Ageing is often accompanied by cognitive decline and an increased risk of dementia. Exercise is a powerful tool for slowing brain ageing and enhancing cognitive function, as well as alleviating depression, improving sleep, and promoting overall well-being. The connection between exercise and healthy brain ageing is particularly intriguing, with exercise-induced pathways playing key roles. This review explores the link between exercise and brain health, focusing on how skeletal muscle influences the brain through muscle-brain crosstalk. We examine the interaction between the brain with well-known myokines, including brain-derived neurotrophic factor, macrophage colony-stimulating factor, vascular endothelial growth factor and cathepsin B. Neuroinflammation accumulates in the ageing brain and leads to cognitive decline, impaired motor skills and increased susceptibility to neurodegenerative diseases. Finally, we examine the evidence on the effects of exercise on neuronal myelination in the central nervous system, a crucial factor in maintaining brain health throughout the lifespan.

Aging is a complex, progressive, and irreversible biological process that entails numerous structural and functional changes in the organism. These changes affect all bodily systems, reducing their ability to respond and adapt to the environment. Chronic inflammation is one of the key factors driving the development of age-related diseases, ultimately causing a substantial decline in the functional abilities of older individuals. This persistent inflammatory state (commonly known as "inflammaging") is characterized by elevated levels of pro-inflammatory cytokines, an increase in oxidative stress, and a perturbation of immune homeostasis. Several factors, including cellular senescence, contribute to this inflammatory milieu, thereby amplifying conditions such as cardiovascular disease, neurodegeneration, and metabolic disorders. Exploring the mechanisms of chronic inflammation in aging is essential for developing targeted interventions aimed at promoting healthy aging. This review explains the strong connection between aging and chronic inflammation, highlighting potential therapeutic approaches like pharmacological treatments, dietary strategies, and lifestyle changes.

Hyperglycemic changes in the cellular biological properties of retinal pigment epithelium cells are involved in the pathophysiology of diabetic retinopathy (DR). To assess the effects of the new anti-diabetic agent imeglimin (Ime) on DR, the pharmacological effects of Ime and those of metformin (Met) in combination with the PPARα agonist GW7646 (GW) on adult retinal pigment epithelium (ARPE19) cells cultured in high-glucose conditions were compared.

Cell viability, levels of reactive oxygen species (ROS), monolayer barrier function measured by transepit very much helial electrical resistance (TEER), and metabolic functions determined by an extracellular flux analyzer were evaluated.

While glucose concentrations did not alter cell viability regardless of the presence of Met or Ime, levels of ROS were significantly increased by the high-glucose conditions, and increased levels of ROS were significantly alleviated by the combination of Ime and GW but not by Met alone. Similarly, TEER values were increased by high-glucose conditions, but the effects of high-glucose conditions were dramatically enhanced by the combination of Ime and GW. Furthermore, a metabolic assay showed that an energetic shift was induced by the combination of Ime and GW, whereas energy status became quiescent with Met or Ime alone.

The collective results suggest that Ime in combination with GW has synergetic effects on high-glucose-induced cellular biological changes in ARPE19 cells.

Advances in digital technologies and artificial intelligence (AI) are reshaping healthcare delivery, with AI increasingly integrated into nursing practice. These innovations promise enhanced diagnostic precision, improved operational workflows, and more personalized patient care. However, the direct impact of AI on clinical outcomes, workflow efficiency, and nursing staff well-being requires further elucidation.

This integrative review synthesized findings from 18 studies published through November 2024 across diverse healthcare settings. Using the PRISMA 2020 and SPIDER frameworks alongside rigorous quality appraisal tools (MMAT and ROBINS-I), the review examined the multifaceted effects of AI integration in nursing. Our analysis focused on three principal domains: clinical advancements and patient monitoring, operational efficiency and workload management, and ethical implications.

