Global Population Ages Research Articles

Out-of-hospital onset versus in-hospital onset for clinical outcomes in spontaneous intramuscular hematoma diagnosed by computed tomography: a retrospective cohort study.

The aging global population and the increasing use of antithrombotic agents have made spontaneous intramuscular hematomas (SIH) a growing concern. The association between the settings of SIH onset and clinical outcomes remains unclear. The aim of this study was to determine these associations. A retrospective cohort study was conducted in a tertiary hospital in Hiroshima, Japan between January 2008 and January 2022. We included consecutive patients aged ≥ 15years with SIH at any site diagnosed by computed tomography. The subjects were divided into two groups according to onset settings: out-of-hospital onset and in-hospital onset. The main outcome was treatment failure (composite of change in initial treatment and in-hospital death), and in-hospital mortality was also assessed. We used inverse probability of treatment weighting (IPTW) to estimate the causal effects of onset settings on outcomes. Of 84 included subjects with SIH, 63 had out-of-hospital onset and 21 had in-hospital onset. One subject (1.6%) with out-of-hospital onset and four subjects (19%) with in-hospital onset experienced treatment failure. In the IPTW cohort, in-hospital onset was associated with treatment failure [odds ratio (OR) 29, 95% confidence interval (CI) 7.2-270]. In addition, one subject (1.6%) with out-of-hospital onset and three subjects (14%) with in-hospital onset died during hospitalization. In-hospital onset was associated with a high rate of in-hospital mortality (OR 25, 95% CI 6.3-240) in the IPTW cohort. SIH with in-hospital onset had a poorer prognosis than that of SIH with out-of-hospital onset, suggesting that onset setting might be a novel predictor of clinical outcomes for SIH.

Translation and Adaptation of the STOPP/START Criteria Version 3 for Potentially Inappropriate Prescribing in Older People to European Portuguese: A Study Protocol.

As the global population ages, managing medication use in older adults becomes increasingly complex due to polypharmacy and the associated risks of adverse drug events. To improve the safety and appropriateness of medication use in the older population, tools like the Screening Tool of Older Persons' Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) criteria have been developed. The availability of updated criteria is crucial to better support healthcare professionals in Portuguese-speaking regions. The aim of this study is to translate and validate the STOPP/START version 3 criteria for Portuguese, providing an updated and useful tool for healthcare professionals. This study will be conducted through four phases: I) translation of the STOPP/START version 3 criteria to European Portuguese; II) collection of sociodemographic, clinical, and medication data; III) intrarater reliability study; and IV) interrater agreement study. This study obtained ethics approval by the Ethics Committee of the Administração Regional de Saúde do Centro, Portugal. The availability of the translated criteria will enable the integration of STOPP/START version 3 into clinical practice in Portugal, facilitating improved medication safety and appropriateness. This integration is expected to lead to better management of polypharmacy and a reduction in adverse drug events, ultimately enhancing patient outcomes and supporting evidence-based prescribing practices.

Considering Biomarkers of Neurodegeneration in Alzheimer’s Disease: The Potential of Circulating Cell-Free DNA in Precision Neurology

Neurodegenerative diseases, such as Alzheimer’s disease (AD), are a growing public health crisis, exacerbated by an aging global population and the lack of effective early disease-modifying therapies. Early detection of neurodegenerative disorders is critical to delaying symptom onset and mitigating disease progression, but current diagnostic tools often rely on detecting pathology once clinical symptoms have emerged and significant neuronal damage has already occurred. While disease-specific biomarkers, such as amyloid-beta and tau in AD, offer precise insights, they are too limited in scope for broader neurodegeneration screening for these conditions. Conversely, general biomarkers like neurofilament light chain (NfL) provide valuable staging information but lack targeted insights. Circulating cell-free DNA (cfDNA), released during cell death, is emerging as a promising biomarker for early detection. Derived from dying cells, cfDNA can capture both general neurodegenerative signals and disease-specific insights, offering multi-layered genomic and epigenomic information. Though its clinical potential remains under investigation, advances in cfDNA detection sensitivity, standardized protocols, and reference ranges could establish cfDNA as a valuable tool for early screening. cfDNA methylation signatures, in particular, show great promise for identifying tissue-of-origin and disease-specific changes, offering a minimally invasive biomarker that could transform precision neurology. However, further research is required to address technological challenges and validate cfDNA’s utility in clinical settings. Here, we review recent work assessing cfDNA as a potential early biomarker in AD. With continued advances, cfDNA could play a pivotal role in shifting care from reactive to proactive, improving diagnostic timelines and patient outcomes.

