To determine whether patients aged >75 years with spinal cord injury benefit from specialized inpatient rehabilitation regarding functional outcomes and discharge destination, compared with patients aged 60–75 years. Patients >75 years showed significantly lower functional gains but were still frequently discharged home after rehabilitation. Rates of in-hospital mortality and complications did not differ significantly between age groups. Many patients aged >75 years who underwent specialized inpatient rehabilitation were discharged home despite lower functional gains, highlighting that advanced age alone was not necessarily associated with institutional discharge within this rehabilitation-selected cohort. To evaluate functional outcomes and discharge destination after specialized inpatient rehabilitation in patients aged > 75 years with spinal cord injury (SCI). This retrospective single-center cohort study included 160 patients aged ≥ 60 years who completed inpatient SCI rehabilitation at the specialized SCI unit of BG Trauma Center Frankfurt, Germany (2010–2025). Patients were grouped into 60–75 and > 75 years. Functional status was assessed using the Spinal Cord Independence Measure (SCIM) at admission and discharge. Outcomes included discharge destination, functional gain (ΔSCIM), in-hospital complications, and medication at discharge. The mean age was 67 ± 5 years in the 60–75-year group and 80 ± 4 years in the > 75-year group; 75.0
To investigate the associations of malnutrition and dehydration with cognitive frailty in older adults undergoing comprehensive geriatric assessment. Malnutrition was highly prevalent among individuals with cognitive frailty and remained significantly more common than in matched robust controls, whereas hydration status did not differ significantly between groups. Improvements in nutritional status during follow-up were associated with resolution of cognitive frailty, while persistent cognitive frailty was accompanied by declining nutritional status. Malnutrition appears to be a key and potentially modifiable component of cognitive frailty, highlighting the importance of routine nutritional assessment and targeted nutritional interventions in older adults. Cognitive frailty (CF), defined as the coexistence of physical frailty and cognitive impairment without dementia, is a potentially reversible geriatric syndrome. Although malnutrition and dehydration are considered modifiable contributors, their relative roles in CF remain unclear. Adults aged ≥65 years who underwent comprehensive geriatric assessment were included. CF was defined using Fried’s frailty criteria and cognitive test scores (MoCA or MMSE). Nutritional status was assessed using the Mini Nutritional Assessment (MNA), and hydration status was evaluated by calculated plasma osmolarity. Age-, sex-, and Charlson Comorbidity Index comparisons were performed using 1:1 propensity score matching. Longitudinal changes in CF and nutritional status were examined in participants with follow-up data. Among 232 individuals with CF, malnutrition and dehydration were present in 31.3
Portugal is one of the most rapidly aging countries in Europe, highlighting the need for adequate undergraduate training in the care of older adults. However, Geriatric Medicine (GM) teaching in Portugal remains heterogeneous, and its alignment with the European Union of Medical Specialists (UEMS) undergraduate recommendations is unclear. We aim to map current GM education practices across Portuguese medical schools and to provide a national overview to support future curricular improvements. A descriptive observational study was conducted using an online structured questionnaire sent to the presidents of the pedagogical councils of all 11 Portuguese schools. The survey assessed the presence and characteristics of geriatrics teaching, including dedicated courses, mandatory or elective, and geriatrics content integrated into other curricular units, in accordance with the UEMS undergraduate framework. Responses were obtained from 9 out of the 11 Portuguese medical schools. Five schools reported offering a mandatory geriatrics course, three as standalone courses, with European Credit Transfer and Accumulation System credits ranging from 1 to 8 ( 28–224 h of estimated total student workload). Four schools reported offering an elective geriatrics course. Although most UEMS-recommended topics were addressed in schools with mandatory courses, several areas—including fecal incontinence, sexuality, palliative care, ethical and legal issues, and older people abuse—were inconsistently covered. GM teaching in Portugal remains uneven, with mandatory training present in only half of the medical schools and limited practical exposure. These findings highlight a gap between undergraduate medical education and the needs of future physicians caring for an aging population, supporting the need for curricular strengthening and greater national harmonization. To map current GM education practices across Portuguese medical schools and to provide a national overview to support future curricular improvements. Five schools reported offering a mandatory geriatrics course, three as standalone courses. Although most UEMS-recommended topics were addressed in schools with mandatory courses, several areas—including fecal incontinence, sexuality, palliative care, ethical and legal issues, and older people abuse—were inconsistently covered. There is an important gap between undergraduate medical education and the needs of future physicians caring for an aging population.