The review demonstrates that AI integration in nursing has yielded substantial clinical and operational benefits. AI-powered monitoring systems, including wearable sensors and real-time alert platforms, have enabled nurses to detect subtle physiological changes-such as early fever onset or pain indicators-well before traditional methods, resulting in timely interventions that reduce complications, shorten hospital stays, and lower readmission rates. For example, several studies reported that early-warning algorithms facilitated faster clinical responses, thereby improving patient safety and outcomes. Operationally, AI-based automation of routine tasks (e.g., scheduling, administrative documentation, and predictive workload classification) has streamlined resource allocation. These efficiencies have led to a measurable reduction in nurse burnout and improved job satisfaction, as nurses can devote more time to direct patient care. However, despite these benefits, ethical challenges remain prominent. Key concerns include data privacy risks, algorithmic bias, and the potential erosion of clinical judgment due to overreliance on technology. These issues underscore the need for robust ethical frameworks and targeted AI literacy training within nursing curricula.

This review demonstrates that AI integration holds transformative potential for nursing practice by enhancing both clinical outcomes and operational efficiency. However, to realize these benefits fully, it is imperative to develop robust ethical frameworks, incorporate comprehensive AI literacy training into nursing education, and foster interdisciplinary collaboration. Future longitudinal studies across varied clinical contexts are essential to validate these findings and support the sustainable, equitable implementation of AI technologies in nursing. Policymakers and healthcare leaders must prioritize investments in AI solutions that complement the expertise of nursing professionals while addressing ethical risks.

The aging population, defined as individuals 65 years or older, is rapidly increasing, with age as the most significant and independent risk factor for cardiovascular diseases (CVD). Older women show greater susceptibility to cardiac remodeling and dysfunction compared to men. Despite this, the specific molecular drivers of sex differences in cardiac aging remain poorly understood. In this study, cardiac fibrosis and gene expression profiles were investigated in left atrial appendage samples obtained from 24 consecutive patients undergoing cardiac surgery. Using Masson's trichrome staining, we found that cardiac fibrosis significantly increased with age in females (p = 0.02) but not in males (p = 0.27). A subsequent medium-throughput gene expression analysis targeting approximately 800 cardiovascular genes revealed no differences in overall cardiac gene expression between sexes based on principal component analyses (PCA). However, pathway-specific analyses identified the thrombosis and hemostasis pathway as prominently dysregulated in females. Specifically, older females showed significant upregulation of PTPN1, PTPN11, and RAPGEF4, genes implicated in cardiac remodeling and metabolic health, compared to younger females, while males exhibited no significant changes across the age range. Correlation analyses confirmed significant positive associations between PTPN1, PTPN11, and RAPGEF4 expression and age in females but not in males. These findings suggest that aging in females is associated with cardiac fibrosis, which is likely driven by the sex-specific upregulation of key genes within the thrombosis and hemostasis pathway.

To identify the reasons and/or risk factors for hospital admission and/or emergency department attendance for older (≥60 years) residents of long-term care facilities.

Older adults' use of acute services is associated with significant financial and social costs. A global understanding of the reasons for the use of acute services may allow for early identification and intervention, avoid clinical deterioration, reduce the demand for health services and improve quality of life.

Systematic review registered in PROSPERO (CRD42022326964) and reported following PRISMA guidelines.

The search strategy was developed in consultation with an academic librarian. The strategy used MeSH terms and relevant keywords. Articles published since 2017 in English were eligible for inclusion. CINAHL, MEDLINE, Scopus and Web of Science Core Collection were searched (11/08/22). Title, abstract, and full texts were screened against the inclusion/exclusion criteria; data extraction was performed two blinded reviewers. Quality of evidence was assessed using the NewCastle Ottawa Scale (NOS).

Thirty-nine articles were eligible and included in this review; included research was assessed as high-quality with a low risk of bias. Hospital admission was reported as most likely to occur during the first year of residence in long-term care. Respiratory and cardiovascular diagnoses were frequently associated with acute services use. Frailty, hypotensive medications, falls and inadequate nutrition were associated with unplanned service use.

Modifiable risks have been identified that may act as a trigger for assessment and be amenable to early intervention. Coordinated intervention may have significant individual, social and economic benefits.

This review has identified several modifiable reasons for acute service use by older adults. Early and coordinated intervention may reduce the risk of hospital admission and/or emergency department.

This systematic review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology.

No patient or public contribution.

Prevalence of type 2 diabetes increases with age. Both the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) promote the enrollment of older patients to randomized controlled trials (RCTs) in diabetes. The objective of this study was to assess the eligibility criteria limiting the inclusion of older adults to RCTs in type 2 diabetes.

