Effectiveness of a structured online rehabilitation program in enhancing functional performance in older adults: A non-randomized intervention trial.

This study aimed to characterize the health, functional, cognitive, nutritional, and psychological profiles of very old adults (≥ 80 years) enrolled in a community-based Healthy Aging Center (HAC) program. A cross-sectional observational study was conducted among community-dwelling individuals aged ≥ 80 years who completed home-based interviews between October 2023 and March 2024. Participants were assessed using the Clinical Frailty Scale (CFS), Katz Index of Activities of Daily Living (ADL), Lawton-Brody Instrumental ADL (IADL), Mini-Cog, Mini-Mental State Examination (MMSE), Geriatric Depression Scale-Short Form (GDS-SF), Patient Health Questionnaire-2 (PHQ-2), Mini Nutritional Assessment-Short Form (MNA-SF), Timed Up and Go (TUG), and Sit-to-Stand (STS) tests. Descriptive analyses, bivariate group comparisons (χ² and t-tests), and correlation analyses were performed. Missing data were reported for each scale, and sensitivity analyses were conducted to minimize bias. A total of 337 participants (mean age 85.3 ± 4.5 years; 51.9% women) were included. Based on the CFS, 27.9% (n = 94) were classified as vulnerable, 20.8% (n = 70) as mildly frail, and 18.1% (n = 61) as moderately frail. According to the Katz ADL, 61.7% were partially dependent and 37.4% fully independent; similar patterns were observed with Lawton IADL. Cognitive impairment was more prevalent in women (57.3% vs. 32.6%, p < 0.001), who also had higher rates of depression (p < 0.001), frailty (p = 0.011), and functional dependence. Men demonstrated better mobility performance on the TUG and STS (p = 0.004). Depressive symptoms correlated with both poorer health status (r = 0.421, p < 0.001) and malnutrition risk (r = - 0.364, p < 0.001). Malnutrition was associated with greater frailty (p = 0.022) and depression (p < 0.001). Dementia was more common in the oldest participants (p = 0.005), particularly those with neurological conditions (p = 0.035). Frailty, malnutrition, cognitive impairment, and depressive symptoms were frequent among community-dwelling very old adults, particularly women. These cross-sectional findings emphasize the need for multidisciplinary and gender-sensitive strategies within HACs to support functional independence and mental well-being. Longitudinal and multivariate studies are warranted to confirm these associations.

To clarify the incidence of activities of daily living (ADL) decline following transcatheter aortic valve implantation (TAVI) and to investigate its contributing factors, including anesthesia methods and sedative drugs. This retrospective study included 128 patients who underwent transfemoral TAVI between December 2018 and June 2023. ADL was assessed using the Katz Index preoperatively and one week postoperatively. Patients with decreased scores were assigned to the ADL-decline group. Clinical, physical, cognitive, and perioperative data were analyzed. Multivariate logistic regression analysis was performed to identify predictors of ADL decline. ADL decline occurred in 25 patients (20%), who were significantly older (87.9 vs. 85.1years, p = 0.004), had lower preoperative Short Physical Performance Battery (SPPB) scores (7.2 vs. 9.7, p = 0.001), and lower preoperative grip strength (14.6 vs. 17.4, p = 0.04). All three patients of with postoperative cerebral infarction experienced ADL decline. No significant differences in anesthesia methods (general anesthesia vs. monitored anesthesia care) or sedative drugs (propofol vs. remimazolam) were noted. Multivariate analysis revealed that older age (adjusted odds ratio [OR]: 1.15; 95% confidence interval [CI]: 1.01-1.31; p = 0.03) and lower preoperative SPPB score (adjusted OR: 0.83; 95% CI: 0.69-0.98; p = 0.03) were independent predictors of ADL decline. Older age and reduced preoperative physical function were associated with ADL decline after TAVI. In contrast, anesthesia methods and sedative drug choices did not influence postoperative ADL. These findings may help guide patient selection and inform perioperative rehabilitation strategies to preserve independence after TAVI.

