Quality Of Life In Population Research Articles

The connection between aging, cellular senescence and gut microbiome alterations: A comprehensive review.

The intricate interplay between cellular senescence and alterations in the gut microbiome emerges as a pivotal axis in the aging process, increasingly recognized for its contribution to systemic inflammation, physiological decline, and predisposition to age-associated diseases. Cellular senescence, characterized by a cessation of cell division in response to various stressors, induces morphological and functional changes within tissues. The complexity and heterogeneity of senescent cells, alongside the secretion of senescence-associated secretory phenotype, exacerbate the aging process through pro-inflammatory pathways and influence the microenvironment and immune system. Concurrently, aging-associated changes in gut microbiome diversity and composition contribute to dysbiosis, further exacerbating systemic inflammation and undermining the integrity of various bodily functions. This review encapsulates the burgeoning research on the reciprocal relationship between cellular senescence and gut dysbiosis, highlighting their collective impact on age-related musculoskeletal diseases, including osteoporosis, sarcopenia, and osteoarthritis. It also explores the potential of modulating the gut microbiome and targeting cellular senescence as innovative strategies for healthy aging and mitigating the progression of aging-related conditions. By exploring targeted interventions, including the development of senotherapeutic drugs and probiotic therapies, this review aims to shed light on novel therapeutic avenues. These strategies leverage the connection between cellular senescence and gut microbiome alterations to advance aging research and development of interventions aimed at extending health span and improving the quality of life in the older population.

Oral health inequalities among geriatric population: A systematic review

ABSTRACT As per the World Health Organization, governments should aim to accomplish two significant global milestones by 2030: reducing health disparities and granting universal accessibility to healthcare. The aim of this article was to systematically review the inequalities and understand the multifactorial causation of oral health inequalities among the older adults. Methods: Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) standards were used to carry out the review and is documented in PROSPERO CRD42026695761. Two authors did the search and screening in accordance with the protocol. Electronic databases such as PubMed, Google Scholar, and EBSCOhost articles of the last 10 years were searched for research presenting data on oral health status and oral health related quality of life in the elderly population. Quality assessment was performed using the Newcastle Ottawa Scale (NOS) for retrospective and prospective research. Results: Only 24 studies fulfilled the eligibility criteria and were incorporated into the qualitative synthesis. Multiple aspects of oral health and the related variables influencing disparities in oral health in the elderly population living in institutions have a positive link. Conclusion: The findings support the notion that this demographic consists of weak, dependent individuals who have poor oral health. The vulnerable elderly institutionalized population was recognized and validated, thus helps in providing measures that will eventually focus the risk factors to improve their OHRQoL.

Management of Rotator Cuff Tears in Severely Osteoporotic Patients

Management of rotator cuff tears (RCT) in osteoporotic patients presents significant challenges for treating clinicians because of compromised bone quality. We present a case series of 2 patients with RCT and severe osteoporosis highlighting the complexities of operative and nonoperative management and underscoring the importance of preoperative optimization and careful surgical planning in this vulnerable population. Patient 1 experienced initial improvement postarthroscopic RCT repair but required revision surgery because of anchor pullout, with eventual conversion to reverse total shoulder arthroplasty. Patient 2 faced intraoperative challenges because of previously undiagnosed osteoporosis, leading to difficulties in securely placing suture anchors, and was referred to the fracture liaison service (FLS) for osteoporosis management postoperatively. A multifaceted approach integrating preoperative optimization, advanced surgical techniques, and postoperative management is advised to improve operative success. Extensive perioperative bone quality assessments and augmentation strategies are warranted, including medication comanagement through an FLS if available. Detailed surgical planning is crucial, focusing on arthroscopic repair technique while considering various anchor factors to mitigate failure including proper placement, design, and pullout analysis. Intraoperative bone augmentation with materials such as calcium phosphate, magnesium phosphate, and polymethyl methacrylate cements significantly improves anchor fixation strength in osteoporotic bone. Consideration of a transosseous approach and potential for conversion to an open procedure is also an option when necessary. This review highlights the unique challenges and potential options available to treating clinicians when managing RCT in osteoporotic patients. Continued research and refinement of emerging treatment strategies are essential to improve outcomes and quality of life in this patient population.