Age-related volume decrease in subcortical gray matter is a part of healthy brain aging in men.

With the global population aging, the number of individuals over 60 is expected to double by 2050. Brain volume increases until age 13, stabilizes between 18 and 35, then declines by 0.2% annually. Magnetic resonance imaging (MRI) studies highlight significant gray matter atrophy, necessitating differentiation between normal aging and neurodegeneration. This study assessed the impact of aging on subcortical gray matter in healthy males to identify biomarkers of physiological aging. A retrospective study of 106 healthy males who underwent brain MRI from 2012 to 2016, divided into two age groups: younger and older than 35years. MRI scans were performed using a 3T machine, and volumetric analysis was conducted with VolBrain software. Subcortical gray matter volumes were compared between groups. The Shapiro-Wilk test evaluated normality. Student's t-test and Mann-Whitney U test were used for statistical analysis, with significance defined as p < 0.05. Total intracranial volume was comparable between age groups (p = 0.527). Significant volume reductions (p < 0.05) were observed in subcortical gray matter structures, including the nucleus accumbens, caudate nucleus, globus pallidus, putamen, thalamus, and ventral diencephalon, particularly on the right side in the elderly group. Subcortical gray matter volume in healthy males shows significant differences between older and younger individuals (p < 0.05), with asymmetrical reduction and certain structures on the right aging more rapidly. These findings are significant for distinguishing healthy aging from neurodegeneration.

Developing a quality indicator system for evaluating internet plus home care nursing services based on the SERVQUAL model: a Delphi-analytic hierarchy process study

Background In the context of global population aging and the rapid development of information technology, the demand for Internet Plus Home Care Nursing (Internet+ HCN) services have been on the rise, especially in China. Internet+ HCN services have the potential to maximize existing human resources to counter the shortage of medical healthcare services. However, at present, Internet+ HCN services are difficult to scale due to the lack of standardized service quality governance. Quality indicators for service evaluation of Internet+ HCN services are under-defined. Objective To develop a quality indicator system for evaluating Internet+ HCN services, and to shed theoretical light on assessing mHealth service quality from a user experience perspective. Methods An initial quality indicator system was established based on scenarios related to Internet+ HCN services. The Delphi Method was applied to modify the indicators according to experts’ opinions, and the analytic hierarchy process (AHP) was applied to calculate the indicator weight. Finally, a quality indicator system for evaluating Internet+ HCN services was developed based on the SERVQUAL model. Results Altogether, 17 experts from relevant fields such as nursing education, clinical nursing, health management, and health informatics were consulted through email surveys. The response rates in both rounds of Delphi and the AHP were 100%. The average expert authority coefficients were 0.912 and 0.925 respectively in the two rounds of Delphi. Kendall’s W, indicating variation coefficients, ranged from 0.262 to 0.265. Finally, a quality indicator system for evaluating Internet+ HCN services, comprising five primary indicators and 15 secondary indicators, was developed. Primary indicators and their AHP generated the following weights: assurance (0.245), reliability (0.240), tangibles (0.192), responsiveness (0.190), and empathy (0.132). Conclusions By measuring the services quality gap between user expectations and perceptions, the proposed SERVQUAL model-based quality indicator system shows potential in improving the quality of Internet+ HCN services through the perspective of user experiences.