Multifactorial falls risk assessment incorporates assessment of modifiable falls risk factors, including fall-risk-increasing drugs(FRIDs) identified by Screening Tool of Older Persons Prescriptions in older adults with high fall risk(STOPPFall), orthostatic hypotension(OH) and mobility(measured by Timed-Up-and-Go(TUG)). The aim of this study is to assess the prevalence of these falls risk factors and incidence of falls in a large population-based cohort of community-dwelling older people. Data from The Irish Longitudinal Study on Ageing(TILDA) Waves 1,3,and 6 was used. STOPPFall medications were recorded at each wave. OH was defined as an orthostatic drop in systolic blood pressure ≥20 mmHg(upon standing from sitting) and/or reporting orthostatic unsteadiness. Mobility impairment was defined by TUG ≥12 s. Falls were self-reported. Participants aged ≥65 years at TILDA Waves 1(2009–2011,n=3507,mean age 73.3, 52.5
To examine the feasibility, acceptability, and preliminary effects of the co-created Join4Joy approach in nursing home residents, across three European countries. The intervention was feasible, safe, and well accepted with strong satisfaction, and no reported adverse events. Quantitative outcomes showed small positive changes or maintenance in physical and psychosocial measures, while qualitative data highlighted enjoyment, social connection, and perceived functional benefits. Join4Joy presents a co-created and enjoyable physical activity-based approach that may support engagement, well-being, and functional maintenance among nursing home residents. Nursing home residents increasingly enter care with advanced frailty, multimorbidity, and functional dependence, underscoring the need for engaging, adaptable physical activity (PA) programmes. Join4Joy is a co-created approach designed to promote movement and social connection among older adults through enjoyable activities. This study examined its feasibility, acceptability, and preliminary effects across five nursing homes in Spain, France, and Germany. This multicentre mixed-method study (ClinicalTrials.gov: NCT06100835) was delivered in two phases. Residents aged ≥ 65 years participated in 12 weekly 60-min PA sessions. Feasibility was assessed through attendance, procedural indicators, data completion, and retention; acceptability was evaluated using participant satisfaction and qualitative feedback, while safety was monitored throughout. Quantitative assessments evaluated physical function (SPPB), daily functioning (modified Barthel Index), quality of life (EQ-5D-5L), PA and sedentary behaviour (IPAQ-SF, SBQ, accelerometry), perceived improvement (PGI-I), and enjoyment (PACES-SF). Qualitative interviews and focus groups explored participant experiences. Of 81 enrolled residents, 75 completed the intervention (retention = 92.6
To describe the development of the European Geriatric Medicine Specialty Exam (EGeMSE), from its early conception within the European Union of Medical Specialists-Geriatric Medicine Section (UEMS-GMS) to implementation of the first pilot examinations. This narrative article was based on a review of UEMS-GMS meeting minutes, European Geriatric Medicine Society (EuGMS) educational documents, appendices, reports, presentations, policy documents, and other relevant archival and publicly available sources. The evolution of the EGeMSE was reconstructed chronologically. Discussions regarding a European Geriatric Medicine examination began in 2003 and evolved through successive working groups addressing postgraduate training, curricula, and assessment. During the following decade, the initiative became closely linked to development of a common European postgraduate curriculum and collaborative educational structures involving the UEMS-GMS, EuGMS, European Academy for Medicine of Ageing, International Association of Gerontology and Geriatrics–European Region, and other organisations. From 2018 onwards, the UEMS-GMS proposed a formal partnership with the British Geriatrics Society and the Federation of the Royal Colleges of Physicians of the United Kingdom, enabling adaptation of an established examination model to create a two-paper, multiple-choice, English-language European postgraduate examination. Following the first pilot examination in April 2025, the EGeMSE was recommended as a benchmark assessment of specialist knowledge within the 2025 European Training Requirements for the Specialty of Geriatric Medicine. The EGeMSE represents the culmination of more than 2 decades of European collaboration and provides a voluntary benchmark for specialist knowledge that supports the harmonisation of postgraduate Geriatric Medicine education across Europe. To describe the development of the pilot European Geriatric Medicine Specialty Exam (EGeMSE). The examination was developed through collaboration amongst multiple European organisations. It was implemented through a formal partnership between the European Union of Medical Specialists—Geriatric Medicine Section, the British Geriatrics Society, and the Federation of the Royal Colleges of Physicians of the United Kingdom, with support from the European Geriatric Medicine Society and others. The EGeMSE provides a voluntary European benchmark for specialist knowledge and supports harmonisation of postgraduate Geriatric Medicine education across Europe.