This cross-sectional analysis of ClinicalTrials.gov included phase 2, 3 and 4 RCTs of drugs and biologicals, with enrollment ≥100, registered at ClinicalTrials.gov and started from 2014 through 2023.

A total of 278/594 (46.8%) trials had a limit of 90 years of age or less (primary outcome). The odds of the age limits were higher in RCTs funded from non-commercial sources (adjusted odds ratio (aOR), 2.83, 95% confidence interval (CI), 1.77-4.52; p < 0.001) and phase 2 trials (aOR, 2.38; 95% CI, 1.49-3.81; p < 0.001). A total of 542/594 (91.2%) trials had other relevant exclusion criteria, mostly those concerning comorbidities common in older patients (secondary outcome). However, none of the RCTs excluded patients with frailty which is a key factor determining the prognosis of older patients with diabetes. Only two trials enrolled solely older persons.

Most RCTs in type 2 diabetes have the eligibility criteria limiting the enrollment of older patients. The age limits should be eliminated and patients should be excluded based on scientifically justified criteria especially those concerning comorbidities and frailty. Moreover, the benefits and harms of new drugs in older patients with multimorbidity and/or frailty should be assessed in dedicated phase 4 trials.

(1) Background: Multiple lumbar spinal stenosis (LSS) is a degenerative disease that is increasingly prevalent with global aging. Multilevel fusion surgery is burdensome to perform in elderly patients, especially with osteoporosis and underlying disease. This study introduces open midline decompression (OMD) with ligament reconstruction as an alternative stabilization technique for elderly patients with multilevel LSS. (2) Methods: A retrospective review included 42 elderly patients aged 70 or older diagnosed with LSS at three or more levels and who underwent OMD with ligament reconstruction. Pre- and postoperative clinical and radiologic data were analyzed. (3) Results: Thirty-three patients underwent three-level surgeries, and twelve patients underwent four-level surgeries. The mean operative time was 240 ± 42.2 min (74.6 ± 14.9 min per level) with a mean blood loss of 282.9 ± 167.1 cc. Clinical outcome (VAS) and quality of life parameters (SF-12) showed significant improvement after surgery. Postoperative MRI showed sufficient decompression. Dynamic X-rays showed improvement in instability after surgery, but it was statistically insignificant. (4) Conclusions: OMD with ligament reconstruction provides effective neural decompression while preserving the posterior arch and offers soft stabilization with artificial ligaments. It is a safe and viable surgical option for elderly patients with multilevel LSS.

Phloretin exhibits strong antioxidant and anti-aging properties by inhibiting mitochondrial oxidation of glutamate, succinic acid, and ascorbic acid. However, its clinical application is limited by poor aqueous solubility and low oral bioavailability. To enhance its bioavailability and efficacy, we incorporated phloretin into nano-micelles (phloretin-MM) using the thin film dispersion method. Characterization revealed that the optimal formulation had TPGS and Pluronic F68 in a 4:1 ratio as the excipients, which resulted in spherical micelles with an average particle size of 33.28 nm and an encapsulation efficiency of 71.2 ± 0.48%. The in vitro release profile showed that the phloretin-MM showed significantly higher cumulative release rates than free phloretin across various pH conditions, while the pharmaceutical analysis in rats indicated that phloretin-MM significantly improved the oral bioavailability of phloretin (about 5 folds) in circulation. Additionally, through the analysis of the staining of zebrafish under light microscopy and the average gray value, it can be concluded that phloretin has anti-aging drug effect, and phloretin-MM is better than free phloretin. These findings suggest that TPGS/Pluronic F68-modified phloretin-MM could serve as an excellent nano-drug carrier system, potentially enhancing the solubility, bioavailability, and anti-aging effects of phloretin for broader clinical applications.

To identify and report results from studies of anxiety and depression, as measured by The Hospital Anxiety and Depression Scale (HADS) in patients ≥ 80 years admitted to hospital settings, and to inform nurses, researchers and educators in nursing about these findings.

Systematic review.

MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane, Epistemonikos, Scopus and Web of Science Core Collection of studies published until October 2023.

A search strategy was developed with a university librarian. Four independent reviewers screened titles and abstracts based on predefined inclusion criteria. Data were systematically extracted, descriptively analysed, and Critical Appraisal Skills Programme checklists were used to assess studies.

