Metabolic syndrome in Korean older adults: Prevalence, determinants, and nursing implications.

Perceived burdensomeness and happiness in cohabiting older adults: The serial mediating roles of mental well-being and loneliness.

This study describes the design, development, and evaluation of VitalMindAI, a web application that provides personalized cognitive stimulation for older adults with mild cognitive impairment, focusing on memory, attention, and language. This innovative tool integrates web scraping techniques and generative artificial intelligence to provide cognitive exercises tailored to each older adult's unique needs, facilitating caregivers' work and improving the quality of geriatric care. Requirements for developing VitalMindAI were identified through interviews with caregivers at a gerontological center. Based on this information, we created a functional prototype that enables the generation, validation, and management of cognitive activities tailored to the individual needs of older adults. The results showed a significant reduction in the time required to generate cognitive exercises, from several minutes to less than a minute (with VitalMindAI), which evidences the efficiency of VitalMindAI and its high acceptance among caregiver users. Previously, exercises were generated manually by caregivers, taking an average of 15 to 20 min per activity. This demonstrates the improvement achieved with VitalMindAI. In addition, VitalMindAI has demonstrated its ability to dynamically generate content that stimulates cognitive functions in memory, attention, and language, without causing technical interruptions. The evaluation of VitalMindAI was conducted through tests with professional caregivers from a gerontological center, utilizing the Think-Aloud technique and the System Usability Scale (SUS) questionnaire. The Think-Aloud sessions revealed that users found VitalMindAI to be intuitive, agile, and appropriate to the real needs of the gerontological context. However, as a result of the evaluation, users suggested improvements in the visual hierarchy and terminology used. After applying the SUS questionnaire, VitalMindAI obtained an average score of 87.5, placing it in the “Excellent” category for usability. Overall, VitalMindAI proves to be a viable, scalable, and valuable solution for geriatric care settings, automating key tasks and enhancing cognitive stimulation of memory, attention, and language through accessible and intelligent technologies.

Physio-Cognitive Decline Syndrome (PCDS) is a clinical characterized by concurrent declines in physical and cognitive functions that precede disability. Taiwan's rapidly aging population highlights declines in physical and cognitive functions as precursors to disability, posing key challenges in geriatric care. Research shows these declines begin in early middle age and progress with age. Understanding middle-aged and older adults' experiences and coping strategies for Physio-Cognitive Decline Syndrome (PCDS) is essential for developing effective interventions. This study explored the subjective experiences and perceptions of PCDS among middle-aged and older adults to identify key themes and coping strategies in response to such declines. This qualitative study utilized purposive sampling, semi-structured face-to-face interviews with middle-aged (55-64 years) and older (≥65 years) adults to explore PCDS perceptions. Data were analyzed using content analysis. Participant experiences and perceptions formed three themes: (1) aging accelerates PCDS progression, (2) PCDS threatening daily life, and (3) adapting to changes. These findings further delineate a four-phase PCDS process: Individual Perception (recognizing decline), Life Threat (impact on daily life), Adaptation (accepting reality), and Positive Coping (implementing management strategies). Correspondingly, participants developed coping strategies to mitigate physical and cognitive decline, seek professional assessment, and strengthen support systems. Middle-aged and older adults with PCDS face physical and cognitive declines, mobility limitations, psychological stress, and social isolation. They adopt coping strategies like health maintenance, cognitive training, and social participation. Family and social support systems play a crucial role in their coping processes, while seeking professional medical assistance and engaging in community activities further enhance their confidence in managing PCDS.

