Interventions For Older Adults Research Articles

Midpoint of sleep is associated with sleep quality in older adults with and without symptomatic Alzheimer's disease.

Disrupted sleep is common in individuals with Alzheimer's disease (AD) and may be a marker for AD risk. The timing of sleep affects sleep-wake activity and is also associated with AD, but little is known about links between sleep architecture and the midpoint of sleep in older adults. In this study, we tested if the midpoint of sleep is associated with different measures of sleep architecture, AD biomarkers, and cognitive status among older adults with and without symptomatic AD. Participants (N = 243) with a mean age of 74 underwent standardized cognitive assessments, measurement of CSF AD biomarkers, and sleep monitoring via single-channel EEG, actigraphy, a home sleep apnea test, and self-reported sleep logs. The midpoint of sleep was defined by actigraphy. A later midpoint of sleep was associated with African-American race and greater night-to-night variability in the sleep midpoint. After adjusting for multiple potential confounding factors, a later sleep midpoint was associated with longer rapid-eye movement (REM) onset latency, decreased REM sleep time, more actigraphic awakenings at night, and higher < 2 Hz non-REM slow-wave activity. Noninvasive in vivo markers of brain function, such as sleep, are needed to track both future risk of cognitive impairment and response to interventions in older adults at risk for AD. Sleep timing is associated with multiple other sleep measures and may affect their utility as markers of AD. The midpoint of sleep may be changed through behavioral intervention and should be taken into account when using sleep as a marker for AD risk.

A novel electronic health record-based, machine-learning model to predict severe hypoglycemia leading to hospitalizations in older adults with diabetes: A territory-wide cohort and modeling study.

Older adults with diabetes are at high risk of severe hypoglycemia (SH). Many machine-learning (ML) models predict short-term hypoglycemia are not specific for older adults and show poor precision-recall. We aimed to develop a multidimensional, electronic health record (EHR)-based ML model to predict one-year risk of SH requiring hospitalization in older adults with diabetes. We adopted a case-control design for a retrospective territory-wide cohort of 1,456,618 records from 364,863 unique older adults (age ≥65 years) with diabetes and at least 1 Hong Kong Hospital Authority attendance from 2013 to 2018. We used 258 predictors including demographics, admissions, diagnoses, medications, and routine laboratory tests in a one-year period to predict SH events requiring hospitalization in the following 12 months. The cohort was randomly split into training, testing, and internal validation sets in a 7:2:1 ratio. Six ML algorithms were evaluated including logistic-regression, random forest, gradient boost machine, deep neural network (DNN), XGBoost, and Rulefit. We tested our model in a temporal validation cohort in the Hong Kong Diabetes Register with predictors defined in 2018 and outcome events defined in 2019. Predictive performance was assessed using area under the receiver operating characteristic curve (AUROC), area under the precision-recall curve (AUPRC) statistics, and positive predictive value (PPV). We identified 11,128 SH events requiring hospitalization during the observation periods. The XGBoost model yielded the best performance (AUROC = 0.978 [95% CI 0.972 to 0.984]; AUPRC = 0.670 [95% CI 0.652 to 0.688]; PPV = 0.721 [95% CI 0.703 to 0.739]). This was superior to an 11-variable conventional logistic-regression model comprised of age, sex, history of SH, hypertension, blood glucose, kidney function measurements, and use of oral glucose-lowering drugs (GLDs) (AUROC = 0.906; AUPRC = 0.085; PPV = 0.468). Top impactful predictors included non-use of lipid-regulating drugs, in-patient admission, urgent emergency triage, insulin use, and history of SH. External validation in the HKDR cohort yielded AUROC of 0.856 [95% CI 0.838 to 0.873]. Main limitations of this study included limited transportability of the model and lack of geographically independent validation. Our novel-ML model demonstrated good discrimination and high precision in predicting one-year risk of SH requiring hospitalization. This may be integrated into EHR decision support systems for preemptive intervention in older adults at highest risk.