Out of 7076 identified studies, three met the eligibility criteria. Data from 420 participants aged ≥ 80 years were analysed, revealing anxiety prevalence rates between 6% and 18% and mean scores below 4. Depression prevalence rates ranged from 7% to 17%, with a mean score below 4. Most patients with depression were not previously recognised as being depressed.

Few publications reported on anxiety and/or depression in hospitalised patients aged ≥ 80 years using HADS. A gap in the knowledge base has been identified.

Anxiety and depression are mental health conditions that can lead to adverse events and strongly affect aging. Increased understanding of the role that these conditions have on hospitalised patients ≥ 80 years is important for nurses when in contact with this patient group.

There is a need for more studies to generate evidence regarding anxiety and depression in an increasingly common and challenging hospital population by building upon evidence that is based on validated instruments such as the Hospital Anxiety and Depression Scale.

The PRISMA guideline was followed, and the review registered in PROSPERO (Registration number CRD 42022380943).

No patient or public contribution.

CRD 42022380943.

Using a modified Delphi process, we engaged 28 experts in clinical trials, geriatrics, and research translation to determine if there were consensus around what clinical endpoints should be used for trials evaluating the efficacy of interventions to prevent or treat multiple age-related conditions. Four focus groups developed themes. Statements related to those themes were circulated back to participants in a survey. There was consensus (more than 66% agreed or disagreed) that outcome measures should include multiple health dimensions including-age-related disease, function and patient reported outcomes that reflect participants goals; and be tailored to population characteristics. Experts felt that blood-based biomarkers would be unlikely to be accepted as primary endpoints of efficacy trials. Plausible components mentioned as part of a composite endpoint included mortality, mobility function and the onset of multiple age-related diseases. Our findings provide guidance on acceptable approaches to endpoint selection guiding the design of future geroscience trials.

The Irisin/FNDC5 protein family has emerged as a pivotal link between exercise and the prevention of age-associated diseases. Irisin is highly expressed during exercise from skeletal and cardiac muscle cells, playing a critical role in mediating systemic health benefits through its actions on various tissues. However, Irisin levels decline with age, correlating with a heightened incidence of diseases such as muscle weakness, cardiovascular disorders, and neurodegeneration. Notably, the administration of Irisin has shown significant potential in both preventing and treating these conditions. Recently, an Irisin/FNDC5 homolog was identified in an invertebrate Drosophila model, providing valuable insights into its conserved role in exercise physiology. Importantly, Irisin/FNDC5 has been demonstrated to regulate autophagy-a process essential for clearing excessive nutrients, toxic aggregates, and dysfunctional organelles-in both flies and mammals. Dysregulated autophagy is often implicated in age-related diseases, highlighting its relevance to Irisin/FNDC5's functions. These findings deepen our understanding of Irisin/FNDC5's roles and its potential as a therapeutic target for mitigating aging-related health decline. Further studies are needed to elucidate the precise mechanisms by which Irisin regulates autophagy and its broader impact on physiological aging and related diseases.

Observed patient survival after cardiothoracic interventions should ideally be placed in the context of matched-general-population survival. This study outlines several methodologies of matching general population mortality to the study sample, subsequently calculating cumulative matched-general-population survival, highlighting their respective advantages, disadvantages, and limitations.

A multicenter data set containing survival data after the Ross procedure was used for methodological illustration. General population mortality was extracted from country-specific life tables in the Human Mortality Database. The matched-general-population mortality, also known as background mortality, was obtained by matching general population mortality to the study sample using different matching strategies, iteratively considering median/individual age and median/individual calendar year, besides country and sex. The corresponding cumulative matched-general-population survival was calculated subsequently. Sensitivity analyses were performed to assess the impact of varying patient ages on survival estimates by adding and subtracting 15 years from individual patients. A web-based Shiny Application (App) was developed to easily calculate cumulative matched-general-population survival.

