Objectives To develop a predictive model for nasogastric tube (NGT) removal and examine survival-related factors among community-dwelling residents. Design Retrospective cohort study (2016–2020) using medical records. Setting and Participants A total of 255 home care residents with NGTs from a regional hospital in Taiwan. Methods This retrospective study was conducted to identify predictors across 30 variables from clinical records and nursing assessments. Logistic regression and Cox proportional hazards models assessed predictors of successful NGT removal, with model performance evaluated using ROC curve. Results Key predictors of successful NGT removal (18.0%, n = 46) and 12-month survival were activities of daily living, instrumental activities of daily living, and upper limb strength. Survival was higher in the removal group, and the model showed good accuracy (AUC = 0.811). Conclusion This model provides a clinically applicable tool that incorporates functional and medical indicators to assess NGT removal readiness, demonstrating strong predictive validity.

Studies have shown links between nutrition in older adults and marital status. Few studies explore the interaction of gender and marital status with a healthy diet in the US for older adults. Using a sample of oldest olds living in an independent, retirement community dwelling in Florida, we found a statistically significant difference in healthful diet between women and men, controlling for marital status, health status, social isolation, loneliness, and other covariates. We also found a significant negative relationship between healthful diet and widowhood (b = −3.85, p < .000). Likewise, older adults who were divorced or never married had lower healthful diet scores than those who were married or remarried (b = −7.31, p < .000), disability was associated with a lower healthful diet (b = −.30, p < .01), and loneliness was negatively associated with healthful diet. The results have important implications for medical advisers and those involved in providing support to these older adults.

Meaningful moments are brief, non-pharmacological person-centered interactions or activities that evoke positive emotions in hospitalized patients living with dementia and connect them to their history, identity, or surroundings. The aim of the study was to (a) identify key elements of an innovation primarily designed for long-term care that would be suitable for facilitating meaningful moments for people with dementia in a hospital environment, (b) determine the preferred way of introducing these key elements into practice, and (c) map out determinants, implementation strategies, mechanisms, and outcomes using the Implementation Research Logic Model. Successful implementation required an approach focused on knowing the person, sharing meaningful moments, and incorporating those approaches into everyday care routines. Factors for success included an iterative feedback loop, persuasive education, clear roles, and effective leadership.

People with dementia are often hospitalized from the emergency department (ED) for “borderline cases,” where outpatient or inpatient management may be clinically reasonable. We sought to investigate how ED physicians make and communicate about decisions in borderline cases. Through cognitive interviews, we asked attending ED physicians from an academic hospital to share their approach to scenarios representing borderline cases with people with dementia and verbalize communication about ED disposition with patients and care partners. We deductively coded responses related to patient/care partner engagement and key features of communication and then elucidated themes related to content and phrasing of communication. Of 21 physicians, two-thirds stated they would offer the option of admission or discharge, but few explicitly communicated admission versus discharge as a choice. Shared decision-making is applicable to these situations and could provide a consistent structure to communication about disposition.

Background: A frailty index (FI) can identify individuals with frailty in a population of interest. Previous literature suggests a need for frailty assessment methods for older adults in China and that urbanization may impact frailty status. We used a FI to examine the association between frailty and urbanization as living in a less urbanized area may put older adults at a higher risk frailty and poor healthcare outcomes. Methods: We included adults aged 55 years and older (n = 7695) from the China Health and Nutrition Survey (2018). The FI was based on health outcomes correlating with a deficit score divided by number of health items: robust (<0.08), pre-frail (0.08–0.24), and frail (≥0.25). We used multinomial logistic regression models to examine associations between urbanization tertile (low, medium, and high) and frailty, using our novel FI. We also conducted sub-analyses examining how urbanization level modifies the relationship between frailty status and region of residence, and education and income levels. Results: Living in an area of low versus high urbanization was associated with higher odds of frail versus robust (1.5; 1.2–2.0), and pre-frail versus robust (1.6; 1.4–2.0) status in the fully adjusted model. Generally, higher odds of worse frailty status (e.g., pre-frail or frail) was associated with lower tertiles of urbanization for region, income, and education when compared to the highest urbanization tertile. Conclusions: A FI can help identify specific characteristics that may benefit from individualized interventions to counteract frailty. Living in less urbanized areas was associated with higher odds of pre-frailty and frailty. Inclusion of urbanization level, geographic residence, and social determinants of health in FI development can help identify older adults most at risk of frailty and contribute to individual and policy-level frailty prevention interventions.

Several interventions for care partners of persons living with dementia target the negative effects of behavioral symptoms. Evidence suggests that actively engaging care partners improves outcomes. However, there is little information on the best approaches to optimize active engagement. Enhancing Active Caregiver Training (EnACT) is an arts-based intervention designed to help care partners address the behavioral symptoms of dementia. The purpose of this study is to describe the process of partnering with care partners of persons living with dementia (n = 9) to refine EnACT. We conducted a series of three iterative focus groups to (1) identify video vignettes, (2) test intervention activities, and (3) gather feedback. Focus groups were analyzed in three cycles using structural, descriptive, and pattern coding. Intervention revisions focused on narrowing vignette topics, removing confusing components, enhancing accessibility, and adding facilitator training. Partnering with care partners improved intervention feasibility in preparation for future testing.

Older adults are disproportionately exposed to increased harm and adverse outcomes in abusive contexts. This systematic review aimed to explore and evaluate current literature on the role of paramedics responding to older adults in abusive contexts, with a specific focus on the vulnerability-reducing and protective potential of paramedics. A systematic review of the literature was undertaken using the Joanna Briggs Institute Systematic Review Guidelines. From an initial yield of 584 results, 18 sources of evidence met the criteria for inclusion and subsequent data extraction. Predominantly North-American literature indicated that older adults experience nuanced, disproportionate and complex vulnerability in abusive contexts, and that paramedics have a poorly defined and inconsistently applied duty of care. Consequently, this systematic review provides key recommendations for enhancing the capacity of paramedics to respond to the unmet needs and vulnerabilities of older adults either experiencing or at risk of abuse or neglect.

Objectives: To examine whether personality traits and health behaviors predict falls in community-dwelling older adults. Methods: Longitudinal data from the Canadian Longitudinal Study on Aging (CLSA) at baseline (2011–2015) and follow-up two (2018–2021) were analyzed using logistic regression for 5270 adults aged 65 and older, with an alpha level of 0.05. Results: At baseline, participants’ mean age was 72 years, with 51.1% female. Most identified as White (96.7%) and had education beyond secondary (81.5%). Increased physical activity (OR: 1.012, 95% CI: 1.01–1.014), decreased alcohol consumption (OR: 1.634, 95% CI: 1.419–1.883), and smoking cessation (OR: 2.8, 95% CI: 2.198–3.568) increased fall risk, while conscientiousness (OR: 0.832, 95% CI: 0.792–0.874) and openness (OR: 0.959, 95% CI: 0.922–0.998) were protective at follow-up two. Personality changes significantly influence falls. Discussion: Findings highlight the complex interplay between personality traits, health behaviors, and falls, suggesting a one-size-fits-all approach to fall prevention may be insufficient.