BMC Geriatrics最新文献

{"title":"Understanding and integrating the needs and preferences of people living with dementia in the inpatient setting: a qualitative study.","authors":"Alyse Lennox, Denise Goodwin, Felicity Leavold, Renae Nicol, Velandai Srikanth, Darshini Ayton, Madeleine Berends, Myra Thiessen, Daphne Flynn, Chris Moran","doi":"10.1186/s12877-025-05932-7","DOIUrl":"10.1186/s12877-025-05932-7","url":null,"abstract":"<p><strong>Background: </strong>People living with dementia (PLWD) have poorer outcomes than cognitively normal people when admitted to hospital. One reason for this difference is related to the challenges in learning and integrating the needs and preferences of PLWD into clinical care. We aimed to obtain a range of perspectives on the challenges in supporting PLWD in hospital and explore opportunities for improvement.</p><p><strong>Methods: </strong>Using an exploratory qualitative study design, we conducted interviews with nine people supporting PLWD (current / ex-spouses or children of PLWD) and 11 nursing, medical and allied health staff members at a single Australian hospital. Data were thematically analysed using a framework approach.</p><p><strong>Results: </strong>Participants described how best practice in supporting PLWD included understanding and integrating patient needs and highlighted the importance of family and the multidisciplinary team working in partnership. A number of factors inhibiting quality care provision were described, including uncertainty around responsibility for communicating with families to understand needs of PLWD; unsuitable tools; lack of opportunities for families to communicate with staff; and, resource and environmental constraints. Participants discussed potential for improvement, emphasising the need for a pre-emptive, rather than reactive solution. They expressed support for the idea of a 'hospital admission kit', containing both information about PLWD and their familiar items. Implementation considerations were also noted, with various perspectives on the timing of initiation, updating, responsible person(s), format, content and how it should be incorporated into clinical workflows.</p><p><strong>Conclusions: </strong>We found that hospital staff and those supporting PLWD felt that integrating the needs and preferences of PLWD into hospital care was important. The concept of a pre-prepared 'toolkit' that was ready in the case of a need to attend hospital was felt to be valid and potentially helpful. More work is required to design aspects such as format, content and the workflows needed to generate accountability and reliability in creating, updating and incorporating it into hospital care.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"342"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075818","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":"Factors associated with mental health literacy and demand for mental health services among older adults in China: a cross-sectional study.","authors":"Haihui Chen, Zijuan Ma, Ruidian Huang, Yujing Liu, Lianghua Li, Zhengyuan Zhou, Dongfang Wang, Wei Wang, Junxu Lin, Weishi Lin, Luning Yin, Rui Zhang, Xuan Mo, Yunge Fan, Fang Fan","doi":"10.1186/s12877-025-06003-7","DOIUrl":"10.1186/s12877-025-06003-7","url":null,"abstract":"<p><strong>Background: </strong>There is limited research on mental health literacy (MHL) among Chinese older adults as well as their demand and willingness for mental health services (MHS). This study investigated the factors associated with them among Chinese older adults. Additionally, predictors of MHL as well as demand and willingness for MHS were compared between older adults living alone and those not living alone.</p><p><strong>Methods: </strong>This study is a cross-sectional study conducted among 494 older adults in Guangzhou, China. Sociodemographic characteristics, frequency of participating in community-based activities, mental health status, MHL, and demand and willingness for MHS were assessed through self-reported questions. A series of logistic regression analyses were conducted to examine factors associated with the MHL and demand and willingness for MHS.</p><p><strong>Results: </strong>The awareness rates for the three MHL-related questions were between 65.3% and 73.7%, and 62.0% and 69.6% of the participants indicated the demand and willingness, respectively, for MHS. Frequently participating in community-based activities increased the likelihood of awareness of the MHL-related questions (ORs = 2.92-4.18, CIs = [1.50,9.28]), as well as the demand and willingness for MHS (ORs = 2.16-2.24, CIs = [1.19,4.20]). Similar significant associations were found among the older adults who were not living alone but not among those living alone.