Masticatory function may influence physical capacity and independence in older age. This study estimated total life expectancy (LE) and healthy LE (defined as years free of self- or proxy-reported limitations in activities of daily living (ADL) or in physical function) by masticatory function status among older adults, aged 60 and above. Using three waves of data (2009-2015) on 3381 participants of a nationally representative survey of older Singapore citizens and permanent residents, inverse probability weighted-multistate life table models estimated total and healthy LE, stratified by self- or proxy-reported masticatory function and dental prostheses use. Impaired masticatory function was associated with shorter total and ADL-free LE, with greater reductions among dental prostheses users. At age 60, individuals without masticatory impairment lived 2.9 more ADL-free years than those with masticatory impairment (18.0 years [95 % CI 17.1-18.9] vs 15.1 years [95 % CI 13.9-16.3]); this gap narrowed to 1.7 years at age 80. Individuals with masticatory impairment spent 6-12 % higher proportion of remaining life with ADL limitations. Dental prostheses improved healthy LE overall but gains in ADL-free years were greater for individuals without masticatory impairment. For physical function-based healthy LE, masticatory impairment was associated with reductions of 0.9-2.2 years among non-users and 0.6-1.1 years among prostheses users. Masticatory function is a determinant of healthy ageing. Dental prostheses provide partial compensation in healthy LE when masticatory function is impaired among older adults. Geriatric care should integrate oral functional screening with objective assessments of mastication where feasible and prioritize function-oriented rehabilitation to extend healthy LE.

Geroprotective effects of diet and exercise plus metformin in frail older veterans with obesity: The DEMFOS randomized trial protocol.

Comparing ChatGPT and DeepSeek for Deprescription Support in Geriatric and Palliative Care: An Exploratory Study

CONTENT DOMAINS OF ORAL HEALTH-RELATED QUALITY OF LIFE IN OLDER ADULTS: A SYSTEMATIC REVIEW AND CONCEPTUAL SYNTHESIS.

Growth differentiation factor-15 as a clinical biomarker of frailty, sarcopenia and functional decline: A systematic literature review.

Older adults with multimorbidity and complex needs account for alarge proportion of patients treated in emergency departments. Since the management of geriatric patients is associated with ahigh retention time for nursing staff, the German Society for Internal Intensive Care and Emergency Medicine (DGIIN), the German Society for Emergency Medicine (DGINA), and the German Society for Geriatrics (DGG) recommend exploring the use of specially trained care assistants to reduce the workload of nursing staff in emergency departments. Amonocenter case study (n = 145) demonstrated that ahigh frailty score is associated with longer retention times for nurses.

Assessment of Cardiac Frailty in Preclinical Models of Heart Failure and Ageing - Parallels Between Discovery and the Clinic.

BackgroundDisgust sensitivity and ageism significantly affect nursing interns’ motivation to work in gerontological nursing. However, the complex interactions between these factors remain underexplored.ObjectiveThis study used network analysis to explore relationships among nursing interns’ disgust sensitivity, ageism and motivation to pursue a career in gerontological nursing and to identify key nodes in this network.MethodsThis study recruited 698 nursing interns. The Disgust Scale–Revised (DS‐R), the Fraboni Scale of Ageism and the Gerontological Nursing Career Motivation Questionnaire were used as measures. Centrality and bridge centrality indices were used to identify central and bridge symptoms. Network stability was assessed using a case‐dropping bootstrap procedure. The network comparison test was used to analyse differences in networks by gender and residence. Bayesian networks were used to investigate possible probabilistic connections among variables.ResultsNetwork analysis identified ‘antilocution’ (D5) as the most central node in the overall network, whereas ‘expectation’ (D7) had the highest bridge strength. Bayesian network analysis further revealed that ‘avoidance’ (D4) had the greatest probabilistic influence and was strongly linked to other nodes associated with ageism and disgust sensitivity. ‘Practicality’ (D9) and ‘importance’ (D10) also showed significant probabilistic associations within the motivation domain. The network structure proved stable and reliable, with no significant differences attributable to gender or to residence.ConclusionsThis study highlights the complex relationships among disgust sensitivity, ageism and motivation for a career in gerontological nursing. It identifies ‘antilocution’ (D5) in ageism and ‘expectation’ (D7) in career motivation as central nodes, associated with negative attitudes and lower career identity. Additionally, ‘avoidance’ (D4) behaviour shows a probabilistic association with higher levels of disgust sensitivity and with ageism. These findings suggest targeted interventions to improve the well‐being and career motivation of nursing interns in gerontological nursing.

