INTRODUCTION:Older individuals are at risk of malnutrition resulting from chronic diseases-related body and muscle mass reduction. In turn, nutritional deficiencies may enhance catabolic processes, leading to accelerated aging and comorbidity, thus creating a vicious cycle. Our study aimed to assess the prevalence of malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria and to determine the health correlates of malnutrition in a representative sample of community-dwelling older adults. METHODS:We used the GLIM criteria to diagnose malnutrition in 5,614 participants of the PolSenior2 study. The PolSenior2 study was a population-based survey designed to assess the medical, psychological, social, and economic characteristics of community-dwelling older adults. RESULTS:Malnutrition was diagnosed in 13.4% of the participants using the GLIM criteria. Results of multiple logistic regression showed that the risk of depression [OR 4.18, p<0.001], peptic ulcer disease [OR 2.73, p<0.001], past stroke [OR 1.71, p<0.001], cognitive impairment [OR 1.34, p = 0.015], and chronic pain [OR 1.23, p = 0.046] were independent correlates of malnutrition. CONCLUSION:Due to the high risk of malnutrition, special attention should be paid to individuals in late old age. Suspected malnutrition should also be considered in people at risk of depression, with peptic ulcer disease, past stroke, and cognitive impairment. Chronic pain should also prompt the diagnosis for malnutrition.

BackgroundStudies about the needs of older individuals in Central Asia are very sparse. Thus, this study aimed to evaluate the needs of older adults in Kazakhstan with the EASYCare Standard 2010 (EC) questionnaire.MethodsThe study involved 524 participants aged 65 and older from various regions in Kazakhstan. Data were collected by trained research staff, and the participants’ needs were examined using median split with the three summarizing indexes of the EC system (Independence score, Risk of breakdown in care, and Risk of falls).ResultsSubjects with primary education had approximately double odds of scoring above the median compared to those with higher education in Independence score (p < 0.01) and Risk of breakdown in care (p < 0.01). Individuals with primary education also had 60% higher odds of scoring above the Risk of falls scale threshold, indicating a risk in this category (p < 0.05). For the Risk of falls scores, financial situation was also significant; individuals having not enough to make ends meet had 75% higher odds than the remaining ones (p < 0.01).ConclusionOur analysis highlights the importance of tailored interventions to address the unmet needs of the Kazakh population, particularly among those with lower education and those with financial concerns. The study also underscores the need for sustainable, comprehensive eldercare policies in Kazakhstan that account for the growing older population.

This paper explores the exceptional intercultural encounter between secular therapists and Ultra-Orthodox Jews in Israel, focusing on two key aspects. Firstly, it explores the distinctive attributes and conflicts inherent in treating Ultra-Orthodox individuals. On the one hand is the secular Israeli therapist, whose base is in Western philosophy that prioritizes individuality, cultural diversity, and tolerance of differences. On the other hand is the Haredi client, entrenched in values from Jewish tradition and religious principles that amplify solidarity and collectivism while rejecting prevalent secular culture. The existing socio-political climate in Israel often positions these two as potentially conflicting cultures. Secondly, the paper seeks to illuminate the uncommon dynamics of the minority-majority power balance within the therapeutic relationship. In contrast to prevalent literature in intercultural therapy, which typically frames the client as a representative of a disadvantaged minority and the therapist as a representative of a dominant majority, this article aims to unravel a nuanced power balance, where those in the minority perceive the dominant culture both as a threat to its way of life and as a despised entity, but paradoxically rely entirely on its financial support. This reveals a complex and intricate interplay of dominance and dependence, shaping a therapeutic relationship that defies conventional expectations.