In total, 1431 hospital survivors from the Ross procedure from 5 countries (25.7% female; median age, 48.5 [interquartile range, 42.7-54.0] years) were included. Fifteen-year survival was 88.3% (95% CI, 85.3-90.6). Cumulative matched-general-population 15-year survival varied from 87.7% to 89.8% using the 3 methods of different complexities. For 15-year-older patients, the cumulative matched-general-population 15-year survival was 67.4%, 59.8%, and 63.2%, respectively, using the simplest to the most comprehensive matching methods; for 15-year-younger patients, it was 96.9%, 96.1%, and 96.7%, respectively.

Different methodologies to match general population mortality to observed patient mortality yield variable estimates of cumulative matched-general-population survival, especially in older patients. The cumulative matched-general-population survival should ideally be calculated by considering country, sex, individual patient age, and calendar year (both updated annually). This method can be easily implemented using the web-based Shiny App enclosed in this article.

As a microvascular complication, diabetic kidney disease is the leading cause of chronic kidney disease and end-stage renal disease worldwide. While the underlying pathophysiology driving transition of diabetic kidney disease to renal failure is yet to be fully understood, recent studies suggest that cellular senescence is central in disease development and progression. Consequently, understanding the molecular mechanisms which initiate and drive senescence in response to the diabetic milieu is crucial in developing targeted therapies that halt progression of renal disease.

To understand the mechanistic pathways underpinning cellular senescence in the context of diabetic kidney disease, we reviewed the literature using PubMed for English language articles that contained key words related to senescence, inflammation, fibrosis, senescence-associated secretory phenotype (SASP), autophagy, and diabetes.

Aberrant accumulation of metabolically active senescent cells is a notable event in the progression of diabetic kidney disease. Through autocrine- and paracrine-mediated mechanisms, resident senescent cells potentiate inflammation and fibrosis through increased expression and secretion of pro-inflammatory cytokines, chemoattractants, recruitment of immune cells, myofibroblast activation, and extracellular matrix remodelling. Compounds that eliminate senescent cells and/or target the SASP - including senolytic and senomorphics drugs - demonstrate promising results in reducing the senescent cell burden and associated pro-inflammatory effect.

Here we evidence the link between senescence and diabetic kidney disease and highlight underlying molecular mechanisms and potential therapeutic targets that could be exploited to delay disease progression and improve outcomes for individuals with the disease. Trials are now required to translate their therapeutic potential to a clinical setting.

This pilot study assessed the feasibility of using facial thermography to detect intra-oral problems in older adults with cognitive decline and care-resistant behaviors, who are often unable to communicate pain or early symptoms.

Twenty-three older adults (mean age 73.7 ± 13.2 years) with cognitive decline were enrolled. Thermal images of four facial views were taken using a smartphone-connected thermal camera. Intra-oral examinations were conducted, and the thermographic data were analyzed to extract temperature values in the regions of interest (ROI). Point-biserial correlations and ROC curve analyses were performed to evaluate associations between temperature data and clinical findings, with a significance level of p < 0.05.

Intra-oral issues requiring treatment were found in 12 participants, with six reporting clinical pain. The overall mean temperature in the ROI was 33.5 ± 3.9 °C, and significant temperature differences were found between the body and ROI temperatures. Correlations were observed between clinical problems and various temperature metrics, including the minimum and maximum ROI temperatures (rpb=-0.327, p = 0.002 and rpb=-0.309, p = 0.003). ROC analysis indicated that ROI temperature could predict the presence or absence of clinical problems, with AUC values ranging from 0.651 to 0.796 for different metrics.

Thermographic facial imaging shows significant potential as a non-invasive tool for detecting oral health problems in vulnerable older adults. While promising, further research is essential to enhance image quality, streamline the technique, and incorporate AI for improved diagnostic accuracy and ease of use.

This non-invasive, inexpensive technique is easy to perform, independent of patient compliance and, is promising to detect early oral problems in noncommunicative patients.

