Community-dwelling Elderly Population Research Articles

Cognitive Decline, Depression, and Sarcopenia: A risk for home care

Abstract Background: The aging process involves a decline in mental and physical abilities. Objective: The aim of this study is to assess the relationship between cognitive decline, depression, and sarcopenia in the community-dwelling elderly population. Methods: This is a quantitative, cross-sectional study. The evaluations were started with a form that contained information of body characteristics (age, sex, height, weight, Body Mass Index, Total Muscle Mass, Total Muscle Mass Index, Abdominal Circumference), sarcopenia characteristics (Calf Circumference, Timed Up and Go Test, Walking Speed Test, Sit and Stand Test, Handgrip Strength Test, and Quadriceps Femoral Strength Test), for the assessment of cognitive decline (Clock Drawing Test), and for depression (Geriatric Depression Scale). Results: A total of 266 community-dwelling elderly people participated in this study, of whom 1/3 had pre-sarcopenia. It was possible to verify that in the Clock Drawing Test (p=0.037) and in the Geriatric Depression Scale (p=0.001), as well as in their question repartition, the group of elderly with pre-sarcopenia presented the worst results. Conclusion: At the end of the study, it was possible to conclude that cognitive decline, depression, and sarcopenia, in fact, are associated. Keywords: Aged, Cognitive Decline, Depression, Sarcopenia.

Effectiveness of personalized meal recommendation in improving dietary behaviors of Chinese community-dwelling elders: study protocol for a cluster randomized controlled trial

BackgroundInappropriate eating behaviors, particularly a lack of food diversity and poor diet quality, have a significant impact on the prognosis of certain chronic conditions and exacerbate these conditions in the community-dwelling elderly population. Current dietary interventions for the elderly have not adequately considered the nutritional needs associated with multiple chronic conditions and personal dietary preferences of elderly individuals. A personalized recommendation system has been recognized as a promising approach to address this gap. However, its effectiveness as a component of an elderly-targeted dietary intervention in real-world settings remains unknown. Additionally, it is unclear whether this intervention approach will be user-friendly for the elderly. Therefore, this study aims to examine the effectiveness of a personalized meal recommendation system designed to improve dietary behavior in community-dwelling elders. The implementation process in terms of System usability and satisfaction will also be assessed.MethodsThe trial has been designed as a 6-month, non-blinded, parallel two-arm trial. One hundred fifty community-dwelling elders who meet the eligibility criteria will be enrolled. Subjects will be allocated to either the intervention group, receiving personalized meal recommendations and access to corresponding food provided as one component of the intervention, as well as health education on elder nutrition topics, or the control group, which will receive nutritional health education lectures. Outcomes will be measured at three time points: baseline at 0 months, 3 months, and 6 months. The primary outcomes will include dietary diversity (DDS) and diet quality (CDGI-E) of enrolled community-dwelling elders, representing their dietary behavior improvement, along with dietary behavior adherence to recommended meals. Secondary outcomes will measure the perceived acceptability and usability of the personalized meal recommendation system for the intervention group. Exploratory outcomes will include changes in the nutritional status and anthropometric measurements of the community-dwelling elders.DiscussionThis study aims to examine the effectiveness, acceptability, and usability of a personalized meal recommendation system as a data-driven dietary intervention to benefit community-dwelling elders. The successful implementation will inform the future development and integration of digital health strategies in daily nutrition support for the elderly.Trial registrationChinese Clinical Trial Registry ChiCTR2300074912. Registered on August 20, 2023, https://www.chictr.org.cn/showproj.html?proj=127583

Abstract P284: Effects of a Laughter Program on Cardiovascular Risk Factors in Community-Dwelling Older Adults

