Adult Group Research Articles

Soft robotic shorts improve outdoor walking efficiency in older adults

Peoples' walking efficiency declines as they grow older, posing constraints on mobility, and affecting independence and quality of life. Although wearable assistive technologies are recognized as a potential solution for age-related movement challenges, few have proven effective for older adults, predominantly within controlled laboratory experiments. Here we present WalkON, a pair of soft robotic shorts designed to enhance walking efficiency for older individuals by assisting hip flexion. The system features a compact and lightweight tendon-driven design, using a controller based on natural leg movements to autonomously assist leg propagation. To assess WalkON's impact on daily walking, we initially conducted a technology assessment with young adults on a demanding outdoor uphill 500 m hiking trail. We then validated our findings with a group of older adults walking on a flat outdoor 400 m track. WalkON considerably reduced the metabolic cost of transport by 17.79% for young adults during uphill walking. At the same time, participants reported high perceived control over their voluntary movements (a self-reported mean score of 6.20 out of 7 on a Likert scale). Similarly, older adults reduced their metabolic cost by 10.48% when using WalkON during level ground walking, while retaining a strong sense of movement control (mean score of 6.09 out of 7). These findings emphasize the potential of wearable assistive devices to improve efficiency in outdoor walking, suggesting promising implications for promoting physical well-being and advancing mobility, particularly during the later stages of life.

Leukemic B cells expression of CD200 and Leukocyte-associated immunoglobulin-like receptor-1 (LAIR-1, CD305) in Chronic Lymphocytic Leukemia patients in relation to Treg frequency

BackgroundChronic lymphocytic leukemia (CLL) is characterized by a wide range of tumor-induced immune alterations. Regulatory T cells (Treg) play a central role in these immune responses. CD200 and Leukocyte-associated immunoglobulin-like receptor-1 (LAIR-1, CD305) are inhibitory markers said to be involved in Treg immune response. We aimed to analyze the expression of CD200 and LAIR-1 on leukemic cells and assess their interactions with the Treg frequency to elucidate their role in the CLL course. Subjects and methodsThis study was conducted on 70 participants: 50 newly diagnosed CLL cases classified according to Rai staging system into group 1 (n = 25) patients with stages 0, I, and II, and group 2 (n = 25) of advanced patients with stages III and IV. In addition to control group (n = 20) of healthy adults. Flow cytometry was used to investigate Treg frequency in bone marrow (BM) proportional to CD4+ T cell and to assess leukemic cell expression of CD200 and LAIR-1. Also, in-silico database analysis was performed to identify study markers interactions for future personalized target therapy. ResultsComparison between CLL groups 1 and 2 revealed increased leukemic cell percentage expressing LAIR-1 (p = 0.021) in group 1. Group 2 showed significant increase in frequency of Treg in BM and leukemic cells expressing CD200. There was a strong positive correlation between frequency of Treg and leukemic cells expressing CD200 (r = 0.669, p = 0.000). On the other hand, there was a negative correlation between frequency of Treg and leukemic cell expressing LAIR-1 (r = −0.342, p = 0.015). ROC curve analysis revealed that increased frequency of leukemic cells expressing CD200 yielded sensitivity (SN) and specificity (SP) of 96 % and 84 %, respectively in detecting CLL progression, with an AUC of 0.965. Leukemic cell percentages expressing LAIR-1 yielded a lower SN (75 %), SP (72 %), with an AUC of 0.688. ConclusionTreg frequency in BM was significantly increased in CLL advanced stages according to Rai classification. Leukemic cells CD200 and LAIR-1 expression were differently associated with Treg frequency. Increased CD200 expressions on leukemic cells can be considered a sensitive and specific biomarker in detecting CLL progression. As demonstrated by the in-silico research, CD200 blockade targeting may offer therapeutic benefits for CLL treatment through Treg suppression.

