Aging Population Research Articles

Analysis of prognosis and medical resource utilization in elderly patients with trauma: A retrospective cohort study in one trauma center

Background: Trauma is consistently among the top ten causes of death worldwide. The aging population, constituting 15.21% of adults aged over 65 in Taiwan as of November 2019, has significantly impacted healthcare expenditures. This study aimed to explore the prognosis and resource utilization in patients with geriatric trauma. Methods: This retrospective analysis included ER admissions between January 2015 and December 2017 at a Level I trauma center in southern Taiwan. Of the 5,185 eligible patients, 1,743 were elderly. Comparisons between the age groups assessed medical resource use, patient characteristics, trauma profiles, and management. Outcomes examined included mortality, complications, length of hospital stay, duration of ICU stay, and costs. Results: Elderly patients, predominantly women, exhibit more blunt injuries often resulting from accidental falls. They experienced longer hospital stays and higher medical expenses, as well as increased complication and mortality rates. Mortality predictors included age, GCS score, trauma severity score (≥16), complications, surgery, and initial hypotension. Complications correlated with prolonged length of hospital stay (LOS), early blood transfusion, and mortality, impacting overall expenditure along with trauma severity, ICU days, surgery, and AIS score (≥3). Conclusion: Elderly patients had a longer LOS, higher mortality and complication rates, and higher total medical costs. The required medical expenses for elderly trauma cases were relatively higher than those for younger individuals. Relevant authorities should consider patient age when formulating policies for trauma reimbursement. Based on our findings, healthcare resource utilization can be reduced by decreasing the length of hospital stay and mitigating trauma severity. We recommend collecting more detailed data, extending the study period, and engaging in multicenter collaborations to validate our findings and provide a roadmap for further research. We suggested that interventional studies are needed to test strategies aimed at reducing resource utilization and improving outcomes in elderly trauma patients, which would be valuable.

Environmental Impact and Sustainability Associated with the Practice of Dermatology

Purpose: The environmental impact of the practice of medicine including dermatology can be significant, driven by a growing and aging population that increasingly demands medical resources. This review explores the environmental effects of the practice of dermatology and identifies actionable solutions to reduce negative environmental impacts. Methods: A PubMed search was conducted using the terms (“environmental impact” OR “sustainability”) AND “dermatology.” Results were screened to include English-only articles between 2018 - 2024 and excluded duplicates. Further exploration of dermatology’s environmental effects was enhanced through citation tracking and additional PubMed searches. Results: A total of 25 articles were included based on relevance and search terms and an additional 21 were added. Results were categorized into six categories for data representation. Patient travel was the largest contributor to negatively impact the environment, followed by waste management practices, journal publication and written patient material, and traveling to medical conferences. The environmental impact of pharmaceuticals, including topicals, is also notable. Potential sustainable alternatives include teledermatology, more appropriate waste production and segregation, and electronic versus printed formats and more virtual conferences. Additionally, dermatologic disease evolves in response to a changing environment, with new data indicating epidemiological shifts due to climate change. More sustainable practices within dermatology also have the potential to cut total overhead expenses. Conclusions: Clinical and surgical subspecialties, specifically dermatology, can contribute significantly to environmental pollution, leading to environmental and financial impacts, but implementing simple, documented methods can reduce their ecological footprint and provide potential financial benefits.

A Web-Interface Based Decision Support System for Optimizing Home Healthcare Waste Collection Vehicle Routing

Background: The significant increase in home healthcare (HHC) driven by technological advancements, an ageing population, and heightened disease outbreaks—especially evident during the COVID-19 pandemic—has created an urgent need for improved medical waste management. Methods: This paper presents the development of a decision support system with a web-based interface designed for efficient medical waste collection in the HHC sector. Results: The system utilises Flask for backend operations, with HTML and CSS for the user interface, and manages data using JSON files. Its flexible design supports real-time adjustments for various vehicle types and changing waste production locations. It incorporates dynamic routing by employing two sophisticated metaheuristic algorithms: the Strength Pareto Evolutionary Algorithm (SPEA-2) and the Non-Dominated Sorting Genetic Algorithm (NSGA-II). This setup supports different dataset sizes and vehicle fleets, including Internal Combustion Engine (ICE) vehicles and Electric Vehicles (EVs). Conclusions: The automation reduces uncertainties in waste collection by minimising human intervention. The system is built to be easily adaptable for other sectors with minor modifications and can be expanded to test various scenarios with new selectable parameters.