Prolonged hospitalization as a risk factor for cognitive decline in older patients with atrial fibrillation

ABSTRACT Ageism remains a global challenge that undermines the quality of care for older adults. Nursing students, as future healthcare professionals, are in a key position to prevent age-related discrimination through educational interventions. This study aimed to evaluate the effect of structured older adult care training on nursing students’ attitudes toward ageism. A randomized controlled trial was conducted with 120 undergraduate nursing students in Türkiye (60 experimental, 60 control). The experimental group completed an eight-week face-to-face older adult care program, while the control group received no intervention. Data were collected using a sociodemographic questionnaire and the Positive and Negative Ageism Scale (PNAS). Pre- and posttest scores were analyzed using non-parametric tests (p < 0.05). The experimental group showed a significant improvement in Positive Ageism scores compared with the control group (Z = −2.267, p = 0.023), whereas no significant change occurred in the control group. Gender and income were associated with differences in attitudes toward older adults. Structured geriatric care education enhanced students’ positive attitudes toward older adults and contributed to more favorable perceptions of aging. Trial Registration: NCT06488885

As the population across the World Health Organization Eastern Mediterranean Region (EMR) ages, healthcare systems are increasingly strained by the rising burden of non-communicable diseases and the growing demand for chronic geriatric care. Effective health workforce planning is essential to address these evolving needs. However, limited evidence exists on the applicability of workforce planning models tailored specifically to older adults in the EMR. The purpose of this review is to examine current models and strategies in health workforce planning for older adult care in the EMR, with a focus on regionally tailored, financially sustainable, and policy-relevant solutions. A mixed methods systematic review following JBI methodology was conducted. Five databases (MEDLINE, Embase, Scopus, CINAHL, and Web of Science) were searched for English-language qualitative, quantitative, and mixed-methods studies examining workforce planning models relevant to older adults' care in the EMR. The review focused on identifying approaches to workforce supply, demand and needs forecasting, competency development, retention, and financial sustainability in healthcare systems. The data were synthesized using a convergent integrated approach and the included studies were assessed for quality using the QuADS tool. Among the total 1152 records identified, 11 studies met the inclusion criteria, covering four EMR countries (Iran, Lebanon, Jordan, and Saudi Arabia) across three healthcare settings. The key findings highlighted persistent shortages in geriatric, rehabilitation, and chronic disease specialists; limited use of forecasting models; and insufficient professional development opportunities. Major barriers included health professional migration, poor working conditions, and financial instability. Critical enablers included integrated supply-and-demand forecasting, competency-based training, and retention strategies such as improved remuneration, career progression, and supportive work environments. Financial sustainability was highlighted as a cross-cutting concern. This review highlights the urgent need for regionally adapted data-driven workforce planning models that integrate forecasting, competency development, and retention strategies to meet the care demands of aging populations in the EMR.

ObjectiveTo analyze the effectiveness of a virtual educational intervention on care performance and knowledge of family caregivers of older adults with stroke sequels, when compared with usual guidance.MethodsA randomized pragmatic trial was carried out with 58 family caregivers of older adults with stroke sequels, randomized to the Intervention Group and Management Group. For Intervention Group a massive, open, online course was made available to equip caregivers with the necessary tools to assist older adults in activities of daily living after discharge. Moreover, telecommunication consultations were held on the seventh, thirtieth, sixtieth and eightieth days to check the course progress and possible difficulties. The course and telephone calls were made by research nurses. Caregiver assessment was carried out close to hospital discharge, before the intervention, and 90 days later, using three indicators of the outcome "Caregiver Performance: Direct Care" and six indicators of the outcome "Knowledge: Stroke Management" of the Nursing Outcomes Classification.ResultsA significant improvement was observed in intragroup assessment in Intervention Group for the indicator "Assists with care recipient's activities of daily living needs" (p < 0.001) of the outcome "Caregiver Performance: Direct Care" and for the indicator "Causes and contributing factors" (p = 0.021) of the outcome "Knowledge: Stroke Management". The indicator "Strategies to maintain skin integrity" of the outcome "Knowledge: Stroke Management" showed statistical significance in intergroup assessment, with better results for Control Group (p = 0.040), in addition to a significant improvement in intragroup assessment for Intervention Group (p = 0.008).ConclusionsThe intervention was effective for Intervention Group members, improving performance and knowledge about care for older adults when comparing baseline and final assessments.Implications for PracticeThe use of a massive, open, online course and telephone monitoring improves outcomes in care for older adults after discharge, which reflects the importance of nurses' educational. Registered in Clinical Trials (NCT05553340).DescriptorsStroke; Family Caregiver; Educational Technology; Standardized Nursing Terminology; Geriatric Nursing; Transition from Hospital to Home.