Efficacy of the Otago-Exercise-Programme to reduce falls in community-dwelling adults aged 65-80 when delivered as group or individual training: Non-inferiority-clinical-trial

BackgroundThe Otago Exercise Programme is an effective intervention for falls prevention. However, there is limited evidence in relation to studies that compare efficacy for falls prevention when delivered Otago Exercise Programme in a group or individual format in a primary care context.ObjectiveTo compare the Otago Exercise Programme delivered as a group vs. individual format for community dwelling older adults, over a one year period. The hypothesis was that neither format would be inferior to the other.MethodsDesign:A four-year multicentre, randomized, non-inferiority clinical trial, with two arms— Otago Exercise Programme group training and individual Otago exercise training. Setting(s): 21 primary healthcare centers. Participants: A sample size of 728 participants was established. Participants were aged between 65 and 80 years; living in the community; able to walk independently; and agreed to take part in the study and provided signed informed consent. Intervention: The Otago Exercise Programme was delivered mainly by nurses in primary care, with five face to face sessions, and a reinforcement 6 months later. Participants were encouraged to exercise at home between face to face sessions. Data collection: at baseline and after 6 and 12 months from October 2017 to 2020. Primary outcome: people who reported at least one fall. Secondary outcomes: number of falls, cause of falls, consequences and assistance, adherence and satisfaction. Group allocation was blinded to the researchers involved in analysis. Reporting: Consolidated Standards of Reporting Trials recommendations for the Statement for Randomized Trials of Nonpharmacologic Treatments.ResultsEight hundred twenty-seven participants were randomized (226 were allocated in group training and 272 in individual training). The analysis of the proportion of people who reported at least one fall and number of falls showed no differences between individual and group training. Assessment of the equivalence between the interventions at 12 months showed that the confidence interval for the difference of people who reported at least one fall was found to be within the equivalence limit of 10% considered. However, in those participants with a previous history of falls, group format showed potentially greater benefit. The participants in individual training presented higher scores on the Exercise Adherence Rating Scale test. No differences were found in satisfaction between the groups.ConclusionsThe group Otago Exercise Programme is equivalent to individually delivered Otago Exercise Programme in terms of prevention of falls over a 12-month follow up. Adherence was higher in individual training. Implications: Healthcare professionals could offer either Otago Exercise Programme format dependent on patient preference and be confident that that standardized intervention provides patient benefit.Trial RegistrationClinicalTrials.gov (NCT03320668). Data registration 31/10/2017.

Design of the VOILA-intervention study: A 12-week nutrition and resistance exercise intervention in metabolic or mobility compromised Dutch older adults and the response on immune-metabolic, gut and muscle health parameters

BackgroundExercise and nutrition interventions can slow ageing-induced decline in physiology. However, effects are heterogeneous and usually studied separately per outcome domain. In the VOILA study, we simultaneously study various health outcomes relevant for older adults and the inter-individual heterogeneity in response to a lifestyle intervention. MethodsVOILA is a 12-week lifestyle intervention in 3 groups of older adults (≥60 years), with compromised mobility (n=50), compromised metabolic health (n=50), or recovering from total knee replacement (TKR, n=70, of which 20 randomized to standard care only). The intervention includes high-intensity resistance exercise training thrice weekly, nutritional counselling, and nutritional supplements every morning and evening (including 20-25g whey protein and (evening only) 5.5g Biotis™ GOS). We measure immune-metabolic, gut health, muscle mass and physical functioning at baseline and after completion of the intervention/standard care. An additional reference group of healthy older adults (n=50) will undergo baseline measurements only. DiscussionImprovements in various physiological systems are expected, but with differences between groups/individuals. This study will provide insights into how the physiological state of older adults influences the extent of lifestyle-induced health improvements to create better tailored interventions to attenuate biological ageing and improve the health span of subgroups and individuals.

Radiological perspective on earthquake trauma: differences in children and adults.