Predictors of major adverse cardiac and cerebrovascular events after percutaneous coronary intervention in older adults: a systematic review and meta-analysis

AimWe systematically reviewed and meta-analyzed the predictors of major adverse cardiac and cerebrovascular events (MACE/MACCE) in older adults who underwent PCI.MethodsThree databases, PubMed, Embase, and Scopus, were searched for observational studies considering the out-of-hospital MACE/MACCE in adults ≥ 60 years old with coronary artery disease (acute or chronic) who underwent PCI. Studies were eligible if they had determined at least two statistically significant predictors of MACE/MACCE by multivariable analysis. We used the QUIPS tool to evaluate the risk of bias in the studies. Random-effects meta-analysis was utilized to pool the hazard ratios (HRs) of the most reported predictors.ResultsA total of 34 studies were included in the review. Older age (HR = 1.04, 95% Confidence Interval (CI): 1.03–1.06, P-value < 0.001), diabetes (HR = 1.36, 95% CI: 1.22–1.53, P < 0.001), history of myocardial infarction (MI) (HR = 1.88, 95% CI: 1.37–2.57, P < 0.001), ST-elevation MI (STEMI) at presentation (HR = 1.72, 95% CI: 1.37–2.18, P < 0.001), reduced left ventricular ejection fraction (LVEF) (HR = 2.01, 95% CI: 1.52–2.65, P < 0.001), successful PCI (HR = 0.35, 95% CI: 0.27–0.47, P < 0.001), eGFR (HR = 0.99, 95% CI: 0.97-1.00; P-value = 0.04) and left main coronary artery (LMCA) disease (HR = 2.07, 95% CI: 1.52–2.84, P < 0.001) were identified as predictors of MACE.ConclusionWe identified older age, diabetes, history of MI, STEMI presentation, lower LVEF, and LMCA disease increased the risk of MACE/MACCE after PCI in older adults. Meanwhile, higher eGFR and successful PCI predicted lower adverse events risk. Future studies should focus on a more robust methodology and a precise definition of MACE.RegistrationPROSPERO (CRD42023480332).

Lemborexant Treatment in Older Adults with Insomnia and Objective Short Sleep: Rates of Response and Remission (P8-9.015)

Lemborexant Treatment in Older Adults with Insomnia and Objective Short Sleep: Rates of Response and Remission (P8-9.015)

Pain-related single nucleotide polymorphisms: association with lumbar spinal stenosis patient experience and non-surgical treatment outcomes.

Lumbar spinal stenosis (LSS) is common in our aging population resulting in pain and functional impairment. Recent advances in pain research have identified several single nucleotide polymorphisms (SNP) associated with inter-individual symptom and treatment response. The goal of the current study was to investigate the association of SNPs in Neuropeptide Y (NPY) and Catechol-O-methyltransferase (COMT) with pain, function, and treatment outcomes in Lumbar spinal stenosis (LSS) patients receiving non-surgical treatments. An exploratory observational biomarker study was performed ancillary to a previously published clinical trial evaluating three different non-surgical treatments for LSS. Saliva samples were obtained for single nucleotide polymorphism genotyping and blood samples were collected for NPY protein. Data on pain and function collected as part of the clinical trial at baseline, 2 and 6 months were examined for association with known polymorphisms in NPY and COMT. Subjects with the NPY rs16147 TT genotype exhibited higher baseline symptom severity but also a higher likelihood of responding to non-surgical treatments. Subjects with the COMT rs4680 GG genotype also exhibited higher baseline symptom severity but did not demonstrate greater response to treatment. NPY rs16147 and COMT rs4680 are important potential biomarkers associated with pain and function. NPY genotype may be useful in predicting response to non-surgical treatments in older adults with LSS.

Effects of expressive arts therapy on cognitive function and depression among older adults with MCI in Taiwan

ABSTRACT Older adults with mild cognitive impairment (MCI) are at increased risk of progression to dementia. Whether it is feasible to engage this population in expressive arts therapy and yield effects on cognition and depression for older adults with MCI remained unclear. The aim of this study examined the effects of expressive arts therapy on the cognitive function and depression levels of older adults with MCI in day care centers in Taiwan. A quasi-experimental design was conducted in a sample of day care centers older adults with MCI. A total of 88 participants with MCI were assigned to the intervention or comparison group. The intervention groups participated in an expressive arts therapy for 12 weeks in addition to their daily activities. Data were collected at the baseline point and immediately after post-intervention. Generalized estimating equations were used to examine the effect of the intervention on the outcomes. At week 12, findings indicated that the intervention group had significant improvement in cognitive function and depression over time than the comparison group. These findings provide evidence for the feasibility and efficacy of expressive arts therapy intervention in older adults with MCI.