Introduction: While there have been several intervention studies on the psychological effects of laughter, few have examined both the psychological and physical effects in community-dwelling older people. This study aimed to examine the effects of a laughter program on body weight, waist circumference, heart rate, blood pressure, grip strength, and health-related quality of life (HRQOL) in community-dwelling older adults using an intervention trial in Japan. Hypothesis: Laughter-based interventions are effective in reducing cardiovascular risk factors and improving quality of life in the community-dwelling elderly population. Methods: In Yao City, Osaka Prefecture, two school districts were selected and participants were recruited for a laughter program for seniors aged 70 and older in each district. One of the two districts was assigned to receive the laughter program first (laughter intervention group), and the other was assigned to receive the laughter program later (control group). A total of 87 people applied to participate (40 in the intervention group, mean age 75 years; 37 in the control group, mean age 75 years), and the intervention group received 10 laughter programs over 12 weeks. The laughter program was composed of an approximately 30-min lecture about laughter and health, or an approximately 30-min appreciation of rakugo by a professional performer of rakugo , a traditional form of Japanese comic storytelling, and an approximately 60-min laughter yoga class by the laughter yoga teachers. Rakugo was regarded as part of the laughter lectures, and three lectures were given. In both groups, participants were measured for weight, waist circumference, blood pressure, grip strength, and HRQOL at baseline and after 12 weeks. The effects of the laughter program on these factors were analyzed using analysis of covariance for change in each measure, adjusted for age, sex, baseline values, and medication use. Results: None of the participants were injured or physically ill from the laughter program. The laughter program significantly improved the mean waist circumference ( p <0.001), heart rate ( p = 0.04), grip strength ( p <0.001), and mental component summary scores of HRQOL ( p = 0.04). A similar tendency occurred for the mean changes in diastolic blood pressure and physical component summary scores of HRQOL. No significant changes were observed for body weight and systolic blood pressure. Conclusion: The comprehensive 12-week laughter intervention program, consisting primarily of laughter yoga, significantly improved physical and psychological functions such as waist circumference, heart rate, grip strength, and HRQOL among community-dwelling older adults.

Association between Perceived Stress and Motoric Cognitive Risk Syndrome in an Elderly Population: Rugao Longevity and Aging Study

Plain Language SummaryPrevious studies have indicated a correlation between perceived stress and cognitive decline. However, it remains unknown whether high levels of perceived stress can result in motoric cognitive risk (MCR) syndrome. Perceived stress has been defined as the result of a series of environmental events and demands (stressors) perceived by an individual as exceeding their subjective capacity to cope. MCR syndrome is a novel pre-dementia syndrome consisting of subjective memory complaints (SMCs) and slow gait speed. MCR syndrome is a public health problem with a prevalence of 6.3–9.6% in community-dwelling elderly populations in different countries. It is important to identify and treat risk factors for MCR. This will help prevent MCR in order to prevent dementia at an early stage. This study investigated the relationship between perceived stress and MCR in a community-based population. The study cohort comprised 852 elderly individuals from the Rugao Longitudinal Aging Cohort. Perceived stress was assessed using the 10-item Perceived Stress Scale (PSS-10), while MCR was defined as the coexistence of SMCs and slow gait speed. In conclusion, we discovered a significant association between high levels of perceived stress and an increased risk of MCR among individuals aged 70 and older in the community.

Wearable dynamic electrocardiogram monitor-based screening for atrial fibrillation in the community-dwelling elderly population

BackgroundAtrial fibrillation (AF) is a major public health problem with high rates of morbidity, disability and mortality, especially in the elderly population. This study explored the diagnosis and treatment status of AF in adults aged ≥65 years in the community through wearable dynamic electrocardiogram (ECG) monitoring. MethodsWe conducted a cross-sectional study in 4 random communities within the Qingpu district of Shanghai, China. Between January 1, 2020 and June 30, 2022, the ECGs of 3852 adults aged 65 years or older were examined through wearable dynamic ECG monitoring. Data from 3839 participants were ultimately analyzed. Multivariate logistic regression was used to determine the independent predictors of AF. ResultsWearable dynamic ECG monitoring detected AF in 360 elderly people, 78 of whom were diagnosed with AF for the first time. Multivariate logistic regression analysis revealed that snoring, renal dysfunction, coronary heart disease and high CHA2DS2-VASc score were independent risk factors for AF. Among patients with unknown AF, 68 (87.20 %) met the criteria for anticoagulant therapy based on the CHA2DS2-VASc score. Only 4 (5.88 %) patients were taking anticoagulants. Of the patients with a clear history of AF, 249 (84.98 %) needed an anticoagulant strategy, but only 18 (7.23 %) took oral anticoagulants. ConclusionMany elderly people have silent AF, and wearable dynamic ECG monitoring can be used to screen for AF effectively.