To compare dual-energy X-ray absorptiometry (DXA)- and bioelectrical impedance analysis (BIA)-based classifications of low muscle mass and sarcopenia under the Asian Working Group for Sarcopenia (AWGS) 2025 height-adjusted, body mass index (BMI)-adjusted, and combined criteria in older Korean adults. The BMI-adjusted criterion alone yielded closer DXA–BIA agreement than the height-adjusted criterion, but substantial discordance remained under the combined height-or-BMI definition. Overall sarcopenia agreement appeared high, because most participants had normal handgrip strength; among those with low handgrip strength, modality-dependent low-muscle-mass discordance persisted. DXA and BIA should not be treated as interchangeable for low-muscle-mass classification. Interpretation should specify the measurement device, derived muscle variable, and body-size adjustment criterion, and should be integrated with muscle-strength assessment. To compare dual-energy X-ray absorptiometry (DXA)- and bioelectrical impedance analysis (BIA)-based classifications of low muscle mass and sarcopenia under the Asian Working Group for Sarcopenia (AWGS) 2025 criteria. We analyzed nationally representative 2024 Korea National Health and Nutrition Examination Survey data from 1178 adults aged ≥65 years with both DXA and BIA measurements (survey-weighted mean age, 72.1 years; 54.3
To evaluate whether Machine Learning algorithms can identify, at the individual level, patients for whom BIA-derived Appendicular Skeletal Muscle Mass estimation is sufficiently reliable for clinical use. Estimation error was significantly higher in outpatients than in healthy subjects (MAPE 4.12
To describe and compare geriatricians’ roles in geriatric oncology and onco-surgical care across Europe. Geriatric oncology practices varied widely across 34 countries: 19
Circulating neudesin, nesfatin-1, and irisin levels were measured in older adults with primary sarcopenia, and their diagnostic value was evaluated. Older adults with sarcopenia exhibited significantly lower serum concentrations of neudesin, nesfatin-1, and irisin. After adjustment for body mass index (BMI), neudesin and nesfatin-1 remained independently associated with sarcopenia, while the association with irisin was attenuated. All three biomarkers demonstrated good discriminatory ability for identifying sarcopenia. The results support the hypothesis that sarcopenia is characterized by dysregulation of the brain–muscle–metabolic axis, in addition to muscle loss. Circulating biomarkers may contribute to future risk stratification strategies. However, larger prospective studies are required before clinical application. Sarcopenia is an age-related geriatric syndrome characterized by the progressive loss of skeletal muscle mass, strength, and physical performance. Although muscle-based assessments remain central to diagnosis, no specific circulating biomarker is currently available for early detection. Emerging evidence suggests that neudesin, nesfatin-1, and irisin are involved in muscle metabolism, energy homeostasis, and the regulation of inflammation. This study aimed to investigate the association of these biomarkers with primary sarcopenia in older adults and to evaluate their potential diagnostic utility. This study included 88 participants aged ≥ 65 years (58 women, 30 men), excluding secondary sarcopenia. Diagnosis was based on EWGSOP2 criteria. Serum neudesin, nesfatin-1, and irisin levels were measured by enzyme-linked immunosorbent assay (ELISA). Sociodemographic characteristics, comorbidities, medication use, anthropometric parameters, and comprehensive geriatric assessment data were collected. Serum concentrations of neudesin, nesfatin-1, and irisin were significantly lower in individuals with sarcopenia compared to non-sarcopenic controls (p = 0.001, p < 0.001, and p < 0.001, respectively). After adjustment for body mass index (BMI), neudesin and nesfatin-1 remained independently associated with sarcopenia, whereas the association between irisin and sarcopenia was attenuated. All three biomarkers demonstrated good discriminatory ability for sarcopenia. Reduced serum concentrations of neudesin, nesfatin-1, and irisin are significantly associated with primary sarcopenia in older adults. Nesfatin-1 and neudesin appear to be the most robust biomarker candidates, independent of adiposity. These results suggest that sarcopenia involves alterations in interconnected metabolic, endocrine, and neurotrophic pathways within the brain–muscle–metabolic axis. This study is the first to evaluate a combined neurotrophic, myokine, and metabolic biomarker panel in primary sarcopenia. Additional prospective studies are necessary to validate these findings and determine their clinical relevance.