</p><p><strong>Conclusions: </strong>Based on the results of this study, policymakers and clinicians are advised to develop more targeted community-based activities for older adults and focus especially on those living alone to enhance their MHL and increase willingness for MHS.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"343"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075705","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":"Comparison of the efficacy and safety of remimazolam and propofol for fiberoptic bronchoscopy in older patients: a prospective, randomized controlled study.","authors":"Binggao Chai, Jiaxi Guo, Zhiwei Xu, Tao Chen, Hongquan Wang, Zhenqiang Zhu, Jian Zhong, Kanzheng Chen, Jianlong Du, Xianhui Kang","doi":"10.1186/s12877-025-05984-9","DOIUrl":"https://doi.org/10.1186/s12877-025-05984-9","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to compare the efficacy and safety of remimazolam with those of propofol in older patients undergoing fiberoptic bronchoscopy with preserved spontaneous breathing.</p><p><strong>Methods: </strong>Sixty older patients were randomly and equally divided into a remimazolam group (group R) and a propofol group (group P). Both groups received 0.15 µg/kg of sufentanil for analgesia. Group R received an initial dose of 0.2 mg/kg remimazolam and was injected with a maintenance dose of 1 mg/kg/h. Group P received an initial dose of 2 mg/kg propofol and was injected with a maintenance dose of 4 mg/kg/h. The primary evaluation indicators were the success rate of sedation and the incidence of hypotension. The secondary evaluation indicators were respiratory depression, hypertension, tachycardia, bradycardia, awakening time, quality of recovery-15 (QOR-15) score, patient satisfaction, physician satisfaction, and adverse events.</p><p><strong>Results: </strong>Success rates of sedation were similar between group R (96.7%) and group P (100%). The incidence of hypotension in group R was lower than that in group P (2/30 vs. 10/30, p = 0.01). Respiratory depression was lower in group R than in group P (3/30 vs. 10/30, p = 0.03). Fewer patients reported injection pain in group R (0/30 vs. 7/30, p = 0.01). There were no significant differences in hypertension, tachycardia, bradycardia, awakening time, QoR-15 score, patient satisfaction, physician satisfaction, or adverse events between the two groups.</p><p><strong>Conclusions: </strong>Remimazolam has a high sedation success rate for painless fiberoptic bronchoscopy in older patients, and the incidence of hypotension and respiratory depression is lower than that of propofol. Remimazolam may be a better choice for sedation during painless fiberoptic bronchoscopy in older patients with preserved spontaneous breathing.</p><p><strong>Trial registration: </strong>ChiCTR2300069041; 6/3/2023.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"337"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075680","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":"Construction and evaluation of a nomogram model for predicting the risk of hospital-acquired pneumonia in elderly patients with acute ischemic stroke.","authors":"Man Huang, Wan Wang, Wu-Lin Li, Yan-Qing Chen, Xian-Ting Chen, Ye Liu, Yan Li, Dong-Mei Ren, Fei Wang","doi":"10.1186/s12877-025-05936-3","DOIUrl":"https://doi.org/10.1186/s12877-025-05936-3","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we aimed to develop and validate an easy-to-use model to predict the risk of hospital-acquired pneumonia (HAP) in elderly patients with acute ischemic stroke (AIS).</p><p><strong>Methods: </strong>A total of 2861 elderly AIS patients who were admitted to Jiading District Central Hospital Affiliated with Shanghai University of Medicine & Health Science from January 2016 to December 2023 were selected. Among these patients, 699 were diagnosed with HAP (HAP group), and 2162 patients were included in the control group (non-HAP group). Univariate and multivariate logistic regression analyses were performed to determine the risk factors for HAP after AIS. These factors were then used to establish a scoring system, from which a nomogram model was developed with R software.