Ab. No. 69 Comparative Study on Effect of Square Stepping Exercises With Conventional Balance Exercises on Balance in Community Dwelling Elderly Population: A Randomized Control Trial

Introduction: Determining & comparing the effects of Square Stepping Exercises (SSE) versus Conventional balance exercises after 4 weeks training in the older adults. To tackle age-related decline in balance performance in elderly, physical interventions are essential. SSE is a novel intervention that can enhance balance and reduce the risk of falls. Methods: 40 healthy community dwelling older individuals of age 60 years & more with ability to walk backwards for 3 meters were included in the study. Participants were randomly allocated into two groups of 20 each using sealed envelope method. Limits of Stability (LOS) and Mini-BES Test were assessed as outcome measures prior to and after the 4 weeks of training. Non-Parametric test were used to analyze the data of Mini BESTest as the data was not normally distributed. Whereas the rest of the data (LOS) were normally distributed, hence parametric tests were used to analyze. Results: Both the groups showed statistically significant results when compared to their pre-intervention scores (p<0.0001) The between group comparison did not show any statistically significant difference on balance components (p>0.05). Conclusions: Both Conventional balance training exercises and Square stepping exercises were found to be equally effective in improving balance in elderly. Implications: SSE does not have an advantage over the conventional balance exercises, however it can be used as an adjunct to the conventional balance training to introduce variety in training of community dwelling elderly with adequate safety measures in place.

Prevalence of mild cognitive impairment in an urban, community dwelling, elderly population and its association with Serum Vitamin B12 levels in South India.

AbstractBackgroundPrevalence of cognitive disorders is becoming higher in low and middle income societies with increasing lifespan1. Multiple factors contribute to emergence of cognitive disorders including genes, lifestyle, diet and nutrition, co‐morbid metabolic and vascular risk factors 2. There has been only a few studies from India, looking at the prevalence of cognitive impairment in the community. Ageing and dietary preferences pose a higher risk for B12 and Folic acid deficiencies, contributing to cognitive difficulties3. Our study aims to look at the prevalence of cognitive impairment in a community dwelling elderly population and the association of mild cognitive Impairment (MCI) with serum B12 levels.MethodA total of 308 individuals above the age of 60 were screened for medical issues and psychiatric illnesses. Those who fulfilled the intake criteria were evaluated using Subjective Memory Complaint Questionnaire (SMCQ), MOCA, ACE‐R or RUDAS and FAB. Serum B12 levels were evaluated for all the individuals.Result51.8 percent of individuals had normal cognitive function. The prevalence of cognitive impairment was 48.8%. Among these 42.3% of individuals had mild cognitive impairment. There was no significant correlation between MCI and Serum B12 levels in the screened population.ConclusionThere is a high prevalence of cognitive difficulties in the studied population.Dietary deficiency of Vitamin B12 does not appear to be a major factor contributing to the MCI. Alzheimer’s disease, vascular cognitive impairment and lifestyle and metabolic risk factors may need to be considered as contributory factors

Prevalence of subjective cognitive decline and its association with physical health problems among urban community dwelling elderly population in South India