Economic impact of retirement on the elderly population: a literature review

ABSTRACT This literature review examines the economic impact of retirement policies on the elderly, focusing on labor supply, consumption, and health. The aging global population pressures public pension systems, prompting reforms like increasing retirement age and reducing benefits, which significantly affect labor supply, demand, and economic growth. The review discusses the effects of retirement age and pension changes on labor supply, the ‘retirement-consumption puzzle,’ where consumption declines at retirement due to changes in time cost and health shocks, and mixed health outcomes post-retirement influenced by health behaviors. China’s fixed retirement policy offers a unique context for studying these effects, highlighting gender-specific impacts. The review emphasizes the need for balanced retirement policies that consider financial sustainability and health implications, promoting retirees’ consumption levels. This comprehensive analysis aids in evaluating retirement policy reforms’ costs and benefits across different institutional contexts.

PROMOÇÃO DA SAÚDE E BEM-ESTAR EM IDOSOS ATRAVÉS DE PROGRAMAS DE EXERCICIOS FUNCIONAL: UMA REVISÃO INTEGRATIVA

This study presents an integrative review on the benefits of functional exercises for elderly health and well-being. With the global aging population and associated public health challenges, it is crucial to explore practices that enhance quality of life (SILVA; SANTOS, 2019). The research analyzed studies that highlight how functional training aids in maintaining physical fitness, autonomy, and disease prevention. Observed benefits include improvements in physical abilities, such as strength and balance, and cognitive function (ALMEIDA; CARDOSO, 2022), as well as a positive impact on social interaction and psychological well-being among the elderly (FREITAS; ALMEIDA, 2021). The study also discusses adapting exercise programs to meet individual needs, considering factors like health conditions and reduced mobility (RODRIGUES; LIMA, 2023)

Designing AI for Partnership in Care

As the global population ages, promoting active aging and enabling older adults to age in place has become increasingly important. This paper explores the role of technology in this process, particularly in helping older adults identify and pursue meaningful activities and provide care for loved ones. Through two example projects -- the design of a social robot that supports older adults' experience of a sense of meaning and purpose (ikigai), and an exploration of how technology can assist with caregiving -- we demonstrate how technology can enhance the care for older adults. This short paper highlights how technology can create a more fulfilling and supportive active aging experience, empowering older adults to engage with what and who they care about and enhancing their caring relationships.

Aging-associated mechanisms of atrial fibrillation progression and their therapeutic potential

Atrial fibrillation (AF) is the most common sustained arrhythmia, with a particularly high prevalence in the elderly. As the global aging population rapidly expands, it is increasingly important to examine how alterations to the aging heart contribute to an increased AF susceptibility. This work critically reviews the key molecular mechanisms that may underpin the complex association between aging and AF. Moreover, we identify emerging novel opportunities for therapeutic intervention that may be able to prevent and/or improve the current treatment paradigms for age-related AF. This review contributes to a holistic understanding of the intricate relationship between aging and AF.

Mapping the evolution of liver aging research: A bibliometric analysis.

With the increasing of the global aging population, healthy aging and prevention of age-related diseases have become increasingly important. The liver, a vital organ involved in metabolism, detoxification, digestion, and immunity, holds a pivotal role in the aging process of organisms. Although extensive research on liver aging has been carried out, no bibliometric analysis has been conducted to evaluate the scientific progress in this area. To analyze basic knowledge, development trends, and current research frontiers in the field via bibliometric methods. We conducted bibliometric analyses via a range of analytical tools including Python, the bibliometrix package in R, CiteSpace, and VOSviewer. We retrieved publication data on liver aging research from the Web of Science Core Collection Database. A scientific knowledge map was constructed to display the contributions from different authors, journals, countries, institutions, as well as patterns of co-occurrence keywords and co-cited references. Additionally, gene regulation pathways associated with liver aging were analyzed via the STRING database. We identified 4288 articles on liver aging, authored by 24034 contributors from 4092 institutions across 85 countries. Notably, the years 1991 and 2020 presented significant bursts in publication output. The United States led in terms of publications (n = 1008, 25.1%), citations (n = 55205), and international collaborations (multiple country publications = 214). Keywords such as "lipid metabolism", "fatty liver disease", "inflammation", "liver fibrosis" and "target" were prominent, highlighting the current research hotspots. Notably, the top 64 genes, each of which appeared in at least 8 articles, were involved in pathways essential for cell survival and aging, including the phosphatidylinositol 3-kinase/protein kinase B, Forkhead box O and p53 signaling pathways. This study highlights key areas of liver aging and offers a comprehensive overview of research trends, as well as insights into potential value for collaborative pursuits and clinical implementations.