</p><p><strong>Results: </strong>Univariate analysis revealed 17 factors that were significantly associated with the development of HAP after AIS in elderly patients (P < 0.05). Multivariate logistic regression analysis including these factors revealed that age, the national institute of health stroke scale (NIHSS) score within 24 h of admission (Kwah LK. J Physiother 60:61, 2014), the stress hyperglycemia ratio (SHR), smoking status, and dysphagia status were independent risk factors for HAP after AIS. According to the oxfordshire community stroke project (OCSP) classification, patients classified as having the total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), and posterior circulation infarct (POCI) sub-types had a significantly increased risk of HAP compared with those classified as having the lacunar infarct (LACI) sub-type. A nomogram model constructed from these six risk factors yielded a C-index of 0.834 (95% confidence interval (CI): 0.811-0.857), indicating high accuracy. Calibration and clinical decision curve analyses revealed the reliability and clinical value of the proposed model.</p><p><strong>Conclusion: </strong>Our proposed nomogram provides clinicians with a simple and reliable tool for predicting HAP from conventional data. The model can also help clinicians make personalized treatment decisions for patients at different risk levels.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"340"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075682","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":"Prevalence of frailty and association with intrinsic capacity decline among community-dwelling older people in Cameroon: a cross sectional study.","authors":"Marie-Josiane Ntsama Essomba, Régine Mylène Mballa Mba, Landry Ekwalla Kameni, Patrick Tchebegna, Florence Denise Mvondo Lema, Maturin Tabue-Teguo","doi":"10.1186/s12877-025-06011-7","DOIUrl":"https://doi.org/10.1186/s12877-025-06011-7","url":null,"abstract":"<p><strong>Background: </strong>Frailty and impairment in intrinsic capacity (IC) have been shown to increase the risk of poor outcomes in older people. We aimed to determine the prevalence of frailty and its association with decline in IC among people aged 60 and over in Cameroon.</p><p><strong>Methods: </strong>This cross-sectional study included community-dwellers aged ≥ 60 years. Frailty was assessed using Fried's criteria and IC decline using step 1 of the Integrated Care for Older People (ICOPE). Any abnormality reported for one of the six IC domains was considered as a positive screening. The significance level was p < 0.05.</p><p><strong>Results: </strong>Among 108 participants included (64.8% women, median age 70 years (65-75)), all had a decline of at least one IC. The prevalence of frailty was 52.8%.The main domains involved were cognition (93.5%), vision (88%) and hearing (87%). Compared to participants without frailty, the frail group was older, achieved lower education, had fewer children, had a more frequent history of falls and a higher number of deficits in IC domains. In the multivariable model, after adjusting for age, sex and comorbidities, the participants with preserved mobility (OR 0.18, 95%CI 0.068-0.49) and vitality (OR 0.11 95%CI 0.04-0.28) were likely to have a lower risk of frailty.</p><p><strong>Conclusion: </strong>Frailty and IC impairment were common in this group of older Cameroonians. Further research with the monitoring of trajectories of IC and frailty as a research outcome may allow better comparison to tailor interventions taking into account our local resources.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"335"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075789","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":"Translation and validation of the Thai clinical frailty scale and classification tree in older adults.","authors":"Panas Jesadaporn, Siripong Teepaneeteerakul, Nuttanun Wongsarikan, Kochaphan Phirom, Supannika Poonthananiwatkul, Panita Limpawattana","doi":"10.1186/s12877-025-06013-5","DOIUrl":"10.1186/s12877-025-06013-5","url":null,"abstract":"<p><strong>Background: </strong>The Clinical Frailty Scale (CFS) is widely used for frailty assessment, but has not yet been formally validated for use in Thai populations. This study evaluated the reliability and validity of the Thai versions of the CFS (CFS-Thai) and its Classification Tree (CFS-CT-Thai).