AbstractBackgroundThe incidence of cognitive disorders is increasing in India1. Stage II of the preclinical Alzheimer’s Disease (PCAD) is characterised by subjective complaints of decline in cognition, termed Subjective Cognitive Decline (SCD)2,3. Objective assessments of cognition is normal in that stage. There are no studies from India that looked at SCD in the community. Our study aims to look at the prevalence of SCD in an urban dwelling elderly population and its correlates.Method418 individuals above the age of 60 were screened using Subjective Memory Complains Questionnaire (SMCQ) and also screened for medical and psychiatric illness. Objective measurement of cognitive functions was done using MOCA.Results372(92.5%) had reported at least 1 subjective complaint using the participant version of the Subjective Memory Complaint Questionnaire(SMCQ). Among those without any reported subjective complaints,17(56.6%) had objective cognitive impairment on assessments. In total,13 (3.49%) had normal cognition and 179(48.12%) of the evaluated subjects had pre‐MCI SCD. There is no statistically significant association between physical health parameters of Diabetes mellitus and Hypertension or any sociodemographic variables except educational attainment. The mean subjective complaints score is lesser and means objective cognition scores are higher in those with higher secondary school educational attainment (p value<0.001) when compared to those who don’t.ConclusionsThere is significant morbidity of cognitive decline in the elderly. Subjective memory complaints are present in most of the elderly(92.5%) and 179(48.12%) had pre‐MCI SCD. SCD is a complex condition that requires further longitudinal studies with biomarker assessment to understand the mechanism of progression to AD.

Lower heart rate variability is associated with loss of muscle mass and sarcopenia in community-dwelling older Chinese adults

Autonomic nervous system (ANS) disorders may occur in skeletal muscle disease, but the link between them has not been fully established. Studying the relationship between them may yield insights into the mechanisms and treatment of disease. This study aimed to explore the association between heart rate variability (HRV), sarcopenia, and subscales of sarcopenia (muscle mass, muscle strength, and physical mobility). 2514 community-dwelling older Chinese participants were included in this study. The Asian Working Group for Sarcopenia guidelines were used to define sarcopenia. HRV was measured by 90-s electrocardiogram RR interval data. All HRV parameters were transformed using natural logarithms. Multiple regression analysis and multivariate linear regression was performed using potential correlates. The overall prevalence of sarcopenia was 15.1% (18.5% in males and 12.6% in females). In the logistic regression analysis model, there was a significant association between log-transformed standard deviation of RR interval (lnSDNN) (OR=0.736, p=0.019), log-transformed coefficient of variation of RR intervals (lnCVRR) (OR=0.751, p=0.020), log-transformed low-frequency power (lnLF) (OR=0.861, p=0.008), log-transformed high-frequency power (lnHF) (OR=0.864, p=0.003) and sarcopenia in the general population after adjusting for age, sex, body mass index (BMI), daily activity levels, hypertension, heart disease and cardiac drugs. In addition, in multivariate linear regression, lnSDNN (β=0.146, p=0.001), lnCVRR (β=0.120, p=0.010), lnLF (β=0.066, p=0.002) and lnHF (β=0.065, p<0.001) remained significantly positively associated with muscle mass, but there were no significant differences in grip strength and walking speed. Sarcopenia was independently associated with lower heart rate variability in a community-dwelling elderly Chinese population. In addition, muscle mass was positively associated with heart rate variability in the elderly.

Sociodemographic features associated with the MoCA, SPPB, and GDS scores in a community-dwelling elderly population