Social participation, loneliness, and physical inactivity over time: evidence from SHARE.

We aimed to explore the reciprocal effects of social participation, loneliness, and physical inactivity over a period of 6 years in a representative sample of European adults over 50 years old. A longitudinal study with a six-year follow-up period was conducted. Four waves of the Survey of Health, Ageing and Retirement in Europe project were used. This study includes 64,887 participants from Europe and Israel, who were aged 50 or older at the first time. The relationship between participation in social activities, loneliness and physical inactivity was analyzed, controlling for age, gender, and disability. A series of cross-lagged panel models (CLPMs) were applied to analyze the relationships among these variables. A CLPM with equal autoregressive cross-lagged effects across waves was the best fit to the data (χ2 = 7137.8, CFI = .972, RMSEA = .049, SRMR = .036). The autoregressive effects for the three variables showed high stability across waves, and all the cross-lagged effects in the model were statistically significant. Social activity and physical inactivity maintained a strong negative cross-lagged effect, while their cross-lagged effects on loneliness were comparatively smaller. Social activity had a positive cross-lagged effect on loneliness, while physical inactivity had a negative cross-lagged effect on loneliness. These findings highlight the importance of promoting physical activity and social participation and addressing loneliness through targeted interventions in older adults.

Professionals’ perspectives on interventions to reduce problematic alcohol use in older adults: a realist evaluation of working elements

ObjectivesThis study set out to understand how (which elements), in what context and why (which mechanisms) interventions are successful in reducing (problematic) alcohol use among older adults, from the perspective...

Effectiveness of the online-based comprehensive cognitive training application, Smart Brain, for community-dwelling older adults with dementia: a randomized controlled trial.

The fourth industrial revolution has brought about developments in information and communication technologies for interventions in older adults with dementia. Currently, most interventions focus on single interventions. However, community-dwelling older adults with dementia require comprehensive cognitive interventions, and clinical studies analyzing the effects of comprehensive interventions based on randomized controlled trials are lacking. The aim of the study was to examine the effects of an information and communication technology-based comprehensive cognitive training program, Smart Brain, on multi-domain function among community-dwelling older adults with dementia. This was a two-group, randomized, controlled trial. This study was conducted at participant's home. We analyzed older adults with dementia. Participants were randomly allocated to either the intervention group (N.=30) or the control group (N.=30). Older adults with dementia in the intervention group received 8 weeks of Smart Brain comprehensive cognitive training using a tablet, whereas the control group received a similar tablet but without the training. We measured the outcomes at baseline, and at 4 and 8 weeks. Cognitive function, depression, quality of life, balance confidence, physical ability, nutrition, and caregiver burden were compared between groups. In the intervention group, cognitive function statistically increased from baseline to both week 4 (2.03; 95% CI 1.26 to 2.81) and week 8 (2.70; 95% CI 1.76 to 3.64). Depression was statistically different from week 0 to week 8 (-1.67, 95% CI -2.85 to -0.48). Physical ability statistically increased from baseline to both week 4 (-0.85; 95% CI 1.49 to -0.20) and week 8 (-1.44; 95% CI -2.29 to -0.59). Nutrition statistically increased from baseline to both week 4 (0.67; 95% CI 0.05 to 1.28) and week 8 (1.10; 95% CI 0.36 to 1.84). Smart Brain significantly improved cognitive function, reduced depression, and enhanced physical and nutritional status in older adults with dementia. This demonstrates its potential as an effective non-pharmacological intervention in community-based dementia care. Smart Brain's personalized approach, which integrates user-specific preferences and expert guidance, enhances engagement and goal achievement in dementia care. This enhances self-esteem and clinical outcomes, demonstrates the application's potential to innovate rehabilitation practices.