Postinsertion Management of Cholecystostomy Tubes for Acute Cholecystitis: A Systematic Review

Background: Percutaneous gallbladder drainage (PGD) is indicated to treat high-risk patients with acute cholecystitis. Trends suggest increasing use of PGD over time as the population ages and lives longer with multiple comorbidities. There is no consensus on the management of cholecystostomies tube once inserted. This review aims to synthesize and describe the most common protocols in terms of the need and timing of follow-up imaging, management of a destination tube, timing of tube removal, and optimal interval time from tube positioning to delayed cholecystectomy. Methods: The study protocol has been registered on the International Prospective Register of Systematic Reviews–PROSPERO. Studies on adult patients diagnosed with acute cholecystitis who underwent a PGD from 2000 to November 2023 were included. The databases searched were MEDLINE, Embase, and Cochrane. The quality assessment tools provided by the NHLBI (National Heart, Lung, and Blood Institute) were applied and descriptive statistics were performed. Results: We included 22,349 patients from 94 studies with overall fair quality (6 prospective and 88 retrospective). In 92.7% of papers, the authors checked by imaging all patients with a PGD (41 studies included). Depending on protocol time, 30% of studies performed imaging within the first 2 weeks and 35% before tube removal (40 studies included). In the case of a destination tube, 56% of studies reported removing the tube (25 studies included). In the case of tube removal, the mean time after insertion was more than 4 weeks in 24 of the 33 included studies (73%). Interval cholecystectomies are more frequently performed after 5 weeks from PGD (32/38 included studies, 84%). Limitations included high clinical heterogeneity and prevalent retrospective studies. Conclusions: A standard management for percutaneous cholecystostomy after insertion is difficult to define based on existing evidence, and currently we can only rely on the most common existing protocols.

A 25-Year Retrospective of Health IT Infrastructure Building: The Example of the Catalonia Region

Over the past decades, health care systems have significantly evolved due to aging populations, chronic diseases, and higher-quality care expectations. Concurrently with the added health care needs, information and communications technology advancements have transformed health care delivery. Technologies such as telemedicine, electronic health records, and mobile health apps promise enhanced accessibility, efficiency, and patient outcomes, leading to more personalized, data-driven care. However, organizational, political, and cultural barriers and the fragmented approach to health information management are challenging the integration of these technologies to effectively support health care delivery. This fragmentation collides with the need for integrated care pathways that focus on holistic health and wellness. Catalonia (northeast Spain), a region of 8 million people with universal health care coverage and a single public health insurer but highly heterogeneous health care service providers, has experienced outstanding digitalization and integration of health information over the past 25 years, when the first transition from paper to digital support occurred. This Viewpoint describes the implementation of health ITs at a system level, discusses the hits and misses encountered in this journey, and frames this regional implementation within the global context. We present the architectures and use trends of the health information platforms over time. This provides insightful information that can be used by other systems worldwide in the never-ending transformation of health care structure and services.

Role of apoptosis-associated proteins p53 and bcl-2 in the pathogenesis of nervous system diseases

