Developing models of aged care that align with Māori aspirations has been identified as a national priority in a recent report by the New Zealand (NZ) Aged Care Commissioner. We aimed to identify key considerations useful for informing Māori aged care and to identify known gaps and proposed solutions, which could be prioritised in health and social service design, delivery and implementation, and for investigation in future research. We undertook a critical review of peer-reviewed academic and grey literature to identify relevant studies. Studies were grouped into three pre-defined areas: components and values of care models; physical spaces of care; and infrastructures of care. We included 45 articles that focussed on diverse areas including broad experiences of older age, quality of life and well-being, frailty, housing and aged residential care. Findings relating to care models highlighted the aspiration for holistic care models that supported maintaining independence and included meaningful activities. Connection to place and community was important within physical spaces of care and a cross-sectoral approach that allowed for connected and informed decision-making and appropriate resourcing was an important infrastructure consideration. By identifying relevant knowledge relating to models, physical spaces and infrastructures of care, this review provides an evidence base for future health and social service development and identifies gaps in knowledge, which require further research.

The study aimed to examine the impact of a mobile application-based self-management and chronic disease platform in transitional care for older adults with diabetes. A prospective non-randomised concurrent controlled clinical trial was adopted from May to November 2023. Participants were allocated based on their scheduled appointment times, received routine outpatient care or 12-week transitional care information and support intervention including chronic disease management platform and Slow Health. Changes in anxiety, depression, diabetes self-management, self-efficacy and the perceived social support scores of the two groups after 1-month and 3-month intervention were compared. A total of 124 participants were enrolled. The experimental group demonstrated a more pronounced decrease in anxiety, exhibited lower levels of diastolic blood pressure (DBP), showed significantly lower levels of depression, higher levels of diabetes self-management and self-efficacy, and comparable levels of perceived social support compared to the control group. The program has the potential to improve transitional care in older adults with diabetes, warranting further promotion.

Calcium supplementation is widely used in older adults, but its long-term effects on cognitive function remain unclear. This study assessed the association between pharmacological calcium supplementation and cognitive decline over 7 years in cognitively healthy older women. This prospective cohort study included 227 women (mean age 79.9 ± 3.6 years) from the Toulouse centre of the EPIDOS study. Cognitive function was assessed using the Short Portable Mental Status Questionnaire (SPMSQ) at baseline and after 7 years. Cognitive decline was defined as a decrease of at least one point in SPMSQ score. Calcium supplement use at baseline was recorded. Multivariable logistic regression was used to evaluate the association between supplementation and cognitive decline, adjusted for age, obesity, physical activity, instrumental activities of daily living (iADL) score, education level, dietary calcium and vitamin D intake, number of comorbidities and selected chronic conditions. Cognitive decline occurred in 26% of participants. Calcium supplementation was reported by 12% of patients and was independently associated with an increased risk of cognitive decline (OR = 3.64; 95% CI: 1.47-9.01; p = 0.005). Obesity and comorbidity burden were also significant risk factors. Calcium supplementation was associated with a threefold increased risk of cognitive decline in older women over a 7-year follow-up. These results suggest caution in prescribing calcium supplements and underscore the need for further research on their neurological safety in ageing populations.

This study aimed to assess the validity and reliability of the Turkish version of the Rapid Sarcopenia Screening (RSS) tool, designed to provide a quick and practical method for identifying sarcopenia in older adults. A cross-sectional observational study was conducted among 150 individuals aged 60 years and older attending a geriatric outpatient clinic in Türkiye. The RSS underwent forward-backward translation and linguistic validation. Construct validity was examined by correlation with the SARC-F. Internal consistency was assessed using Cronbach's alpha, whereas intra-rater and inter-rater reliability were evaluated with intraclass correlation coefficients (ICCs). Discriminant validity was analysed using receiver operating characteristic (ROC) curves. The median age of participants was 75 years (range: 62-103), and 59% were female. According to EWGSOP2 criteria, 27% were diagnosed with sarcopenia. The RSS showed good internal consistency (Cronbach's alpha = 0.768). A strong inverse correlation with SARC-F scores (rho = -0.688, p < 0.001) supported construct validity. ROC analysis demonstrated good discriminatory power (AUC = 0.817). Reliability was also excellent, with intra-rater and inter-rater ICCs of 0.980 and 0.963, respectively. The Turkish RSS is a valid, reliable and practical screening tool for detecting sarcopenia in older adults. Its brevity and reliance on self-reported items support its feasibility for routine clinical practice and suggest its potential as an alternative screening method in Türkiye.