</p><p><strong>Methods: </strong>In this cross-sectional study, 213 participants aged ≥ 65 years (127 outpatients and 86 inpatients) were enrolled from two tertiary care hospitals in Thailand. The CFS and CFS-CT were translated into Thai using standard procedures. Inter-rater reliability was evaluated in a subsample of 53 inpatients. Concurrent validity was examined using the Thai version of the FRAIL scale (T-FRAIL), the Eastern Cooperative Oncology Group Performance Status (ECOG PS), and the modified Thai Frailty Index (mTFI).</p><p><strong>Results: </strong>The CFS-Thai showed strong inter-rater reliability (κ = 0.80, p < 0.001) and excellent agreement with the CFS-CT-Thai (κ = 0.94, p < 0.001). It demonstrated moderate correlation with T-FRAIL (ρ = 0.53) and strong correlation with ECOG PS (ρ = 0.76) and mTFI (ρ = 0.73). Using mTFI as the reference standard, the CFS-Thai showed high sensitivity (92.7%) and lower specificity (55.0%) at cut-off ≥ 4 (AUC = 0.74, 95% CI: 0.62-0.86), while cut-off ≥ 5 improved specificity (79.3%) and retained high sensitivity (93.5%) (AUC = 0.86, 95% CI: 0.81-0.92). ECOG PS ≥ 2 provided balanced diagnostic performance (sensitivity 83.9%, specificity 93.3%, AUC = 0.89, 95% CI: 0.82-0.95).</p><p><strong>Conclusions: </strong>The CFS-Thai and CFS-CT-Thai are reliable and valid instruments for frailty assessment in Thai older adults. Their diagnostic accuracy supports integration into clinical practice, especially in settings with limited geriatric expertise. Further studies should examine their implementation across diverse populations and their predictive value for clinical outcomes.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"339"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075732","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":"Instrumental activities of daily living and self-rated health in community-dwelling older adults: cross-sectional findings from the HUNT Study (HUNT4 Trondheim 70+).","authors":"Anne Kusk Pedersen, Linda Ernstsen","doi":"10.1186/s12877-025-05983-w","DOIUrl":"https://doi.org/10.1186/s12877-025-05983-w","url":null,"abstract":"<p><strong>Background: </strong>The population of older adults is growing, posing new challenges for society and healthcare services. Instrumental Activities of Daily Living (IADL) describe individuals' ability to handle more complex activities in their daily life and to the extent to which they can live independently. Self-rated health (SRH) is a frequently used metric in health research and is a robust predictor for institutionalization and mortality. Therefore, the purpose of this study is to investigate the association between IADL function and SRH among community-dwelling older adults in Norway, and to determine the influence of cognitive function.</p><p><strong>Methods: </strong>A total of 1104 community-dwelling adults aged 70 or older participating in the population-based Trøndelag Health Study (HUNT) 4 Trondheim 70 + were included. Logistic regression was used to examine the association between IADL function and SRH. IADL function was divided into two groups, IADL limitation (requiring help to complete one or more daily activities) and no IADL limitation. SRH were dichotomized into good and poor SRH.</p><p><strong>Results: </strong>Of the 1104 included participants 127 (11.5%) experienced IADL limitation. After adjustment for gender, age, cohabiting status, educational level, physical activity, gait speed, grip strength, depressive symptoms, limiting long-term illness and cognitive function, participants with IADL limitation had significantly higher odds of poor SRH compared to those without IADL limitation (odds ratio 3.26, 95% confidence interval 1.89-5.61, p < 0.001).</p><p><strong>Conclusions: </strong>These cross-sectional results from an urban population of community-dwelling older adults showed a strong association between IADL limitation and poor SRH independent of cognitive function, emphasizing the importance of investigating the prospective relationship between IADL and SRH. Intervention studies are needed to confirm whether improving IADL function can impact SRH in older adults.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"334"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075709","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":"Validity and reliability of inertial measurement units for measuring gait kinematics in older adults across varying fall risk levels and walking speeds.","authors":"Lulu Yin, Peng Chen, Junkai Xu, Yixue Gong, Yifang Zhuang, Yiming Chen, Lin Wang","doi":"10.1186/s12877-025-05993-8","DOIUrl":"https://doi.org/10.1186/s12877-025-05993-8","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine whether the validity and reliability of inertial measurement units (IMUs) in measuring lower extremity joint kinematics differed among different walking velocities and varying fall risk older adults.