BMC Geriatrics最新文献

{"title":"Association of the overlap of cognitive impairment and depression with 6-month mortality in hospitalized older adults: results from the Re.Po.SI register.","authors":"Theresa Westgård, Gianluca Bianco, Alessandro Nobili, Mauro Tettamanti, Alessandra Marengoni, Alberto Zucchelli","doi":"10.1186/s12877-025-05818-8","DOIUrl":"10.1186/s12877-025-05818-8","url":null,"abstract":"<p><strong>Background: </strong>When admitted to hospital for unplanned medical needs, the complexity of multiple conditions, including cognitive and mental health, might put older people at greater risk, affecting their survival. This study aimed to investigate the prevalence of cognitive impairment versus cognitive impairment with depression and their association with six-month mortality in older people after an unplanned hospital admission in Italy.</p><p><strong>Methods: </strong>In Re.Po.SI. a multi-centre study performed in Italy, standardized web-based case report forms were used to collect data on socio-demographic factors, clinical parameters, diagnoses, treatment history and at discharge, clinical events during hospitalization, and outcome data was collected. A comprehensive geriatric assessment was conducted using Cumulative Illness Rating Scale (CIRS), Geriatric Depression Scale (GDS-4), Barthel Index, and Short Blessed Test (SBT). To explore the interrelationship between depression and cognitive impairment, a variable categorized the study population into four mutually exclusive groups. This variable assessed the association between its categories and six-month mortality in a Cox multivariate analysis.</p><p><strong>Results: </strong>One thousand nine hundred fifty six participants were included, with a median age of 80 years (IQR: 73-85). Those who died within six months were likely to be older (82 vs. 79 years), male (56.2% vs. 47.2%), had moderately reduced ability to perform daily activities (82.0 vs. 93.0), exhibited greater illness severity (CIRS-IS: 1.8 vs. 1.6), had more chronically prescribed medications (6.0 vs. 5.0), and had a worse SBT score (10.0 vs. 7.0). When stratified based on cognitive impairment and depression, one-third had neither condition (33.2%), 21.9% had depression, 20.7% had a cognitive impairment, and 24.3% had both conditions. Six-month mortality was higher among people with cognitive impairment only (33.2%) followed by those with both conditions (28.8%), and depression only (22.7%). The unadjusted semi-parametric survival analysis revealed that the hazard ratio (HR) for people with cognitive impairment only was 2.08, for those with both conditions HR was 1.75, and for people with depression only HR was 1.30.</p><p><strong>Conclusion: </strong>While depression alone may contribute to mortality risk, cognitive impairment appears to play a more substantial role in increasing the risk of dying within 6 month from an acute hospitalization. Further research is needed to confirm these finding.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"185"},"PeriodicalIF":3.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656119","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":"Association between early sitting and functional mobility recovery after hip-fracture surgery in older patients: a prospective cohort study.","authors":"Clarissa Catalano-Nadakhovskaia, Carlos Pérez-López, Esther García-Lerma, Laura Alexandra Ivanov, Oscar Macho-Perez, Alejandro Rodríguez-Molinero","doi":"10.1186/s12877-025-05831-x","DOIUrl":"10.1186/s12877-025-05831-x","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures significantly impact older adults, leading to compromised mobility and various adverse outcomes. The importance of early post-surgery mobilization in regaining pre-fracture levels of mobility is recognized, but lacks standardized definitions and implementation strategies. This study aimed to assess the impact of early sitting position 24 h after hip-fracture surgery on functional mobility recovery after 30 days using data from the Spanish National Hip Fracture Registry (RNFC).</p><p><strong>Methods: </strong>Prospective cohort study, including patients aged ≥ 75 years admitted for hip-fracture surgery between 2017 and 2020 at Sant Camil Residential Hospital. Data from the RNFC were analyzed, and linear regression models were developed to assess the association between early sitting after surgery (ESAS) and mobility recovery at 30 days after surgery.</p><p><strong>Results: </strong>Of 486 identified patients, 321 were included, with an estimated ESAS prevalence of 38.32% (95% CI: 32.97-43.88). ESAS was significantly associated with improved mobility recovery at 30 days. Multivariate regression models consistently revealed ESAS as a modest independent predictor of better post-surgery mobility. Factors such as age, cognitive capacity, and general health also impacted mobility recovery.</p><p><strong>Conclusion: </strong>The ESAS effect, while modest, emerges as a significant predictor of hip mobility recovery among older patients with hip fractures 30 days after surgery. These findings underscore the potential of this low-risk, low-cost intervention in enhancing functional mobility recovery strategies and emphasize the need for further research to uncover its broader implications in post-operative care. Implementation of early sitting could be enhanced, as only a third of patients in our study underwent this simple intervention.