission in elderly patients with hip fractures: a retrospective cross-sectional study.","authors":"Daxue Zhang, Jian Kang, Yongli Zhang, Ruiting Yan, Lijun Guo, Xuchun Li","doi":"10.1186/s12877-026-07608-2","DOIUrl":"https://doi.org/10.1186/s12877-026-07608-2","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies have found that the relationship between changes in BMI and renal function outcomes remains unclear, with both increases and decreases in BMI being associated with a decline in eGFR, especially in the elderly hip fracture population. Therefore, this study aimed to investigate the association between BMI and eGFR upon hospital admission in elderly patients with hip fractures, to better understand the underlying pathophysiological connections and provide a basis for clinical patient management.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study involving 1,417 elderly patients with hip fractures, collecting clinical data such as BMI and eGFR at admission. Generalized additive models, smooth curve fitting, and two-piecewise linear regression models were used to explore the linear and non-linear relationships between BMI and eGFR.</p><p><strong>Results: </strong>A total of 1,417 patients with hip fractures were included, with females accounting for 73.04%. The mean age of the patients was 77.57 ± 8.73 years. The mean eGFR was 80.23 ± 21.76 mL/min/1.73 m², and the mean BMI was 22.04 ± 3.25 kg/m². After adjusting for age, sex, fracture classification, number of comorbidities, smoking, hypertension, coronary heart disease, diabetes mellitus, white blood cell, lymphocyte, neutrophil, hemoglobin, red cell distribution width, albumin and globulin, a significant correlation between BMI and eGFR was still observed (β: -0.72, 95% CI: -1.04 to -0.40). Trend analysis after categorizing BMI into four groups showed that the decrease in eGFR increased progressively with increasing BMI. Non-linear analysis revealed an inflection point at a BMI of 27.5 kg/m². To the left of the inflection point, for every 1 kg/m² increase in BMI, eGFR decreased by 0.91 mL/min/1.73 m², while no correlation was found to the right of the inflection point.</p><p><strong>Conclusion: </strong>There is a non-linear relationship between BMI and eGFR at admission in elderly patients with hip fractures, with a clear inflection point. This suggests that BMI should be considered an indicator for renal function risk assessment when managing these patients, and that targeted renal protective measures should be considered for patients in different BMI ranges.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833404","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":"Guideline-directed medical therapy in older adults with heart failure; Are there differences across age group?","authors":"Schee Li Kwa, Bui Khiong Chung, Zhun Foo Tan, Janice Kee Wei Wong, Zi Yang Lian, Kok Choon Cheah, Ka-Shing Tan, Chun-Hau Lam, Mae Jane Khaw, Siew Yap Chai, Melvinder Singh A/L Jasbinder, Lee Yee Ting, Jordan Ching Bing Hoo, Chelfi Zhi Fei Chua, Min Ting Wong, Pey Woei Ting, Jun Xun Ng, Qing Wei Lim, Ching Hua Chai, Wei Ming Cho, Alex Zhi Yang Koh, Tze Cheng Wong, Weng Kee Ho, Wun Khang Chong, Rebecca Su Li Chew, Jothiswaran Namasoo, Ing Chiew Yew, Hwei Sung Ling","doi":"10.1186/s12877-026-07571-y","DOIUrl":"https://doi.org/10.1186/s12877-026-07571-y","url":null,"abstract":"<p><strong>Title: </strong>Guideline-Directed Medical Therapy in Older Adults with Heart Failure; Are There Differences Across Age Groups?</p><p><strong>Background: </strong>Older adults remain underrepresented in heart failure (HF) studies evaluating guideline-directed medical therapy (GDMT). This study aimed to assess clinical characteristics, HF GDMT pillars use, and outcomes across age groups of older adults with HF.</p><p><strong>Methods: </strong>This retrospective, multicentre sub-analysis of the Sarawak Heart Failure Registry included patients aged ≥ 65 years. Participants were stratified into youngest-old (65-70 years), middle-old (71-75 years), and oldest-old (> 75 years). GDMT use, dosing, and clinical outcomes, including all-cause mortality and HF readmission, were evaluated at baseline, 3 and 6 months. Multivariable regression analyses were performed to identify factors associated with outcomes and GDMT optimisation.