February 2023 saw major earthquakes in Pazarcık and Elbistan, causing significant devastation in Turkey. Patients were transferred to hospitals in neighboring provinces, with multiple traumas-especially fractures and organ injuries-forming the main reasons for hospital admissions. This study aimed to examine earthquake-related injuries in pediatric and adult populations to understand differences. This study analyzed 1,220 adults and 590 pediatric patients with radiological imaging out of 8,704 earthquake trauma cases. Radiological images were assessed independently by two radiologists. Statistical analysis using SPSS examined relationships between variables such as age group and injury type. Results showed 40% of adults and 64% of children had normal radiological findings. Cerebral and extremity traumas were most common in pediatrics, while adults showed more extremity, thoracic, and spinal traumas. Significant differences between adult and pediatric groups were observed in cranial fractures, thoracic and lumbar vertebral fractures, hemopneumothorax, lung contusions, rib fractures, femur and talocalcaneal fractures, and compartment syndrome (p<0.001). Earthquake-related injuries may vary between children and adults. Due to children's more flexible anatomical structure, it is believed that earthquake-related injuries occur less frequently in children. In this study, head traumas were more common in children compared to adults. The rate of cranial fractures was significantly higher in children, with a higher incidence of epidural hematoma compared to adults. Spinal traumas were more frequent in adults than in children, attributed to children's greater flexibility reducing the risk of entrapment under rubble. Pediatric thoracic compliance being significantly higher than in adults often resulted in milder chest traumas. However, compartment syndrome was more common in children, with a lower rate of accompanying bone fractures compared to adults. No significant difference was observed between children and adults in maxillofacial, abdominal, and pelvic traumas. These findings provide insights for future disaster healthcare planning and management.

Exposure to tropospheric ozone and NO2 in the ambient air of Tehran metropolis: Spatiotemporal distribution and inhalation health risk assessment

BackgroundAir pollution has emerged as a critical challenge in the 21st century, necessitating alert monitoring of key pollutants such as ozone and nitrogen dioxide (NO2)F. These pollutants are exacerbated by urbanization and industrialization, posing significant health risks, particularly in densely populated metropolitan areas. ObjectiveThe aim of this study was inhalation health risk assessment of NO2 and ozone in various scenarios and spatiotemporal Distribution Interpolation. MethodsData were collected from the Tehran Air Quality Control Center, encompassing 18 monitoring stations from March 2019 to February 2022. Health risk assessments (HRA) were performed for adult age groups across three different exposure scenarios (3, 8, and 12 h) And a sensitivity analysis was also conducted to determine the relative importance of each parameter in assessing the risks of each scenario. ResultsThe hazard index (HI) values for NO2 and ozone in all three scenarios were found to range from 0.24 to 1.56 and 0.04 to 0.49, respectively and body weight is a risk-lowering factor in sensitivity analyses. The interpolation results of ozone, NOx, and NO2 using the IDW approach from March 2019 to February 2022 showed that overall, the north and northeast of Tehran had the highest concentrations of NO2 and NOx, and the north and west had the highest concentrations of ozone. SignificanceThis study underscores the HRA with exposure to NO2 and ozone, particularly for individuals spending more than 8 h outdoors. Given Tehran's high population density and persistent air pollution, it is imperative to implement effective control policies to safeguard public health. The findings advocate for limiting outdoor activity to less than 8 h per day, especially for vulnerable occupational groups. Additionally, the study highlights the importance of considering body weight in health risk assessments.

Vocal consensus building for collective departures in wild western gorillas.

The ability to coordinate actions is of vital importance for group-living animals, particularly in relation to travel. Groups can only remain cohesive if members possess a cooperative mechanism to overcome differences in individual priorities and social power when coordinating departures. To better understand how hominids achieve spatio-temporally coordinated group movements, we investigated vocally initiated group departures in three habituated groups of western gorillas (Gorilla gorilla) in the Central African Republic. The large sexual dimorphism of gorillas has led to the untested assumption that the silverback males are the sole decision-makers in gorilla groups, although there are also observations that suggest otherwise. To address this, we analysed the direction and timing of group departures and found that high-ranking individuals (silverbacks and high-ranking females) were more successful in indicating the direction of future travel than others, but that the timing of departure was the apparent result of a cumulative vocal voting process among all adult group members. Our findings illustrate that even in species with a large sexual size dimorphism, travel decisions can be taken collectively via a consensus-building process.

Correlation between sphenoid sinus pneumatization and sella turcica dimensions using computed tomography.