Designing state-level policies to support independent pharmacies in providing specialty care services in rural regions

This review paper explores the critical role of independent pharmacies in rural regions, emphasizing their potential to deliver specialty care services despite facing significant challenges. These challenges include financial constraints, regulatory barriers, and limited specialized training and resource access. The paper argues that comprehensive state-level policies are necessary to support these pharmacies, enabling them to overcome these obstacles and enhance healthcare access in rural areas. Key policy recommendations include providing financial incentives such as grants and subsidies, regulatory reforms to streamline licensing processes and expand the scope of practice for pharmacists, and promoting partnerships between pharmacies, healthcare providers, and telehealth services. The paper also highlights the importance of integrating independent pharmacies into state health programs and adopting advanced technologies like telepharmacy and electronic health records. Future research directions are suggested, focusing on the impact of digital health technologies and evolving healthcare payment models on independent pharmacies in rural regions. The paper concludes by underscoring the need for targeted policy interventions to strengthen the role of independent pharmacies in rural healthcare, thereby improving health outcomes and quality of life for rural populations.

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.

Post-Acute Admission Mortality Rates for Nursing Home Residents

Abstract Background Nursing home residents (NHRs) constitute a vulnerable demographic with intricate healthcare requirements, often burdened by multiple comorbidities. A specialised geriatrician-led acute care team for NHRs was established in a University Teaching Hospital. This service prioritises the unique needs of NHRs, delivering tailored treatments in environments conducive to their well-being, while also striving to mitigate the adverse effects associated with avoidable hospitalizations. Methods An analysis of NHR admissions to a University Teaching Hospital in 2023, showed that 307 out of 343 (89.5%) were discharged back to the community. All discharged NHRs were followed up. Their 3 and 6 month mortality rate post discharge was 8% (n=24) and 13% (n=40) respectively. Majority of these frail NHRs survived beyond six months following hospital admissions, indicative of the potential impact of a specialized gerontological care follow-up. Results This specialist team has a post-discharge follow-up protocol for all admitted NHR residents, aimed to detect potential deteriorations and offer alternative avenues of review, minimizing unnecessary emergency department visits, particularly in non-urgent cases. Interventions such as the FastTrack Fracture service, direct ED reviews, and facilitating outpatient appointments were instrumental in this endeavour. Conclusion In summary, the establishment of this specialised geriatrician-led acute care team for NHRs marks a substantial stride in addressing the multifaceted needs of frail older adults in nursing homes. By leveraging the expertise of gerontologically attuned practitioners and emphasizing person-centered care approaches, these services provide a holistic and individualized solution to enhance outcomes and elevate the quality of life for this vulnerable population. Sustained investment in the development and expansion of such services is paramount for advancing care standards for older adults and fostering a more age-friendly healthcare milieu.

Age-related decline in source and associative memory.

This review explores the multifaceted nature of age-related decline in source memory and associative memory. The review highlights the potential effects of age-related decline in these types of memory. By integrating insights from behavioral, cognitive, and neuroscientific research, it examines how encoding, retrieval, and neural mechanisms influence this decline. Understanding these processes is critical to alleviate memory decline in older adults. Directing attention to source information during encoding, employing unitization techniques to strengthen memory associations, and utilizing metacognitive strategies to focus on relevant details show promise in enhancing memory retrieval for older adults. However, the review acknowledges limitations in processing resources and executive function, necessitating a nuanced approach to the complexities of age-related decline. In conclusion, this review underscores the importance of understanding the complexities of age-related source and associative memory decline and the potential benefits of specific cognitive strategies. It emphasizes the need for continued research on age-related memory function to improve the quality of life for aging populations.

Cross-cultural adaptation and validation of the Arabic version of the knee and hip health-related quality of life (Mini-OAKHQOL) questionnaire in male Saudi patients with osteoarthritis: a methodological observational design.