Health care systems differ worldwide, allowing learning from each other and improving care for older adults with similar clinical profiles. In the early 1990s, Dr. Howard Bergman and Dr. Mark Clarfield from Canada and Dr. Joseph Ouslander from the United States described the approach to care for the same patient in their respective health care systems. Yet, challenges identified then, such as limited access to geriatric medicine care, as well as multimorbidity and system constraints, remain relevant to the care of older adults today. This article revisits the original exercise summarizing the joint symposium of the America, Canadian, and European geriatric medicine societies, held at the 2025 European Geriatric Medicine Society (EuGMS) Congress in Iceland. Using the case of an 82-year-old woman with multimorbidity, frailty, and social vulnerability, experts examined how three systems would manage key aspects of care for this patient: Delirium prevention (U.S.), falls and rehabilitation (Canada), and medication optimization (Europe). Each presentation situated clinical priorities within broader systemic realities, including workforce shortages, care fragmentation, and policy challenges. Emerging models, such as Age-Friendly Health Systems and the Hospital Elder Life Program in the U.S., Acute Care for the Elderly units and Geriatric Rehabilitation Units in Canada and structured medication review initiatives in Europe, illustrate innovations and persistent gaps. By contrasting clinical strategies and organizational structures, this analysis identifies transferable best practices and policy levers to improve geriatric medicine care globally. Recommendations emphasize harmonizing geriatric expertise, embedding evidence-based interventions, and fostering cross-system learning to optimize outcomes for older adults.

Prognostication uncertainty in advanced dementia impedes timely palliative referrals. Despite rapid development of dementia prognostication models, most have not progressed beyond external validation, with implementation in routine clinical practice as part of the electronic medical record system remaining underexplored. Empirical gaps exist in understanding interdisciplinary perspectives from palliative and geriatric specialties regarding implementation complexities of such hospital-based innovations. This formative study evaluated implementation of a validated PROgnostic Model for Advanced DEmentia (PRO-MADE) as a clinical decision support tool in a Singapore tertiary care setting. PRO-MADE informs physicians of patients' one-year mortality risk to initiate end-of-life care plans, including inpatient specialist and community palliative care referrals. Focus group discussions and in-depth interviews with key stakeholders were analysed and triangulated through rapid deductive-inductive qualitative approach using template analysis, underpinned by the Consolidated Framework for Implementation Research and its Outcomes Addendum. Through maximum variation purposive sampling, 30 professionals across the hospital and community settings participated in seven focus group discussions and two in-depth interviews. Twelve physician implementers from the geriatric medicine specialty, eight healthcare professionals from the palliative medicine specialty, and 10 community-based multidisciplinary palliative care professionals were involved. Five main themes characterise the complexities shaping PRO-MADE's adoption and implementation across key interrelated contextual domains: outer and inner settings (alignment with and operationalisation of palliative care related policies), inner setting and innovation (competing views between disciplines on workflow integrability in clinical practice), inner setting and individuals (alignment of implementation intent with clinical setting; accessibility and adaptation of the electronic medical record system for implementation), and outer setting and individuals (relevance of prognostication for palliative care delivery to patients and families). Findings reflect that implementing prognostication-informed care models involve navigating implementers' professional role and identity preservation in managing end-of-life care, compatibility with clinical practice, and family's needs and readiness. This implementation research study uncovered factors at the structural, disciplinary identity, interprofessional and patient-caregiver-provider levels influencing PRO-MADE's adoption and implementation for end-of-life care planning and palliative support. Findings suggest the need for targeted implementation strategies, including early stakeholder engagements and adapting integration to clinical settings and patient-family needs to optimise implementation success.