BackgroundAn accurate evaluation of cognitive function, physical health, and psychological health is fundamental for assessing health problems in the elderly population, and it is important to identify the necessity of early therapeutic intervention. The objective of this study was to evaluate the states of mental and physical functions and to investigate the relationships between sociodemographic features and these functions in a community-dwelling elderly population.MethodsThis community-based cross-sectional study was conducted in a suburban district of Shanghai, China. A total of 1025 participants aged 60–89 years underwent investigations of demographic and lifestyle features and a multidimensional geriatric evaluation comprising the Montreal Cognitive Assessment (MoCA), Short Physical Performance Battery (SPPB), and Geriatric Depression Scale (GDS).ResultsThe results of the multivariate linear regression models demonstrated that the MoCA and SPPB scores decreased with advancing age (all P < 0.01). However, the GDS score did not exhibit an age-related decrease (P = 0.09). Both sex and living alone influenced the MoCA score (P < 0.01 and P = 0.04, respectively), SPPB score (P < 0.01 and P = 0.04, respectively), and GDS score (P < 0.01 and P < 0.01, respectively). A higher education level was related to better MoCA and SPPB scores (all P < 0.01). Furthermore, age and sex had interactive effects on the MoCA score (P = 0.03) and SPPB score (P < 0.01). The kernel-weighted local polynomial smoothing curves exhibited similar trends.ConclusionsIt is imperative to develop a more sensitive evaluation of physical function, and to encourage various intellectually and emotionally stimulating social activity strategies to promote healthy aging, especially in elderly women and those living alone who have a low education level.

Selenium and coenzyme Q10 improve the systemic redox status while reducing cardiovascular mortality in elderly population-based individuals.

Serum sulfhydryl groups (R-SH, free thiols) reflect the systemic redox status in health and disease, and may be amenable to therapeutic modulation. Since R-SH are readily oxidized by reactive species, oxidative stress is characterized by reduced serum R-SH levels. Selenium and coenzyme Q10 supplementation may improve the systemic redox status. This study aimed to evaluate the effect of supplementation with selenium and coenzyme Q10 on serum free thiols and to study associations with the risk of cardiovascular mortality in elderly community-dwelling individuals. In this randomized, double-blind, placebo-controlled trial, serum R-SH were measured colorimetrically and adjusted for albumin in 434 individuals at baseline and after 48 months of intervention. Selenium yeast (200 μg/day) and coenzyme Q10 (200 mg/day) or placebo were provided as dietary supplements. After 48 months of intervention, participants receiving combined selenium and coenzyme Q10 supplementation demonstrated increased levels of serum R-SH compared to placebo (P = 0.002). In prospective association analysis, the highest rate of cardiovascular mortality after a median follow-up of 10 years (IQR: 6.8-10.5) was observed in the lowest quartile (Q1) of R-SH levels. Baseline albumin-adjusted serum R-SH were significantly associated with the risk of cardiovascular mortality, even after adjustment for potential confounding factors (hazard ratio [HR] 1.98 per SD, 95% CI: 1.34-2.91, P < 0.001). Supplementation with selenium and coenzyme Q10 to an elderly community-dwelling population low on the two substances, significantly improved serum R-SH levels, supporting a reduction in systemic oxidative stress. Low serum R-SH levels were significantly associated with an increased risk of cardiovascular mortality in elderly individuals.

Associations of sarcopenia with peak expiratory flow among community-dwelling elderly population: based on the China Health and Retirement Longitudinal Study (CHARLS).

To cross-sectionally and longitudinally investigate the correlations of sarcopenia and its components with peak expiratory flow (PEF) among Chinese community-dwelling elderly people. The data were extracted from the China Health and Retirement Longitudinal Study (CHARLS). A total of 4053 participants aged ≥ 60years were enrolled from CHARLS 2011, and 2810 were followed up until 2015. Participants were classified into no-sarcopenia, non-severe sarcopenia, and severe sarcopenia groups based on skeletal muscle mass index (SMI), hand grip strength (HGS), and physical performance [gait speed, five-repetition chair stand test (5CST) and short physical performance battery (SPPB)]. Multivariate linear and logistic regression analyses were used to evaluate the associations of sarcopenia and its components with PEF cross-sectionally and longitudinally. In the cross-sectional analysis, the prevalence of non-severe sarcopenia was 14.6% and severe sarcopenia was 4.9%. The results of linear regression analysis revealed that sarcopenia and its components were all correlated with PEF and PEF%pred. In the longitudinal analysis, compared with non-sarcopenia, subjects with severe sarcopenia were associated with a higher risk of PEF (OR = 2.05, 95%CI = 1.30-3.26) and PEF%pred (OR = 1.83, 95%CI = 1.17-2.86) decline. The changes in physical performance were correlated with changes in PEF and PEF%pred. No associations were observed between changes in SMI and PEF as well as PEF%pred. We demonstrated the associations of baseline sarcopenia status with PEF and longitudinal PEF decline. Also, the changes in physical performance were associated with changes in PEF during a 4-year follow-up. Itindicates that improving sarcopenia, especially physical performancemay increase PEF.