Strategies to Improve Environmental Comfort of Institutionalized Older Adults: A Scoping Review

The demographic trends of an aging global population present significant challenges and opportunities for healthcare, particularly in providing optimal care environments for older adults living in long-term care facilities, with it being imperative to ensure these environments provide basic care and promote overall well-being through enhanced environmental comfort. This scoping review intends to show evidence-based practices enhancing the environmental comfort of institutionalized older people. Following the Joanna Briggs Institute’s methodology, this scoping review’s inclusion criteria included studies in English, Portuguese, or Spanish between 2013 and 2023, focused on institutionalized people over the age of 65 years residing in long-term care settings where nurses implemented strategies or interventions designed to enhance environmental comfort in which older residents themselves directly evaluated, indexed in Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Psychology and Behavioral Sciences Collection, DART-Europe, or Repositório Científico de Acesso Aberto de Portugal (RCAAP). Out of 497 initially retrieved studies, none of them met the established criteria, leading this study to be an empty review. The absence of studies meeting the inclusion criteria indicates a significant gap in the existing literature, highlighting the need for specialized training programs that equip nurses with the skills and knowledge to implement effective comfort-enhancing interventions, ensuring that the unique and challenging needs of older people are covered.

Neutrophil percentage-to-albumin ratio is associated with cognitive function in adults aged over 60 years: An analysis of data from the NHANES 2011-2014.

The aging global population is increasing the attention to cognitive decline in older individuals. This study sought to examine the potential link between the neutrophil percentage-to-albumin ratio (NPAR) and cognitive function. We analyzed data from the National Health and Nutrition Examination Survey 2011-2014 using multivariate logistic regression and smooth curve fitting, to investigate the correlation between NPAR and cognitive performance. Restricted cubic spline analysis assessed the linear relationship with high-risk cognitive dysfunction, while piecewise linear regression identified thresholds. Subgroup analyses confirmed the consistency and reliability of our findings. Our study included data from 2759 individuals aged >60 years. NPAR showed a significant correlation with Consortium to Establish a Registry for Alzheimer's Disease (CERAD) word learning score, CERAD delayed recall score, total z-score and a high risk of cognitive dysfunction. Furthermore, there were statistically significant trends in the changes in CERAD word learning, digit symbol substitution test, and CERAD delayed recall scores as the NPAR quartile increased, these trends were inverted U-shaped. When the NPAR exceeded 14.57, there was a positive association with the likelihood of a high risk of cognitive impairment. The link between NPAR and cognitive performance was notably stronger in individuals with moderate body mass index and those aged 73-80 years. A strong link was observed between the NPAR and cognitive function. NPAR may serve as a tool to identify individuals at increased risk of cognitive decline.

Gratitude and Subjective Well-Being in Older Chinese Adults in Nursing Homes: The Mediating Roles of Self-Efficacy and Social Support.

