BMC Geriatrics最新文献

{"title":"Multicomponent intervention to tailor prescriptions to patients with dementia in an intermediate care hospital: pre-post quasi experimental study.","authors":"Matilde Barneto-Soto, Joan Espaulella-Panicot, Emma Puigoriol-Juvanteny, María Eugenia Campollo Duquela, Nuria Fonts, Mariona Espaulella-Ferrer, Núria Molist-Brunet","doi":"10.1186/s12877-025-05783-2","DOIUrl":"10.1186/s12877-025-05783-2","url":null,"abstract":"<p><strong>Objectives: </strong>In persons with dementia, polypharmacy may be discordant with the goals of care. It is necessary to design interventions that align treatment regimens with the patient's situation, prognosis and preferences. The objectives of this study conducted at an intermediate care were to: i) identify inappropriate prescribing per the main care goal; ii) compare the pharmacotherapy data pre and post a medication review based on the degree of cognitive impairment; iii) assess the implementation of the proposed prescribing recommendations three months after discharge.</p><p><strong>Design: </strong>Pre-post quasi-experimental study.</p><p><strong>Setting and participants: </strong>Patients with dementia discharged from an intermediate care hospital between November 2021 and April 2022.</p><p><strong>Methods: </strong>Demographic, clinical and pharmacotherapy data were evaluated at admission. Medication reviews and interviews with the caregivers were conducted to align pharmacologic therapies with the overall goals of care. At discharge, information on the proposed prescribing recommendations was shared with the primary care team in the discharge summary. Follow up to evaluate implementation of the prescribing recommendations proposed during the medication review was performed at three months.</p><p><strong>Results: </strong>Of the 97 patients included, 94.8% had at least one inappropriately prescribed medication. At discharge, the mean number of chronic medications taken per patient decreased by 29.6%, from 8.05(SD 3.5) to 5.67(SD 2.7) (p < 0.001); the anticholinergic burden decreased by 18.6%, from 1.59(SD 1.0) to 1.29(SD 0.9) (p < 0.001); and therapeutic complexity decreased by 28.4%, from 29.23(SD 13.8) to 20.94(SD 11.3) (p < 0.001). At 3 months implementation of the proposed prescribing recommendations was 90.0%.</p><p><strong>Conclusions and implications: </strong>Admission to an intermediate care hospital provides the ideal setting for a multicomponent intervention, tailoring prescriptions to the patient's overall goals of care and preferences, improving the pharmacotherapy parameters related to side effects, and ensuring that the proposed prescribing recommendations are maintained over the medium term.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"134"},"PeriodicalIF":3.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522690","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":"Prediction of sarcopenia at different time intervals: an interpretable machine learning analysis of modifiable factors.","authors":"Xiaodong Chen, Liping Li","doi":"10.1186/s12877-025-05792-1","DOIUrl":"10.1186/s12877-025-05792-1","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to develop sarcopenia risk prediction models for Chinese older adults at different time intervals and to identify and compare modifiable factors contributing to sarcopenia development.</p><p><strong>Methods: </strong>This study used data from 3,549 participants aged 60 and older in the China Health and Retirement Longitudinal Study (CHARLS). Sarcopenia status was evaluated by the AWGS2019 algorithm. Full models for 2- and 4-year sarcopenia risk, considering multifactorial baseline variables, were compared with modifiable models. Eight machine learning (ML) algorithms were used to build these models, with performance evaluated by the area under the receiver operating characteristic curve (AUC-ROC). SHapley Additive exPlanations (SHAP) was applied for model explanation.</p><p><strong>Results: </strong>The average age of participants was 67.0 years (SD = 6.1), with 47.8% being female (1,696 participants). The ML models achieved moderate performance, and eXtreme Gradient Boosting (XGBoost) emerged as the best model for both the full and modifiable models in the 2-year prediction, with AUCs of 0.804 and 0.795, respectively (DeLong test, P = 0.665). In contrast, in the 4-year prediction, the Light Gradient Boosting Machine (LightGBM) performed best with AUCs of 0.795 and 0.769, respectively (P = 0.053). The SHAP analysis highlighted gender and estimated glomerular filtration rate (eGFR) as the most important predictors in both the full and modifiable models.</p><p><strong>Conclusions: </strong>Prediction models based on modifiable factors at different time intervals can help identify older Chinese adults at high risk of sarcopenia. These findings highlight the importance of prioritizing functional capacity and psychosocial determinants in sarcopenia prevention strategies.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"133"},"PeriodicalIF":3.