Background Population ageing is a significant global challenge. Healthcare systems of all types are under great strain because of the health needs of the elderly. In this regard, one of the solutions is the utilisation of daycare facilities for the elderly. Current information shows that the topic of daycare facilities in Saudi Arabia does not receive sufficient attention. Therefore, the objective of this study was to assess the population's willingness to consider elderly daycare for their older relatives in Saudi Arabia. Methods The research employs a cross-sectional study design in which questionnaires were randomly distributed to Saudi citizens aged between 18 and 59 years. A total of 730 participants were included. IBM SPSS Statistics for Windows, version 28.0. (IBM Corp., Armonk, NY), Kendall's Tau correlation and ordinal logistic regression analysis were used to identify important factors associated with public willingness to consider their relatives in daycare centres. Results Around three-fifths of the Saudi population are willing to enrol the elderly in daycare institutions. People aged 45-51 years were three times more willing to consider elderly daycare institutions for their older relatives (aOR: 3.85, 95% CI: 1.72-8.33) as compared to younger aged 18-26 years. Factors that are associated with higher willingness include "Seniors play an important role in our society" (aOR: 1.67, 95% CI: 1.30-2.13) and "The elders are wise and knowledgeable about the traditions of their community" (adjusted odds ratio {aOR}: 1.49, 95% CI: 1.19-1.89). The factors associated with higher willingness are awareness regarding the existence of elderly daycare institutions in Saudi Arabia (aOR: 1.37, 95% CI: 1.11 to 1.67). Other important factors associated with a higher willingness to consider daycare are the nature of the occupation, financial capacity, being strong enough physically to handle the elderly, and understanding the elderly. Conclusion It has been suggested that many Saudis are fully aware of the concept of elderly daycare centres and willing to let their older relatives join them. Therefore, spreading awareness and introducing daycare centres to more people can make a difference in our community to provide the care our elderly deserve.

This study aimed to explore the association and prediction of hip abduction-adduction and knee flexion-extension isokinetic absolute and relative strength and power at 60°/s and 180°/s from functional tests performance (i.e., Up-and-Go Test [seconds], 30-Second Chair Stand Test [repetitions and relative and allometric power], 30-Second Arm Curl Test [repetitions], and 6-Minute Walk Test [meters]) in older adults.

Five hundred and fifty participants (404 women; age: 69.12 ± 5.29 years) enrolled in this cross-sectional study. Participants attended the laboratory once. Isokinetic concentric-concentric strength was assessed before physical fitness tests. Agility and dynamic tests were completed before strength and aerobic resistance tests within the physical fitness tests.

Significant trivial-to-moderate correlations (positive and negative) were found between all the tests and the isokinetic strength and power of the knee and the hip. The performance in the UGT and 6MWT showed the best direct correlations with isokinetic strength and power (|r| = 0.09-0.48), and the 30CS and 30 AC showed inconsistent positive and negative correlations (r = -0.46-0.44). Significant regression equations including the functional tests, age, and sex were found, with higher values for knee isokinetic strength and power (R2 = 0.19-0.44) compared to hip (R2 = 0.09-0.35) and no clear pattern regarding better or worse predictability at higher angular velocities.

Isokinetic knee and hip strength and power are associated with functional fitness in older adults. The functional fitness tests, along with age and sex are predictive variables of older adults' lower-limb isokinetic strength, although explaining at most 44 % of the variance.

The rapid aging of the global population necessitates addressing age-related conditions through innovative strategies. Nutritional supplements have emerged as potential interventions for preventing or slowing age-related changes, with betaine being a promising candidate. This systematic review aims to provide a comprehensive analysis of current literature on the impact of betaine on the aging process. Specifically, we summarize the mechanisms through which betaine is proposed to affect aging, we integrate existing findings, we identify gaps in the literature, and we discuss practical implications for promoting healthy aging. Evidence suggests that betaine may counteract aging-related changes in methylation potential by increasing concentration of S-adenosylmethionine, a key methyl donor. Additionally, betaine reduces homocysteine concentrations, potentially mitigating vascular, neurodegenerative, and oxidative damage. Betaine has also been shown to enhance mitochondrial function, to reduce oxidative stress, and to attenuate inflammation. It may serve as a preventive agent against sarcopenia by promoting anabolic signaling pathways and improving muscle strength in younger adults. Betaine may also exert an effect on bone remodeling and adipose tissue metabolism, with animal studies indicating enhanced fat oxidation and reduced fat synthesis. Although certain limited studies have suggested betaine's potential in mitigating age-related neurodegenerative diseases, the currently available evidence does not establish a clear link between dietary betaine intake and the incidence of cardiovascular diseases or type-2 diabetes. In conclusion, emerging evidence highlights the potential of betaine in attenuating age-related changes. However, further research is required to elucidate the efficacy and safety of betaine supplementation in older populations.