With an aging global population, there has been a growing interest in the subjective well-being (SWB) of older people. As a positive emotion, gratitude has been found to be significantly and positively associated with SWB. However, the mechanisms underlying the relationship between gratitude and SWB remain poorly understood. This study aimed to examine the mediating effects of social support and self-efficacy in the relationship between gratitude and SWB among older Chinese adults in nursing homes. A cross-sectional study. A sample of 354 older adults in nursing homes aged 60 years and above was recruited across three nursing homes in Guangzhou, China. Participants completed the Gratitude Questionnaire-Six-Item Form, the World Health Organization's well-being index, the General Self-efficacy questionnaire and the Multidimensional Scale of Perceived Social Support. Structural equation modelling was used to evaluate the relationships between gratitude, self-efficacy, social support and SWB. A bootstrap test was performed to test mediating roles of self-efficacy and social support. Gratitude was found to be significantly and positively associated with SWB (β = 0.294, p < 0.001). Self-efficacy and social support independently mediated the relationship between gratitude and SWB (indirect effect of self-efficacy: Standardised β = 0.105, 95% CI [0.061, 0.157]; indirect effect of social support: Standardised β = 0.116, 95% CI [0.444, 0.191], all p < 0.001). Additionally, the results indicated that the mediating effect of self-efficacy was not significantly different from that of social support in the link between gratitude with SWB. These findings presented strong evidence that self-efficacy and social support provided the underlying mechanisms through which gratitude was associated with SWB in Chinese nursing home residents. This highlighted the need to develop interventions aiming at increasing gratitude, self-efficacy and social support to promote SWB among elderly people. No patient or public contribution.

Non-canonical Pathways Associated to Amyloid Beta and Tau Protein Dyshomeostasis in Alzheimer's disease: a narrative review.

Alzheimer's Disease (AD) is the most common form of dementia among elderly people. This disease imposes a significant burden on the healthcare system, society, and economy due to the increasing global aging population. Current trials with drugs or bioactive compounds aimed at reducing cerebral Amyloid beta (Aβ) plaques and tau protein neurofibrillary tangles, which are the two main hallmarks of this devastating neurodegenerative disease, have not provided significant results in terms of their neuropathological outcomes nor met the expected clinical end-points. Ageing, genetic and environmental risk factors, along with different clinical symptoms suggest that AD is a complex and heterogeneous disorder with multiple interconnected pathological pathways rather than a single disease entity. In the present review, we highlight and discuss various non-canonical, Aβ-independent mechanisms, like gliosis, unhealthy dietary intake, lipid and sugar signaling, and cerebrovascular damage that contribute to the onset and development of AD. We emphasize that challenging the traditional "amyloid cascade hypothesis" may improve our understanding of this age-related complex syndrome and help fight the progressive cognitive decline in AD.

Mitochondrial Reactive Oxygen Species Dysregulation in Heart Failure with Preserved Ejection Fraction: A Fraction of the Whole

Heart failure with preserved ejection fraction (HFpEF) is a multifarious syndrome, accounting for over half of heart failure (HF) patients receiving clinical treatment. The prevalence of HFpEF is rapidly increasing in the coming decades as the global population ages. It is becoming clearer that HFpEF has a lot of different causes, which makes it challenging to find effective treatments. Currently, there are no proven treatments for people with deteriorating HF or HFpEF. Although the pathophysiologic foundations of HFpEF are complex, excessive reactive oxygen species (ROS) generation and increased oxidative stress caused by mitochondrial dysfunction seem to play a critical role in the pathogenesis of HFpEF. Emerging evidence from animal models and human myocardial tissues from failed hearts shows that mitochondrial aberrations cause a marked increase in mitochondrial ROS (mtROS) production and oxidative stress. Furthermore, studies have reported that common HF medications like beta blockers, angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, and mineralocorticoid receptor antagonists indirectly reduce the production of mtROS. Despite the harmful effects of ROS on cardiac remodeling, maintaining mitochondrial homeostasis and cardiac functions requires small amounts of ROS. In this review, we will provide an overview and discussion of the recent findings on mtROS production, its threshold for imbalance, and the subsequent dysfunction that leads to related cardiac and systemic phenotypes in the context of HFpEF. We will also focus on newly discovered cellular and molecular mechanisms underlying ROS dysregulation, current therapeutic options, and future perspectives for treating HFpEF by targeting mtROS and the associated signal molecules.

