Hospitalization in older adults often leads to disability in daily living activities, thereby increasing the risk of functional and cognitive impairments. Thisrandomized controlled trial analyzed the serum protein profile of patients admitted to an acute geriatric unit who engaged in supervised multicomponent functional exercise program compared with a control group. Potential protein biomarkers were assessed using the Olink serum proteomics platform employing two predefined panels: Cardiometabolic and Inflammation. Notably, the short-term exercise intervention was associated with moderate but consistent changes in the serum proteome. Nominal differences (p < .05, unadjusted) were observed for amyloid beta precursor-like protein 1 (APLP1), complement C1q tumor necrosis factor-related protein 1 (C1QTNF1), interleukin-8 (CXCL8), interleukin-7 (IL-7), M-phase phosphoprotein 8 (MPHOSPH8), neurotrophin 3 (NTF3), tissue-type plasminogen activator (PLAT), SFRS1-interacting protein (PSIP1), pleiotrophin (PTN), cardiac-type troponin I (TNNI3), and von Willebrand factor (vWF); conversely, levels of CD40 ligand (CD40LG) were reduced. These findings suggest that short-term multicomponent functional exercise during acute hospitalization can induce changes in the serum proteome. These molecular alterations provide exploratory insights into the biological processes associated with the functional benefits observed following the intervention in hospitalized older adults.

Objectives: To determine whether baseline nutritional biomarkers can predict functional response to a multicomponent exercise program in older adults during acute hospitalization.Design: Secondary analysis of a randomized controlled trial.Setting: Acute Geriatric Unit of a tertiary public hospital in Navarra, Spain.Participants: A total of 303 hospitalized patients aged > 75 years.Intervention: Multicomponent exercise intervention (resistance, balance, and gait training) versus usual care.Measurements: Functional response was defined as an increase of ≥ 1 point in the Short Physical Performance Battery (SPPB) score from admission to discharge. Nutritional status was assessed using baseline serum biomarkers (total cholesterol, albumin, total proteins, and vitamin D) and the Mini Nutritional Assessment (MNA).Results: In the exercise group, 85.3% of the participants were functional responders. Responders had higher baseline total cholesterol levels (148 vs. 126.5 mg/dL; p=0.01) then non-responders. Adjusted logistic regression confirmed that cholesterol was a significant predictor (OR 1.016 per mg/dL; 95% CI 1.00–1.03; p=0.006). In the overall cohort, a significant interaction between baseline cholesterol and exercise intervention was identified (interaction OR 1.019 per mg/dL; 95% CI 1.005–1.032; p=0.006). Conclusion: Baseline total cholesterol, which reflects metabolic reserve, predicts and modulates the functional response to in-hospital exercise. These findings suggest that metabolic reserves enhance the capacity to respond to rehabilitation stimuli. Nutritional assessment should be integrated into rehabilitation strategies to identify older adults with physiological resilience who can benefit from such programs.

Introduction:Oxidative stress, driven by the imbalance between reactive species from oxygen and nitrogen and antioxidant defense mechanisms, plays a pivotal role in aging-related pathologies. Structured multicomponent exercise interventions have mitigated hospital-acquired disability by improving physical and cognitive function and quality of life. However, the underlying molecular mechanisms of this improvement remain partially understood. Methods:We conducted a secondary analysis of a randomized controlled trial to investigate the impact of a supervised exercise program on oxidative stress in hospitalized older adults. Participants were randomized to a 3-day tailored exercise program based on baseline functional capacity. Serum malondialdehyde (MDA) levels (μmol/mL) and the oxidative oxidation of total proteins (PO) were measured. RESULTS: Seventy-two participants were included in this subanalysis (mean age 86.8 years [SD 4.96], 53.8% female [n = 39]). The exercise group showed a minimal change in MDA levels, while the control group exhibited a significant increase, with a between-group difference of -0.24 μmol/mL (p < 0.01). Subgroup analyses demonstrated significant benefits in patients with diabetes and in women. The intervention improved functional capacity and subjective health status. Participants with lower baseline oxidative stress levels showed greater improvement in SPPB compared to those with higher baseline levels. Discussion:Structured exercise may mitigate the increase in oxidative stress in hospitalized older adults, particularly in women and those with diabetes. The magnitude of functional improvements could depend on baseline oxidative status, highlighting the need for personalized interventions. Future research should explore long-term effects, biomarkers, and tailored protocols to optimize outcomes in this population.