Alzheimer disease (AD) is the most common neurodegenerative disorder, affecting millions worldwide. COVID-19 has increased the risk of acute complications and death for patients with AD, but the long-term effects on survivors have been little studied. Thus, given the potential role of SARS-CoV-2 in accelerating cognitive decline, this study aimed to assess the effect of COVID-19 on functional deterioration, AD progression, and mortality in these patients. This retrospective cohort study examined medical records of patients with mild to moderate AD treated at a public dementia clinic in southern Brazil between March 2020 and March 2025. Sociodemographic and clinical data were extracted, including COVID-19 status confirmed by molecular testing. AD progression was assessed using the Mini-Mental State Examination (MMSE) and the Katz Index. Multivariate statistical analyses were conducted to identify associations between COVID-19 infection and disease progression. Survival was described by Kaplan-Meier test and analyzed by Cox regression. A total of 105 individuals with DA were included, of whom 28 (26.7%) were COVID-19 survivors during the follow-up period. COVID-19 patients showed rapid AD progression compared with the control group (OR 4.76; 95% CI: 1.04-21.7; P = 0.044). Likewise, SARS-CoV-2 infection decreased patients' functionality, as indicated by the Katz index (P=0.001). Functional impairment was observed in both mild and hospitalized cases of COVID-19. Hospitalized patients during COVID-19 demonstrated lower survival rates at the 5-year follow-up. These findings suggest that SARS-CoV-2 infection may accelerate AD progression and reduce survival, particularly in cases requiring hospitalization. Future multicenter studies with large sample sizes are needed to confirm these findings.

Introduction: An aging population and increasing care complexity are placing growing pressure on home healthcare services worldwide. Rising demand, nurse shortages, and high workloads risk reducing patient satisfaction and care quality, potentially leading to poorer outcomes. Accurate assessment of care intensity is essential for efficient resource allocation and optimal nurse–patient alignment. Objective: Beyond improving care delivery, insights in care intensity can also play a key role in supporting nurse-retention strategies. Existing tools, such as the Katz Index and BelRAI, omit several critical determinants. This study examines these gaps and outlines directions for developing a more comprehensive care intensity instrument (CII) for home healthcare. Methods: A narrative review was conducted to examine existing CIIs in home care and to identify missing determinants. Additional insights were obtained through expert consultation and field engagement. Instruments were analyzed to determine which determinants are currently captured in widely used assessment tools. Results: Eight CIIs currently validated or used in Belgian home healthcare were identified. Their coverage of patient-related determinants varied: physical health was consistently assessed, whereas mental and behavioral aspects received less attention, and social or environmental factors appeared in only a few tools. Nursing-related determinants—such as workload, skills, work environment, and demographics—were mostly absent. Conclusions: None of the instruments provided a fully comprehensive assessment integrating both patient and nursing determinants. This narrative review, complemented by expert consultation and field engagement, highlights the need for a CII that integrates patient determinants with nursing determinants to improve the quality, safety, and efficiency of home healthcare.

Carbapenem-resistant Enterobacterales (CRE) intestinal colonization is a key risk factor for subsequent infection. The composition of the intestinal microbiota is likely to play a role in the colonization. The aim of the study was to compare the gut microbiota composition between colonised (Col) patients and decolonised (DeCol) patients. Patients were identified from a database of CRE colonised patients. They were categorized as either currently Col or having spontaneously DeCol. Baseline characteristics and survival in the following year after the gut microbiota characterization were also collected. Gut microbiota composition was analysed. A total of 37 patients were included: 14 in the Col group and 23 in the DeCol group. No significant differences in terms of age, BMI, sex, KATZ index, toxics, diet and comorbidity were observed. Previous hospital admission and infections caused by CRE and/or other microorganisms were more frequent in the Col group. During the 12-month follow-up, mortality was higher in the Col group (Col 43% vs. DeCol 9%, p = 0.035). Differences in beta diversity were observed according to Col status (Bray Curtis distance, PERMANOVA, p = 0.013) but not according to recent antibiotic treatment or hospital admission. Suterella, Roseburia faecis and Eubacterium ventriosumwere enriched in DeCol patients. CRE colonisation was associated with a higher abundance of Ruthenibacterium lactatiformans. The composition of faecal microbiota was different between patients with ongoing CRE colonisation and those who achieved decolonisation. Further studies are needed to assess if specific bacterial taxa could be a marker of a longer colonisation risk.