Chronic back pain in adults is often a cause of absenteeism from work, limitations in social interactions, and difficulties in performing daily activities. This study aimed to check whether the functioning of everyday activities in elderly patients after neurosurgery improved over time compared to their condition before the procedure and whether there is a connection between fitness, self-esteem, and pain intensity. This was a cross-sectional study carried out using an anonymous survey. This study included patients over 60 years of age from the neurosurgical ward. The following scales were used to assess cognitive functioning, depression, functional status: basic and instrumental activities of daily living (IADL), back pain disability (QBPDS), pain intensity, and self-esteem. The level of independence in terms of IADL and QBPDS increased, and the intensity of pain decreased. Surgery reduced pain intensity from 8 ± 0.8 to 6.1 ± 1.4 points. The level of self-esteem (RSES) remained at a low level. The passage of time after neurosurgical treatment has a beneficial effect on reducing pain intensity and increasing independence in life activities. Daily physical activity and rehabilitation are important factors supporting the return to independence.

The COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) is a patient-reported outcome measure designed to assess the long-term effects of COVID-19. The scale was validated and is commonly used in the general population. In this study, we assess the utility of the C19-YRS in evaluating the post-COVID burden among residents of long-term care facilities with a mean age of 79. C19-YRS and Barthel index evaluations were performed among 144 residents of long-term care facilities reporting new or worsened symptoms or functioning three months after convalescence from COVID-19. The C19-YRS-based screening showed that 70.9% of COVID-19 convalescents had ≥1 complaint three months after recovery. The highest C19-YRS-scored symptoms (indicating a higher burden) were breathlessness, fatigue, and cognitive and continence problems; however, symptomatology was very heterogeneous, revealing a high complexity of the disease in older persons. The mean total C19-YRS score was higher in hospitalized patients (n = 78) than in the outpatient group (n = 66) (p = 0.02). The functioning subscale of the C19-YRS strongly correlated with the Barthel index, with r = −0.8001 (p < 0.0001). A moderately strong correlation existed between retrospectively reported C19-YRS-based functioning and the Barthel index score reported before illness (r = 0.7783, p < 0.0001). The C19-YRS is instrumental in evaluating the consequences of COVID-19 among long-term-care residents. The assessment allows for a broad understanding of rehabilitation needs.

PurposeChanges in nutritional status are important extrapulmonary manifestations of the chronic obstructive pulmonary disease (COPD). The study aimed to assess the prevalence of different body composition phenotypes in older patients with COPD and to investigate the relationship between these phenotypes and the severity of the disease, as well as physical performance of the subjects.Patients and methodsThe study included 124 subjects aged ≥60 with COPD. In all of them body composition analysis and muscle strength measurement were performed. Additionally, data from patients’ medical records were analyzed. Study sample was divided into four groups based on the phenotypic body composition: normal phenotype (N), sarcopenia, obesity and sarcopenic obesity (SO).ResultsIncidence of sarcopenia was significantly higher in patients with severe or very severe COPD based on GOLD in comparison with subjects with mild or moderate obstruction (p = 0.043). Participants with sarcopenia, obesity and SO had lower results of the 6-min walk test than subjects with N (225.77 m, 275.33 m, 350.67 m, 403.56 m, respectively). Moreover, sarcopenia and SO had lower results than obesity (p = 0.001, p = 0.041, respectively).ConclusionSarcopenia is common in patients with advanced COPD. Sarcopenia and SO are associated with poorer physical performance. All older people with COPD should routinely have their body composition assessed, instead of simply measuring of body weight or body mass index (BMI).

In the original publication [...].

The aim of this study was to compare the effectiveness of traditional neurological rehabilitation and neurological rehabilitation combined with a rehabilitation robot for patients with post-COVID-19 fatigue syndrome. Eighty-six participants transferred from intensive care units due to post-viral fatigue after COVID-19 were randomly divided into two groups: the intervention group and the control group. The control group received standard neurological rehabilitation for 120 min a day, while the intervention group received the same neurological rehabilitation for 75 min a day, complemented by 45 min of exercises on the rehabilitation robot. The Berg scale, Tinetti scale, six-minute walking test, isokinetic muscle force test, hand grip strength, Barthel Index, and Functional Independence Measure were used to measure the outcomes. Both groups improved similarly during the rehabilitation. Between groups, a comparison of before/after changes revealed that the intervention group improved better in terms of Functional Independence Measure (p = 0.015) and mean extensor strength (p = 0.023). The use of EMG-driven robots in the rehabilitation of post-COVID-19 fatigue syndrome patients was shown to be effective.