</p><p><strong>Results: </strong>A total of 176 patients were included. Comorbidity burden increased with age, whereas coronary artery disease was more prevalent in the youngest-old group. HF GDMT pillars use declined with increasing age, particularly for renin-angiotensin system inhibitors and SGLT2 inhibitors, while beta-blocker use remained consistently high. At 6 months, 50% of the oldest-old achieved three GDMT pillars, although fewer achieved four compared with younger groups. LVEF improved in all age groups, most notably in the youngest-old. NYHA functional class improvement was greater in younger patients. Mortality at 6 months was numerically higher in the youngest-old (16.0%), while HF readmission was slightly higher in the oldest-old (12.5%), without statistical significance. In multivariable analyses, age, comorbidities, and LVEF were not independent predictors of outcomes.</p><p><strong>Conclusion: </strong>Older adults with HF demonstrated consistent structural and functional improvement across age groups despite differences in GDMT use. Outcome variation was not independently explained by age or comorbidity burden, suggesting that disease phenotype and physiological reserve may play a greater role. These findings provide real-world evidence from a multiethnic Asian population and support individualized, multidisciplinary care strategies for older adults with HF.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833411","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":"The impact of a caregiver educational intervention on improving the quality of life of caregivers of community-dwelling activity-limited older adults in Sri Lanka: a quasi-experimental study.","authors":"H S Maliga S K Wijesiri, Sudharshani Wasalathanthri, Shreenika D S Weliange, Chandrika N Wijeyaratne","doi":"10.1186/s12877-026-07613-5","DOIUrl":"https://doi.org/10.1186/s12877-026-07613-5","url":null,"abstract":"<p><strong>Introduction: </strong>This study explored the impact of a caregiver educational intervention on improving the quality of life (QoL) of caregivers of community-dwelling activity-limited older adults.</p><p><strong>Methods: </strong>This non-randomized, controlled quasi-experimental study with geographically defined groups was conducted in two selected secretariat divisions of the Colombo District in the Western Province of Sri Lanka. The sample of caregivers (N = 72) for the intervention (n = 36) and control (n = 36) groups was selected depending on the highest degree of activity limitations in older adults. The need-based educational intervention delivered to the intervention group consisted of 2-4 sessions (two weeks apart) with live demonstrations. The QoL of both groups was assessed with the Sinhala-validated WHOQOL-BREF questionnaire before and 6 months after the intervention. Data were analyzed by SPSS 20 using Mann-Whitney U and Wilcoxon signed-rank tests to compare mean scores.</p><p><strong>Results: </strong>The mean±SD age of the caregivers was 55.75±12.9 years; the majority were female (80.6%, n = 58), 44.4% (n = 32) were unknown to have a chronic disease, while 26.4% (n = 32) and 27.8% (n = 19) reported having 2 and 3 chronic diseases, respectively. Many caregivers (77.8%, n = 56) perceived their health as satisfactory. Six months after the educational intervention, scores had significantly higher ratings in the overall QoL (61.97±10.33 vs. 51.61±10.99), physical health (68.55±12.39 vs. 54.76±11.32), psychological (69.21±12.04 vs. 54.86±11.89) and social relationships domains (46.06 ±16.72 vs. 34.49 ±17.94) in the intervention group compared to controls (p < 0.01). No significant change was observed in the environmental domain (64.06±12.21 vs. 62.33±11.45; p > 0.05) between the two groups. Pre- vs. post-intervention scores of the overall and the four domains of QoL showed a significant increase in the intervention group (p < 0.001), whereas scores of overall QoL and all three domains except the environmental domain showed a significant decline (P < 0.001) after 6 months when compared to pre-6 months values in the control group.</p><p><strong>Conclusions: </strong>The caregiver educational intervention positively changes the QoL of caregivers of activity-limited older adults. The involvement of healthcare professionals in caregiver education will improve the QoL of caregivers through knowledge enhancement.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833375","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}