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522691","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":"Drug prescription patterns and compliance with WHO and beers criteria in older patients.","authors":"Mahan Malekzadeh, Yousef Khadivi, Seyed Mojtaba Sohrevardi, Golnaz Afzal","doi":"10.1186/s12877-025-05780-5","DOIUrl":"10.1186/s12877-025-05780-5","url":null,"abstract":"<p><strong>Background: </strong>As the population ages, the prevalence of chronic diseases increases, leading to greater reliance on multiple medications that are conducted to increase the risk of adverse drug reactions (ADR) that may cause higher morbidity and mortality rates. This study aims to evaluate medication prescribing patterns in the older adults and assess compliance with the World Health Organization (WHO) guidelines and Beers Criteria.</p><p><strong>Methods: </strong>A cross-sectional study was conducted over six months in 2022, collecting prescriptions for patients aged 65 and above from a 24-hour community pharmacy in Iran. The prescriptions were analyzed according to the WHO prescribing guidelines, including the mean number of prescribed drugs, the number of injectable drugs and antibiotics per prescription, and also the prescription of drugs with generic names and from the list of Essential Drug List (EDL). In addition, the prescriptions were assessed according to the Beers Criteria for the frequency of prescription of potentially inappropriate medications (PIMs). Also, polypharmacy, which is defined as the prescription of more than five drugs per prescription, has been investigated based on the number of drugs prescribed per prescription.</p><p><strong>Results: </strong>1,053 older patient prescriptions were assessed, whose average age was 72.3 ± 6.7 years, with 36.2% of prescriptions involving polypharmacy (five or more drugs). The most frequent medical discipline of prescribers was general practice (30.3%). The average number of drugs per prescription was 4.1 ± 2.1, which exceeded the WHO recommendation. Additionally, 47.3% of prescriptions contained at least one PIM according to the Beers Criteria, with non-steroidal anti-inflammatory drugs (NSAIDs) being the most common (17.9%). The relative frequency of injectable drugs and antibiotics used per prescription was 20.8 and 18.9%, respectively, while 7.6% of prescriptions did not use generic names.</p><p><strong>Conclusions: </strong>The study highlights concern about levels of polypharmacy and PIM use in older patients. While the low rate of antibiotic prescribing and relatively high use of generic drugs indicate some positive adherence to WHO guidelines, the frequent prescription of PIMs and the high average number of drugs per prescription point to substantial room for improvement.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"135"},"PeriodicalIF":3.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522591","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":"CSEPC: a deep learning framework for classifying small-sample multimodal medical image data in Alzheimer's disease.","authors":"Jingyuan Liu, Xiaojie Yu, Hidenao Fukuyama, Toshiya Murai, Jinglong Wu, Qi Li, Zhilin Zhang","doi":"10.1186/s12877-025-05771-6","DOIUrl":"10.1186/s12877-025-05771-6","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's disease (AD) is a neurodegenerative disorder that significantly impacts health care worldwide, particularly among the elderly population. The accurate classification of AD stages is essential for slowing disease progression and guiding effective interventions. However, limited sample sizes continue to present a significant challenge in classifying the stages of AD progression. Addressing this obstacle is crucial for improving diagnostic accuracy and optimizing treatment strategies for those affected by AD.</p><p><strong>Methods: </strong>In this study, we proposed cross-scale equilibrium pyramid coupling (CSEPC), which is a novel diagnostic algorithm designed for small-sample multimodal medical imaging data. CSEPC leverages scale equilibrium theory and modal coupling properties to integrate semantic features from different imaging modalities and across multiple scales within each modality. The architecture first extracts balanced multiscale features from structural MRI (sMRI) data and functional MRI (fMRI) data using a cross-scale pyramid module. These features are then combined through a contrastive learning-based cosine similarity coupling mechanism to capture intermodality associations effectively. This approach enhances the representation of both inter- and intramodal features while significantly reducing the number of learning parameters, making it highly suitable for small sample environments. We validated the effectiveness of the CSEPC model through experiments on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset and demonstrated its superior performance in diagnosing and staging AD.</p><p><strong>Results: </strong>Our experimental results demonstrate that the proposed model matches or exceeds the performance of models used in previous studies in AD classification. Specifically, the model achieved an accuracy of 85.67% and an area under the curve (AUC) of 0.98 in classifying the progression from mild cognitive impairment (MCI) to AD. To further validate its effectiveness, we used our method to diagnose different stages of AD. In both classification tasks, our approach delivered superior performance.