France is experiencing rapid population aging, increasing demand for healthcare services and pressure on unscheduled care pathways for frail and multimorbid older adults. A significant proportion of transfers to acute care, including emergency departments, are considered potentially avoidable, particularly when timely access to geriatric expertise is lacking. In 2024, a territorial geriatric hotline was implemented at Toulouse University Hospital to provide community-based physicians with rapid access to geriatric advice and optimize patient care pathways. The purpose of this study was to describe the development, implementation, and early activity of a territorial geriatric hotline for community-based physicians and assess its feasibility and role in patient orientation. We conducted a monocentric, observational, descriptive study of the Haute-Garonne territorial geriatric hotline (June 2024-November 2025). The hotline was developed with 15 local professional healthcare networks and provided rapid access to geriatricians for general practitioners. Only calls requesting general geriatric advice or hospitalization were analyzed; calls related to supra-specialty expertise (onco-geriatrics, cardio-geriatrics, dementia care and palliative care) were redirected internally. Among 1,789 calls corresponding to general geriatric advice or hospitalization, multiple calls could relate to a single patient. Each clinical episode (i.e., one patient situation, potentially involving multiple calls) was consolidated into a single record. Only clinical episodes with complete data (n = 393) were included in the detailed analysis. Data collected included patient characteristics, reasons for the call, and patient orientation. Analyses were descriptive. During 18 months, 3,627 calls were received, with monthly activity increasing from 100 to 425 calls. Among these, 1,789 calls corresponded to requests for general geriatric advice or hospitalization. These calls corresponded to a lower number of clinical episodes, as several calls could occur for the same patient. Due to the constraints of routine data collection, only clinical episodes with complete documentation were included in the detailed analysis (n = 393). Among these clinical episodes, the mean age was 84.3 ± 7.6 years and 55.5% were women. Calls were placed by 243 general practitioners. Common reasons for calls included impaired general condition (19.3%), falls (12.5%), neurodegenerative diseases (11.2%), hematology/onco-geriatrics (10.4%), nutrition/metabolic disorders (9.4%), and pain (8.1%). Following calls, patient orientation included hospitalization in an acute geriatric unit (35.4%), provision of geriatric advice (27.2%), day hospital admission (16.0%), reorientation to another care pathway (7.6%), and emergency department referral (7.4%). A territorial geriatric hotline integrated into local professional healthcare networks is feasible and widely utilized, as reflected by the overall call volume. It facilitates rapid access to geriatric expertise and, based on the analysis of calls with complete data, may contribute to improving patient orientation, and to proposing alternatives to emergency department transfers. However, the study design did not allow for the systematic evaluation of the clinical outcomes associated with these alternatives. The model demonstrates how limited geriatric resources can be leveraged to strengthen interprofessional coordination, optimize care pathways, and enhance equity in access to geriatric care. These results provide a basis for further evaluation of its impact on patient outcomes and healthcare system efficiency.

The development and integration of geriatric medicine into national health care systems vary widely across countries. While a robust care workforce requires providers from several disciplines, including nursing, social sector, rehabilitation, psychiatry, neurology, and others, a strong core of highly qualified geriatricians is essential to delivering older person-centred and integrated care. The number and professional profile of geriatricians, along with the status of the specialty, are important to informing efforts to reshape health care systems in response to the global ageing scenario. WHO developed and distributed a structured questionnaire to representatives of national geriatrics and gerontology societies beginning in March 2025. The survey collected data on the status of the geriatric medicine specialty, including its formal recognition at the country level, the estimated number of practising geriatricians, and information on training curricula, professional environments, and systemic challenges. A total of 48 national societies completed the survey. Recognition of geriatric medicine ranged widely, from full specialty status in some countries to subspecialty or non-recognition in others. The number of practicing geriatricians per 100,000 persons aged 60 years and older ranged from <0.1 to >30 across countries, illustrating marked workforce disparities and some severe shortages. Where the geriatric medicine specialty is formally available, pre-service training durations ranged from 24 to 96 months. Geriatricians worked in diverse settings, though integration into primary care and public health was limited. Training in and exposure to geriatric medicine principles during undergraduate and postgraduate medical training were minimal in many countries. Key challenges included workforce shortages, fragmentation of care, and undervaluation of the speciality's role in informing health care for older people. Strategic priorities reported by respondents included investment in training, policy development, and institutional support. The survey highlights disparities in geriatric medicine across countries and identifies several challenges and priorities. Strengthening education, policy, and workforce development is essential to meet the needs of ageing populations and support healthy ageing worldwide. At the same time, countries should also think of innovative approaches and building capacity of existing other health occupations to improve geriatric care. Future updates of this survey will provide longitudinal insights into workforce evolution. These findings provide a global evidence base to guide workforce planning and policy under the United Nations Decade of Healthy Ageing (2021-2030).