Various approaches exist to quantify the aging process and estimate biological age on an individual level. Frailty indices based on an age-related accumulation of physical deficits have been developed for human use and translated into mouse models. However, declines observed in aging are not limited to physical functioning but also involve social capabilities. The concept of "social frailty" has been recently introduced into human literature, but no index of social frailty exists for laboratory mice yet. To fill this gap, we developed a mouse Social Frailty Index (mSFI) consisting of seven distinct assays designed to quantify social functioning which is relatively simple to execute and is minimally invasive. Application of the mSFI in group-housed male C57BL/6 mice demonstrated a progressively elevated levels of social frailty through the lifespan. Conversely, group-housed females C57BL/6 mice manifested social frailty only at a very old age. Female mice also showed significantly lower mSFI score from 10 months of age onward when compared to males. We also applied the mSFI in male C57BL/6 mice under chronic subordination stress and in chronic isolation, both of which induced larger increases in social frailty compared to age-matched group-housed males. Lastly, we show that the mSFI is enhanced in mouse models that show accelerated biological aging such as progeroid Ercc1-/Δ and Xpg-/- mice of both sexes compared to age matched littermate wild types. In summary, the mSFI represents a novel index to quantify trajectories of biological aging in mice and may help elucidate links between impaired social behavior and the aging process.

The need for anterior cervical discectomy and fusion (ACDF) for cervical degenerative disc disease (CDDD) will probably grow dramatically in the geriatric population. However, ACDF with self-locking standalone cages in patients over 80 years has not yet been investigated. This study aimed to assess the clinical and radiographic results in patients over 80 years treated by ACDF with self-locking standalone cages.

Between January 2018 and December 2019, patients with CDDD treated with ACDF were retrospectively stratified into two groups: the older group (≥ 80 years) and the younger group (< 65 years). The data collected included the demographics, preoperative comorbidities, intraoperative parameters, length of hospital stay, complications, clinical scores, and radiological parameters.

A total of 123 patients were included in the study. The mean follow-up duration was 28.3 ± 2.4 months. The hospital stay was 5.3 ± 0.6 days and 3.8 ± 0.4 days, respectively, for the older and younger groups. Postoperative complication rate was found higher in the older group than that of the young group without significance. All the patient-reported outcome parameters had significant improvement at the final follow-up. The two groups had no significant differences in terms of the excellent and reasonable rates, fusion rate, and the C2-C7 Cobb angle.

Although a slightly higher incidence of complications, poorer recovery rate, and more extended hospital stay were found, without significant differences, satisfactory clinical and radiographic results were obtained in the older patients. The self-locking standalone cage is a safe and viable option for patients over 80 years who suffer from CDDD. Level of evidence Level IV.

Hyperglycemia-induced effects on cellular metabolic properties and reactive oxygen species (ROS) generation play pivotal roles in the pathogenesis of malignant melanoma (MM). This study assessed how metabolic states, ROS production, and related gene expression are modulated by antidiabetic agents. The anti-diabetic agents metformin (Met) and imeglimin (Ime), inhibitors of fatty acid-binding proteins 5/7 (MF6) and microphthalmia-associated transcription factor (MITF) (ML329), and siRNA-mediated knockdown of angiopoietin-like protein 4 (ANGPTL4), which affect mitochondrial respiration, ROS production, and related gene expression, were tested in A375 (MM cell line) cells cultured in low (5.5 mM) and high glucose (50 mM) conditions. Cellular metabolic functions were significantly and differently modulated by Met, Ime, MF6, or ML329 and knockdown of ANGPTL4. High glucose significantly enhanced ROS production, which was alleviated by Ime but not by Met. Both MF6 and ML329 reduced ROS levels under both low and high glucose conditions. Knockdown of ANGPTL4 enhanced the change in glucose-dependent ROS production. Gene expression related to mitochondrial respiration and the pathogenesis of MM was significantly modulated by different glucose conditions, antidiabetic agents, MF6, and ML329. These findings suggest that glucose-dependent changes in cellular metabolism and redox status are differently modulated by antidiabetic agents, inhibition of fatty acid-binding proteins or MITF, and ANGPTL4 knockdown in A375 cells.