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"184"},"PeriodicalIF":3.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656118","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":"Evidence on non-pharmacological interventions for preventing or reversing physical frailty in community-dwelling older adults aged over 50 years: overview of systematic reviews.","authors":"Annemarie Money, Aylish MacKenzie, Amelia Parchment, Gill Norman, Danielle Harris, Saima Ahmed, Lisa McGarrigle, Helen Hawley-Hague, Chris Todd","doi":"10.1186/s12877-025-05768-1","DOIUrl":"10.1186/s12877-025-05768-1","url":null,"abstract":"<p><strong>Background: </strong>A large proportion of older adults are pre-frail. Interventions aimed at this group provide opportunity to reduce progression of physical frailty. The aim of this overview of reviews is to evaluate evidence for non-pharmacological interventions for the prevention/reversal of physical frailty in community-dwelling adults aged ≥ 50 years.</p><p><strong>Methods: </strong>Medline, Embase, CINAHL, Cochrane Database of Systematic Reviews, Google Scholar and Social Science Citation Index were searched for non-pharmacological interventions that used a validated frailty measurement tool. Review quality was assessed using AMSTAR-2 and a Synthesis Without Meta-analysis (SWiM) approach was adopted.</p><p><strong>Results: </strong>Twenty-three reviews were included, six of which were of high quality. This included 18,768 unique participants from 98 unique primary studies. Physical activity containing an aspect of resistance training, for a minimum of twice per week, was evidenced as being beneficial for reversing frailty (28 primary studies and 3,246 unique participants). However, one randomised controlled trial (RCT) showed resistance training by pre-frail adults (n = 66) for eight weeks was not effective at reversing frailty status. Nutrition interventions combined with physical activity that include resistance training (9 studies, 1,812 participants) were effective at reversing/preventing frailty.</p><p><strong>Conclusion: </strong>The evidence synthesised in this overview of reviews suggests physical activity containing an aspect of resistance training is beneficial at reversing frailty status and preventing frailty progression. Nutrition interventions alone were inconclusive. It is recommended that future studies include a validated tool to assess frailty status, report samples by frailty status and make recommendations based on dose (frequency/duration of minutes per session) and adherence to dose.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"183"},"PeriodicalIF":3.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647075","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":"Utilizing machine learning to identify fall predictors in India's aging population: findings from the LASI.","authors":"Mrinmoy Pratim Bharadwaz, Jumi Kalita, Anandita Mitro, Aditi Aditi","doi":"10.1186/s12877-025-05813-z","DOIUrl":"10.1186/s12877-025-05813-z","url":null,"abstract":"<p><strong>Background: </strong>Depression has a detrimental effect on an individual's mental and musculoskeletal strength multiplying the risk of fall incidents. The current study aims to investigate the association between depression and falls in older adults using machine learning (ML) approach and identify its various predictors.</p><p><strong>Methods: </strong>Data for the study was derived from the Longitudinal Ageing Study in India, (LASI) conducted in 2017-18 for people aged 45-years and above. The study was carried out on 44,066 individuals. Depression was measured using the CIDI-SF scale. Bivariate cross-tabulations were used to study the prevalence of falls. And its association with depression and other independent factors were assessed using the novel ML, the Conditional inference trees (CIT) method.</p><p><strong>Results: </strong>Around 10.8 percent of older adults had fall incidents. CIT model predicted region to be a significant predisposing factor for an older adult to experience falls. Multimorbidity, depression, sleep problems, and gender were other prominent factors. The model predicted that, among depressed older adults, falls incidents were around 80 percent higher than non-depressed.</p><p><strong>Conclusions: </strong>An association between falls and depression was observed. Depressive symptoms were associated with an increased risk of falls, even after controlling for other co-factors. The CIT method leveraged us to select the most important variables to predict falls with great precision. To prevent and manage falls among the expanding and diverse older-aged population, a multilevel and cross-sectoral approach is required. Mental health, especially depression, should be dealt with greater precautions. Public health enthusiasts should focus on the physical as well as mental health of the country's older adult population.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"181"},"PeriodicalIF":3.