This study was performed to determine the dimensions of the sella turcica (ST) in relation to sex, age groups, and sphenoid sinus (SS) pneumatization patterns in a cohort of Iraqi individuals. This cross-sectional study analyzed computed tomography images of 99 individuals (53 men, 46 women) aged 24 to 59 years to measure ST dimensions, including length, width, height, depth, and surface area. SS pneumatization was classified by sex and age. We also examined the relationship between ST size and SS pneumatization patterns. Women exhibited a significantly greater mean ST depth (9.37 mm) than men (8.19 mm). The ST diameter was significantly larger in the middle-aged group (13.1 mm) than in the young adult group (11.83 mm). The ST area showed a highly significant difference between sexes. The sellar pneumatization pattern was the most common, whereas the conchal pattern had the lowest prevalence. A significant correlation was observed between ST size and SS pneumatization. The ST depth and diameter showed statistically significant differences across sex and age groups, respectively. The variability in SS pneumatization patterns underscores the importance of considering pneumatization types during surgical planning to minimize the risk of iatrogenic injury and improve treatment outcomes.

Clinical characteristics and outcomes in middle-aged Fontan patients

BackgroundMiddle-aged Fontan patients are underrepresented in contemporary studies. The purpose of this study was to describe the clinical characteristics and outcomes in middle-aged patients with Fontan palliation. MethodsAll adults with Fontan palliation were divided into ‘middle-aged’ group (>40 years of age at baseline encounter), and ‘young adult’ group. Clinical characteristics were assessed across multiple domains (atrial arrhythmias, heart failure, and hepatorenal function). Clinical outcomes were assessed as composite outcome of death/heart transplant. ResultsOf 455 adults (median age 26 years), 63 (14 %) were middle-aged adults while 392 (86 %) were young adults. Compared to the young adult group, the middle-aged group had a higher prevalence of atrial arrhythmias, greater neurohormonal activation, and worse hepatorenal function. Of 63 patients in the middle-aged group, 26 (41 %) patients died, and 4 (6 %) patients underwent heart transplant. The middle-aged group had a higher 5-year cumulative incidence of death/transplant (45 % versus 21 %, p < 0.001), and 10-year cumulative incidence of death/transplant (64 % versus 29 %, p < 0.001) compared to the young adult group. Higher pulmonary artery wedge pressure (hazard ratio 1.18 [1.09–1.27]), and higher model for end-stage liver disease excluding international normalized ratio score (hazard ratio 1.07, [1.03–1.14]), were associated with death/transplant. ConclusionsAbout 14 % of adults with Fontan palliation were middle-aged, and these patients had higher prevalence of cardiovascular comorbidities, hepatorenal dysfunction, and mortality. These data underscore the need for better risk stratification strategies to identify patients at risk for adverse outcomes and allow for early referral for transplant evaluation in this emerging subpopulation. Clinical summaryThe purpose of this study was to describe the clinical characteristics (comorbidities and end-organ dysfunction) and outcomes (death/transplant) in middle-aged patients with Fontan palliation. Of 455 patients (median age 26 years), 63 (14 %) were middle-aged adults while 392 (86 %) were young adults. Compared to the young adult group, the middle-aged group had a higher prevalence of atrial arrhythmias, greater neurohormonal activation, worse hepatorenal function, and higher risk of death/transplant. The correlates of death/transplant were higher pulmonary artery wedge pressure and hepatorenal dysfunction. These data underscore the need for better risk stratification in this emerging population.

COMPARISON OF COGNITIVE FUNCTION AND DEPRESSIVE SYMPTOMS IN INSTITUTIONALIZED HEALTHY AND OLDER PERSON WITH ALZHEIMER’S DISEASE

Physical activity shows benefits in cognitive function and the prevention and treatment of depression in older adults with Alzheimer’s disease and healthy ones. So, the purpose of this study was to compare cognitive function and depressive symptoms in two groups: a group of older adults with Alzheimer’s disease and a group of older adults without neurodegenerative diseases, by sex and level of physical activity. The sample was 30 participants divided into two groups: 15 participants with Alzheimer’s disease and 15 participants without neurodegenerative diseases. The instruments used were the Geriatric Depression Scale (GDS) and Mini-Mental State Examination (MMSE). The results revealed that older persons with Alzheimer’s disease exhibit a more significant impairment of cognitive skills (p = .001) and a higher incidence of depressive symptoms (p = .001) compared to older persons without neurodegenerative diseases, with no differences between sex (p &gt; .05). Results show that active older person had higher scores in cognitive abilities (p = .001) and a lower incidence of depression (p = .001). It seems that Alzheimer’s disease, typically associated with cognitive abilities decline and incidence of depressive symptoms, and physical activity influence cognitive performance and depressive symptoms in older people with Alzheimer’s disease and without dementia.