Purpose: The admissions of nonagenarians to internal medicine wards are rising. The aim of this study was to analyse the causes of ward admission and blood and renal parameters as potential mortality predictors in this age group. Patients and Methods: Out of 1140 patients, 111 nonagenarians aged 90+ admitted to the Internal Medicine Ward in one general hospital in Poznan in 2019 were studied. Medical records of these patients were analysed to find factors attributable to the hospitalisation. Results: The leading causes of admission were infections and cardiovascular diseases, and the main causes of death were cardiovascular diseases. Elevated C-reactive protein (CRP) level was a statistically significant death predictor. Equally, decreased albumin level was found to be a mortality predictor. No such relationships were obtained for haematological or renal parameters. Conclusion: Our study uniquely analysed a relatively large group of hospitalised nonagenarians and identified those who need particular attention in the ward by identifying those with the highest risk of death. CRP and albumin levels may serve as useful indicators of in -hospital mortality in this age group.

Modern technologies are used to respond to the actual needs of older individuals—both those who are aging in place and those with restricted independence, living in institutions. Increasing the interest of older persons in gerontechnology requires the implementation of educational activities focused on demonstrating the possibilities of technologies and their positive impact on everyday functioning. Education and training tailored for this target group are needed, with semi-permanent support available while using gerontechnology. The educators are advised to adapt their teaching to the varying needs and attitudes to technology among older people. However, education for gerontechnology cannot be limited to older individuals since their needs and attitudes in this regard are different from those of their younger counterparts. Other stakeholders include a wide range of subjects actively involved in creating new technological solutions, those who are disseminating and implementing them, formal and informal caregivers, and healthcare providers as well as teachers and educators. Importantly, the education of all stakeholders must comprise aging literacy, that is, understanding the functioning of older people. In the chapter, various aspects of the education and training of older adults and other stakeholders are discussed.

BACKGROUND While there is a growing body of research examining opinions on social robots in elderly care, there is a lack of comprehensive studies investigating the underlying factors influencing these opinions. The Godspeed Questionnaire Series (GQS) measures perceptions related to human-robot interactions (HRIs). The Comprehensive Geriatric Assessment (CGA) is widely used to evaluate physical, cognitive, and social functions of older patients. The EASYCare 2010 Standard (EC) is a tool for assessing unmet needs in older individuals. TIAGo, a social humanoid robot, integrates perception, navigation, and HRI capabilities. This study aimed to identify the determinants of perception following interactions between older individuals and TIAGo, utilizing the GQS, selected CGA items, and EC. MATERIAL AND METHODS We analyzed a database of opinions from older individuals who interacted with TIAGo, based on the Users' Needs, Requirements, and Abilities Questionnaire. We examined the relationships between the robot's roles (companion/assistant/useful device), its assistive/social functions, and various characteristics of the older participants. RESULTS The study included 161 participants (mean age: 75.2±9.8 years), comprising 89 women and 113 institutionalized individuals. Positive correlations were observed between the robot's role, its functions, and the participants'; perceptions across most evaluated parameters (Anthropomorphism, Animacy, Likeability, Perceived intelligence, Perceived safety). Only a few individual correlations were found for other parameters. CONCLUSIONS The primary determinant of older individuals' opinions was their perception of the robot. Therefore, involving older adults in the co-design process of such robots is crucial. Additionally, a paradigm shift is needed in the study of humanoid social robots, focusing on successful aging rather than deficits associated with aging.