</p><p><strong>Conclusions: </strong>In conclusion, the performance of our model in various tasks has demonstrated its significant potential in the field of small-sample multimodal medical imaging classification, particularly AD classification. This advancement could significantly assist clinicians in effectively managing and intervening in the disease progression of patients with early-stage AD.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"130"},"PeriodicalIF":3.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514494","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":"Predictive value of qSOFA score for mortality in older patients with dengue fever: a retrospective case-control study.","authors":"Chi-Heng Lee, Yu-Chieh Ho, Chien-Chin Hsu, Hung-Jung Lin, Jui-Yuan Chung, Chien-Cheng Huang","doi":"10.1186/s12877-025-05711-4","DOIUrl":"10.1186/s12877-025-05711-4","url":null,"abstract":"<p><strong>Background: </strong>Dengue fever (DF) in older patients is associated with higher mortality, but optimal mortality prediction approaches remain unclear. We assessed the utility of the quick Sequential Organ Failure Assessment (qSOFA) as a predictive tool in older DF patients.</p><p><strong>Methods: </strong>We retrospectively included DF patients aged ≥ 65 years who visited our study hospital between September 1, 2015, and December 31, 2015. Demographics, vital signs, comorbidities, laboratory data, and mortality were collected. Accuracy of qSOFA score ≥ 2 in predicting 30-day mortality was evaluated.</p><p><strong>Results: </strong>626 older DF patients were recruited (mean age: 74.1 years, nearly equal sex distribution). Mean ± standard deviation of qSOFA score was higher in mortality group vs. survival group (0.6 ± 0.8 vs. 0.1 ± 0, p < 0.01). Logistic regression showed qSOFA score ≥ 2 associated with higher mortality risk (odds ratio: 18.74; 95% confidence interval: 4.37 - 50.64). Adjusted area under receiver operating characteristic was 0.75, and Hosmer-Lemeshow goodness of fit test was 0.58. Sensitivity, specificity, positive predictive value, and negative predictive value of qSOFA score ≥ 2 for predicting mortality were 18.5%, 98.7%, 38.5%, and 96.4%, respectively.</p><p><strong>Conclusion: </strong>qSOFA score ≥ 2 is a simple and specific tool for predicting 30-day mortality in older patients with DF, with high specificity and negative predictive value. It can be used to rule out patients at high risk of mortality.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"132"},"PeriodicalIF":3.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514495","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":"The association between exercise, activities, and frailty in older Chinese adults: a cross-sectional study based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data.","authors":"Linyan Dai, Yangyang Tang, Yihong Guo, Xia Lai, Xingsheng Wang, Baoshan Li","doi":"10.1186/s12877-025-05802-2","DOIUrl":"10.1186/s12877-025-05802-2","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to evaluate the association between exercise/activities and frailty in older Chinese adults using the Chinese Longitudinal Healthy Longevity Survey (CLHLS).</p><p><strong>Methods: </strong>This cross-sectional study included 6862 participants aged 65 years or older from the CLHLS 2018. Frailty was assessed using a 38-variable frailty index (FI). Activities included Tai chi, square dance, garden work, raising animals/pets, playing cards/mah-jongg, social activity and housework. Multivariate logistic regression was used to assess the association between exercise/activities and frailty, adjusting for covariates such as gender, age, BMI, chronic diseases, residence, education, co-residence, economic status, smoking, drinking, physical labor history, and nutritional supplements.</p><p><strong>Results: </strong>The mean age of this study was 81.5 (SD = 10.3)years, with 3567 (52%) females. Frailty prevalence was 32.3%. The prevalence of exercise and daily activities was 31% and 78.6%, respectively. Multivariate logistic regression analysis showed that the likelihood of frailty increased with decreased exercise (OR = 1.85, 95% CI: 1.57, 2.18, P < 0.001) and activities (OR = 4.43, 95% CI: 3.74, 5.25, P < 0.001).</p><p><strong>Conclusions: </strong>Participation in exercise/activities is associated with a lower likelihood of frailty. Regular housework may also contribute to reducing frailty risk.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"131"},"PeriodicalIF":3.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514496","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":"Development and validation of a dynamic nomogram for predicting cognitive impairment risk in older adults with dentures: analysis from CHARLS and CLHLS data.","authors":"Tongtong Guo, Xiaoqing Zhao, Xinyi Zhang, Yang Xing, Zhiwei Dong, Haiyan Li, Runguo Gao, Zhiping Huang, Xue Bai, Wengui Zheng, Qi Jing, Shanquan Chen","doi":"10.1186/s12877-025-05758-3","DOIUrl":"10.1186/s12877-025-05758-3","url":null,"abstract":"<p><strong>Background and aims: </strong>Cognitive impairment is a common issue among older adults, with denture use identified as a potential, easily recognizable clinical risk factor. However, the link between denture wear and cognitive decline in older Chinese adults remains understudied. This study aimed to develop and validate a dynamic nomogram to predict the risk of cognitive impairment in community-dwelling older adults who wear dentures.