141 Don't be ageist: considering the use of multimodality treatment in older adults with unresectable locally advanced Non-Small Cell Lung Cancer (NSCLC)

141 Don't be ageist: considering the use of multimodality treatment in older adults with unresectable locally advanced Non-Small Cell Lung Cancer (NSCLC)

Statin utilization and cardiovascular outcomes in a real-world primary prevention cohort of older adults

BackgroundStatins are a cost-effective therapy for prevention of atherosclerotic cardiovascular disease (ASCVD). Guidelines on statins for primary prevention are unclear for older adults (>75 years). ObjectiveInvestigate statin utility in older adults without ASCVD events, by risk stratifying in a large healthcare network. MethodsWe included 8,114 older adults, without CAD, PVD or ischemic stroke. Statin utilization based on ACC/AHA 10-year ASCVD risk calculation, was evaluated in intermediate (7.5%-19.9%) and high-risk patients (≥ 20%); and categorized using low and ‘moderate or high’ intensity statins with a follow up period of ∼7 years. Cox regression models were used to calculate hazard ratios for incident ASCVD and mortality across risk categories stratified by statin utilization. Data was adjusted for competing risk using Elixhauser Comorbidity Index. ResultsCompared with those on moderate or high intensity statins, high-risk older patients not on any statin had a significantly increased risk of MI [HR 1.51 (1.17–1.95); p<0.01], stroke [HR 1.47 (1.14–1.90); p<0.01] and all-cause mortality [HR 1.37 (1.19–1.58); p<0.001] in models adjusted for Elixhauser Comorbidity Index. When comparing the no statin group versus the moderate or high intensity statin group in the intermediate risk cohort, although a trend for increased risk was seen, it did not meet statistical significance thresholds for MI, stroke or all-cause mortality. ConclusionLack of statin use was associated with increased cardiovascular events and mortality in high-risk older adults. Given the benefits appreciated, statin use may need to be strongly considered for primary ASCVD prevention among high-risk older adults. Future studies will assess the risk-benefit ratio of statin intervention in older adults.

Optimizing Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Older Adults

Optimizing Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Older Adults

The safety of a low protein diet in older adults with advanced chronic kidney disease.

A low protein diet (LPD) is recommended to patients with advanced chronic kidney disease (CKD), whereas geriatric guidelines recommend a higher amount of protein. The aim of this study was to evaluate the safety of LPD treatment in older adults with advanced CKD. The EQUAL study is a prospective, observational study, including patients ≥65 years, incident estimated glomerular filtration rate <20 ml/min/1.73m², in six European countries with follow-up up till six years. Nutritional status was assessed by 7-point subjective global assessment (SGA) every 3-6 months. Prescribed diet (gram protein/kilogram/bodyweight) was recorded on every study visit; measured protein intake was available in three countries. Time to death and decline in nutritional status (SGA decrease by ≥2 points) were analysed using marginal structural models with dynamic inverse probability of treatment and censoring weights. Out of 1738 adults (631 prescribed LPD at any point during follow-up) there were 1319 with repeated SGA measurements of which 267 (20%) declined in SGA ≥ 2 points and 565 (32.5%) died. There was no difference in survival or decline in nutritional status for patients prescribed LPD ≤0.8 g/kg ideal bodyweight (Odds Ratio (OR) for mortality 1.15 (95% Confidence interval (CI) 0.86-1.55) and OR for decline in SGA 1.11 (95% CI 0.74-1.66) in the adjusted models. In patients prescribed LPD <0.6 g/kg ideal bodyweight, the results were similar. There was a significant interaction with LPD and higher age >75 years, lower SGA, and higher comorbidity burden for both mortality and nutritional status decline. In older adults with CKD approaching end-stage kidney disease, a traditional LPD prescribed and monitored according to routine clinical practice in Europe appears to be safe.

Chinese expert consensus on multidisciplinary decision-making model for mobility limitation in older adults (2024 edition)

Mobility limitation is an age-related geriatric syndrome that is affected by multiple factors such as aging, multimorbidity, nutritional status, chronic pain, psychological and social factors, which increases the risk of adverse events such as pressure ulcers, venous thrombosis, constipation, frailty, disability, falls and death in older adults. Early identification of mobility limitation and individualized comprehensive management are of great significance to maintain the functional status and quality of life of older adults. However, the understanding of the importance of mobility limitation prevention and treatment in older adults is insufficient, and there is a lack of standardized diagnosis and treatment standards for mobility limitation. Based on evidence-based medicine, this consensus expert group integrated the latest research progress, guidelines and consensus recommendations on mobility limitation and proposed 20 recommendations containing screening, assessment, intervention and comprehensive management, emphasizing the multidisciplinary decision-making model of "screening-comprehensive assessment-multiple interventions-joint management". We aimed to provide guidance and suggestions for the standardized management of mobility limitation in older adults.

Effects of Multicomponent Home-Based Intervention on Muscle Composition, Fitness, and Bone Density After Hip Fracture.