Osteoarthritis (OA) is common in Saudi Arabia, has a significant impact on quality of life (QoL), and lacks a specific questionnaire to measure QoL. The primary objective of this study was to translate and cross-culturally adapt the Mini Osteoarthritis Knee and Hip Quality of Life (Mini-OAKHQOL) questionnaire into Arabic and to determine its psychometric properties among OA knee and/or hip patients in Saudi Arabia. A methodological observational design was conducted and followed standard guidelines for cross-cultural adaptation of Mini-OAKHQOL into Saudi Arabic. Two hundred and eight primary OA knee and/or hip male participants aged between 45 and 80 years with a mean age of 58.65±13.8 years and a BMI of 29.5±1.2 kg/m2 were included and performed the stages of translation to target Arabic language (forward T1 and T2), synthesized an Arabic draft (T12), then back-translated to English (BT1 and BT2), followed by expert committee review to rectify the deficiencies leading to a prefinal stage involving a pilot test on native Arabic speakers, thereby finalized a final Arabic version. The Arabic Mini-OAKHQOL, Arabic Short Form 12 (SF12), and visual analog scale (VAS) were administered to analyze internal consistency (IC), test-retest reliability at baseline as well as one week later (up to the 10th day). The construct validity was tested using Spearman's rank correlation, and factor analysis was done to establish a five-factor fit model. Homogeneity was determined using principal component analysis (PCA). Floor and ceiling effects calculated in percentages. The Arabic Mini-OAKHQOL showed an excellent Cronbach's alpha of the overall scale (α=0.931) for its internal consistency and an excellent intraclass correlation coefficient (ICC) of 0.947 for its retest reliability, with a high response rate of 93.75%. The construct validity of this scale was good with Ar-SF12 and VAS pain. A five-factor model fit was considered acceptable, and factor loading for each item found within the permissible limits confirmed the factorial validity. None of the items, dimensions, or overall scale showed either a floor or ceiling effect. The adapted and tested Arabic Mini-OAKHQOL is a reliable and valid questionnaire to measure the impact of knee and/or hip OA on quality of life in the Saudi Arabian male OA population to reduce the respondent's burden for use in clinical and prospective studies.

La educación física, el deporte y la actividad física a lo largo del curso de vida: implicaciones para la salud y el bienestar

Dear Readers: The research journal Cuerpo, Cultura y Movimiento, in its purpose of disseminating scientific knowledge resulting from research and reflection exercises at national and international level, on this occasion is aimed at those interested in deepening the theory and practice on issues related to physical education aimed at improving the quality of life of children and adolescents, physical activity and health, and sport and its planning processes. In this editorial it is important to understand that life is a continuum of interactions that occur over time and at specific moments; however, human development and health outcomes depend on the experiences and situations that each individual faces in the family, social, economic, environmental and cultural context. In this sense, sport, physical activity, physical exercise, physical education and health become fundamental factors to improve the quality of life in differential populations; this combination of elements throughout all stages of life creates a solid foundation for the integral development of the human being. Hence, health promotion is crucial for individual and collective wellbeing, necessary for the construction of healthier communities.

Clinical outcomes of tocilizumab therapy in polyarticular and systemic juvenile idiopathic arthritis: a single-center analysis (2018-2022)

AbstractThis single-center retrospective study aimed to evaluate the safety and efficacy of Tocilizumab (TOC) in children with polyarticular (pJIA) and systemic juvenile idiopathic arthritis (sJIA) who exhibited inadequate responses to disease-modifying antirheumatic drugs (DMARDs) and biological modifiers (bDMARDs). Conducted at the Department of Pediatric Rheumatology, National Institute of Geriatrics, Rheumatology, and Rehabilitation in Warsaw, Poland, between 2018 and 2022, the study enrolled 29 patients diagnosed with JIA based on International League of Associations for Rheumatology (ILAR) criteria. The cohort comprised 13 sJIA and 16 pJIA patients, aged 2-18 years, receiving TOC treatment for 24 months. Safety and efficacy assessments included analysis of medical documentation, laboratory tests (CRP, ESR, WBC), and Juvenile Disease Activity Score (JADAS) 71 at baseline, 3, 6, 12, and 24 months post-treatment initiation. Significant reductions in CRP and ESR levels were observed within three months, with sustained improvement in JADAS71 scores over the 24-month treatment period. A substantial majority, 73.07% of patients, achieved inactive disease status or low disease activity, highlighting T0C’s effectiveness. Adverse effects were manageable, predominantly involving mild to moderate infections, with no serious adverse events or instances of macrophage activation syndrome (MAS). The study also noted a steroid-sparing effect of TOC, with a reduction in glucocorticoid usage among the cohort. Tocilizumab demonstrates substantial efficacy in reducing disease activity and improving clinical outcomes in patients with pJIA and sJIA, coupled with a favorable safety profile. These findings reinforce the role of TOC as a critical component of the therapeutic arsenal for JIA, offering hope for improved quality of life and disease management in this patient population.