</p><p><strong>Methods: </strong>We selected 2066 elderly people with dentures from CHARLS2018 data as the development and internal validation group and 3840 people from CLHLS2018 as the external validation group. Develop and treat the concentrated unbalanced data with the synthetic minority oversampling technique, select the best predictors with the LASSO regression ten-fold cross-validation method, analyze the influencing factors of cognitive impairment in the elderly with dentures using Logistic regression, and construct a nomogram. Subject operating characteristic curves, sensitivity, specificity, accuracy, precision, F1 score, calibration curve, and decision curve were used to evaluate the validity of the model in terms of identification, calibration, and clinical validity.</p><p><strong>Results: </strong>We identified five factors (age, residence, education, instrumental activities of daily living, and depression) to construct the nomogram. The area under the curve of the prediction model was 0.854 (95%CI 0.839-0.870) in the development set, 0.841 (95%CI 0.805-0.877) in the internal validation set, and 0.856 (95%CI 0.838-0.873) in the external validation set. Calibration curves indicated significant agreement between predicted and actual values, and decision curve analysis demonstrated valuable clinical application.</p><p><strong>Conclusions: </strong>Five risk factors, including age, place of residence, education, instrumental activities of daily living, and depression level, were selected as the final nomogram to predict the risk of cognitive impairment in elderly denture wearers. The nomogram has acceptable discrimination and can be used by healthcare professionals and community health workers to plan preventive interventions for cognitive impairment among older denture-wearing populations.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"127"},"PeriodicalIF":3.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498948","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":"SARC-F: an effective screening tool for detecting sarcopenia and predicting health-related quality of life in older women in Sri Lanka.","authors":"Nirmala Rathnayake, Thilina Abeygunasekara, Gayani Liyanage, Sewwandi Subasinghe, Warsha De Zoysa, Dhammika Palangasinghe, Sarath Lekamwasam","doi":"10.1186/s12877-025-05786-z","DOIUrl":"10.1186/s12877-025-05786-z","url":null,"abstract":"<p><strong>Objective: </strong>The \"Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls\" (SARC-F) is a simple, five-item tool used to identify individuals with suggestive signs of sarcopenia. This study assessed the validity of the Sinhala version of the SARC-F, evaluating its ability to detect sarcopenia in older women and its potential to predict health-related quality of life (HRQoL).</p><p><strong>Methods: </strong>The culturally adapted Sinhala version of the SARC-F, along with the Short Form-36 (SF-36) survey, was administered among 350 older women (aged ≥ 65) attending medical clinics at National Hospital Galle, Sri Lanka. Handgrip strength (HGS) was measured using a handheld dynamometer, and relative appendicular skeletal muscle mass index (RSMI) was estimated with a Sri Lankan-specific anthropometry-based equation. Gait speed (GS) was assessed using 4-m customary-paced walk test.</p><p><strong>Results: </strong>The mean (± SD) age of the participants was 72 (± 5) years, with 56.3% (n = 197) having sarcopenia based on a SARC-F score of ≥ 4. The Sinhala version of SARC-F demonstrated a good internal consistency (Cronbach's alpha = 0.72). A significant positive correlation between SARC-F and HGS indicated concurrent validity (r = 0.23, p < 0.001). Women with sarcopenia had significantly lower HRQoL scores, HGS and GS compared to those without, confirming discriminant validity (p < 0.01). The sensitivity, specificity, and accuracy of the Sinhala SARC-F were 54.8%, 67.3%, and 60.3%, respectively, with an Area Under the Curve (AUC) of 0.61 (95% CI: 0.55-0.67) in detecting probable sarcopenia. The HRQoL domains of SF-36 (excluding emotional well-being), HGS and GS were inversely correlated with SARC-F (Spearman's rho range: -0.19 to -0.56, p < 0.001). SARC-F significantly associated with the physical function and pain domains of SF-36 explained 42% of the variance in the model (r = 0.65, R2 = 0.42).</p><p><strong>Conclusions: </strong>The Sinhala version of SARC-F is a reliable and valid tool for screening sarcopenia in Sinhala-speaking older women in Sri Lanka. It can be integrated into clinical practice to identify those with suggestive signs of sarcopenia and to predict HRQoL enabling timely interventions. Future studies with larger, more diverse populations, including men, are needed to enhance the tool's generalizability and diagnostic accuracy.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"129"},"PeriodicalIF":3.