Mechanistic factors on the pathway to improving independent ambulatory ability among hip fracture patients by a multicomponent home-based physical therapy intervention that emphasized aerobic, strength, balance, and functional training are unknown. The aim of this study was to determine the effects of 2 different home-based physical therapy programs on muscle area and attenuation (reflects muscle density) of the lower extremities, bone mineral density (BMD), and aerobic capacity. Randomized controlled trial of home-based 16 weeks of strength, endurance, balance, and function exercises (PUSH, n = 19) compared to seated active range-of-motion exercises and transcutaneous electrical neurostimulation (PULSE, n = 18) in community-dwelling adults >60 years of age within 26 weeks of hip fracture. In PUSH and PULSE groups combined, the fractured leg had lower muscle area and muscle attenuation and higher subcutaneous fat than the nonfractured leg (p < .001) at baseline. At 16 weeks, mean muscle area of the fractured leg was higher in the PUSH than PULSE group (p = .04). Changes in muscle area were not significantly different when compared to the comparative PULSE group. There was a clinically relevant difference in change in femoral neck BMD between groups (p = .05) that showed an increase after PULSE and decrease after PUSH. There were generally no between-group differences in mean VO2peak tests at 16-week follow-up, except the PUSH group reached a higher max incline (p = .04). The treatment effects of a multicomponent home-based physical therapy intervention on muscle composition, BMD, and aerobic capacity were not significantly different than an active control intervention in older adults recovering from hip fracture. ClinicalTrials.gov Identifier: NCT01783704.

The impact of community music therapy intervention in older adults’ care home communities: Assessing community music therapists’ views

Community music-therapy (CMT) service evaluation in older adults’ care home communities is an important process to enhance the quality of therapists’ outputs and the development of client-centred approaches to meet the needs of residents and community. However, administrative limitations that could affect therapists’ contact time with clients may lead to the underestimation of service evaluation within the system. This study aims to explore community music therapists’ perceptions of the impact of their services in older adults’ care home communities using a qualitative approach based on semi-structured interviews. The therapists were asked to reflect on specific aspects of their community music therapy service, potential cognitive-behavioural and physiological effects of therapy, best-practices for assessment in MT and challenges experienced in this particular setting. Participants highlighted the unique value of CMT in care home communities. They demonstrated the ability to detect and assess impacts of CMT using clinical analysis methods, which can improve care plans for the residents. However, certain limitations, such as reduced hours, inadequate funding and a lack of recognition of CMT’s benefits by care home staff, were identified. Moreover, the analysis shed light on how COVID-19 impacted the CMT service in this context, emphasizing the need for adaptability and resilience in providing care. The implications of the results in an Italian community context are further analysed and discussed, stressing the importance of supporting CMT as a fundamental service in care home communities for older adults. By addressing the highlighted limitation and embracing the perspectives of community music therapists, care homes can optimize their services and enhance the well-being of their residents.

Rho Kinase Inhibitors: Strategies in Glaucoma Treatment in Older Adults.

Glaucoma is a leading cause of irreversible blindness which preferentially affects older individuals. No medications or therapies which are currently in our arsenal actually treat glaucoma itself. We know that intraocular pressure (IOP) is currently the only modifiable risk factor for glaucoma. The primary treatments for glaucoma include medications, laser therapies, and surgical therapies. The Rho kinase inhibitors are the newest class of medications currently on the market and in development for topical IOP-lowering therapy. Studies have shown their ability to lower eye pressure individually and in combination with other medications. Their ability to potentially provide neuroprotective effects for disease modification also gives this class exciting potential for glaucoma treatment.