The Relationship between Elevated Homocysteine and Metabolic Syndrome in a Community-Dwelling Middle-Aged and Elderly Population in Taiwan.

(1) Background: Metabolic syndrome has become a serious health problem in society. Homocysteine is a biomarker for cardiovascular disease. We investigated the relationship between homocysteine levels and metabolic syndrome. (2) Methods: A total of 398 middle-aged and elderly individuals were included in our study. First, we divided the participants into two groups: the metabolic syndrome group and the nonmetabolic syndrome group. Second, according to tertiles of homocysteine levels from low to high, the participants were divided into first, second, and third groups. Pearson's correlation was then calculated for homocysteine levels and metabolic factors. Scatterplots are presented. Finally, the risk of metabolic syndrome in the second and third groups compared with the first group was assessed by multivariate logistic regression. (3) Results: In our study, the metabolic syndrome group had higher homocysteine levels, and the participants in the third group were more likely to have metabolic syndrome. Multivariate logistic regression revealed that the third group, which had the highest homocysteine level, was associated with metabolic syndrome with an odds ratio of 2.32 compared with the first group after adjusting for risk factors. (4) Conclusions: We concluded that high plasma homocysteine levels were independently associated with MetS in our study population.

Gender-Specific Prevalence and Risk Factors of Sarcopenic Obesity in the Korean Elderly Population: A Nationwide Cross-Sectional Study.

Sarcopenic obesity (SO) is characterized by the combination of sarcopenia and obesity. This study evaluates the gender-specific prevalence of SO and examines the identified gender-specific risk factors in a community-dwelling elderly population aged 75-84 years. A total of 813 subjects participated in the study via the Korea National Health and Nutrition Examination Survey. The SO prevalence in males and females was 15.46% (95%CI: 11.36-20.70) and 13.59% (95%CI: 10.59-17.28), respectively. The clinical sex-specific risk factors for males were low height, high weight, body mass index, waist circumference, skeletal muscle index, fasting glucose, and triglycerides. The clinical risk factors for females were low height, high weight, body mass index, waist circumference, skeletal muscle index, smoking status, fasting glucose, total cholesterol, and systolic blood pressure. These results are essential to assist healthcare professionals and primary care clinicians with early detection, diagnosis, and intervention for potential SO patients by acknowledging the sex-based prevalence and risk factors.

The Impact of Regular Salah Practice on Balance and Fall Prevention among Community Dwelling Elderly Population

Background: In older population, the incidence of fall is high and balance disorder is one of the high-risk factorsin them. Falls may result in various drastic episodes. Due to fear of fall the older people tends to be more immobileand stay indoors, hence their physical activities are reduced. one of the religious physical activities in muslims aresalah.Salah is a form of slow and moderate exercise. This research aims to examine the impactof regular salah practiceon balance &amp; fall prevention among community dwelling elderly population.Methods: A case control study is carried out in sample size of 162 community dwellingelderly. The assessmentof balance is done with berg balance scale, fear of fall with fallefficacy scale respectively. the statistical analysis isdone with spss.v.20.Conclusion: The result of the present study supports the assumption that religious prayers(such as Islamic prayers)beneficially influence human performance, particularly balanceand also prevents falls in elderly population.Therefore, any exercise protocol proven to be beneficial to humans should be consider beyond its religious aspect.