</p><p><strong>Methods: </strong>Forty-five older adults were categorized into low and high fall risk. Lower extremity joint angles during walking were simultaneously measured using inertial measurement units (IMUs) and an optical motion capture (OMC) system across slow, preferred, and fast walking speeds. The Coefficient of Multiple Correlation (CMC) was employed to assess waveform consistency, while systematic error (SE) was calculated to quantify deviations. For discrete kinematic parameters, Pearson's correlation coefficient (r), intra-class correlation coefficients (ICCs), and root mean square error (RMSE) were computed. A two-way analysis of variance utilizing statistical parametric mapping methods was conducted to compare differences in lower extremity joint angles across fall risk categories and varying walking speeds.</p><p><strong>Results: </strong>For lower extremity joint waveforms, IMUs demonstrated very good to excellent validity (low fall risk: CMC = 0.872-0.957, SE = 4.8°-9.6°; high fall risk: CMC = 0.894-0.974,SE = 4.5°-6.9°) and reliability (within-raters: low fall risk: CMC = 0.924-0.982, SE = 3.9°-6.5°; high fall risk: CMC = 0.914-0.974, SE = 1.0°-2.5°; between-raters: low fall risk: CMC = 0.953-0.981, SE = 2.2°-5.9°; high fall risk: CMC = 0.903-0.985, SE = 1.7°-2.2°) for joint kinematics in the sagittal plane across various walking velocities in both low and high fall risk individuals. For discrete parameters, r values of peak joint angles and ROM measured by IMUs and OMC system were generally higher in the sagittal plane compared to the frontal and transverse planes. ICC values between within-raters and between-raters comparisons ranged from moderate to excellent, with RMSE values between 2.1°- 8.4° for both within-rater and between-rater comparisons in the sagittal plane. There are significant differences in the joint angles of lower limbs between different fall risk groups and different walking speeds in specific gait cycle intervals.</p><p><strong>Conclusion: </strong>IMUs are valid and reliable for measuring joint kinematics both low- and high-fall risk older adults across different walking speeds. However, caution is warranted when interpreting data from the frontal and transverse planes. Additionally, high fall risk individuals had smaller joint angles, while faster walking speeds increased joint angles during specific gait cycles.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"336"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075826","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":"Impact of multidimensional assessment on anti-fracture treatment decisions in patients with fragility hip fractures within a Fracture Liaison Service.","authors":"Chiara Ceolin, Stefania Sella, Cristina Simonato, Ester Bukli, Giulia Bano, Valentina Camozzi, Anna Bertocco, Marco Onofrio Torres, Alberta Cecchinato, Martin Diogo, Mor Peleg Falb, Francesca Guidolin, Maria Grazia Rodà, Michele Cannito, Antonio Berizzi, Andrea Venturin, Vito Cianci, Elisa Pala, Mariachiara Cerchiaro, Deris Gianni Boemo, Maria Vittoria Nesoti, Gaetano Paride Arcidiacono, Paolo Simioni, Pietro Ruggieri, Giuseppe Sergi, Sandro Giannini, Marina De Rui","doi":"10.1186/s12877-025-06009-1","DOIUrl":"https://doi.org/10.1186/s12877-025-06009-1","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis is a chronic condition characterized by increased fracture risk. Fragility fractures, especially hip fractures, represent a significant health and economic burden due to population aging. Despite the efficacy of approved treatments in lowering fracture recurrence, post-fracture treatment rates remain suboptimal. To address these issues, various post-fracture care programs, including Fracture Liaison Services (FLS), have been implemented worldwide. While FLS models effectively reduce refracture risk and maintain cost-effectiveness, it is unclear if these benefits apply equally to all patients, especially those with higher comorbidities and reduced functional capacity, who may face worse prognoses. This study aimed to identify the primary factors influencing anti-fracture therapy decisions in older patients with fragility fractures, using a multidimensional geriatric assessment approach integrated into our FLS program.