Cost-Effectiveness of Respiratory Syncytial Virus Vaccines for Adults

&#x0D; Three economic evaluations and 1 summary of economic evaluations were identified that assessed the cost-effectiveness of 2 respiratory syncytial virus (RSV) vaccines of interest (RSVPreF3 [Arexvy] and RSVpreF [Abrysvo]) compared with no intervention in older adults residing in high-income countries. No economic evaluations assessing mRNA-1345 were identified. No publications investigating RSV vaccination in adults aged 59 years or younger were identified.&#x0D; &#x0D; In total, 5 economic evaluations for RSV vaccines in adults were identified.&#x0D; Four economic evaluations were conducted in the US and 1 was conducted in Hong Kong. All results were presented in terms of incremental cost-utility ratios (i.e., incremental cost per quality-adjusted life-years gained). Net cost per outcome averted was reported for 1 economic evaluation, and cost per hospitalization averted was reported for 3 economic evaluations.&#x0D; The results of all publications found that RSVPreF3 (Arexvy) and RSVpreF (Abrysvo) were more costly and more effective than no intervention for RSV-associated disease. All publications reported that vaccinating older adults against RSV disease was potentially cost-effective. All publications noted that the cost-effectiveness was dependent on vaccine cost, vaccine efficacy, the waning of vaccine protection, RSV hospitalization incidence, health care unit costs, and respective regional willingness-to-pay thresholds.&#x0D; &#x0D; &#x0D; The generalizability of the identified economic evaluations may be limited because the study settings were notably different from Canada. To estimate the cost-effectiveness of RSV vaccinations in Canada, a de novo economic evaluation conducted from a Canadian setting comparing RSVPreF3 (Arexvy), RSVpreF (Abrysvo), and mRNA-1345 is required.&#x0D;

Exclusion of older patients from randomized clinical trials in Parkinson's disease.

Prevalence of Parkinson's disease (PD) increases with age. The purpose of this study was to evaluate the eligibility criteria in randomized clinical trials (RCTs) in PD, especially those limiting the enrollment of older adults. We examined RCTs of pharmacological and non-pharmacological anti-parkinsonian interventions registered with ClinicalTrials.gov and started from 2013 through 2022. Primary outcome was proportion of RCTs with an upper age limit of 85years of age or less. Secondary outcome was proportion of RCTs with other exclusion criteria. Associations between trial characteristics and the presence of the age limits were determined using logistic regression. Our study included 420 RCTs. Two hundred thirty-nine (57%) of these had an upper age limit of 85years of age or less. Proportion of these trials significantly increased over time. The odds of the presence of an upper age limit were significantly associated with the investigational site location, phase, and timeframe for theprimary endpoint assessment. Three hundred fifty-six (85%) trials had other eligibility criteria limiting the enrollment of older patients; these often (n = 285; 68%) included cognitive impairment. Overall, 386 (92%) RCTs either explicitly excluded older adults or had criteria indirectly limiting their enrollment. Underrepresentation of older patients in clinical trials in PD considerably reduces the generalizability of their results. Some eligibility criteria should be modified to enable the investigators to assess the benefits and harms of new therapeutic interventions in older adults. This problem is important in view of rapidly growing number of older patients with PD.

Nutrition interventions for body composition, physical function, cognition in hospitalized older adults: A systematic review of individuals 75 years and older.

Globally, the oldest old population is expected to triple by 2050. Hospitalization and malnutrition can result in progressive functional decline in older adults. Minimizing the impact of hospitalization on functional status in older adults has the potential to maintain independence, reduce health and social care costs, and maximize years in a healthy state. This study aimed to systematically review the literature to identify nutritional interventions that target physical function, body composition, and cognition in the older population (≥ 75 years). A systematic review was conducted to evaluate the efficacy of nutritional interventions on physical function, body composition, and cognition in adults aged ≥ 75 years or mean age ≥80 years. Searches of PubMed (National Institutes of Health, National Library of Medicine), Scopus (Elsevier), EMBASE (Elsevier), Cumulative Index to Nursing and Allied Health Literature (CINAHL) with Full Text (EBSCOhost), and PsycInfo (EBSCOhost) were conducted. Screening, data extraction, and quality assessment were performed in duplicate and independently (CRD42022355984; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=355984). Of 8311 citations identified, 2939 duplicates were excluded. From 5372 citations, 189 articles underwent full-text review leaving a total of 12 studies for inclusion. Interventions were food-based, protein-based, carbohydrate-based, personalized, or used parenteral nutrition. Ten studies monitored anthropometric or body composition changes with three showing maintenance or improvements in lean mass, body mass index, triceps skinfold, and mid-upper arm circumference compared with the control group. Six studies monitored physical function but only the largest study found a beneficial effect on activities of daily living. Two of three studies showed the beneficial effects of nutritional intervention on cognition. There are few, high-quality, nutrition-based interventions in older adults ≥75 years. Despite heterogeneity, our findings suggest that large, longer-term (>2 weeks) nutritional interventions have the potential to maintain body composition, physical function, and cognition in adults aged 75 years and older during hospitalization.