Diseases of the central nervous system occupy a leading place, along with cardiovascular and oncological diseases, and the proportion of patients suffering from diseases of the nervous system is increasing as the population ages. This group of diseases includes acute conditions, such as ischemic stroke, and chronic multifactorial diseases — Alzheimer's and Parkinson's diseases, epilepsy, etc. The development of specific methods for their treatment is difficult, and these drugs are not very effective. Almost all brain diseases are based on common mechanisms such as oxidative stress, inflammation and neuronal death. Most often, cells die by apoptosis due to an imbalance between pro-apoptotic and anti-apoptotic factors. This work examines two of them: the apoptosis-promoting transcription factor and tumor suppressor p53 and its opposing B-cell lymphoma protein Bcl-2. The choice of these proteins for study is due to the fact that both proteins are key regulators of apoptosis and are important in the pathogenesis of nervous diseases, since neurons are not highly proliferating cells. The p53 protein is involved in the regulation of many genes responsible for DNA repair, apoptosis, and other biochemical cellular processes; this is especially important when studying neuronal pathology. Bcl-2 suppresses apoptosis in various cells, including neurons, by controlling mitochondrial membrane permeability and inhibiting caspases. In diseases, its expression can either increase, for example, in the case of malignant tumors, or decrease, as in the case of neurodegenerative processes. It has been established that p53 and Bcl-2 are in close interaction in the process of regulating apoptosis; their ratio may be an important prognostic factor. The purpose of this work was to assess the role of these proteins in the pathogenesis of various diseases of the nervous system, and to search for general patterns of changes in their expression and coexpression.

A Study on Alzhemier Disease in Takum, Taraba State, Nigeria: An ARIMA Model Approach

Alzheimer’s disease, a progressive neurodegenerative disorder, represents a significant and growing public health burden, particularly as life expectancy increases worldwide. In sub-Saharan Africa, including Nigeria, the disease's prevalence is rising due to aging populations and urbanized lifestyles that elevate risk factors for cognitive decline. This study investigates the trends and projected incidence of Alzheimer’s disease in Takum, Taraba State, Nigeria. The research utilizes patient records from General Hospital Takum, spanning from 2012 to 2021. Following diagnostic tests and data transformations, the ARIMA(1,2,0) model was selected as the best fit for predicting future case counts. The findings reveal a steady increase in Alzheimer’s cases, consistent with global patterns, highlighting the need for proactive measures in healthcare planning. The study thus recommends the need for increased public awareness, investment in diagnostic infrastructure, and support systems for caregivers.

Tissue-Specific Effects of Aging on Repeat-Mediated Mutation Hotspots In Vivo

Aging constitutes complex and dynamic alterations in molecular and physiological processes and is associated with numerous disorders, in part due to increased genetic instability. The aging population is projected to double by 2050, underscoring the urgent need to better understand the relationships between aging and age-related disorders. Repetitive DNA elements are intrinsic sources of genetic instability and have been found to co-localize with mutation hotspots in human cancer genomes. In this study, we explored the relationship between aging and DNA repeat-mediated genetic instability in vivo using an H-DNA-forming mirror-repeat sequence from the cancer-associated human c-MYC gene. Utilizing a unique mutation-reporter mouse model, we observed tissue-specific effects of aging on H-DNA-induced genetic instability, with mutation frequencies increasing in spleen tissues and remaining unchanged in testis tissues. Analysis of the mutation spectra revealed large deletion mutations as the primary contributor to increasing H-DNA-induced mutations, supported by increased cleavage activity of H-DNA structures in aged spleen tissues. Our findings demonstrate that aging has distinct tissue-specific effects on repeat-mediated, cancer-associated mutations, providing insights into the complex relationship between aging and cancer.