The Impact of Hba1c Levels on Diabetic Patients' Sugar Control and Its Influence on Eye Health: Clinical Study

This study utilized a cross-sectional design to examine the effect of HbA1c levels on the regulation of blood sugar and its effects on eye health in a group of diabetic adults in Iraq. One hundred and fifty participants in all filled out a structured questionnaire that evaluated their comprehension of diabetes, methods for managing it, and knowledge of diabetic eye problems. The findings indicated that although most participants possessed a satisfactory overall comprehension of diabetes, a considerable number exhibited a deficiency in their grasp of the importance of HbA1c values and its connection to the regulation of blood sugar over an extended period. Participants utilized many ways to regulate their diabetes; however, their adherence to these methods was inconsistent. In addition, a significant number of participants were not regularly undergoing eye examinations to detect indicators of diabetic retinopathy, despite being aware of the possibility of eye-related issues. These findings indicate that there is a need for enhanced patient education, increased adherence to diabetes management regimens, and improved integration of eye care services within the overall diabetes care system to address the difficulties faced by this group. Enhancing these components has the potential to result in improved long-term results for patients with diabetes in Iraq. The study emphasizes the significance of comprehensive strategies for managing diabetes that give priority to both controlling blood sugar levels and preventing microvascular problems, such as diabetic retinopathy which can lead to visual loss.

Beyond brain injury: Examining the neuropsychological and psychosocial sequelae of post-traumatic epilepsy.

This study investigates neuropsychological and psychosocial outcomes in patients with traumatic brain injury (TBI) and post-traumatic epilepsy (PTE) compared to a healthy control group. Utilizing a quasi-experimental cross-sectional design, the research involved patients with TBI and PTE referred from a Taiwanese medical center. An age- and education-matched control group of healthy adults without traumatic injuries was also recruited. The study involved analyzing retrospective medical records and applying a comprehensive suite of neuropsychological tests and psychosocial questionnaires. Executive function measures revealed significantly reduced performance in both the TBI and PTE groups compared to controls. Specifically, the MoCA scores were lowest in the PTE group, followed by the TBI group, and highest in the controls. Measures of subjective symptomatology showed comparably elevated levels in both the TBI and PTE groups relative to controls. The research suggests that PTE may intensify the difficulties faced by individuals with TBI, but its impact on overall recovery might not be significant, considering the trajectory of the brain injury itself. Notably, the MoCA results indicate that cognitive deficits are more pronounced in PTE patients compared to those with TBI, underscoring the necessity for targeted neuropsychological assessments. Further investigation is essential to explore PTE's broader neuropsychological and psychosocial impacts. These findings advocate for tailored care strategies that address both neuropsychological and psychosocial needs, ensuring comprehensive management of TBI and PTE.

Effects of Time Intervals and Semantic Weight on Action Fluency Tasks in Older Adults

Objectives: The purpose of this study was to investigate the differences in performance of action fluency tasks (AFT) based on time intervals and the semantic weight of verbs among groups of healthy young and older adults and to explore the correlation between working memory and the performance. Methods: A total of 62 Korean-speaking individuals, consisting of 31 healthy young and older adults, participated in the AFT and their performance was analyzed by the semantic weight of verbs (Heavy vs. Light) and time interval (first 30 sec vs. last 30 sec). They also participated in a working memory task. To measure working memory capacity, word span tasks (WST) - forward and backward were conducted. Results: In both groups, performance on the AFT was higher in the first 30 sec and there were more productions of heavy verbs compared to light verbs. Additionally, a positive correlation was observed in the older adults between the number of heavy verbs produced in both the first 30 sec and last 30 sec and the scores on the WST-backward. Conclusion: In this study, through a qualitative analysis based on time intervals and semantic weight, we confirmed that the first 30 sec of the AFT can be a useful source for analyzing results. Furthermore, it highlighted that the semantic weight of verbs could serve as an efficient method for predicting aging.