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647036","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":"Extracted step parameters during the timed up and go test discriminate between groups with different levels of cognitive ability-a cross-sectional study.","authors":"Niklas Löfgren, Lars Berglund, Vilmantas Giedraitis, Kjartan Halvorsen, Erik Rosendahl, Kevin J McKee, Anna Cristina Åberg","doi":"10.1186/s12877-025-05828-6","DOIUrl":"10.1186/s12877-025-05828-6","url":null,"abstract":"<p><strong>Background: </strong>Identifying cognitive impairment at an early stage is important to enable preventive treatment and lifestyle changes. As gait deviations precede cognitive impairment, the aim of this study was to investigate if step parameters during different Timed Up and Go (TUG) conditions could discriminate between people with different cognitive ability.</p><p><strong>Methods: </strong>Participants (N = 304) were divided into the following groups: (1) controls, n = 50, mean age:73, 44% women; (2) Subjective cognitive Impairment (SCI), n = 71, mean age:67, 45% women; (3) Mild Cognitive Impairment (MCI), n = 126, mean age: 73, 42% women; and (4) dementia disorders, n = 57, mean age: 78, 51% women. Participants conducted TUG and two motor-cognitive TUG-conditions: TUG while naming animals (TUGdt-NA) and reciting months in reverse order (TUGdt-MB). Tests were video recorded for data extraction of valid spatiotemporal parameters: step length, step width, step duration, single step duration and double step duration. Step length was investigated with the step length/body height ratio (step length divided by body height). Logistic regression models (adjusted for age, sex and education) investigated associations between step parameters and dichotomous variables of groups adjacent in cognitive ability: dementia disorders vs. MCI, MCI vs. SCI, and SCI vs. controls. Results were presented as standardized odds ratios (sORs), with 95% confidence intervals (CI⁹⁵) and p-values (significance level: p < 0.05). The areas under the Receiver Operating Characteristic curves were presented for the step parameters/conditions with the highest sORs and, where relevant, optimal cutoff values were calculated.</p><p><strong>Results: </strong>Step length showed greatest overall ability to significantly discriminate between adjacent groups (sOR ≤ . 67, CI⁹⁵: .45-.99, p = ≤ . 047) during all group comparisons/conditions except three. The highest sOR for step-length was obtained when discriminating between SCI vs controls during TUGdt-MB (sOR = .51, CI⁹⁵:.29- .87, p = .014), whereby the area under the curve was calculated (c-statistics = .700). The optimal cut-off indicated a step length of less than 32.9% (CI⁹⁵ = 22.1-43.0) of body height to identify SCI compared with controls.</p><p><strong>Conclusions: </strong>The results indicate that step length may be important to assess during TUG, for discrimination between groups with different cognitive ability; and that the presented cut-off has potential to aid early detection of cognitive impairment.</p><p><strong>Trial registration number: </strong>NCT05893524 (retrospectively registered 08/06/23).</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"182"},"PeriodicalIF":3.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647083","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":"Older adult's acceptance and uptake of referral after screening for cognitive impairment: a cross-sectional study in China.","authors":"Caiyun Tang, Lily Dongxia Xiao, Rong Huang, Ying Hu, Yao Wang","doi":"10.1186/s12877-025-05824-w","DOIUrl":"10.1186/s12877-025-05824-w","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that the referral situation after cognitive screening is not optimistic. However, little is known about the situation in China. The current study assessed the cognitive function of older adults with an Eight-item Ascertain Dementia (AD8) score of ≥ 2 in a community health center and investigated their willingness to accept referrals.</p><p><strong>Methods: </strong>In our cross-sectional study, a total of 970 participants completed a cognitive screen using AD8. Those with a score of ≥ 2 were further assessed using the Mini-Mental State Examination. Sociodemographic information was collected. The participants were asked to respond to a questionnaire about their acceptance and uptake of referral after screening and their knowledge of cognitive impairment. The data were analyzed using descriptive statistics, the chi-square test, the Mann-Whitney U rank sum test, and binary logistic regression.</p><p><strong>Results: </strong>We screened 140 older adults with cognitive impairment from 970 participants. Among the 140 subjects, 37 (26.43%) indicated a willingness to be referred, and 103 (73.57%) declined to be referred. We investigated the reasons for declining referrals, and 69 (66.99%) indicated that they thought referrals were unnecessary. The knowledge of referrals, attitude toward referrals, and knowledge of cognitive impairment showed significant differences concerning participants' willingness to be referred(all p < 0.01). The participants with high knowledge of cognitive impairment were willing to accept referrals (p = 0.009; OR = 1.305; 95% CI: 1.070-1.591).</p><p><strong>Conclusions: </strong>Chinese older adults with cognitive impairment exhibit a low willingness to be referred. Health education in older adults is needed to raise awareness of cognitive impairment, dementia prevention, treatment, and care.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"178"},"PeriodicalIF":3.