TREINO COGNITIVO MOTOR NO EQUILÍBRIO FUNCIONAL E COGNIÇÃO DE IDOSOS: UMA REVISÃO BIBLIOGRÁFICA

With the aging population, the preservation of cognitive abilities and functional balance in elderly individuals has emerged as a critical issue for maintaining autonomy and quality of life in this population. The practice of activities that combine cognitive and motor stimuli, known as cognitive-motor training, has been suggested as an effective strategy to mitigate the physical and cognitive declines associated with aging. In light of this, the present study aims to analyze the effects of cognitive-motor training on functional balance and cognition in the elderly, based on a literature review. The methodology adopted was a literature review using scientific databases such as Google Scholar and the CAPES Periodicals Platform to select articles addressing the impact of cognitive activities combined with physical exercises on the balance and cognitive abilities of elderly individuals. The main results suggest that cognitive-motor training has positive effects on functional balance, enhancing postural stability and mobility in the elderly. These benefits directly impact the reduction of fall risks, a determining factor for quality of life in older age. Additionally, cognitive-motor training was found to contribute to improvements in memory, attention, and mental processing, highlighting the potential of this intervention for maintaining cognition in elderly individuals. However, the review identified some important limitations, as many of the studies analyzed were conducted in specific contexts, which may limit the generalization of results to different profiles of elderly individuals and environments. Therefore, future research should explore the diversity of approaches and adapt protocols to different realities, seeking to validate the observed effects across a broader range of conditions. It is concluded that cognitive-motor training represents a valuable strategy for promoting balance and cognition in the elderly, potentially contributing to the maintenance of autonomy and quality of life. From this review, the importance of developing personalized interventions and investigating new methodologies that maximize the benefits of cognitive-motor training is emphasized, consolidating it as an effective and safe practice in elderly health care.

Complexity of the Therapeutic Regimen in Older Adults with Cancer: Associated Factors

Background/Objectives: Population aging is a worldwide phenomenon and is often associated with multimorbidity and polypharmacy. Complex medication regimens are common among older adults and contribute to the occurrence of harmful health outcomes. Age is one of the main risk factors for cancer. This study aimed to determine and characterize the therapeutic complexity in older patients with cancer, and analyze the factors associated with high complexity and the impact of the oncological context. Methods: A cross-sectional study with patients aged ≥65 years with cancer was conducted in three hospitals in northern Portugal. Data collection was obtained using self-reports. The medication regimen complexity was assessed using the Medication Regimen Complexity Index (MRCI). Descriptive and association statistical analysis were performed. Logistic, linear, simple and multiple regression analysis were conducted, with and without automatic variable selection. Results: A total of 552 patients were included (median age, 71; IQR, 68–76). The mean MRCI before the oncological context was 18.67 (SD 12.60) and 27.39 (SD 16.67) after the oncological context, presenting a statistically significant difference in the values obtained (p < 0.001). An elevated complexity was significantly associated with polypharmacy, chronic diseases and with the administration of high-risk medications (p < 0.05). High MRCI values showed a relationship with the occurrence of potential drug interactions (p < 0.001). There was no relationship with the existence of cardiac risk comorbidity. Conclusions: This study demonstrated the existence of high therapeutic complexity in older patients with cancer, suggesting the need for intervention to prevent medication-related problems in this vulnerable population.

PREVENÇÃO E TRATAMENTO NA SAÚDE DO IDOSO: UMA PESQUISA INTEGRATIVA

Population aging is a global phenomenon that challenges health systems to meet the growing demand for adequate and personalized care for the elderly population. In this context, the implementation of integrated care for the health of the elderly is seen as a promising approach to ensure efficient and comprehensive care, which includes coordination between different professionals and levels of care. The general objective of this study was to analyze the challenges and perspectives of this care model, seeking to identify the main barriers and benefits that it provides to the health and well-being of the elderly. The research sought to highlight how integration between health teams can improve the quality of life of the elderly, reducing complications, hospitalizations and promoting greater satisfaction with health services. The results reveal that integrated care promotes important benefits, such as reducing the fragmentation of treatments, more effective control of chronic diseases and the possibility of closer and continuous monitoring of the health of the elderly. On the other hand, significant obstacles were identified, such as the lack of infrastructure and the shortage of professionals specialized in geriatrics and gerontology, which compromise the full application of the model. The research also highlights the role of monitoring and communication technologies, such as telemedicine, which have great potential to facilitate the monitoring of the elderly, although they still face barriers to their adoption in the health system. It is concluded that, despite the challenges, the integrated care model represents a viable and effective alternative for promoting healthy aging and quality of life. Public policies aimed at adequate financing, training of professionals and the safe use of technologies are essential to ensure the successful implementation of this model and its positive impact on the health of the elderly population.