Hospitalization is usually linked to dramatic adverse events in older adults, including hospital-associated disability (HAD). Despite advancements in geriatric medicine to mitigate this trend, hospital models have often remained antiquated rather than being designed to minimize the risk of harm and reduce the associated burdens. The objective of this narrative review is to identify the personal and in-hospital process risk factors that may contribute to the development of HAD and determine efficacious therapeutic strategies to reverse these negative consequences. Age, sex, ethnicity, number of comorbidities, frailty, dementia, functional status at hospital admission, and polypharmacy may influence the development of HAD. Additional factors related to hospital processes, including prolonged length of hospital stay, low mobility, malnutrition, muscle function loss, social isolation, and sensory alterations, may increase the risk of HAD. Comprehensive geriatric assessment and in-hospital physical exercise appear to be effective therapeutic strategies for preventing HAD in acutely hospitalized older adults and should be part of the clinical routine. However, further research is necessary to examine the feasibility and effectiveness of new integrative care models to provide optimal and widely accessible treatments.

BACKGROUND:Olfactory impairment is a well-established prodromal marker of neurodegeneration. However, the synergistic role of combined olfactory and gustatory dysfunction remains under-investigated in geriatric clinical practice. This scoping review aims to synthesize current evidence on the relationship between dual chemosensory decline and cognitive deterioration in aging. METHODS:Following PRISMA-ScR guidelines, we conducted a comprehensive search across PubMed, Scopus, Web of Science, and Cochrane databases for studies published between 2015 and 2025. Inclusion criteria focused on clinical research evaluating both smell and taste functions in the context of cognitive impairment and neurodegenerative diseases. RESULTS:Our analysis of the identified literature suggests that combined chemosensory deficits are significantly correlated with cognitive decline. Our findings indicate that the concurrent loss of olfactory and gustatory sensitivity could serve as potential biomarker of cortical and subcortical neurodegenerative progression, reflecting a breakdown in central multisensory integration centres critical for geriatric cognitive homeostasis. CONCLUSION:Dual assessment of olfaction and gustation may represent a promising candidate biomarker of neurodegenerative progression compared to isolated olfactory testing. We propose the integration of standardized chemosensory protocols into routine geriatric assessments as a pragmatic strategy for early cognitive risk stratification and follow-up. This approach holds significant translational potential for monitoring neurodegenerative trajectories in older adults.

INTRODUCTION:Improvisational theatre is an activity that combines many of the recommendations that promote healthy aging: physical exercise, cognitive stimulation, socialization, meditation and music therapy. The purpose of the study is to assess whether improvisational theatre can enhance physical and cognitive function, as well as quality of life and emotional status of older adults. DESIGN:A quasi-experimental study was conducted in five groups (two from residential facilities and three comprising community dwelling older adults), utilizing a convenience-based sample size. SAMPLE AND SETTING:Fifty-six participants were recruited, with a mean age of 76.6 (9.3), of whom 73% were women, 34% lived in residential facilities, and 66% lived in the community. RESULTS:While Barthel Index and Lawton Index remained stable along the intervention period, we found statistically significant changes in all the other physical-related assessed variables (SPPB, hand-grip strength, FRAIL index). There was also significant improvement in the MoC@ scale, verbal and semantic fluency, EuroQol, loneliness and depression. Sensitivity analyses indicated that some effects may be context-dependent and influenced by subgroup composition (Visual Analogue Scale, MoC@, FRAIL, and verbal fluency). CONCLUSION:Improvisational theatre enhanced physical, mental, social, and emotional well-being of participants. Incorporating improvisational theatre training is a valuable addition to interventions aimed at addressing the challenges posed by an aging population on a broader scale.

Hospitalisation in older adults is frequently associated with a significant risk of functional and cognitive decline. This study aims to evaluate the effectiveness of a multicomponent exercise program designed to prevent such declines in acutely hospitalised older adults. The intervention will be implemented across three European hospitals with the goal of enhancing the quality of life and functional independence of this vulnerable population. This study will be conducted as a multicentre, randomised controlled trial with two arms: one group will receive a multicomponent exercise program, while the control group will receive standard care. The intervention will consist of individualised sessions focusing on resistance training, balance, and aerobic exercises over four days during hospitalisation. The primary outcome will focus on functional capacity, which will be assessed using the Short Physical Performance Battery. The primary outcome will be measured at baseline, discharge, and 30- and 90-days post-discharge. In addition to this primary outcome, secondary outcomes will include the Barthel Index, cognitive function assessed through the Mini-Mental State Examination, quality of life measured by the EuroQol-5D-3L, and psychological well-being evaluated using the Geriatric Depression Scale (GDS). Additional metrics will include length of hospital stay and readmission rates within 30- and 90-days post-discharge. Trial registration: ClinicalTrials.gov NCT06634147.