Appendicular Muscle Mass Index was Stronger than Body Mass Index in Association with Atherosclerosis in the Community-Dwelling Elderly.

Low muscle mass is associated with advanced atherosclerosis. However, only very few studies on the elderly have investigated a dose-response relationship between muscle mass and atherosclerosis. Furthermore, whether the relationship between muscle mass and atherosclerosis is stronger than that between body mass index (BMI) and atherosclerosis among the elderly population remains to be determined. A community-based sample of apparently healthy elderlies (≥ 65 years) was cross-sectionally examined for the association between appendicular skeletal muscle mass (ASM) and brachial-ankle pulse wave velocity (baPWV), a measure of atherosclerosis. We categorized the participants according to sex-specific quintiles of the ASM index (ASM/height2) or BMI. Using multivariable linear regression, we compared the slope of one standard deviation higher ASM index for baPWV with the corresponding slope of BMI, separately (single-index model) and jointly (simltaneously-adjusted model). The ASM index and BMI of a total of 995 participants (60.0% women, mean age 73 years) were significantly inversely associated with baPWV in a dose-response manner across the quintiles in both sexes. The slope for the ASM index tended to be greater than that for BMI in the single-index and simultaneously-adjusted models in both sexes after adjusting for confounders. Among a community-dwelling elderly population, the association between ASM and baPWV was stronger than, and independent of that between BMI and baPWV. These findings suggest that ASM provides more important information on atherosclerosis in the elderly than BMI does.

The effectiveness of interventions to prevent loneliness in the community-dwelling elderly population

Abstract Background Loneliness and social isolation have comparable health effects to widely acknowledged and established risk factors. Although the elderly are particularly affected, the effectiveness of interventions to prevent and/or mitigate social isolation and loneliness in the community-dwelling elderly is unclear. The aim of this review of reviews was to pool the findings of systematic reviews addressing the question of effectiveness. Methods Ovid MEDLINE®, Health Evidence, Epistemonikos and Global Health (EBSCO) were searched from January 2017 to November 2021. Two reviewers independently assessed each systematic review in two consecutive steps based on previously defined eligibility criteria and appraised the methodological quality using AMSTAR 2. One author extracted data from both systematic reviews and eligible studies; another checked this. We conducted meta-analyses to pool the study results. We report the results of the random-effects and common-effect models. Results We identified 5 systematic reviews containing a total of 30 eligible studies, 16 with a low or moderate risk of bias. Our random-effects meta-analysis indicates an overall SMD effect of 0.63 [95% CI: -0.10; 1.36] for loneliness and was unable to detect an overall effect of the interventions on social support [SMD: 0.00; 95% CI: -0.11; 0.12]. Discussion The results show interventions can potentially reduce loneliness in the non-institutionalised, community-dwelling elderly population living at home. As confidence in the evidence is low, rigorous evaluation is recommended. Key messages • The meta-analysis indicates that psychosocial interventions have the potential to reduce loneliness in the community-dwelling elderly population. • As confidence in the evidence is low, healthcare providers should only implement interventions that are, firstly, based on a sound theory of change and, secondly, subject to rigorous evaluation.

Antibiotic Prescription in the Community-Dwelling Elderly Population in Lombardy, Italy: A Sub-Analysis of the EDU.RE.DRUG Study.