Social, health and lifestyle-related determinants of older adults’ preferences for place of death in South Tyrol, Italy – a cross-sectional survey study

BackgroundAs the global aging population expands, understanding older adults’ preferences for place of death becomes pivotal in ensuring person-centered end-of-life care.ObjectiveThis study aimed to investigate the influence of sociodemographic, health, and lifestyle-related factors on end-of-life care preferences of older adults in South Tyrol, Italy.MethodsEmploying a cross-sectional design, a population-based survey was conducted with a stratified probabilistic sample of adults aged ≥ 75 years in South Tyrol (Autonomous Province of Bolzano/Bozen, Italy). From a randomly selected sample of 3,600 older adults, participants were invited to respond to a questionnaire that included items on older adults’ preferences for place of death and socio-demographic and health- and lifestyle-related factors, including frailty (e.g., PRISMA-7). Descriptive and multinomial logistic regression analyses were performed.ResultsThe majority (55.3%) of the 1,695 older adults (participation rate: 47%) expressed a preference for dying at home and 12.7% indicated a desire for specialized end-of-life care in a healthcare facility. However, 27.9% refrained from disclosing their end-of-life care preferences. The factors influencing these preferences concerning the place of death included age, native language, educational level, living situation, and community. Compared to the preference of dying at own home or home of family or friends, older adults aged ≥ 85 years (OR = 0.57, P = 0.002) and living in an urban area (OR = 0.40, P < 0.001) were less likely to prefer dying at a hospital, palliative care unit, or hospice. Older adults living alone (OR = 1.90, P < 0.001), Italian-speaking (OR = 1.46, P = 0.03), and those with an educational level above high school (OR = 1.69, P = 0.002) were more likely to prefer dying at a hospital, palliative care unit, or hospice.ConclusionsEnd-of-life care preferences among older adults in South Tyrol were associated with socio-demographic, yet not health- and lifestyle-related factors. Recognizing and integrating these preferences is essential for developing, implementing, and evaluating interventions to promote advance care planning and provide effective, patient-centered end-of-life care.

Gut microbiota and metabolic profile changes unveil the deterioration of alveolar bone inflammatory resorption with aging induced by D-galactose.

The global aging population has led to a rise in age-related health issues, such as malnutrition, metabolic disorders, and even immune decline. Among these concerns, periodontitis holds particular significance for the well-being of the elderly. This study aimed to investigate the impact of aging on inflammatory resorption of alveolar bone in mice with periodontitis, with a specific focus on alterations in the intestinal microenvironment. To achieve this, we established a D-galactose (D-gal)-induced aging mouse model with periodontitis and employed histopathological staining, oxidative stress, and inflammatory factors analyses to assess the severity of periodontitis and the health status. Additionally, the 16S rRNA sequencing and untargeted metabolomics analysis were employed to investigate alterations in the intestinal microbiota and metabolites. Our results showed that D-gal-induced aging mice with periodontitis experienced more pronounced alveolar bone inflammatory resorption and disruptions in the gut barrier, accompanied by an overall decline in physical condition. The microbial composition and structure of aged mice also underwent significant modifications, with a decreased Firmicutes/Bacteroidetes (F/B) ratio. Furthermore, metabolomics analysis demonstrated that D-gal-induced aging primarily influenced lipids and lipid-like molecules metabolism, and enrichment observed in the rheumatoid arthritis and histidine metabolism pathways. These findings provide further evidence that the aging process exacerbates age-related alveolar bone loss (ABL) through disturbances in intestinal homeostasis.