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633505","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":"Falls among geriatric cancer patients: a systematic review and meta-analysis of prevalence and risk across cancer types.","authors":"Doddolla Lingamaiah, Ganesh Bushi, Shilpa Gaidhane, Ashok Kumar Balaraman, G Padmapriya, Irwanjot Kaur, Madan Lal, Suhaib Iqbal, G V Siva Prasad, Atreyi Pramanik, Teena Vishwakarma, Praveen Malik, Promila Sharma, Mahendra Pratap Singh, Ankit Punia, Megha Jagga, Muhammed Shabil, Rachana Mehta, Sanjit Sah, Quazi Syed Zahiruddin","doi":"10.1186/s12877-025-05722-1","DOIUrl":"10.1186/s12877-025-05722-1","url":null,"abstract":"<p><strong>Background: </strong>Falls represent a significant health concern among the older adults, particularly geriatric cancer patients, due to their increased susceptibility from both age-related and cancer treatment-related factors. This systematic review and meta-analysis aimed to synthesize global data on the prevalence and risk of falls in this population to inform targeted fall prevention strategies.</p><p><strong>Methods: </strong>Following PRISMA 2020 guidelines, we conducted a comprehensive search of PubMed, Embase, and Web of Science up to October 2024. Articles were screened using Nested Knowledge software by two independent reviewers. Eligible studies included those involving geriatric cancer patients aged 60 years or older reporting on fall prevalence. Quality assessment was performed using a modified Newcastle-Ottawa Scale, and meta-analysis was conducted using random-effects models with R software.</p><p><strong>Results: </strong>From 1,365 identified studies, 86 met the inclusion criteria, encompassing 180,974 participants. The pooled prevalence of falls was 24% (95% CI, 20%-28%), with substantial heterogeneity (I² = 100%). Country- and cancer-type-specific analyses revealed variability in fall prevalence, with breast cancer patients showing the highest prevalence. The comparative risk analysis did not show a statistically significant difference in fall risk between cancer patients and non-cancer controls.</p><p><strong>Conclusion: </strong>Falls are a prevalent and concerning issue among geriatric cancer patients, with substantial variability influenced by cancer type and study design. Personalized fall prevention strategies tailored to cancer-specific risk factors are essential. Further research is warranted to explore the complex interplay of cancer treatments, frailty, and fall risk in this vulnerable population.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"179"},"PeriodicalIF":3.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633490","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":"Long-term mortality impact of postoperative hyperactive delirium in older hip fracture surgery patients.","authors":"Mingyang Sun, Wan-Ming Chen, Szu-Yuan Wu, Jiaqiang Zhang","doi":"10.1186/s12877-025-05817-9","DOIUrl":"10.1186/s12877-025-05817-9","url":null,"abstract":"<p><strong>Background: </strong>Postoperative hyperactive delirium is a common and serious complication in older patients undergoing surgery, but the association between delirium and mortality remains controversial. Compared to other delirium subtypes, hyperactive delirium is characterized by more overt clinical manifestations, facilitating accurate detection and evaluation. This study aimed to clarify this association by comparing long-term mortality between patients with and without postoperative hyperactive delirium, using propensity score matching for robust analysis.</p><p><strong>Methods: </strong>We conducted a cohort study to evaluate the association between postoperative hyperactive delirium and long-term mortality in older patients undergoing emergency hip fracture surgery. We used the Taiwan National Health Insurance Service database to identify patients aged 65 years or older who underwent emergency hip fracture surgery between 2008 and 2018. The primary outcome was all-cause mortality.</p><p><strong>Results: </strong>A total of 270,437 patients were included in the analysis, with 6,795 patients in the postoperative hyperactive delirium group and 263,642 patients in the no postoperative hyperactive delirium group. After PSM, both groups contained 6,795 patients, ensuring balanced baseline characteristics for comparison. Postoperative hyperactive delirium was an independent risk factor for all-cause death, with an adjusted hazard ratio of 1.62 (95% confidence interval, 1.51-1.74; P < 0.0001) after PSM. Subgroup analysis revealed that older patients with postoperative hyperactive delirium consistently exhibited significantly higher adjusted hazard ratios of all-cause death compared with those without postoperative hyperactive delirium, regardless of age, sex, income levels, or ASA scores. Although the difference in 5-year overall survival between groups (81.7% vs. 89.8%, P < 0.0001) was statistically significant, the high survival rates in both groups suggest a modest absolute clinical impact.</p><p><strong>Conclusion: </strong>Postoperative hyperactive delirium is an independent risk factor for long-term mortality in older patients undergoing emergency hip fracture surgery. While the statistical association is evident, it is important to carefully consider the modest absolute difference in survival rates and its implications for clinical application.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"180"},"PeriodicalIF":3.