Apixaban is widely recommended as first line therapy for atrial fibrillation (AF) and venous thromboembolism (VTE). Despite the widespread availability of dosing guidelines, anecdotal evidence suggests clinicians do not routinely follow these recommendations. Inappropriate dose reduction is associated with suboptimal patient outcomes. This project aimed to review current prescribing practices of apixaban 2.5 mg against guidelines to identify potentially inappropriate prescribing. A single-centre, retrospective review of all adult patients admitted to a large tertiary hospital in Perth, Australia, who were dispensed apixaban 2.5 mg between 1 January 2023 and 31 December 2024, was undertaken. Patients were identified via dispensing records. Demographics, indication, comorbidities, concurrent medications and laboratory data were collated. Each case was assessed against current guidelines to determine whether dosing was appropriate or potentially inappropriate. Data were analysed using quantitative statistics. A total of 303 patients were dispensed apixaban 2.5 mg in the audit period. Of these 178 (59%) were newly initiated. The mean age of the cohort was 79 years (standard deviation [SD] 12.6), with 49% female. Of the 128 patients (72%) newly initiated on apixaban 2.5 mg for non-valvular AF, 53 (41%) patients received a potentially inappropriate dose. A further 19 patients (11% of the entire cohort) received a potentially inappropriately low dose for acute VTE treatment. A significant proportion of patients initiated on apixaban 2.5 mg received potentially inappropriate doses. These findings highlight the need for targeted anticoagulation stewardship and clinician education to optimise patient outcomes.

The aim of this study was to assess the longitudinal association between transitioning to adult caregiving, grandparent childcare and mental health outcomes (depressive symptoms, life satisfaction and cognitive functioning) and physical health outcomes (pain interference) in South Africa from 2015 to 2022. We used information from three waves of the 'Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI)'. To evaluate within-person changes over time, symmetric and asymmetric linear fixed-effects (FE) regressions were employed and also stratified by sex. Adjusted FE regression analysis found a positive association between the change in grandchild care and beginning to provide grandchild care and depressive symptoms in the total sample and among women. Onset of adult caregiving, change in grandchild care and beginning to provide grandchild care were negatively associated with life satisfaction and positively associated with pain interference, while ceased grandchild care was positively associated with life satisfaction and negatively associated with pain interference. Onset of adult caregiving was negatively associated with cognitive functioning, and change in grandchild care and beginning to provide grandchild care were positively associated with cognitive functioning. Transitions into caregiving-both for grandchildren and adults-are associated with poorer well-being, including higher depressive symptoms (especially among women), lower life satisfaction and greater pain interference, supporting a role-strain perspective. However, initiating or changing grandchild care is linked to better cognitive functioning, suggesting potential stimulation benefits. In contrast, ceasing grandchild care is associated with improved life satisfaction and reduced pain.

The aim of this study was to estimate the prevalence of sarcopenia and examine its associations with glycaemic control, blood pressure and lifestyle behaviours among older adults in Korea. We conducted a secondary analysis of the 2023 Korea National Health and Nutrition Examination Survey that included 1394 adults aged 65 years or older. Sarcopenia followed Asian Working Group for Sarcopenia 2019 criteria (low appendicular skeletal muscle mass index and low handgrip strength). Complex-sample descriptive tests and multivariable logistic regression identified independent correlates adjusting for sociodemographic, behavioural and clinical covariates. Blood pressure was measured per standard protocol; fasting glucose and haemoglobin A1c (HbA1c) were assayed in a central laboratory. Sarcopenia prevalence was 14% (n = 199). Age 76 years or older (OR 3.19, 95% CI 2.27-4.49) and poor glycaemic control (HbA1c ≥ 7.0%; OR 1.89, 95% CI 1.16-3.08) were associated with higher odds of sarcopenia. Protective factors included body mass index ≥ 25 kg/m2 (OR 0.32, 95% CI 0.21-0.48), meeting the World Health Organization physical activity guideline (OR 0.50, 95% CI 0.28-0.90) and alcohol consumption in the past year (OR 0.58, 95% CI 0.41-0.82). Hypertension diagnosis and smoking were not significant. Diastolic, but not systolic, blood pressure was lower among participants with sarcopenia. In a nationally representative Korean sample, sarcopenia was common and linked to modifiable factors-glycaemic control and physical activity. Findings support integrating HbA1c monitoring, resistance and aerobic exercise promotion, and nutrition counselling into community and primary care to reduce sarcopenia risk and support healthy ageing.