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients aged 65 and above with hip fractures admitted to Azienda Ospedale-Università Padova. Patients were categorized based on anti-fracture treatment (bisphosphonates, Denosumab, anabolic agents) or calcium/vitamin D supplements only. Clinical data, including the Multidimensional Prognostic Index (MPI) and its components, were collected. Statistical comparisons between treated and untreated groups were made, and a CHAID decision tree was used to explore decision-influencing factors.</p><p><strong>Results: </strong>The study included 493 patients (average age 84.7 years, 71.8% female). Patients receiving anti-fracture treatment were notably younger, with only 11.2% classified as MPI class 3 (severe prognosis) compared to 60.8% of untreated patients (p < 0.001). Among treated patients (n = 427), 75.3% received bisphosphonates, 7.3% Denosumab, and 2.2% anabolic agents. The CHAID decision tree highlighted MPI class as the primary determinant of treatment, with functional autonomy (Instrumental Activity of Daily Living or IADL) and cognitive status as subsequent factors, leading to an overall prediction accuracy of 70%.</p><p><strong>Conclusion: </strong>The integration of the MPI into multidisciplinary taking care of old patients with hip fractures may provide a structured approach for individualizing treatment decisions, considering aspects such as prognosis, functional autonomy, and cognitive status. Further studies are needed to validate the long-term outcomes of this approach.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"338"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207628","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":"Exploring the association between hemoglobin glycation index and cognitive function in older adults with hypertension: a cross-sectional study.","authors":"Hong Ding, Tingyue Kang, Wenbo Gao, Qi Wang, Shu Liu, Xiaowei Zhang, Jing Yu","doi":"10.1186/s12877-025-05999-2","DOIUrl":"10.1186/s12877-025-05999-2","url":null,"abstract":"<p><strong>Background: </strong>The Hemoglobin Glycation Index (HGI) quantifies the difference between the actual and expected values of glycosylated hemoglobin (HbA1c), a marker that has been closely linked to various adverse health outcomes. Nonetheless, a significant gap exists in the current literature concerning the association between HGI and cognitive function. This study aims at testing such association in older adults with hypertension, a topic that has not yet been extensively investigated.</p><p><strong>Methods: </strong>A linear regression model between glycated hemoglobin A1c (HbA1c) levels and fasting plasma glucose (FPG) was constructed for the calculation of the HGI. The cross-sectional study focused on evaluating the cognitive function of hypertensive individuals (≥ 60 years old), based on the data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES), by using a series of standardized tests, including the Word List Learning (CERAD-WL) and Delayed Recall (CERAD-DR) tests from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). Weighted logistic and linear regression models served for evaluating the effect of HGI on hypertensive patients' cognitive function. Restricted cubic spline (RCS) curves assisted in detecting the underlying nonlinear associations between HGI and cognitive outcomes. Furthermore, subgroup analyses and interaction tests were performed to gain deeper insights into these associations.</p><p><strong>Results: </strong>The study included 1023 participants ≥ 60 years old from 2011 to 2014 NHANES. Higher HGI was accompanied by lower DSST score (P = 0.009). In the fully adjusted model, participants in the highest quartile (Q4) of HGI possessed a lower DSST score (β = -4.50, 95% CI -8.10- -0.88) versus the lowest quartile (Q1), and were more likely to exhibit low cognitive function as evaluated by the DSST (OR = 2.21, 95% CI 0.98-5.03). According to the results from RCS analysis, HGI presented a linear relevance to cognitive function scores in older adults with hypertension. There is no interaction between HGI and the stratifying variables (sex, age, BMI, alcohol consumption, and smoking status).</p><p><strong>Conclusion: </strong>High HGI was an important risk factor leading to reduced cognitive performance in hypertensive patients, ensuring HGI to be used for effectively predicting patients' cognitive decline.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"331"},"PeriodicalIF":3.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973101","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}