GAMETERAPIA NA FISIOTERAPIA: UM RECURSO PARA REDUZIR O RISCO DE QUEDAS EM IDOSOS DA COMUNIDADE - REVISÃO DE LITERATURA.

The aging population worldwide has led to an increased prevalence of falls among older adults, resulting in fractures, loss of mobility, and increased dependency. This systematic review analyzed the effectiveness of gamification and virtual reality in preventing falls and improving balance in older adults, promoting active aging. Studies published between 2019 and 2024 were analyzed in the Google Scholar, PubMed (Medline), and Lilacs (BVS) databases, considering clinical trials and observational studies with individuals over 65 years of age. The results indicate that the inclusion of gamification with conventional physiotherapy can be effective in improving balance, muscle strength, and cognitive function in older adults, reducing the risk of falls and promoting independence. Due to its playful and motivating nature, it facilitates adherence, just as virtual reality offers an immersive experience that reduces the fear of falling. It is concluded that these interventions require more research to personalize the games and adapt the technologies to the specific needs of the elderly population. Furthermore, it is essential to investigate the long-term effects of gamification and its integration into public health programs.

The clinical impact of EGFR alterations in elderly glioblastoma patients: results from a real-life cohort.

The incidence of glioblastoma in the elderly population is increasing as the worldwide population ages. The differential and poorer survival in the elderly population compared to younger patients is partially explained. The present study aimed to investigate the clinical impact of epidermal growth factor receptor EGFR-altered glioblastoma in a real-life elderly glioblastoma population. A bicentric and retrospective study was conducted. Patients were 70years or older and suffering from histomolecularly confirmed glioblastoma. Single nucleotide variants (SNV), amplification, or chromosome 7 polysomy were sought. The primary endpoint was the comparison of overall survival (OS) in patients with or without EGFR alteration. Secondary objectives were to determine other clinical parameters correlated with EGFR alteration status. Seventy-three patients were analyzed: 41.1% had at least one EGFR alteration. The presence of EGFR alteration did not impact overall survival: HR 0.97 [0.6-1.57], p = 0.9; the median overall survival was 6.5months [5.3-9.3] in the EGFR-altered group versus 7months [4.5-10] in the EGFR wild-type group, p = 0.75. In multivariate analysis, tumor resection was associated with a significant overall survival improvement: the median OS in the resected group (n = 20) was 11months [95% CI 7.8-22] versus a median OS of 5.5months [4.6-7.8] in the unresected group (n = 53), without correlation to EGFR alteration status. In the modern era of molecular characterization and improved treatment modalities, the presence of at least one EGFR alteration did not influence survival outcomes in an elderly population of glioblastoma patients.

Understanding the Role of Alcohol in Metabolic Dysfunction and Male Infertility

Purpose: Over the past 40–50 years, demographic shifts and the obesity epidemic have coincided with significant changes in lifestyle habits, including a rise in excessive alcohol consumption. This increase in alcohol intake is a major public health concern due to its far-reaching effects on human health, particularly on metabolic processes and male reproductive function. This narrative review focuses on the role of alcohol consumption in altering metabolism and impairing testicular function, emphasizing the potential damage associated with both acute and chronic alcohol intake. Conclusion: Chronic alcohol consumption has been shown to disrupt liver function, impair lipid metabolism, and dysregulate blood glucose levels, contributing to the development of obesity, metabolic syndrome, and related systemic diseases. In terms of male reproductive health, alcohol can significantly affect testicular function by lowering testosterone levels, reducing sperm quality, and impairing overall fertility. The extent of these effects varies, depending on the frequency, duration, and intensity of alcohol use, with chronic and abusive consumption posing greater risks. The complexity of alcohol’s impact is further compounded by individual variability and the interaction with other lifestyle factors such as diet, stress, and physical activity. Despite growing concern, research on alcohol’s effects remains inconclusive, with significant discrepancies across studies regarding the definition and reporting of alcohol consumption. These inconsistencies highlight the need for more rigorous, methodologically sound research to better understand how alcohol consumption influences metabolic and reproductive health. Ultimately, a clearer understanding is essential for developing targeted public health interventions, particularly in light of rising alcohol use, demographic changes, and the ongoing obesity crisis.