Research on the application of intelligent detection wristband screen projection function for elderly people with blurred eyes

This study aims to explore the screen projection function of intelligent detection wristbands to enhance the user experience of elderly people with blurred eyes. Nowadays, the design of smart wearable devices on the market often fails to fully consider the special needs of elderly users. This study analyzed the main difficulties faced by elderly users when using smart bracelets through questionnaire surveys and prototype testing. To address this issue, this study proposes a screen projection function for intelligent detection wristbands, which presents key information in a projected form, significantly improving the readability and visibility of the information. At the same time, elderly users with blurred vision are invited to conduct tests, and results show that a large number of participants indicate that this function has increased their confidence and enthusiasm in using the wristband, as well as their interest in health monitoring. The study also suggests that the design of future smart devices should fully consider the physiological and psychological characteristics of elderly users, and incorporate more humanized functions. In summary, this study provides empirical evidence for the design and improvement of smart detection wristbands, demonstrating the enormous potential of technology in improving the quality of life for the elderly population.

Quantitative relationship between grip strength and quality of life in the older adult based on a restricted cubic spline model.

Grip strength have been showed diverse associations with quality of life for the older adult population in the literature, still there is lack of evidence of the threshold value of grip strength for maintaining good quality of life in older adults. The purpose of this study was to study the dose-effect relationship between grip strength and quality of life in the older adult, and to explore the factors affecting quality of life in the older adult, so as to provide effective theoretical basis for realizing healthy aging. A total of 105 older adult people over 60 years old were selected from 3 communities in Beijing. Grip strength was measured by hand dynamometer apparatus and quality of life was assessed by 36-item Short-Form (SF-36). On the basis of controlling confounding factors, the dose-effect relationship between grip strength and quality of life was analyzed with the restricted cubic spline model. The results showed that there was a dose-effect relationship between grip strength and physical component summary (PCS) (p < 0.01). However, grip strength was not significantly associated with mental component summary (MCS) (p > 0.05). The threshold value of grip strength for male and female is 34.75 and 23.2 kg, for normal weight group and overweight and obesity group is 24.82 and 29.00 kg, for 60-69, 70-79, 80+ years group is 24.88, 23.37, and 22.97 kg, respectively. When the grip strength value is lower than the threshold value, the increase of grip strength was related to significant improvement of quality of life of the older adult, and when the grip strength value is higher than the threshold value, the quality of life can be maintained in good condition. A dose-effect relationship was found between grip strength and physical health in quality of life. Results of our study indicated that the grip strength of the older adults needed to be greater than certain threshold values to maintain good quality of life.

Body mass index and joint mobility in a group of elderly people from Romania

Multiple factors are responsible for changes in mobility and health with aging. Chronic pain, fractures or injuries, sarcopenia, obesity, fibromyalgia, osteoarthritis, osteoporosis or neuro-muscular diseases decrease the ability to walk or move in order to function independently. Obesity is one of the comorbidities that decrease the quality of life in old population for both men and women. Material and methods. The research was carried out online and 224 respondents over the age of 51 were selected for this study. Data were statistically analyzed. Results. The most common diseases affecting the joints in our study group are arthrosis (14.72%), osteoporosis (12.12%) and lumbosciatics (10.82%). 27.84% of women declared that they suffer from osteoporosis and only 6.67% of men. 36.61% of the subjects are overweight and 30.80% of them suffer from obesity, with a general BMI range between 14.2 and 50.00. Discussion. In our study group, as in scientific literature, elderly people’s mobility is affected mostly by conditions associated with high values of BMI and endocrine disorders.

Vascular Impairment, Muscle Atrophy, and Cognitive Decline: Critical Age-Related Conditions.