Background: Stroke is a clinical manifestation of sudden focal or global brain dysfunction that lasts more than 24 hours or can result in death without any vascular abnormalities. It is the third leading cause of death after heart disease and cancer. According to the World Stroke Organization (2022), over 12.2 million people—or one in four individuals over 25 years old—may experience a stroke, with more than 101 million people currently living with the condition. Data from the Indonesian Health Survey reports a stroke prevalence of 8.3 per thousand. And one of them causes a decrease in daily living activities. Purpose: This study aims to examine the effect of Bio Energy Power Exercise on the activities of daily living (ADL) in stroke patients at Yastroki Yogyakarta. Method: The research design uses methods using a quasi-experimental design with a pretest-posttest one-group approach. The sample consisted of 16 participants who met the inclusion criteria. Data were collected using the Katz Index questionnaire, administered before and after the intervention. The intervention involved Bio Energy Power Exercise performed twice a week for four weeks, with each session lasting 20 to 30 minutes. Result: The results of the test using the Wilcoxon signed-rank test showed that p&lt;0.05 (p=0.000), this shows that there is a significant influence of bio energy power gymnastics on daily living activities in stroke patients. Conclusion: Bio Energy Power Exercise has a significant positive effect on the activities of daily living in stroke patients, highlighting its potential as a beneficial rehabilitation intervention.

Aims: This study aimed to evaluate the functional, clinical, and cognitive profiles of hospitalized older adults in a general hospital in the Brazilian Amazon, contributing to understanding the relationship between frailty, cognitive decline, and functionality during hospitalization. Study Design: Prospective and analytical cohort study. Place and Duration of Study: Conducted at Hospital Jean Bitar, Belém, Pará, Brazil, from March to June 2023. Methodology: The study included 45 patients aged 65 years or older, assessed within 48 hours of admission using validated instruments such as the Clinical Frailty Scale (CFS), 10-Point Cognitive Screener (10-CS), Katz Index for Basic Activities of Daily Living (BADL), and Lawton Scale for Instrumental Activities of Daily Living (IADL). Statistical analyses were performed using BioEstat® 5.4, applying G and Chi-Square tests (α = 0.05). Results: The mean age was 76.3 years, with a slight predominance of females (51.1%, p = 0.8815). The most frequent admission diagnoses were gastrointestinal bleeding (24.4%) and consumptive syndrome (22.2%). A statistically significant association was found between sex and cognitive impairment (p = 0.0030; Cramer’s V = 0.42), with females showing a higher prevalence of probable cognitive impairment (73.9%). The 10-CS revealed a significant difference across cognitive categories (p = 0.0006; V = 0.51). The CFS demonstrated a significant association with mortality risk (p = 0.0282), where higher frailty scores correlated with greater mortality probability. Conclusion: Functional dependence and cognitive decline were prevalent among hospitalized older adults, particularly among females, with significant associations between frailty, cognition, and mortality. These findings reinforce the need for comprehensive geriatric assessments to guide care strategies and improve quality of life in this population.

BackgroundAging is a complex, multifactorial process in which nutritional alterations, sedentary lifestyle, and chronic diseases can increase the risk of functional limitations, dependence, and disability in older adults. Identifying the degree of frailty is essential for designing programs to enhance their quality of life. The objective of the study was to determine the prevalence of frailty and its association with nutritional status, functionality, physical activity, and socioeconomic level in older adults in Azuay, a province in Ecuador, during post-pandemic period of 2023.MethodsA cross-sectional study was conducted with 294 older adults from Azuay Anthropometric measurements were taken, and validated questionnaires were administered to collect demographic data. Frailty was assessed using criteria validated by Fried and Watson. The Katz Index was employed to determine the level of dependency, physical activity was assessed using the short version of IPAQ, and socioeconomic level was determined according to the Ecuadorian Institute of Statistics and Censuses (INEC). Data were analyzed using SPSS version 26.0, employing frequency distribution, measures of central tendency (mean) and dispersion (standard deviation). Odds Ratio (OR) with a 95% confidence interval to explore associations.ResultsThe mean age was 74.1 years (± 7.1), with a higher prevalence between 65 and 74 years (52.4%). Women represented 72.1% of the sample, nearly half were married, 67.7% had completed primary education, and over a quarter were engaged in household work. According to BMI, women showed a higher prevalence of overweight and obesity, along with greater abdominal obesity. Both sexes reported moderate levels of physical activity. The prevalence of frailty in women was higher than in men (10.4% vs. 4.9%) and was significantly associated with physical inactivity (OR = 1.634, 95% CI 1.458–1.817; p < 0.001) and low socioeconomic level (OR = 2.176, 95% CI 1.027–4.608; p < 0.039).ConclusionsFrailty prevalence was high among older adults and was significantly associated with low physical activity and low socioeconomic status. These findings highlight critical challenges for Ecuador’s public and private healthcare systems in implementing proactive measures to delay the onset of frailty and improve quality of life in this population.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12877-025-06232-w.