Challenges and Opportunities in Managing Geriatric Depression: The Role of Personalized Medicine and Age-Appropriate Therapeutic Approaches

The global aging population has experienced rapid growth in recent decades, leading to an increased prevalence of psychiatric disorders, particularly depression, among older adults. Depression in the geriatric population is often compounded by chronic physical conditions and various psychosocial factors, significantly impacting their quality of life. The main question raised in this review is as follows: how can personalized medicine and age-appropriate therapeutic approaches improve the management of geriatric depression? This paper explores the epidemiology of geriatric depression, highlighting the influence of gender, race, and socioeconomic status on its prevalence. The classification and diagnosis of geriatric depressive disorders, based on ICD-11 and DSM-5 criteria, reveal the complexity of managing these conditions in older adults. Personalized medicine (PM) emerges as a promising approach, focusing on tailoring treatments to the individual’s genetic, clinical, and environmental characteristics. However, the application of PM in this demographic faces challenges, particularly in the context of pharmaceutical forms. The need for age-appropriate drug delivery systems is critical, given the prevalence of polypharmacy and issues such as dysphagia among the older patients. This study emphasizes the importance of developing patient-centric formulations to enhance the effectiveness of personalized therapy in geriatric patients.

Epidemiology of Dementia in the Campania Region (Italy): A 2015-2020 population-based study

Abstract As the global population ages, dementia poses a significant health challenge, ranking seventh among leading causes of death worldwide. Considering the high societal and financial burden of dementia, our study aims to provide estimates of prevalence and incidence for any dementia and Alzheimer’s dementia (AD) in the Campania Region (South Italy). It is Population-based study, using routinely collected healthcare data of individuals living in the Campania Region (South Italy) from 2015 to 2020. We included individuals aged ≥65 years who had at least one administrative record for dementia and/or AD. Prevalence rates adjusted for age and sex used 2020 European population as reference. To estimate incidence, we tested three possible algorithms, which differed for the duration of the time interval between study baseline (Jan 1, 2015) and index date (first record for dementia and/or AD in administrative databases). We employed a clinical database for the validation of our algorithms towards neuropsychological test results. Among individuals, 80,392 had dementia, of which 35,748 had AD. The age- and sex-standardized prevalence rates per 1,000 individuals for any dementia and AD were 77.64 (95%CI=77.57; 77.68) and 34.05 (95%CI=34.01; 34.09), respectively. There were 82.10 incident cases of any dementia per 100,000 per year (0.79 sensitivity and 0.62 specificity), and 59.89 incident cases of AD per 100,000 per year (0.80 sensitivity and 0.59 specificity). The capture-recapture method showed low number of undetected cases (1.7% for any dementia and 3.0% for AD). Our algorithms showed acceptable performance with AUC ranging from 0.59 to 0.72, and double likelihood ratio of correctly identifying individuals above and below MMSE standard cut-offs (24 and 26). Our algorithm, integrating administrative and clinical data, holds potential for assessing dementia’s epidemiological burden, identifying risk factors, planning healthcare access, and developing prevention strategies. Key messages • Providing comprehensive estimates of dementia burden aids public health planning and resource allocation. • Integrated administrative and clinical data provide robust tools for epidemiological analysis and preventive strategies.

Landscape Design Strategies for Healthy Aging-in-Place in Communities: Case Studies from Suzhou, China

As the global population ages, the World Health Organization promotes “Healthy Aging” to enhance the quality of life for the elderly. In China, with its substantial aging population, the “9073” elderly care mode, which prioritizes community-based care, was implemented in 2011. However, the specific needs of elderly residents in different climatic and cultural contexts are often overlooked. This study addresses this gap by examining how community green space design can support healthy aging, using Suzhou as a case study due to its significant elderly population. This research examines the relationship between community environments, elderly needs, and behaviors. Our findings reveal that elderly residents have complex needs, seeking safety, comfort, health, social interaction, and spiritual richness simultaneously. A mismatch was observed between their stated preferences for features like seating and shade and their actual usage patterns, suggesting that existing green spaces may not fully meet their needs. This study underscores the importance of incorporating both expressed preferences and proactive design strategies to enhance the healthy benefit of community green spaces. These insights support the “Healthy China 2030” strategy and promote the well-being of elders, contributing to sustainable urban regeneration.