(1) Background: A robot in care for older adults requires solid research confirming its acceptance. The aim of this study was to present the Polish version of the Godspeed Questionnaire Series (GQS) and assess the perception of the social robot TIAGo; (2) Methods: The study involved older individuals living in the community and care homes and measured perception after interaction with TIAGo using five series of GQS (S1: Anthropomorphism, S2: Animacy, S3: Likeability, S4: Perceived intelligence, and S5: Perceived safety); (3) Results: We studied 178 individuals (age: 75.2 ± 9.6 years, 103 women). Good internal consistency was found. Cronbach’s Alpha was 0.90 for the entire tool (from 0.75 to 0.94 for the individual series). Mean scores for S1 and S2 were comparable but lower than all others (p < 0.001). Average scores for S3 and S4 did not differ but were higher than those of S5. Age, gender and education did not impact the answers, as did the ease of use of technology and self-assessment of independence. Solely, the place of residence influenced the results of S3 and S5; people living in institutions scored higher (p < 0.05 and p < 0.001, respectively); (4) Conclusions: Acceptance does not go hand in hand with the perception of anthropomorphism and animacy.

This paper focuses on three areas: the first is a review of current knowledge about social and service robots for elderly care. The second is an optimization conceptual model aimed at maximizing the efficiency of assigning robots to serve the elderly. The proposed multi-criteria optimization model is the first one proposed in the area of optimization for robot assignment for the elderly with robot utilization level and caregiver stress level. The third is the findings of studies on the needs, requirements, and adoption of technology in elderly care. We consider the use of robots as a part of the ENRICHME project for long-term interaction and monitoring of older persons with mild cognitive impairment, to optimize their independence. Additionally, we performed focus group discussions (FGD) to collect opinions about robot-related requirements of the elderly and their caregivers. Four FDGs of six persons were organized: two comprising older adults, and two of the other formal and informal caregivers, based on a detailed script. The statements of older participants and their caregivers were consistent in several areas. The analysis revealed user characteristics, robot-related issues, functionality, and barriers to overcome before the deployment of the robot. An introduction of the robot must be thoroughly planned, include comprehensive pre-training, and take the ethical and practical issues into account. The involvement of future users in the customization of the robot is essential.

Background: Long-term care facilities were severely impacted during the COVID-19 (Coronavirus Disease 2019) pandemic. Residents surviving the disease might continue to suffer from the post-COVID syndrome, similar to communi-ty-dwelling persons. This study aimed to characterize the longitudinal evolution of activities of daily living in COVID-19 survivors from long-term institutional care. Material/Methods: This was a retrospective study with prospective follow-up of consecutive COVID-19 survivors living in long-term care facilities. The Barthel Index was used to assess changes in functional independence before the dis-ease, right after recovery, and 3 months later. Results: The study enrolled 201 residents of long-term care facilities, median age 79 years old, who survived 3 months after recovery from COVID-19. The disease caused hospitalization in 47% of cases. Early after COVID-19, dete-rioration in activities of daily living was higher in older, hospitalized patients with cardiovascular comorbidity. However, in the long-term follow-up, these factors did not predict functioning. Independence was severely af-fected in hospitalized and non-hospitalized COVID-19 patients. This had implications for post-COVID care and rehabilitation since these interventions were mainly offered after hospitalization. Conclusions: The findings support that residents of long-term care facilities who had COVID-19, even with a mild clinical course, may have persistent impairment in function and ability to perform activities of daily living that require support and rehabilitation.