LIMBERG FLAP FOR SACROCOCCYGEAL PILONIDAL SINUS: A SAFE AND PROMISING SURGERY

Introduction:Sacrococcygeal pilonidal sinus is a common disease of the adult age group, especially male population, causing significant morbidity from both disease and surgery done for the same. It is essentially a cleavage between the buttocks (i.e., natal cleft), and diagnosis is made by identifying the epithelialized follicle opening (i.e., sinus). The name PILONIDAL is taken from Latin meaning nest of hairs. The estimated incidence is 26 per 1,00,000 people1. It generally presents as a cyst, abscess, or sinus tract with or without discharge2. Men affected more often than women1, rare both before puberty and after the age of 40 years3. The etiology of the pilonidal sinus is a matter of controversy. Aims &amp; Objectives:Literature study showed that Limberg flap reconstruction following rhomboid excision of the sinus area was superior to primary closure and other flap procedures and a safe and reliable method in sacrococcygeal pilonidal sinus disease with low complication and recurrence rates. Hence, this study was performed in our setup to evaluate the usefulness of Limberg flap procedure in sacrococcygeal pilonidal sinus, patient compliance, complications and long-term recurrence rates following the procedure. Materials &amp; Methods:The study involves 22 patients, from May 2022 to September 2023. Most of the patients were males of those 4 were females. Average age was 24 years—the oldest was 29 years and the youngest was 15 years. Results:In this study 22 patients were included. Among them 18 were males and 4 were females. Mean age was 24 years (range 15–29 years). Of the 22 patients, 14 had primary disease, 6 had recurrent disease, and 2 came up after having previous incision and drainage for abscess. All patients came with pilonidal sinus, from May 2022, were assessed for its severity and investigated, and then they underwent Limberg flap surgery under spinal anesthesia. Discussion:Sacrococcygeal pilonidal sinus is blind epithelial tract situated in the skin of the natal cleft, close to anal verge, generally containing hair. The etiology is matter of debate initially congenital origin was thought of which is now given up. Main causes for the formation of this sinus are hirsutism, sweating in the area, repeated maceration due to trauma, leading to breakage of the skin barrier, attracting hair inside which initiates a foreign body reaction leading to infection with abscess or sinus formation. Conclusion:Sacrococcygeal pilonidal sinus is headache to both the patient and the treating surgeon because of its repeated infection, persistent pain with discharge, and high recurrence rates with regular procedures.

OPPORTUNITIES FOR THE FORMATION OF INTELLECTUAL SKILLS OF PRESCHOOL CHILDREN THROUGH DEVELOPMENTAL GAMES

In this article, the theories of the formation of intellectual skills of preschool children are substantiated and presented from a practical point of view through the results of practice. In the preschool period, they revealed the possibilities of developing intellectual skills of the child through developing games. The concept of intelligence and intelligence is currently in widespread use and is becoming one of the most relevant topics. In accordance with the period of technological rapid development and globalization of our time, in accordance with demographic growth, new changes are observed in our society. In this regard, the types of skills and abilities that should be present in the younger generation are increasing. In the upbringing and training of preschool children, the focus is on the problem of educating a competitive generation through the development of the child`s physical, communicative, cognitive, intellectual, creative skills, research abilities. In the period from four to five years, the child experiences an important stage, perception and desire to learn the new, the author notes the scientifically sustained theories, the features of the experimental research are analyzed quantitatively and qualitively. The article presented a list of developmental games as effective tools for the development of intellectual skills of children of the adult group. It is written on the basis of the state program for the development of educational system Republic of Kazakhstan and the concept, and for the correct organization of intellectual skills, it is necessary To know the laws and possibilities of physiological development in a child. As noted in the article, the analysis of the content and methods of sensory education scientifically substantiated the development of perception and institution, the sequence of formation of logical thinking, revealed the psychological and pedagogical features of developing games in the formation of intellectual skills of children of preschool age group.