The triad of vascular impairment, muscle atrophy, and cognitive decline represents critical age-related conditions that significantly impact health. Vascular impairment disrupts blood flow, precipitating the muscle mass reduction seen in sarcopenia and the decline in neuronal function characteristic of neurodegeneration. Our limited understanding of the intricate relationships within this triad hinders accurate diagnosis and effective treatment strategies. This review analyzes the interrelated mechanisms that contribute to these conditions, with a specific focus on oxidative stress, chronic inflammation, and impaired nutrient delivery. The aim is to understand the common pathways involved and to suggest comprehensive therapeutic approaches. Vascular dysfunctions hinder the circulation of blood and the transportation of nutrients, resulting in sarcopenia characterized by muscle atrophy and weakness. Vascular dysfunction and sarcopenia have a negative impact on physical function and quality of life. Neurodegenerative diseases exhibit comparable pathophysiological mechanisms that affect cognitive and motor functions. Preventive and therapeutic approaches encompass lifestyle adjustments, addressing oxidative stress, inflammation, and integrated therapies that focus on improving vascular and muscular well-being. Better understanding of these links can refine therapeutic strategies and yield better patient outcomes. This study emphasizes the complex interplay between vascular dysfunction, muscle degeneration, and cognitive decline, highlighting the necessity for multidisciplinary treatment approaches. Advances in this domain promise improved diagnostic accuracy, more effective therapeutic options, and enhanced preventive measures, all contributing to a higher quality of life for the elderly population.

International and domestic experience in standard regulation of bottled drinking water quality

Regulatory control of the quality of bottled drinking water is an important area of protecting health and enhancing quality of life in population, including children. The aim of the study is to conduct a comparative analysis of regulatory measures for the quality of bottled drinking water based on chemical indices, with a view to considering international standards to improve the Russian legal framework in this field. The analysis incorporates foreign regulatory and legal instruments in the area of control and monitoring of the quality of packaged drinking water, such as the Codex Alimentarius and directives of the European Parliament, Council of the European Union, Code of Special Regulations of Food and Drug Administration, ТР ЕАЭС 044/2017 Technical Regulations.Current international and domestic regulations, ensuring bottled water quality, have been analyzed. In spite of the fact that regulatory documents comprise fifty three common indices, over half of the international standard values differ significantly as compared to ТР ЕАЭС 044/2017 Regulations. There are noted advantages of domestic regulations, considering the specific requirements for bottled drinking water for children and the physiological benefits of water. In this study, only the regulation of chemical indices in packaged drinking water has been considered based on 4 regulatory documents. Additionally, the work has not taken into account in detail those indices that are not included in domestic regulations. Conclusion. A comparative analysis of international and national regulations has shown the Russian Federation to have more stringent requirements for the regulatory values of bottled water quality. Taking into account current trends it is necessary to improve and expand constantly the system of regulatory quality control of bottled drinking water by including those indices concentrations of which are regulated by international legislation.

Fractures of the thoracolumbar spine in osteoporosis.

Due to increasing life expectancy, the prevalence of fractures caused by osteoporosis is raising. These fractures significantly reduce the quality of life in the elderly population. They represent both a disease and an injury simultaneously. While they were once treated solely with conservative methods, new techniques and implants are expanding the indications for surgical treatment. This article presents the current treatment options.

Why should a bioengineering lab have engineers and health professionals?

Through the description of the methodology of the development of a bite force measurement device it will be shown how interdisciplinary work of Engineers and Health Professionals bring enhance of life quality to general population. Bite force measurement is a reliable exam to check stomatognathic system (SS) conditions. In order to provide a reliable, low cost and do-it-yourself gnathodynamometer a Dentist joined Bioengineering Laboratory (LabBio) at UFMG. The development of a 3D printed resin structure was made using CAD/CAM and tested by means of FEM. A Carbon Nano Tube (CNT) extensometer developed at CTNANO at UFMG to capture the structure deformation were fixed in two geometries that showed good results in FEM simulation and will be tested in an EMIC universal mechanical testing machine (DL1000) equipped with a 1 kN load cell. The electrical response of the extensometers was monitored using a Keithley 2000 digital multimeter (Tektronix), connected to a computer and remotely controlled by a LabView application (View Point Systems), a data storage protocol in a SD card and in the clouds using IoT and an data acquisition system will be tested. In bench tests both geometries showed good results with deformation capturable from 40 N. Data was codified using an Arduino Nano and a program was developed for data acquisition and storage. The interdisciplinary work generates prototypes with promising results in bench tests. The fruit of the team work may generate a toll that improves life quality of population by allowing more people to be tested and lowering health costs.

