ABSTRACT Background: Daily step count is a simple and informative physical activity (PA) measure in older adults; however, it is often unavailable in clinical settings. Phase angle (PhA), derived from bioelectrical impedance analysis (BIA), could serve as a surrogate muscle quality and habitual activity marker. Objectives: We aimed to examine whether PhA could estimate step count and identify individuals meeting clinically relevant PA thresholds. Methods: In this cross-sectional study, we involved 150 community-dwelling adults (age: ≥60 years) from a frailty outpatient clinic, recording their daily step count over 7 days using a pedometer and measuring their PhA via multi-frequency BIA. Using multiple linear regression, we tested the association between PhA and step count, adjusting for age. Our receiver operating characteristic (ROC) analyses evaluated the potential of PhA to discriminate step thresholds (i.e., ≥2000, 4000, 6000, and 8000 steps/day), stratified by sex and age (i.e., <80 vs. ≥80 years). Results: PhA was significantly associated with step count (β = 2071.6, P < 0.001). ROC analyses demonstrated good discriminatory performance at higher thresholds. In men, PhA revealed excellent discrimination for ≥4000, 6000, and 8000 steps/day (area under the curves [AUCs] ≥0.8), with AUCs of 0.943 and 0.901 for ≥4000 and ≥8000 steps/day, respectively. Conclusion: PhA was significantly associated with daily step count and effectively identified older adults with higher activity levels, particularly males and those aged ≥80 years. PhA might thus serve as a practical proxy for PA when direct measurement is not feasible.
ABSTRACT Background: Alzheimer’s disease (AD) is defined as a neurodegenerative type of disorder and the top reason for dementia, particularly among older people. With an aging population, the prevalence of AD is increasing globally, including in Malaysia, where approximately 8.5%–11% of older people are affected. Family caregivers, often with limited medical training, are the primary care providers, making their knowledge critical in ensuring effective support. Objectives: To assess the knowledge levels of AD and its associated factors among family caregivers of older people. Methods: A cross-sectional study was conducted between May and June 2025 involving 207 family caregivers selected through convenience sampling. Data were collected using a self-administered questionnaire covering sociodemographic characteristics and knowledge of AD (Alzheimer’s Disease Knowledge Scale). Statistical analysis was performed using SPSS, involving descriptive and inferential analyses (Mann–Whitney U and Kruskal–Wallis tests). Results: The findings showed that 58.0% of participants had a moderate level of knowledge regarding AD. There were significant associations between knowledge level and age ( P = 0.036), educational level ( P = 0.011), occupation ( P = 0.001), family income ( P = 0.007), and health problems ( P = 0.036). Conclusion: Most of the family caregivers of older people had a moderate level of knowledge about AD. Knowledge in key areas such as disease progression and caregiving activities remains limited. Improving caregivers’ knowledge through a focused educational program can facilitate earlier recognition of symptoms, enhance dementia care quality, and improve outcomes for individuals with AD.
ABSTRACT Background: The increasing prevalence of fragility fractures in older patients is challenging, and orthogeriatric units (OGUs) have been introduced to improve patient outcomes. Objectives: This study assesses the quality of care provided to older patients with proximal femur fracture (PFF) after the implementation of an OGU and explores factors associated with 1-year mortality. Methods: A retrospective, observational, longitudinal study was conducted using electronic health records of patients aged ≥ 65 admitted with PFFs over a 1-year period. Descriptive statistics and inferential analyses were performed. Results: Out of 391 patients studied, 368 (94%) were included in the analysis. The mean age was 84.02 years (standard deviation: 7.61), with 78.5% female. Pertrochanteric fractures were the most common fracture (52.7%). Surgery within 48 h was achieved in only 19.6% of cases. One-year mortality was 25.4%, significantly associated with sex, age, patient origin, American Society of Anesthesiologists score, two/three or more comorbidities, low hemoglobin at admission, dementia, delirium, hypoxemia, respiratory infections, gastrointestinal bleeding, and readmission within 3 months. Conclusion: The OGU approaches a high-risk population, where comorbidities and perioperative complications influence the 1-year mortality rate.
ABSTRACT Background: Sedentary behavior (SB), defined as low-energy activities performed while sitting or reclining, is a major health risk factor in older adults. Although total sedentary time is linked to adverse outcomes, the effects of its precise timing remain unclear. Objectives: We aimed to identify the diurnal patterns of SB and examine their associations with physical function and depressive symptoms in community-dwelling older adults. Methods: A total of 111 older adults (mean age 73.1 ± 5.8 years; 24 men, 87 women) wore a triaxial accelerometer for 7 consecutive days to assess SB, light-intensity physical activity, and moderate-to-vigorous physical activity. Sedentary time was analyzed in six 3-h intervals from 06:00 to 24:00. Principal component analysis and K-means clustering identified distinct SB patterns. Physical function was measured grip strength and walking speed and depressive symptoms were assessed using the Geriatric Depression Scale. Results: Three clusters were identified: high-activity (HA), nighttime-sedentary (NS), and daytime-sedentary (DS). HA participants had shorter daytime sedentary periods, higher physical activity, and greater functional capacity. DS participants exhibited prolonged daytime SB and higher depressive symptom scores, whereas NS participants showed intermediate characteristics. Conclusion: Timing of SB, beyond total sedentary time, is associated with physical and psychological outcomes in older adults. The DS pattern was associated with higher depressive symptoms, warranting further investigation as a potential focus. These behavioral patterns may also represent potential markers for geriatric syndromes such as frailty and sarcopenia. Longitudinal studies are required to clarify the causal relationships and inform intervention development.