The aim of this study was to investigate the effects of a moderate-intensity multicomponent training (MCT) program on body composition, physical function, glycaemic control and lipid profiles in overweight and obese older people. This single-arm quasi-experimental study included 48 male (n = 10) and female (n = 38) overweight (n = 27) and obese (n = 21) older individuals (69.2 ± 4.3 years; 76.4 ± 12.3 kg; 1.60 ± 0.1 m; 30.3 ± 4.7 kg·m2) who were subjected to a 36-week moderate-intensity MCT intervention, including strength, stretching, endurance and balance exercises, twice a week, along with nutritional counselling and psychoeducation. Body composition, physical function (upper- and lower-body strength endurance, lower-body flexibility and dynamic balance), fasting plasma glucose, total cholesterol (TC), low-density lipoprotein (LDL-c) and high-density lipoprotein (HDL-c) levels were assessed before and after 12, 24 and 36 weeks of intervention. Food consumption was evaluated at baseline and after 36 weeks. Except for TC (p = 0.58; W = 0.014), a significant improvement was detected in LDL-c (p < 0.001; W = 0.132) and HDL-c (p < 0.001; W = 0.195), as well as in fasting glucose (p < 0.001; W = 0.556). Upper- and lower-body strength endurance (both p < 0.0001, W = 0.447 and W = 0.175, respectively), lower-body flexibility (p = 0.02; W = 0.068) and dynamic balance (p = 0.04; W = 0.060) also improved in response to MCT. However, all body composition outcomes remained unchanged throughout the MCT intervention (all p > 0.05). Similarly, no significant differences were identified in the food intake variables (all p > 0.05). Our moderate-intensity MCT program effectively improved physical function, glycaemic control and lipid profile, but not body composition, in overweight and obese older adults.

To explore what is known about the attitudes, beliefs and perceptions of appropriate prescribing from the view of older First Nations Peoples (aged 45 years or older, residing in the community or residential care), substitute decision-makers and health-care professionals working with First Nations Peoples. The scoping review was conducted in accordance with the JBI methodology for scoping reviews and PRISMA-ScR. Databases and grey literature sources were searched with no limitations from inception until 12 May 2025. Titles and abstracts were screened by two independent reviewers, with full-text assessment for inclusion and data extraction undertaken by two independent reviewers. Study characteristics were described descriptively. Five articles were included for analysis. First Nations Peoples represented included Māori, American Indians and Australian Aboriginal and/or Torres Strait Islander Peoples. Health-care workers represented included Aboriginal Health Workers, general practitioners and nurses. From the older First Nations People's perspective, themes regarding traditional medicine use, lack of medication information provision and concerns about adverse effects were identified. Dominant themes from health-care workers included medication information, compliance to medications and continuity of care. Older First Nations Peoples expressed a desire for more medication information and culturally appropriate care. Included studies indicated most health-care workers supported interventions to increase knowledge and understanding of medications for First Nations Peoples. Unfortunately, paternalistic attitudes remain, which limit the provision of information and prevent a trusted partnership from forming.

Hospitalisation provides an opportunity to deprescribe (withdraw inappropriate medications), however, safe and effective deprescribing relies on good communication between relevant stakeholders. The aim of this study was to explore the perspectives of Australian hospital and community pharmacists on communicating information about deprescribing at transitions of care and their role in the deprescribing process. A diverse group of hospital and community pharmacists was purposively recruited. Data were collected via individual semi-structured interviews and focus groups that were audio-recorded and transcribed verbatim using NVivo. Each transcript was thematically analysed using an inductive coding approach, performed by two independent coders. Thirty-two pharmacists were recruited between June and August 2023. Seventeen participants worked in hospitals, 10 in community pharmacies, and five across both settings. Four themes with 12 subthemes were identified, pertaining to (i) how pharmacists communicate about deprescribing on hospital discharge, (ii) how pharmacists collaborate with other healthcare professionals and patients to optimise deprescribing, (iii) how the role of the pharmacist in deprescribing at transitions of care can be optimised, and (iv) how pharmacists feel about their current and future role in deprescribing. Challenges in communicating deprescribing recommendations and ensuring continuity of care when patients transition between care settings were identified. Development of new tools (e.g., templates and guidance on how and what should be communicated) and processes to support communication at the transition of care from hospital to the community are needed to support deprescribing activities.