Hidradenitis Suppurativa in Elderly Patients: Clinical and Therapeutical Outcomes-A Review of the Literature.

The management of hidradenitis suppurativa (HS) in elderly patients presents unique challenges due to its chronic inflammatory nature, heterogeneous clinical presentation and comorbidities. While HS typically affects the anogenital and intertriginous regions, elderly patients may exhibit atypical features such as the involvement of the neck, mammary area and gluteal region. The prevalence of HS in the elderly population is lower and the average age of disease onset is higher than in patients under 65. In contrast, it is unclear whether HS in the elderly has different clinical features. The elderly frequently present multiple comorbidities, including obesity, diabetes, and heart disease, which further complicate management decisions. Therapeutic interventions must consider the frailty and increased risk of multimorbidity and adverse events in elderly patients. While systemic antibiotics remain a mainstay of HS treatment, biologic agents such as TNFα inhibitors and secukinumab offer promising options for refractory cases. However, their safety and efficacy in elderly patients, particularly those with multiple comorbidities, require careful consideration. A comprehensive approach to managing HS in elderly patients involves not only pharmacological interventions but also lifestyle modifications and surgical options where appropriate. Multidisciplinary collaboration between dermatologists, geriatricians and other specialists is essential for tailoring treatment strategies and optimizing long-term outcomes and quality of life in special population.

Usability of APIMedOlder: A Web Application to Manage Potentially Inappropriate Medication in Older Adults.

Considering the increase in the proportion of the older population worldwide, the demand for health system resources also arises. These tools optimize clinical decision-making, thus avoiding iatrogenesis and thus contributing to a better quality of life for the older population. In response, we created an online web application, the APIMedOlder, that provides access to healthcare professionals to allow healthcare professionals to access potentially inappropriate medication identification criteria through a useful tool with a simplified profile, allowing its applicability in clinical practice. This study aims to assess the usability of the APIMedOlder online web application by healthcare professionals. A questionnaire, based on the System Usability Scale, was distributed among 15 healthcare professionals (five pharmacists, four physicians, three pharmacy technicians, and three nurses), to fully explore the website. Overall, healthcare professionals' evaluation of the usability of the APIMedOlder online web application was rated as "Best imaginable" (mean score of 87.17 points), with individual scores ranging from 75 to 100 points. Internal consistency of α = 0.881 (CI 95%: 0.766 - 0.953) was achieved. Specific questionnaire items contributing to this high score included ease of use, learning efficiency, and integration of functions. The overall evaluation of the developed tool was positive, with this online application being recognized as being easy to use and having well-integrated functions.

Intervention combinations within multimodal prehabilitation and their effect on health-related quality of life, fatigue, and adherence in the adult cancer population: an umbrella review protocol.

This umbrella review will investigate intervention combinations that are provided as multimodal prehabilitation and their effect on health-related quality of life, fatigue, and adherence in the adult cancer population. Cancer and treatment-related long-term and late effects are a significant source of impairment worldwide. Multimodal prehabilitation has been the subject of intense research in recent years due to its potential to improve cancer treatment and surgical outcomes. Prehabilitation has been provided in different combinations of exercise, nutrition, and psychological support, although evidence of effectiveness varies in the literature. The review will consider quantitative and mixed methods (segregated approach) systematic reviews investigating the effectiveness of multimodal prehabilitation compared with any other or no intervention for adults with cancer (≥18 years). Systematic reviews focusing solely on unimodal prehabilitation or rehabilitation during or after cancer treatment will be excluded. This review will follow the JBI methodology for umbrella reviews. The following databases will be searched from 2001 onwards: MEDLINE, Emcare, PsycINFO, and AMED (Ovid); CINAHL (EBSCOhost); PEDro; Cochrane Database of Systematic Reviews; and Epistemonikos. Backchaining and forward citation tracking will also be performed. Organizational websites will be searched for relevant gray literature. Two reviewers will perform title/abstract and full-text screening against the inclusion criteria, and disagreements will be resolved via discussion or a third reviewer. Relevant population, intervention, and outcome data will be extracted from included full-text documents, and the quality of reports will be determined using the JBI checklist for systematic reviews. The results will be presented in tabular and narrative format. PROSPERO CRD42024511601.