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633493","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":"Examining the cost burden of dietary supplements in older adults: an analysis from the AAA longroad study.","authors":"Sara Baird, Ryan Moran, Sarah Hacker, Dylan Lawton, Linda Hill","doi":"10.1186/s12877-025-05823-x","DOIUrl":"10.1186/s12877-025-05823-x","url":null,"abstract":"<p><strong>Background: </strong>The use of dietary supplements (DS) has steadily increased over the last several decades, particularly among older adults, contributing to the growth of the multibillion-dollar DS industry. The cost of prescription medication is a known contributor to medication nonadherence, yet the cost burden of DS among older adults is not well understood.</p><p><strong>Methods: </strong>Using medication data from the 5-year multicenter longitudinal cohort AAA LongROAD study of older adults who drive, DS were identified and categorized. Cost estimates were based on prices obtained from a popular online marketplace, using dosing and frequency recommendations from the National Institutes of Health Office of Dietary Supplements database. ANOVA was used to explore associations between demographics and DS cost burden.</p><p><strong>Results: </strong>Of the 2,990 participants at baseline, 2068 (69%) followed up through year 5. The number of DS users ranged from 70.4 to 82.7% of the participants from baseline to year 5. Among the 160 supplement formulations identified, 142 (88%) had price data and were included in the analysis. The mean estimated cost of individual supplements ranged from $0.73 to $49.59 per month. The mean monthly cost burden for all older adult participants ranged from $10.23 (SD 14.74) at baseline to $13.14 (SD 16.93) in year 3, with a mean annual cost burden of $142 per participant across all years. The mean monthly cost burden for DS users only ranged from $14.56 (SD 15.59) at baseline, to $16.45 (SD 17.45) in year 3, with a mean annual cost burden of $186 per DS user across all years. Increased spending was associated with female gender, older age, higher income, not working, and being White non-Hispanic.</p><p><strong>Conclusion: </strong>The use of DS is common among older adults. Using conservative estimates of monthly cost, the spending of older adults on DS is high. The real-world impact of DS costs on older adults, such as the impact on the affordability of prescription medication, is a key point for future research.</p><p><strong>Clinical trial number: </strong>Not applicable.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"177"},"PeriodicalIF":3.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633489","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":"Knowledge, attitude, and practice of frailty management among clinical nurses: a cross-sectional study.","authors":"Xueyan Huang, Haifang Zhou, Ying Feng, Mengchi Li, Rui Wang, Ge Fang, Lumeng Lu, Jian'ao Chen, Wenhui Jiang","doi":"10.1186/s12877-025-05776-1","DOIUrl":"10.1186/s12877-025-05776-1","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a leading risk factor of falls, incapacitation, functional decline, and even death in aging populations globally. Clinical nurses play pivotal roles in screening, prevention, and intervention to reverse or slow the progression of frailty. The present study aimed to (1) understand the extent and influencing factors of knowledge, attitudes, and practices of clinical nurses for managing frailty, (2) elucidate the relationships of the knowledge, attitudes, and practices of clinical nurses for frailty management.</p><p><strong>Methods: </strong>This cross-sectional study was conducted from March to April 2024 on 524 clinical nurses in a tertiary hospital in Zhejiang Province, China. The survey instruments included a questionnaire inquiring about the knowledge, attitudes, and practices of nurses in terms of frailty management, a demographic data form, and a self-designed frailty educational information questionnaire. Data were analyzed by descriptive statistics, univariate analysis, multiple linear regression, and structural equation modeling.</p><p><strong>Results: </strong>Of 524 nurses, Only 37.2% were rated as good in terms of knowledge, attitude, and practice of frailty management, while 55.7% were rated as moderate. Among them, the proportion of nurses with good knowledge (10.3%) and practical skills (13.4%) is much lower than their attitude (65.3%). Structural equation modeling found that knowledge and attitudes were related to frailty management practices, with significant associations between knowledge and practices(β = 0.499, p < 0.001). Of the total effect size of knowledge influencing practice (total effect = 0.624, 95% CI: 0.455,0.791), approximately 20.0% was mediated by attitudes (indirect effect = 0.125, 95% CI: 0.076,0.187). Multiple linear regression analysis showed that age, organizational support, familiarity with relevant guidelines, familiar with the term frailty, and department all had a significant effect on the total score(adjusted R² = 0.264, p < 0.001).</p><p><strong>Conclusions: </strong>Despite inadequate knowledge and limited experience in frailty management, clinical nurses' attitudes towards frailty management were positive, indicating potential for improvement. The model was useful to explain practices in frailty management, thereby providing a theoretical basis for development of targeted training programs.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"174"},"PeriodicalIF":3.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633492","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}