Physical Activity and Cognitive Impairment in a Group of Adults with Down Syndrome from North-Eastern Romania

Background: Down syndrome (DS) is the most prevalent chromosomal condition, with the average life expectancy significantly rising from 25 years in 1983 to 60 years in 2020. People with DS generally can participate in most physical activities that individuals without the disability can, despite some physical limitations. However, the varying degrees of cognitive deficits can present challenges when it comes to performing physical activities. Methods: We conducted a prospective, cross-sectional study in the Cardiovascular Rehabilitation Clinic from the Clinical Rehabilitation Hospital from Iași, Romania, between July 2022 and February 2024 that included 28 patients diagnosed with DS. We collected data regarding age and comorbidities and performed several tests (MMSE, timed-up-and-go test, and handgrip strength). Results: The group consisted of 11 (39%) females and 17 (61%) males with a mean age of 28.07 ± 9.51 years. The weight profile of the study group differed according to the degree of physical activity: 62.50% of those with moderate physical activity were moderately overweight, while 75% of those with minimal activity were overweight or obese. The muscle strength and MMSE score was higher in the group of patients who performed moderate physical activity. Regarding comorbidities, there was a statistically significant difference in the percentage of patients with hearing loss among those with minimal physical activity. Conclusions: Our results provide an update on the very limited data available. The study indicates that people with DS are generally less physically active and face unique health challenges (hearing loss, intellectual disabilities, and osteoarticular pathologies).

Enhancing Care For Nursing Home Residents Through A Specialised Geriatrician-led Acute Care Team

Abstract Background Nursing home residents (NHRs) represent one of the most vulnerable groups of older adults, requiring complex and comprehensive care due to their multiple comorbidities and intricate healthcare needs. The establishment of a specialised Geriatrician-led Acute Care Team specifically for NHRs can provide better clinical outcomes over traditional care models. These services are designed to address the unique needs of this population, providing appropriate treatment in settings conducive to their well-being and aiming to mitigate adverse consequences associated with unnecessary hospitalizations. Methods In 2023, 343 NHRs were admitted to acute care via Emergency Department in a University Teaching Hospital. Of these, 227 (66%) were admitted under the care of this specialized geriatrician-led team, with an average length of stay of 7 days, totalling 376 bed days, and a readmission rate of 15%. In contrast, 112 NHRs admitted under other non-medical services (surgical specialities) had an average length of stay of 9 days, totalling 849 bed days, and a readmission rate of 11%. Results The primary advantage of this specialist team lies in the personalized attention and expertise provided by gerontologically attuned practitioners. These professionals have a profound understanding of age-related changes, complex health conditions, and psychosocial aspects affecting older adults. By tailoring care plans to individual needs and preferences, they optimize treatment outcomes and enhance quality of life for NHRs. Conclusion In conclusion, the establishment of a specialised acute care team specifically for NHRs represents a significant advancement in addressing the complex needs of this cohort. By leveraging the expertise of gerontologically attuned practitioners and emphasizing person-centred care approaches, these services offer a holistic and tailored solution to improve outcomes and enhance the quality of life for this vulnerable population. Continued investment in developing and expanding such services is crucial for advancing care standards for older adults and promoting a more age-friendly healthcare system.

Malnutrition Risk Screening and Dietitian Intervention within an Integrated Care Team for Older Persons

Abstract Background Malnutrition in older adults increases the risk of frailty. Nutritional interventions can improve frailty. A Senior Dietitian joined our Integrated Care for Older Persons Community Specialist Team (ICPOP-CST) in 2022. Our Complete Geriatric Assessment (CGA) form was redesigned in early 2023 which included the Malnutrition Screening Tool (MST). We commenced measuring handgrip strength (HGS) in late 2023. We measured the prevalence of malnutrition risk among our patients, audited MST use and explored dietetic service provision. Methods Data from the first 101 patients with a completed (new) CGA form were obtained from the service’s electronic patient database. Patients with a MST score of 0 or 1 were considered to be at low risk of malnutrition and those with a MST score of 2 or more were considered to be at risk of malnutrition. Results The mean age was 84.8±5.3 years and 65% were female. Malnutrition risk was identified in 39 (38.6%) patients. The MST was completed for 96 (95%) patients and completed correctly in 67 (69.8%). The total score was not summed in 26 out of 29 incorrectly completed screening tools (89.7%). Half (51, 50.5%) of the group of older adults received dietetic assessment and intervention. High protein, high calorie advice was provided for 38 (74.5%) of those seen by the ICPOP dietitian and for 29 (93.5 %) of those at risk of malnutrition. Onward referral to primary care dietitians was made for 14 (27.5%) of those seen by the ICPOP dietitian. HGS measurement was performed in 20 patients - 15 (75.0%) were identified to have probable sarcopenia – 11 (73.3%) of these were at risk of malnutrition. All received dietetic intervention in relation to protein and sarcopenia. Conclusion Malnutrition risk and probable sarcopenia are common among older adults referred to our ICPOP-CST team. The MST screening tool is practical and identifies those requiring dietetic intervention.