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498963","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":"Internet use and life satisfaction among empty nesters in rural areas of Yangzhou: based on propensity score matching and mediating effect model.","authors":"Yitong Liu, Yaning Wang, Zhuoya Yang, Wenkun Xu, Guangyu Tian, Yuexiao Gao, Miaomiao Zhao, Rujian Lu, Yaqin Zhong","doi":"10.1186/s12877-025-05788-x","DOIUrl":"10.1186/s12877-025-05788-x","url":null,"abstract":"<p><strong>Background: </strong>Empty nesters represent a unique group that deserves focused attention. Internet usage is becoming increasingly prevalent among older people. This study preliminarily discussed the differences in life satisfaction between empty nesters who used the Internet and those who did not. This study also provided insight into how Internet use interacted with social participation to improve their life satisfaction.</p><p><strong>Methods: </strong>A face-to-face survey was conducted in Yangzhou City, China, from July to August 2022. Covariates related to life satisfaction, such as sociodemographic characteristics and participants' health behaviors, were collected. Propensity Score Matching (PSM) was used to match Internet users with non-Internet users. Binomial logistic regression was employed to analyze the association between Internet use and life satisfaction, and the KHB method was used to examine the mediating effect.</p><p><strong>Results: </strong>1,177 respondents aged 60 and above were ultimately matched for analysis in this study. The results showed that Internet use was significantly correlated with higher levels of both social participation (β = 0.276, P < 0.05) and life satisfaction (β = 0.433, P < 0.05). Social participation partially mediated the relationship between Internet use and life satisfaction, with a mediating effect of 0.112 accounting for 21% of the total effect. Further analysis of group heterogeneity indicated that the positive association between Internet use and life satisfaction was more prominent among participants who were younger, male, unemployed, had an income, and were in relatively healthy conditions.</p><p><strong>Conclusions: </strong>Internet use was crucial in promoting social participation and enhancing life satisfaction among rural empty nesters. Interventions aimed at improving their life satisfaction should prioritize the creation of inclusive and supportive environments, encouraging social participation, and enhancing digital literacy.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"128"},"PeriodicalIF":3.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498950","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":"Dying in residential care homes during the early COVID-19 pandemic: a qualitative interview study.","authors":"Nancy Preston, Zoë Cockshott, Siân Russell, Rachel Stocker, Jo Knight, Suzanne Mason, Barbara Hanratty","doi":"10.1186/s12877-025-05779-y","DOIUrl":"10.1186/s12877-025-05779-y","url":null,"abstract":"<p><strong>Background: </strong>Early in the COVID-19 pandemic, care homes (long-term care facilities) globally were severely impacted in many ways, including end-of-life care and death of residents. They experienced significantly elevated mortality rates amongst residents, compounded by restrictions on support from external healthcare and specialist palliative care providers. Family access to dying residents was often severely restricted. This paper explores experiences of deaths, dying and end-of-life care in care homes during the first year of the pandemic (Spring 2020-2021).</p><p><strong>Methods: </strong>As part of a wider study of experiences in care homes in Northern England during the early pandemic, we conducted semi-structured interviews with care home staff (16), residents (3), family members (5) and health service staff (10). Interviews were analysed using reflexive thematic analysis, this secondary analysis focusing on experiences of death and dying over the period.</p><p><strong>Results: </strong>Thematic analysis generated three key themes: (1) Preparing for large scale deaths: Care home staff reported a sense of foreboding at requirements to prepare for large scale resident deaths, sometimes feeling left with minimal external support to manage this, and uneasy about the rapid roll-out of emergency care planning to residents; (2) Balancing support and policing visiting during the terminal phase: The requirement to restrict access for family members when their relatives were dying was experienced as distressing for both family members and care home staff; and, (3) Distress surrounding deaths for staff and families: Care home staff were distressed by the frequency and speed of deaths that they witnessed when their care home had a COVID-19 outbreak. Family separation near time of death was a source of distress for everyone involved, with suggestions that this led to regrets in bereavement for family members, and moral distress in staff.</p><p><strong>Conclusions: </strong>The experience of death and dying in care homes in the early waves of the COVID-19 pandemic was extremely challenging for care home staff and family members. Our analysis suggests that the ramifications of stringent visitation policies and the consequent distress may shape experiences in bereavement. Monitoring for longer term consequences, such as prolonged grief and moral injury, should be a priority.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"126"},"PeriodicalIF":3.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11854402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490737","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}