A cross-sectional evaluation of knowledge and attitudes of medical interns regarding social service practices in healthcare institutions

Abstract Interprofessional collaboration is essential for holistic healthcare, yet social work remains under-integrated in medical curricula, particularly in Türkiye. Neoliberal policies have weakened community-based services, increasing the need to address gaps in medical education regarding social work’s role in addressing social determinants of health. This is especially critical given Türkiye’s demographic shifts, such as an aging population and rising social inequalities. This study aimed to assess the knowledge and attitudes of intern doctors at a university in Izmir, Türkiye, regarding social work practices in healthcare and to identify associated factors. A sample of 181 was selected through simple random sampling. Data analysis included descriptive statistics, t-test, Spearman correlation, and factor analyses. The Cronbach’s alpha for the attitude scale was 0.87. A significant portion (34.8 percent) had not heard of the social work profession, and 56.4 percent were unaware of social workers in their institution. Female students and those encountering underserved patients showed higher knowledge scores. There was a weak positive correlation between knowledge and attitudes. Factors influencing attitudes included gender, familiarity with social work, encountering underserved patients and financial status. Changes in medical education are needed to enhance interprofessional collaboration, with further research recommended on gender roles and attitudes towards social work.

Similarities in B Cell Defects between Aging and Obesity.

The aging population is increasing worldwide, and there is also an increase in the aging population living with overweight and obesity, due to changes in lifestyle and in dietary patterns that elderly individuals experience later in life. Both aging and obesity are conditions of accelerated metabolic dysfunction and dysregulated immune responses. In this review, we summarize published findings showing that obesity induces changes in humoral immunity similar to those induced by aging and that the age-associated B cell defects are mainly due to metabolic changes. We discuss the role of the obese adipose tissue in inducing dysfunctional humoral responses and autoimmune Ab secretion.

Financial implications of unpaid clinical placements for allied health, dentistry, medical, and nursing students in Australia: a scoping review with recommendations for policy, research, and practice.

Investing in allied health, dentistry, medical, and nursing undergraduate and postgraduate qualifying education is critical to meet a growing demand on global health care systems. Clinical placements are an integral component of qualifying training and are conventionally unpaid. Widespread economic challenges, attributed to a post-COVID-19 pandemic recovery era and global unrest, have led to growing economic hardship for populations, even in high-income countries like Australia. Allied health, dentistry, medical, and nursing undergraduate and postgraduate students undertaking unpaid clinical placements are not immune from these stressors, which has implications for education providers, ageing populations, the future health care system, and policy-makers. The purpose of this review was to better understand these stressors by scoping the financial implications of unpaid clinical placements for allied health, dentistry, medical, and nursing students in Australian research. The Joanna Briggs Institute's scoping review methodology was used. This involved a search of academic databases and an extensive search of grey literature sources. Literature published from 1 January 2014 was included. Citations were independently screened by two reviewers. Thirty-three research studies were included. Most studies focused on allied health students (n = 12), followed by nursing (n = 11), and medical students (n = 5), with an additional five studies focused on multiple disciplines, including dentistry. One study had an interventional component. Findings were grouped around four concepts: reliance on self-reported measures of financial implications, costs of unpaid clinical placements for students, implications of costs for students, and an urgent need for targeted strategies to redress. The financial implications of unpaid clinical placements for allied health, dentistry, medical, and nursing students in Australia are well-established in research. Impacts are significant for the future of Australia's health workforce and health system. Research findings have been consistent over the past decade in advocating for greater financial support for students undertaking unpaid clinical placements and flexibility of placement models to mitigate the indirect costs of placements. Collaboration between state and federal government, universities, peak professional bodies, and placement host organisations is imperative to implement a suite of strategies to redress the financial burden experienced by students and secure the future of Australia's health workforce.