Background Efficient use of humanoid social robots in the care for older adults requires precise knowledge of expectations in this area. There is little research in this field that includes the interaction of stakeholders with the robot. Even fewer studies have compared the perceptions of older people (as care recipients) and professional caregivers (representing those taking care of older adults in teams with robots). Objective The aim of this study was to analyze whether specific aspects of the perceptions about humanoid robots influence attitudes after interacting with the robot and to compare the opinions of different stakeholders (older people and their professional caregivers) on this topic. We analyzed the potential impact of the differences in perception of the robot between stakeholder groups with respect to how the robot should be designed and tailored to fit the specific needs of future users. We also attempted to define areas where targeted educational activities could bring the attitudes of the two groups of stakeholders closer to each other. Methods The studied group was a conveniently available sample of individuals who took part in the presentation of and interaction with a humanoid social robot. Among them, there were 48 community-dwelling older adults (aged ≥60 years), who were participants of day care units (which may signal the presence of self-care needs), and 53 professional caregivers. The participants were asked to express their views after an interaction with a humanoid social robot (TIAGo) using the Users’ Needs, Requirements and Abilities Questionnaire (UNRAQ) and the Godspeed Questionnaire Series (GQS). Results Compared to the caregivers, older adults not only assessed the robot more positively with respect to its roles as a companion and assistant (P=.009 and P=.003, respectively) but also had higher scores on their need to increase their knowledge about the robot (P=.049). Regarding the robot’s functions, the greatest differences between groups were observed for the social aspects on the UNRAQ, including decreasing the sense of loneliness (P=.003) and accompanying the user in everyday activities (P=.005). As for the GQS, the mean scores of the Animacy, Likeability, and Perceived Intelligence scales were significantly higher for older participants than for caregivers (P=.04, P<.001, and P<.001, respectively). The only parameter for which the caregivers’ scores were higher than those of the older adults was the Artificial-Lifelike item from the Anthropomorphism scale of the GQS (P=.03). Conclusions The acceptance of the social functions of a humanoid robot is related to its perception in all analyzed aspects, whereas the expected usefulness of a care robot is not linked to aspects of anthropomorphism. Successful implementation of robots in the care for older people thus depends on considering not only the fears, needs, and requirements of various stakeholders but also on the perceptions of the robot. Given the differences between the stakeholders, targeted and properly structured educational and training activities for caregivers and prospective users may enable a seamless integration of robotic technologies in care provision.

The aim of the study was to assess the intensity of depressive and anxiety symptoms in those indirectly affected by war in Ukraine and to identify a group of people at particular risk of developing these symptoms. The study encompassed 72 Poles (60 women and 12 men). The measurements were carried out at three time points: (1) in the first month after the outbreak of Russia’s war against Ukraine, (2) in the second month and (3) after six months of the conflict. During the first and second month, the symptom severity of generalized anxiety (GAD-7) was 9.8 ± 5.2 and 7.0 ± 5.6, state anxiety (STAI-X1) was 48.2 ± 10.4 and 45.2 ± 13.9 and depression (BDI) was 10.4 ± 7.5 and 15.4 ± 12.7. After six months, the symptom severity was statistically significantly lower. Greater symptom severity was observed in women, people with low income, those without a job, those who did not have good relationships with people they were close to, those with sleep problems and those who frequently followed the news and talked about the war. This study indicates that in a crisis situation, mental health screening and the identification of people whose condition requires specialized interventions are necessary.

Poor nutritional status (PNS) is a modifiable factor determining abnormalities in body composition-sarcopenia, obesity, and sarcopenic obesity (SO). We aimed to assess the prevalence of these conditions and their association with PNS in 211 community-dwelling older adults. Sarcopenia was diagnosed based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) recommendations. Obesity was diagnosed with the Percent Body Fat (>42% in women and >30% in men). Subjects fulfilling the criteria for obesity and concomitantly with reduced lower and/or upper limbs muscle strength and muscle mass (ALM/BMI < 0.512 in women and <0.789 in men) were classified as SO phenotype. Participants without obesity and sarcopenia were categorized as ‘normal’ phenotype. Nutritional status was estimated with the Mini Nutritional Assessment, and a score of <24 indicated PNS. In total, 49.8% participants had abnormal body composition (60.7% men and 42.5% women; p = 0.001). Sarcopenia, obesity, and SO were diagnosed in 10%, 32.7%, and 7.1% of subjects. PNS was found in 31.3% of the study sample. Its prevalence differed between phenotypes: 81% in sarcopenia, 60% in SO, 14.5% in obesity, and 28.3% in the ‘normal’ phenotype group (p = 0.000). Based on the results, abnormal body composition is prevalent in elderly subjects. Sarcopenia and SO are often associated with PNS.