Abstract Background Hospital-associated functional decline affects nearly one-third of the hospitalized older adults. The aim of this trial is to investigate the effect of a cognitive stimulation intervention provided via immersive virtual reality (IVR), with or without a multicomponent physical exercise intervention (ME) in hospitalized patients aged 75 or older with severe functional dependency at admission (Barthel Index < 60 points). Methods This clinical randomized controlled trial will be conducted in the Acute Geriatric Unit of a tertiary hospital in Spain. A total of 212 acute patients will be enrolled according to the following criteria: age ≥ 75, Barthel Index < 60, able to collaborate, expected length of stay ≥ 5 days, absence of clinical instability and severe dementia (Global Deterioration Scale 7) or other end-stage disease. Patients will be randomly assigned to a control group (CG) or any of the three intervention groups (IG): IVR, ME, or IVR + ME. The IVR group will watch ad-hoc videos showing Spanish regional landscapes and villages, approximately 4 min per day for three consecutive days. The ME group will undergo aerobic and strength exercise for progressive training of the upper and lower limbs. The IVR + ME group will do both cognitive and physical intervention. The primary outcomes will be cognitive and physical measures at discharge. Mood, quality of life, isometric strength, and acceptance of IVR will be also assessed. Discussion This project has the potential to enhance physical and psychological well-being of patients with severe functional dependency hospitalized for acute conditions, using technology. Virtual reality is expected to be favourably perceived by hospitalized older adults. This intervention represents a novelty in the geriatric patients’ care, comprising IVR and/or ME dispensed within the patient’s room, and including patients who are commonly excluded from research clinical trials. Trial registration This study was approved by the Navarra Clinical Research Ethics Committee on May 17th, 2023 (PI_2023/60). The trial is registered at ClinicalTrials.gov, registration number NCT06340282, 24th May 2024.

The objective of the present study is to analyze the epidemiological, clinical and functional characteristics of patients admitted to the University Hospital of Navarra due to SARS-CoV-2 infection, as well as the predictors of mortality, during the first wave of the pandemic caused by this virus.

We cross-sectionally described measured characteristics and lived experiences of older adults classified as frail by three different scales in The Irish Longitudinal Study on Ageing (TILDA). Despite being classified as frail, more than 60

La depresión y el parkinsonismo son consecuencias directas de una lesión, por lo general vascular, que compromete alguna estructura del circuito fronto-subcortical. Su detección representa un desafío diagnóstico, y tiene importantes repercusiones en el manejo terapéutico. Se presenta el caso de un paciente varón de 79 años con buena situación basal global, que ingresa a una unidad de psicogeriatría tras un intento autolítico. Inicialmente se objetiva una depresión franca no psicótica, y llama la atención un aumento de la base de sustentación a la marcha y bradicinesia. Tras el ajuste de tratamiento antidepresivo se evidencia una notable mejoría de la sintomatología afectiva, pero no motora, por lo que se decide solicitar una resonancia magnética que objetiva lesiones isquémicas en ganglios basales. Este caso representa un claro soporte del modelo de circuitos fronto-subcorticales, en el que la presentación clínica, la evaluación neuropsiquiátrica, los datos de neuroimagen y la respuesta terapéutica contribuyen a la comprensión de los déficits que siguen a la lesión de estas estructuras.Consideramos que con este artículo se podrá contar con una información breve y precisa con relación a los mecanismos fisiopatológicos, evaluación, planteamiento diagnóstico y tratamiento del síndrome fronto-subcortical.Depression and parkinsonism are direct consequences of a lesion, usually vascular, that affects some structure of the frontal-subcortical circuit. Their detection represents a diagnostic challenge and has important repercussions in therapeutic management. The case is presented of a 79-year-old male patient with good overall baseline status, who was admitted to a Psychogeriatric Unit after an autolytic attempt. Initially, a non-psychotic frank depression is observed, and an increase in the base of support for walking and bradykinesia is noted. After adjustment of antidepressant treatment, a notable improvement in affective symptoms is evidenced but not in motor symptoms, so it is decided to request a magnetic resonance imaging that shows ischemic lesions in the basal ganglia. This case provides clear support for the frontal-subcortical circuit model, in which the clinical presentation, neuropsychiatric evaluation, neuroimaging data and therapeutic response contribute to understanding the deficits following these types of lesions.We believe that this article will provide brief and accurate information on the pathophysiological mechanisms, evaluation, diagnostic approach, and treatment of the frontal-subcortical syndrome.