BackgroundMalnutrition adversely affects health outcomes and healthcare costs; however, limited data are available on the prevalence and burden of malnutrition in older adults at hospital admission in developing countries. Therefore, this study aimed to undertake malnutrition screening among older adults at hospital admission and examine the relationship between nutritional status and a range of health and socio-ecological factors.MethodsThis cross-sectional study was conducted in a large public referral hospital in Malawi, targeting older adults (aged ≥ 60 years). Participants were screened for risk of malnutrition using the Mini Nutritional Assessment-Short Form (MNA-SF) within 24–48 h of hospital admission. Those at risk of malnutrition/malnourished using the screening tool (MNA-SF) were subsequently assessed to determine a malnutrition diagnosis using the Global Leadership Initiative on Malnutrition (GLIM). Physical function was assessed using the Katz Index of Independence in Activities of Daily Living (Katz Index ADL) and handgrip strength, appetite using the Simplified Nutritional Appetite Questionnaire (SNAQ), food insecurity using a 12-month food insecurity experience scale, and dietary quality with a 30-day food frequency questionnaire. Logistic regression examined the factors associated with the risk of malnutrition/ malnutrition.ResultsThe mean age of 315 older adults was 66.83 ± 6.78 years (range: 60–93 years), and 58.4% (n = 184) were male. Using the MNA-SF, the prevalence of malnutrition risk was 39.7%, and 40.3% were malnourished. Of those who were at risk of malnutrition/malnourished using the MNA-SF, 75% were diagnosed with malnutrition utilizing the GLIM criteria. Risk of malnutrition/malnutrition, screened using MNA-SF, was associated with poor appetite (AOR 2.581; 95% CI 1.310–5.086; p = 0.006), severe functional impairment (AOR 5.182; 95% CI: 1.469–18.279; p = 0.011), polypharmacy (AOR 2.673; 95% CI:1.112–6.426; p = 0.028), and severe food insecurity (AOR 2.293; 95% CI 1.015–5.176; p = 0.046).ConclusionDuring the study period in 2023, the majority of older adults admitted to a large public hospital in Malawi were at risk of malnutrition/malnourished, with multiple associated factors. Routine malnutrition screening using validated tools on admission, subsequent diagnosis of malnutrition using the GLIM criteria, and the availability of adequate nutrition support, including inpatient and discharge care pathways, are needed to prevent further deterioration of nutritional status in this vulnerable population.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12877-025-06463-x.

The antioxidant effect of resveratrol on leukocytes from patients with Alzheimer is independent of SIRT1 signaling pathway

Serological clusters in systemic lupus erythematosus and its clinical and prognostic implications: A longitudinal cohort study.

Cross-view self-supervised heterogeneous graph representation learning.

Cognitive impairment is a growing public health challenge for older adults in nations like India due to demographic changes and chronic diseases, significantly impacting daily function. Despite its importance, there is limited research in quantifying the burden of cognitive impairment. This study aims to assess the prevalence of cognitive impairment among the elderly in an urban area and to determine the associated factors. A community-based cross-sectional study was conducted between July 2024 and February 2025 in an urban area of Chengalpattu district, Tamil Nadu. 300 participants aged 60 years and above were selected using two-stage random sampling. Data were collected using a sociodemographic questionnaire, Montreal Cognitive Assessment (MoCA), Katz index of independence of activities of daily living (ADL) and DASS-21 scale. Logistic regression analysis was used to identify factors associated with cognitive impairment (MoCA score ≤24). The prevalence of cognitive impairment was 36.67%. Mild Cognitive Impairment (MCI) was present in 11.67% of participants. Multivariate analysis revealed that engaging in leisure activities was protective against cognitive impairment (adjusted odds ratio [AOR] 0.332). Factors significantly associated with higher odds of cognitive impairment included gait disturbances (AOR 2.872), dependence in ADL (AOR 5.983) and depression (AOR 7.393). Cognitive impairment is highly prevalent among the elderly in this urban South Indian community. Promoting leisure activities and addressing modifiable factors such as depression, functional dependence and gait disturbances are important strategies for mitigating cognitive decline in this population.