Polypharmacy is a challenging issue in geriatrics. The aim of the study was to characterize correlates of polypharmacy in the PolSenior project. The PolSenior project, was a comprehensive survey in a large and longitudinal representative sample of thePolish older population. The project was conducted by the International Institute of Molecular and Cell Biology in Warsaw between 2008 and 2011. All medications consumed during the week preceding the survey were evaluated for each participant (n = 4793, including 2314 females (48.3%)). Thereafter, the percentage of those with polypharmacy (at least 5 medications) and excessive polypharmacy (at least 10 medications) was calculated, and their correlates were determined. The average number of medications used by participants was 5.1 ± 3.6, and was higher in females than in males (5.5 ± 3.5 vs. 4.8 ± 3.5; p < 0.001). Polypharmacy characterized 2650 participants (55.3%) and excessive polypharmacy—532 of them (11.1%). The independent correlates associated withpolypharmacy were: age over 70 years, female sex, higher than primary education, living in an urban area, comorbidities, any hospitalization during past five years, and visiting general practicioners at least yearly. As for correlates with excessive polypharmacy, they were: age 80–84 years, female sex, living in an urban area, diagnosis of at least four chronic diseases, and at least two hospitalizations in the last five years. This study serves as a starting place to understand patient characteristics associated with polypharmacy, excessive polypharmacy, and identify targeted interventions.

Background: Non-adherence occurs in various groups of patients, including those with chronic diseases. One strategy to increase adherence among oncological patients is to individualise treatment and expand pharmaceutical care. Pharmaceutical labels that remind patients how they should take their medications are of great importance in this respect. Objective: The main objective of this study was to evaluate medication adherence in oncological patients, and to gather their opinions on the individual medication labelling system as an element of effective treatment. Methods: The study was conducted in 2021 among 82 patients of the oncological department of the Centre of Oncology in Radom. The research tool was a questionnaire consisting of personal data and two parts relating to the patient’s disease and the medication labelling system. Results: Nearly half of the respondents reported that they forget to take medications and how they should take them. These problems increased with the age of the patient and the number of administered medications. Of the respondents, 89% stated that the labels with dosing information are helpful. Over 67% agreed that these labels should be affixed to all medications. Nearly 90% of the respondents believed the labels should be available in all pharmacies. Conclusions: Non-adherence is a common phenomenon among oncological patients. Pharmacists providing a labelling service for medicinal products can play a significant role in reducing this phenomenon.

Self-esteem reflects the way we see ourselves. The aim of this study was to determine the relationship among self-esteem, bio-psycho-social functioning, and sociodemographic conditions in the elderly. The study included 300 individuals over 60 years of age living in their home environment. The employed research tools included the Abbreviated Mental Test Score, Rosenberg Self-Esteem Scale (RSES), and EASYCare Standard 2010 questionnaire involving the following scales: independence score, risk of breakdown in care, and risk of falls. Results: The average score achieved by the study group according to the RSES scale was 29.9 ± 5.6 points. In addition, the study group presented a low risk of independence loss (independence score 13.3 ± 18.1), risk of breakdown in care (4.4 ± 2.4), and risk of falls (1.8 ± 1.6). The conducted multivariate analysis demonstrated that a significant (p < 0.05) negative predictor of low self-esteem was education below the secondary level, a poor financial condition, and functional limitations in domain I (seeing, hearing, and communicating skills) of the EASYCare Standard 2010 questionnaire. A relationship was found between self-esteem and the level of bio-psycho-social functioning, as well as between education and the financial situation. The results demonstrate that even successfully ageing individuals require a regular assessment of their functional status and individually adapted support in order to maintain independence and to increase their self-esteem.