BACKGROUND:The objective of the present study is to analyze the epidemiological, clinical and functional characteristics of patients admitted to the University Hospital of Navarra due to SARS-CoV-2 infection, as well as the predictors of mortality, during the first wave of the pandemic caused by this virus. METHODOLOGY:An observational, retrospective study was performed, including all hospitalized patients older than 75 years. Information has been obtained on multiple variables, among which it is worth mentioning previous geriatric syndromes or those that have appeared during hospitalization, or past medical history considered relevant in SARS-CoV-2 infection. A descriptive analysis of the data, comparisons according to various factors of interest and multivariate analysis to analyze factors associated with mortality were carried out. RESULTS:Data have been obtained from a total of 426 patients with a mean age of 83.2 years (52.6% men). 34.7% died in hospital and 4.5% within 1 month after hospital discharge. The factors related to mortality were: worse baseline functional status, chronic kidney disease, and fever or dyspnea as forms of presentation. The most frequent typical symptoms were: fever, dyspnea, cough, asthenia and hyporexia. Up to 42.1% presented delirium as a symptom of atypical onset. We observed a functional deterioration that was not recover after a month of follow-up (baseline Barthel index 81.12; 70.08 at discharge; 75.55 after a month). CONCLUSIONS:SARS-CoV-2 infection has caused high mortality rates in older adults. In this age group, the atypical presentation of this disease and functional deterioration during hospitalization are frequent. In the present study, a worse previous functional status has been identified as a predictor of mortality. More studies are needed to evaluate the impact that the disease and hospitalization have on the older patient, with the aim of implementing preventive, diagnostic and therapeutic measures that are necessary to avoid functional deterioration and adverse health events related to it.

Background: The increase in life expectancy has led to profound changes in disease prevention and health maintenance. Because of the impact of dysbiosis on the host's health, it is worth considering microbiome-targeted therapies to attenuate or delay age-related perturbations.Aim: The aim of the present review was to systematically evaluate the impact of probiotics, prebiotics, and synbiotics on the major events that affect individuals aged 65 or older.Methods: We performed a literature search in MEDLINE and the Cochrane Central Register of Controlled Trials. Randomized Clinical Trials (RCTs) performed on old people and published between 2009 and 2019 were included.Results: Nine RCTs and 1 secondary analysis (n = 475, 55.8% female) were eligible for inclusion and retrieved in this systematic review. Overall, most interventions resulted in improvements in certain parameters when compared to control (glucose homeostasis, cognitive function, frailty phenotype, gut microbiota profile, immune parameters), while others remained unvariable. Conclusions: The use of probiotics and prebiotics raises a great opportunity to modulate the process of aging and looks promising for health prevention in old adults. However, more RCTs in subjects older than 65 years are needed to elucidate the suitability of these supplementations and establish the underlying potential mechanisms.

The aim of this article is to present the research protocol for a study that will evaluate the feasibility of implementation of Health Arcade prototype multidomain intervention based on physical and cognitive training using gamification technologies at improving care for older people hospitalized with an acute illness. A total of 40 older people will be recruited in a tertiary public hospital at Pamplona, Spain. The intervention duration will be four to nine consecutive days. Additionally, the patients will receive encouragement for maintaining active during hospital stay and for reducing sedentary time. Primary implementation-related outcomes will be the adherence to treatment (i.e., number of games and days completed during the intervention period), reaction or response time, and number of success and failures in each game per day. Secondary implementation-related outcomes will be self-perceived grade of difficulty, satisfaction, enjoyment per game and session, and self-perceived difficulties in handling the prototype hardware. Other health-related outcomes will also be assessed such as functional capacity in activities of daily living, mood status, quality of life, handgrip strength, physical activity levels, and mobility. The current study will provide additional evidence to support the implementation of multidomain interventions designed to target older persons with an acute illness based on friendly technology. The proposed intervention will increase accessibility of in-clinical geriatrics services, improve function, promote recovery of the health, and reduce economic costs.