Economic Sociology and Management in the spectrum of modern managerial and economic ideas

The article is devoted to the radical transformation of the structure of knowledge in modern economic sociology and managerial theory, to the transition from slender hierarchies of ideas (the top of which consists of a small number of axioms, and the base of which consists of multiple specific recommendations) to the postmodern market of concepts. The authors made a comparative analysis of such transformation in economic sociology and managerial theory, revealed general regularities and specific factors that determined the difference between the scientific fields of these science. The latter include: 1) subjects conducting scientific research (in managerial theory, along with scientists, managers, consultants, people somehow connected with business were engaged in such practice), 2) a terminology of sciences (in managerial theory, a specific language for communication between managers and employees was actively created), 3) the use of marketing and PR-technologies to promote ideas. The totality of these factors determined a special “landscape” of the subject areas of economic sociology and managerial theory.The article concludes that despite the existing problems caused by multiparadigmality, the emerging “flexible” format of socio-humanitarian knowledge opens new opportunities for creativity in rapid changes of social reality, obsolescence of classical approaches to its cognition, as well as the realization of the variety of phenomena and processes in the field of economics and management.In such situation, each scientific team should choose its own special place in the exhibition of ideas, create its own “exhibits” attractive to the scientific community and the general public. Among the variety of topical and demanded research directions, the article identifies three key thematic blocks reflecting the scientific priorities of the Department of Economic Sociology and Management of Moscow University: 1) institutional changes and institutional context of socio-economic and managerial processes, 2) aging population and digitalization as key factors of economic and management transformation, 3) socio-economic processes and phenomena in the mirror of digital communication.

Study of the Mental Health of the Elderly and Related Factors

Background: Aging and increase in the elderly population are the most important issues in recent years in developed countries and some developing countries. Mental health is one of the crucial aspects of elderly well-being and must be addressed to improve community health. This study is conducted to examine the mental health of the elderly and the related factors in Gorgan city, 2022. Methods: The present study is descriptive-analytical and was conducted using a two-stage cluster random sampling method. First, four comprehensive health service centers were selected as a cluster from among the centers of Gorgan city, and then 263 people were randomly selected from the chosen centers, proportionate to the number of registered elderly individuals in the electronic service system. The standard depression questionnaire for the elderly was utilized for assessment. Data were then entered into SPSS software version 18 and with descriptive and analytical statistical tests, including the Mann-Whitney test, Chi-square test, and logistic regression (The significance level was less than 0.05(. Results: A total of 263 elderly people were evaluated with a mean age of 68.64 ± 7.2 . 143 (54.4%) were male and 120 (45.6%) were female. The prevalence of depression was reported to be 27.8. The occurrence of depression was significantly associated with age, marital status, and the presence of underlying disease conditions (p < 0.05). However, gender, place of residence, and BMI did not show a statistically significant relationship with the occurrence of depression. Aging, underlying diseases, and not being married increase the chance of depression in the elderly. Conclusion: Although the prevalence of depression in the elderly is lower than the average of the whole country in this study, they are in a better condition. However, due to the fact that they are a special target group, as well as the various risk factors of the disease, including age, lack of marriage, and the presence of an underlying disease in this group, it is suggested that more appropriate planning be done to improve their mental health status.

Unveiling China's Fertility Dilemma: Analyzing Risk Factors and Their Global Implications

Abstract: The National Bureau of Statistics of China has announced in 2021 that the country has formally entered the stage of low fertility rate, reaching a historically low of 1.3. Such low birth is far below the replacement level of 2.1 which is needed for maintaining a sustainable population, implying the possibility for China to start a significant demographic shift. Several key factors have contributed to this decline. Factors behind the problem includes Chinas historical policy implementation, socioeconomic factors including the rise of housing price and cost of upbringing and social factors including waning of social norms and ascent of gender equity. Such phenomenon serves as also valuable insights for analyzing global fertility intention for countries like Switzerland, the United States and South Korea. As all global policymakers seek to address the problem of unstable and declining fertility rates and waning fertility intention, the Chinese case could provide intriguing example as supportive evidence.