Aim: This study aimed to investigate the relationship between caregiver burden and depression in caregivers of elderly patients undergoing major abdominal surgery and to evaluate its association with the patient's postoperative functional status. Methods: In this cross-sectional study conducted at a single center, we enrolled 65 patient-caregiver dyads. Patient functional status was assessed using the Katz Index and the Lawton-Brody Instrumental Activities of Daily Living Scale (IADL). Caregiver burden was measured with the Zarit Caregiver Burden Scale, and depression was assessed using the Beck Depression Inventory (BDI). Data on event impact (IES-R) and quality of life (SF-36) were also collected. Correlations between variables were evaluated using Spearman's rank correlation coefficient. Results: The study included caregivers with a mean age of 58.9 ± 13.8 years and patients with a mean age of 70.4 ± 5.8 years. More than half of the caregivers (50.8%) exhibited severe depression according to the BDI. A strong positive correlation was found between caregiving burden and depression (r = 0.53, p &lt; 0.001). Patients with moderately or severely depressed caregivers had significantly lower functional status scores (Katz Index, p &lt; 0.001) compared to patients with non-depressed or mildly depressed caregivers. Conclusions: Our findings reveal a significant positive relationship between caregiver burden and depression, which in turn is associated with poorer patient functional outcomes. These results underscore the critical need for implementing comprehensive psychological support systems for this vulnerable caregiver population to improve both caregiver and patient outcomes.

IntroductionEarly and balanced replacement of blood products appears to be the key factor in improving outcomes of major bleeding patients including acute trauma, cardiac, obstetric and transplant surgery patients. Definitive clinical guidance regarding the optimal ratio of blood products, including those containing fibrinogen, is still lacking. Therefore, we tested the hypothesis that increasing the fibrinogen content to erythrocyte suspension ratio improves the mortality and functional outcomes of patients undergoing surgeries with expected major bleeding.Methods and analysisThe Approximate Dose-Equivalent of Fibrinogen-to-Erythrocyte Suspension (ADEFES) ratio is a multicentre, prospective, observational, cohort study of patients undergoing major surgical procedures with expected major perioperative bleeding (ie, requiring packed red blood cells (PRBC)>4U/24 hours). For 5U of cryoprecipitate and 1.5 U of fresh frozen plasma (FFP), the approximate dose-equivalent for fibrinogen is considered as 1 gram of fibrinogen. Association of the ADEFES ratio at 24 hours will be assessed on the primary objective, which will consist of the composite of 30-day all-cause mortality, 30-day bleeding-specific mortality and the ‘highly-dependent scores’ of Katz index of independence in activities of daily living.Ethics and disseminationThe study protocol was approved by the Ethics Committee of Ankara Bilkent City Hospital (approval no. E2-23-4265, dated 07 June 2023; Chair: Prof. Dr. F.E. Canpolat) and by the institutional review boards of all participating centres. The study will be conducted in accordance with the principles of the Declaration of Helsinki and the Strengthening the Reporting of Observational Studies in Epidemiology guidelines, as well as in compliance with national regulations on data protection and Good Clinical Practice standards. Written informed consent will be obtained from all participants prior to inclusion in the study.The results of this study will be disseminated through peer-reviewed scientific journals, presentations at national and international conferences, and communication with relevant stakeholders including clinical practitioners and healthcare institutions. If applicable, study outcomes will also be shared via institutional newsletters and digital platforms to reach a broader audience in the medical community.Trial registration numberNCT06021184.