This article evaluates Shoojit Sircar’s Piku [1] within the geriatric medical canon, examining its subversion of traditional aging tropes that equate old age with inevitable decline, loss of autonomy, and passive dependency. Centered on the protagonist Bhashkor Banerjee’s chronic constipation, the narrative explores the medicalization of the mundane, where both bowel motion and bodily movement become intertwined sites through which elderly agency is negotiated. Through a gerontological lens, the film portrays the domestic space as a site of conflict between the autonomy of the aging subject and the ethical demands of caregiving. By analyzing Bhashkor’s refusal to be governed—manifested in a cross-country road trip and his reclamation of physical agency via a bicycle ride in Kolkata—this study identifies a shift from the conventional senescence-as-loss narrative. It argues that Piku reimagines ageing through the interdependence of bodily autonomy, mobility, and caregiving, offering a reimagined framework for filial maturity that privileges the elderly subject’s right to pleasure, agency, and negotiated care over clinical safety.
To explore the association between specific classes of fall-risk-increasing drugs and both one-time (1 fall) and recurrent (≥ 2) falls in community-dwelling adults aged 75 and older, utilizing prospective fall ascertainment and adjusting for relevant confounders. Benzodiazepine-related drugs, strong anticholinergics, and antiepileptics were each significantly associated with recurrent falls when adjusting for clinical and sociodemographic factors in this cohort of well-functioning community-dwelling older adults. Fall-risk-increasing drugs are an important modifiable risk factor for recurrent falls among older adults, and identifying individuals at risk is essential when conducting medication reviews or prescribing for this patient group. Fall-risk-increasing drugs (FRIDs) are a significant and modifiable risk factor for falls in older adults. However, prospective data using robust fall ascertainment on specific FRID classes are scarce in community-dwelling populations. We aimed to investigate the association between individual FRID classes and both single and recurrent falls in older community-dwelling adults. We analysed data from a Danish prospective cohort of 241 community-dwelling adults aged ≥ 75 years. Medication records were collected at baseline, and drugs were classified using the STOPPFall consensus FRIDs list. Falls were recorded prospectively for 1 year using monthly fall-calendars, verified using telephone follow-ups. Associations between FRIDs and one-time (1 fall) and recurrent falls (≥ 2 falls) were explored using Cox proportional hazards model, adjusting for clinical and sociodemographic factors. The median (IQR) age was 82 (80, 86) years, 66.4
We set out to evaluate the outcomes of patients who underwent conservative management for undisplaced or valgus-impacted neck of femur fractures. 38 patients were included for analysis, of which 14 patients had no further re-admissions at our unit requiring additional treatment, while 13 patients subsequently underwent surgical correction due to pain, poor mobility or fracture displacement. The mean time to surgical correction following conservative management was 49 days (Range=1, 208), and the 30-day and 90-day mortality was 18
To explore cross-lagged associations between oral health and general health indicators among nursing home residents, conditional on prior status, using interRAI assessments, including the OHS. Oral health and general health are interrelated, with several oral health conditions associated with subsequent dependence on personal care, depressive symptoms, cognitive impairment, and health instability in nursing home residents, and vice versa. Although hypothesis-generating, the findings support considering oral health as an integral part of daily nursing home care and may inform future research and discussions on integrating oral care into routine care practices. Regular health assessments using interRAI instruments, including the Oral Health Screener (OHS), may help identify care needs and improve nursing home residents’ oral health. This study explored longitudinal associations between oral health (OH) and general health (GH) indicators. InterRAI assessments from Flemish and Dutch nursing home residents aged ≥ 65 years (October 2020–February 2024) were included. OH was derived from the OHS and GH from Activities of Daily Living Hierarchy (ADLH), Depression Rating Scale (DRS), Cognitive Performance Scale (CPS) and Changes in Health, End-stage Disease, and Signs and Symptoms (CHESS). A joint model explored overall associations between indicators. Bivariate autoregressive models examined cross-lagged associations conditional on prior status. In total, 12,586 assessments from 5450 residents were analyzed. Mean baseline age was 85.8 years (SD 7.7); 76.0