Inappropriate consumption and over-prescription of antibiotics have been extensively reported. Our aim was to specifically evaluate the antibiotic prescribing patterns and appropriateness among the elderly (≥65 years) from the Lombardy region (Italy) in primary care. Antibiotic consumption (as DID: DDD/1000 inhabitants × day) and prevalence rates in 2018 were assessed, and the prescribing quality was evaluated using ESAC-based indicators and WHO-AWaRe criteria. A multivariate logistic regression analysis was performed to evaluate the association between the probability of receiving an antibiotic prescription and patients’ and physicians’ characteristics. A total of 237,004 antibiotic users were included (mean age ± SD 75.98 ± 7.63; males 42.7%). Antibacterial consumption was equal to 17.2 DID, with values increasing with age in both males and females. The study found that the proportion of patients with at least one antibiotic prescription in 2018 was around 39.1%, with different age-related trends between males and females. Consumption (as DID) of cephalosporines (65–74 years: 1.65; 75–84 years: 2.06; ≥85 years: 2.86) and quinolones (3.88, 4.61, 4.96, respectively) increased with growing age, while consumption of penicillins (6.21, 6.08, 6.04, respectively) and macrolides, lincosamides, and streptogramins (3.25, 2.91, 2.64, respectively) decreased. In 2018, antibiotics considered to have higher toxicity concerns or resistance potential, as reported by WHO-AWaRe tool, were consumed more intensively than those to be used as first choices, independent of age and sex. The probability of receiving an antibiotic prescription was greater in females, in subjects with polypharmacy, in treatment with respiratory drugs, anti-inflammatory agents or glucocorticoids, and with previous hospitalization; but increasing age was less associated with exposition to antibiotics.

Sex Differences of Sarcopenia in an Elderly Asian Population: The Prevalence and Risk Factors.

The loss of muscle mass is widespread in age-related health phenomena in the elderly population. This study examined the prevalence of sarcopenia in a community-dwelling elderly population according to gender. The study also identified gender-specific risk factors in older people aged 75–84 years old. One thousand two hundred and ninety-three participants aged between 75 and 84 years from the National Health and Nutrition Examination Surveys in Korea were investigated. The prevalence of sarcopenia in males and females in the weighted-value sample was 41.2% (95%CI: 35.8–46.8) and 37.2% (32.7–41.9), respectively. Gender-specific clinical risk factors in males were height, weight, body mass index, waist circumference, skeletal muscle mass index, fasting glucose, and triglyceride levels. Height, weight, body mass index, waist circumference, skeletal muscle mass index, and total cholesterols were clinical risk factors for females. These outcomes would be crucial to primary care clinicians and health care professionals when patients require a referral for early detection and treatment. Health care professionals and clinicians can quickly identify potential sarcopenic patients by acknowledging the gender-specific prevalence and risk factors.

Association between Grip Strength, Obesity, and Cardiometabolic Risk Factors among the Community-Dwelling Elderly Population in Taiwan.

The aim of this study was to evaluate the association between grip strength, obesity, and cardiometabolic risk factors among elderly individuals with different grip strength statuses and weight statuses in Taiwan. We conducted a series of community-based health surveys among the elderly population in Chiayi County, Taiwan from 2017 to 2019. This is a cross-sectionally designed health check-up program that was conducted by the local public health bureau. Anthropometric characteristics, handgrip strength, diabetes, and cardiometabolic risk profiles were measured using standard methods. This study recruited 3739 subjects (1600 males and 2139 females). The non-obese subjects had lower blood glucose (BG) levels compared to the obese subjects. The BG levels of non-obese and obese subjects were 102.7 ± 25.6 mg/dL vs. 109.1 ± 34.3 mg/dL for males; and 102.8 ± 30.1 mg/dL vs. 112.5 ± 40.3 mg/dL for females (both p < 0.001). The grip strength was negatively associated with BG in both sexes (β = −0.357, p < 0.001 for males and β = −0.385, p < 0.05 for females). The relationship between the grip strength and the risk of diabetes showed that for every 1 kg increase in the grip strength, there was a 4.1% and 4.5% decrease in the risk for developing diabetes for males and females, respectively (OR = 0.959, 95% CI = 0.940–0.979 for males and OR = 0.955, 95% CI = 0.932–0.978 for females). A higher handgrip strength is associated with a lower BG level and a lower risk for diabetes mellitus in the elderly Taiwanese subjects. Additional health promotion should focus on the obese and sarcopenic population to prevent cardiometabolic comorbidities in later life.