IntroductionDiabetes mellitus (DM) is associated with increased mortality in hospitalized adults. However, data regarding the impact of DM on long-term mortality after discharge in very old patients is scarce.Material and methodsThis prospective study assessed 3-year post-discharge mortality and its predictive factors in older medical patients, focusing on possible differences between patients with and without DM. Medical history, chronic medication use, clinical and laboratory characteristics, Charlson Comorbidity Index (CCI), 5-Fried Frailty score (FFS), Clinical Frailty Scale (CFS), Barthel index (BI), and Katz Index were recorded on admission.ResultsA sample of 815 older adults (46.0% males) with a median age of 83.0 years (IQR: 77.0–88.0) were included in the study. The three-year mortality rate was 54.9% in patients with DM (n=368) and 60.2% in patients without DM (n=447, p=0.13 between groups). In multivariate logistic analysis, nursing home residency, higher CCI, higher CFS, higher FFS, lower BI, the total number of days of hospitalization the past year, and hospital-acquired infections were independently associated with the three-year mortality in both groups. In individuals with DM, lower body mass index (BMI) and elevated urine albumin-to-creatinine ratio (UACR) were identified as additional independent predictors of mortality.ConclusionsA high post-discharge mortality rate was observed in very old medical patients. DM was not identified as an independent factor of post-discharge mortality. Assessment of frailty and disability in very old patients is important for predicting long-term post-discharge mortality. Additionally, in patients with DM, evaluating BMI and UACR may aid in better prediction of three-year mortality.

BackgroundFrailty syndrome (FS) and cognitive impairment are major geriatric concerns, particularly prevalent among hospitalized older adults. The primary objective of this study was to assess the co-occurrence of FS and cognitive impairment in hospitalized geriatric patients. Additionally, the study analyzed the relationship of these conditions with functional status, fall risk, sensory deficits, depressive symptoms, and selected prognostic laboratory parameters. The research hypothesis was that the severity of frailty is correlated with worse cognitive impairment.Material/MethodsThis retrospective study analyzed the medical records of 265 patients consecutively admitted to the Internal Medicine and Geriatrics Ward of the Clinic of Internal Medicine and Cardiology at the University Clinical Centre of the Medical University of Warsaw (UCK WUM) between January 1 and December 31, 2022. During hospitalization, all patients underwent a comprehensive geriatric assessment (CGA), which included the following tools: the Katz Index of Independence in Activities of Daily Living (ADL), the Lawton Instrumental Activities of Daily Living Scale (IADL), the Barthel Index, the Short Tinetti Test, the Norton Scale, the Mini-Mental State Examination (MMSE), and the 15-item Geriatric Depression Scale (GDS-15). Frailty was assessed using the Clinical Frailty Scale (CFS). Laboratory analysis included serum levels of albumin, hemoglobin, lymphocytes, sodium, and thyroid-stimulating hormone (TSH).ResultsMost patients (64.77%) exhibited signs of frailty – 21.59% were classified as pre-frail and 13.63% were non-frail. Frailty severity was correlated with worsening cognitive impairment. Statistically significant associations were observed between CFS scores and clinical parameters such as age (P<0.001), albumin level (P<0.001), hemoglobin level (P=0.002), lymphocyte count (P=0.292), and MMSE score (P<0.001). Scores of functional assessment tools – ADL, IADL, the Norton Scale, the Barthel Index, and the Tinetti Test – were significantly correlated (P<0.05) with both CFS and MMSE outcomes.ConclusionsIn hospitalized geriatric patients, frailty severity is associated with cognitive decline and decreased functional performance. Lower levels of albumin and lymphocytes were associated with more advanced frailty and worse cognitive dysfunction.

Evaluation of the relation between the demographic and clinical profile of individuals with COVID-19 and the functional outcomes after hospital discharge: A cross-sectional study.

&lt;p&gt;In rural Bangladesh, elderly populations face distinct health challenges, with depression, malnutrition, and co-morbidities significantly impacting their well-being. This cross-sectional study evaluated 384 older adults across four divisions of Bangladesh using the geriatric depression scale (GDS-15), mini nutritional assessment (MNA), and Katz Index of activities of daily living (ADL). Depression was found among 62.8% of respondents. About 13.0% of participants were malnourished, and 51.8% were at risk of malnutrition. Self reported hypertension (47.1%), arthritis (46.4%), dental problems (43.5%), and insomnia (37.0%) were profound among respondents. The risk of dementia, anorexia, cardiovascular disease, and hypertension was higher among males than females. Geriatric depression was significantly higher in the elderly who were residing in a nuclear family than their counterparts (AOR = 2.114; 95% CI = 1.328-3.365). Additionally, being unemployed was identified as an independent predictor of GD (AOR = 1.992, 95% CI: 1.070 3.709, p = .030). The higher prevalence of depression and risk of malnutrition highlight the pressing requirement for well-coordinated and comprehensive healthcare strategies. The development of multifaceted approaches, incorporating mental health services, nutritional interventions, and socioeconomic support, would enhance elders' well-being.&lt;/p&gt;