Evaluation of a Nutrition and Exercise Group Intervention for Older Adults with Frailty and Probable Sarcopenia

Abstract Background The prevalence of probable sarcopenia in frail older adults attending a Community Specialist Team (CST) is 52%. Resistance exercise and optimising nutrition are recommended interventions. The aim of this study was to evaluate a nutrition and exercise group for frail older adults with probable sarcopenia. Methods Adults aged ≥65 years, with probable sarcopenia identified through Comprehensive Geriatric Assessment (CGA) by a CST over 18 months were included. At CGA (baseline), sarcopenia infographics and 2 attendances at Dietetic and Physiotherapy group were offered. Group intervention comprised nutrition and exercise information and individualised goal setting. Clinical Frailty Scale (CFS) score, grip strength and 5 Times Sit-to-Stand (5TSS) were measured. Participants' needs and perceived changes in knowledge were evaluated using open questions and Likert Scales. Data was analysed using thematic analysis, descriptive and inferential statistics. Results Intervention was offered to 82 people. Twenty-nine (35%) attended an initial group (18 women, 11 men), with mean age 80.7 years (SD=7). Nine (30%) attended the second group. Participants were significantly less frail (median CFS 4, IQR 4, 6) than non-participants (median CFS 6, IQR 5, 7) (p= 0.002). Male grip strength improved significantly from baseline (mean 22kg, SD=4.21) to first group (mean 27.8kg, SD=4.36) (p=0.007) and to second group (mean 29kg, SD=4.21) (p=0.012). Female grip strength increased non-significantly from baseline (mean 12.6kg, SD=3.38) to first group (mean 14.5kg, SD=5.85), (p=0.127) and to second group (mean 14.83kg, SD=4.21) (p=0.890). Participant’s 5TSS did not change significantly (mean 19.75 sec, SD=6.38 to mean 20.78 sec, SD=7.73) (p=0.782). Nutrition and exercise knowledge improved significantly (p=0.004, p=0.003 respectively). Access to clear information was an identified theme. Conclusion Educational resources and tailored plans within group interventions can improve grip strength and knowledge in older adults living with very mild frailty. Further research is required to design an accessible intervention for more frail cohorts.

The lifestyle of new middle-aged and older adults in Taiwan described by wearable device: age and gender differences.

Studies of lifestyle through comprehensive objective and subjective measurements of health outcomes are lacking. An examination of lifestyle factors in middle-aged and older adults in terms of age, gender, and the interaction effect of age and gender from physiological and psychological perspectives are imperative. Recent advances in technology such as actigraphy have facilitated objective measurements. This exploratory study contributes to research on age and gender interactions on circadian rhythm, physical activity, sleep, and psychological variables by employing wrist accelerometers to measure behavioral circadian rhythm objectively and by using questionnaires to assess psychological status subjectively. The data were drawn from 218 participants aged 50 and older from the "Middle-aged and older adults Chinese Health and Actigraphy in Taiwan (MOCHA-T)". The results: (1) older adult group is associated with declined physical activity (MVPA time 79.9min VS. 107.9min, p = .002), worse sleep efficiency (78.1% VS. 81.9%, p = .008), and earlier lifestyle (Acrophase 14.19h VS. 14.69h, p = .01) comparing to middle-aged group. (2) Women have a more regular lifestyle (Interdaily stability 0.6 VS. 051, p < 0.001), higher physical activity (MVPA time 105.7min VS. 79.3min, p = .004), and better sleep efficiency (81.6% VS. 77.8%, p = .011) than men. (3) Significant age-by-gender interactions existed in life satisfaction (p = .025), relative amplitude (p = .016), and total wake time (p = .038). Furthermore, aging was associated with significant increases in life satisfaction among men as well as significant decreases in relative amplitude and reductions in the total wake time among women. In conclusion, aging exerted differential effects on life satisfaction in men as well as relative amplitude and the total wake time in women. This result highlights disparities in lifestyle arising from interconnected social and biological challenges.