This study aims to evaluate the effect of bodyweight interval training on frailty status in older adults in primary health care. Bodyweight interval training increased the probability of transition to less frail states among older adults over 24 weeks, with improvements in physical-functional performance and reductions in blood pressure parameters. No significant changes were observed in body composition. Bodyweight interval training may represent a strategy for frailty management in older adults in primary health care. To evaluate the effect of bodyweight interval training on frailty status in older adults. A randomized controlled trial was conducted with 60 frail older adults (74.0 ± 6.0 years; 72.4
To examine whether receipt of an acute-care secondary fracture prevention (SFP) incentive after hip fracture surgery is associated with reduced 1-year risk of subsequent major osteoporotic fracture in routine practice. In this nationwide cohort of 11,147 older adults, receipt of the acute-care SFP incentive was associated with a 15
To address the growing global burden of aspiration pneumonia in older adults with frailty, a major cause of recurrent hospitalization, mortality, and healthcare system strain, by developing and evaluating an interprofessional education program to improve collaborative care. This multi-year action research study demonstrates that structured interprofessional education can strengthen collaborative practice, facilitate the formation of new multidisciplinary teams, and promote sustained behavioral and organizational changes in aspiration pneumonia care. In addition, the study clarifies how such programs can be systematically structured and implemented across diverse clinical settings, for example through learner-friendly, streamlined pre-learning modules combined with interactive, case-based simulation workshops. Although interprofessional collaboration has long been considered essential for aspiration pneumonia care, this study shows that such collaboration can be systematically strengthened and sustained through targeted education. Aspiration pneumonia has evolved, with demographics shifting to predominantly frail older adults. However, despite the high healthcare impact, there is no established guideline or curriculum for the education and training of healthcare professionals in managing aspiration pneumonia in older adults. This study aimed to explore optimal educational interventions to improve holistic management of aspiration pneumonia in older adults, and to identify barriers and facilitators towards developing multidisciplinary teams specialized in this area. We conducted a multi-year action research study from 2019 to 2024 using Kern’s six-step model across three annual cycles: exploratory (2020), prototyping (2021), and refinement (2022) phases. Participating hospitals across Japan recruited interprofessional teams consisting of physicians, dentists, nurses, pharmacists, physical, occupational, and speech-language therapists, dietitians, social workers, and care workers. The educational intervention combined streamlined pre-learning modules with interactive workshops featuring case-based simulation. Primary outcomes included participant satisfaction and establishment of a new multidisciplinary team at 6-month follow-up. We integrated quantitative metrics and qualitative thematic analysis to analyze data. A total of 131 participants from 32 hospitals participated. Overall satisfaction scores remained consistently high: 4.4 ± 0.6 (2020), 4.5 ± 0.5 (2021), and 4.5 ± 0.6 (2022) out of 5.0. Pre-learning completion rates improved substantially from 84.4 to 96.1
To use a Plan-Do-Study-Act (PDSA) framework to identify nurses’ barriers in the care for older ED patients and to develop a specific intervention targeting these barriers. Across eight western European ED settings, nurses identified time pressure, behavioral disorders, and communication difficulties as the main barriers to delivering optimal geriatric care. Through three iterative PDSA cycles, we developed and implemented a family-engagement poster that was well received. Yet, we found only a limited measurable impact on nurses’ time use, likely due to the relatively small number of PDSA cycles completed to date. Our findings highlight the value of PDSA cycles for designing and adapting quality improvement interventions in geriatric emergency care, and underscore the need to actively engage all key stakeholders, including frontline nurses and caregiver representatives, as partners in these efforts. Emergency departments (EDs) face significant challenges in delivering high-quality care for older patients. Identifying barriers and developing stakeholder-informed interventions are essential to improve ED care. This study aimed to identify nurses’ perceived barriers to caring for older ED patients and to develop and evaluate a targeted intervention to improve care quality. This multicenter quality improvement project (QIP) was conducted across EDs in four western European countries (2024–2025) using three iterative Plan-Do-Study-Act (PDSA) cycles. Cycle 1 involved a needs assessment among nurses to identify barriers. Cycle 2 focused on developing and evaluating the perceived helpfulness and feasibility of three proposed interventions. Cycle 3 implemented and evaluated the selected intervention. Nurses provided feedback throughout all PDSA cycles. In Cycle 1, 82 nurses from eight EDs in Belgium (n = 22), Germany (n = 20), Switzerland (n = 30), and Iceland (n = 10) identified time constraints (n = 92; 39