Background/Objectives: The global population is undergoing a significant demographic shift characterised by an increasing proportion of older individuals. Healthy aging has become a priority for personal well-being and sustainable healthcare systems, with nutrition playing a pivotal role. However, the rise in non-communicable diseases (NCDs), malnutrition, and a shift in eating behaviour underscore the need for tailored, effective nutrition communication strategies. This research is intended to provide the basic data needed to support the development of tailored nutritional communication strategies and practices. Methods: To investigate these aspects, a cross-national survey about nutrition and nutrition communication was conducted within the framework of the Innovative Training Network SmartAge, focusing on older adults aged 60 years and above in Germany, Switzerland, Spain, and France (each 25%; N = 1000 persons). This paper specifically focuses on the development, methodology, and discussion of the survey and aims to investigate the characteristics of the sample in relation to their dietary patterns and food choices within the European context. Results: The analysis identified significant associations between various plant- and animal-based food items and the variables gender, age group, and country. Spanish participants showed a dietary pattern towards the Mediterranean Diet, while German participants showed tendencies towards the Western Diet. Furthermore, the findings revealed that protein-rich foods such as meat, fish, nuts and seeds, legumes, and (whole) grains were infrequently consumed, particularly among German and Swiss participants. Conclusions: This study highlights the need to promote adequate protein intake among older adults, emphasising diverse sources like legumes, nuts and seeds, (whole) grains, and lean meats to support healthy aging. For the development of future nutrition communication strategies, the influence of the specific social, cultural, and traditional factors needs to be considered.

This study aimed to assess the environmental variables affecting the Body Mass Index of older adults at neighborhood levels (1 ha) while mapping probability distributions of normal, overweight-obese, and underweight older adults. We applied a data-driven method that integrates open-access remote sensing products and geospatial data, along with the first nutritional survey in the Philippines with geo-locations conducted in 2021. We used ensemble machine learning of different presence-only and presence-absence models, all subjected to hyperparameter tuning and variable decorrelation. The cross-validated ensemble model was found to have AUC=0.76-0.93 and TSS =0.45-0.81, which indicates that the models are performing better than random chance. We found that neighborhoods with (a) short distances to the main city, (b) short distances to roads, and (c) with densest road network all drive overweight-obese cases. The latter (c) contrasts the findings in Western developed countries because of delimiting factors in a tropical developing country related to active public transport, crime, weather, the walkability of roads, and even the COVID-19 restrictions during the time of the surveys. The probability distribution maps revealed that the older adults in the Philippine case cities were mostly overweight-obese, especially within and nearby city centers. We finally showed priority neighborhoods for intervention and local policy implementation, providing valuable insights for local government units.

Aging inevitably gives rise to many challenges and transitions that can greatly impact our (mental) well-being and quality of life if these are not controlled adequately. Hence, the key to successful aging may not be the absence of these stressors, but the ability to demonstrate resilience against them. The current study set out to explore how resilience and successful aging may intersect by investigating how various resilience capacity-promoting (protective) and resilience capacity-reducing (risk) factors relate to mental well-being and quality of life. Through a large-scale (N = 2000, age 55+, 30 factors) network analysis, we established the interplay between risk/protective factors from various domains, including demographics, (mental) health, (environmental) stress, lifestyle, coping/personality, and ageism. We revealed some unique pathways through which each of these factors contribute to individuals' mental well-being and/or quality of life, and interpreted these findings in terms of a resilience-based framework of successful aging. Our findings emphasize the complexity of factors that can impact quality of life and mental well-being in later life and can steer researchers and practitioners in devising efficacious, multi-pronged interventions that target risk and protective factors simultaneously, thereby maximizing their potential in boosting beneficial outcomes among older individuals.

Advance care planning can help to align the care provided with the values, goals and preferences of patients at the end of life. Therefore, readiness for advanced care planning is considered a prerequisite and predictor of the patient's willingness to participate in the end of life conversation. The present study was conducted with the aim of investigating the factors affecting patients' readiness for advance care planning (RACP).

This systematic review was searched in 4 databases: PubMed, Scopus, Web of science, ProQuest using relevant keywords. No time limit was considered. The quality of the articles was assessed using Joanna Briggs Institute tool for qualitative studies and the Appraisal Tool for cross-sectional Studies. The data was analyzed based on the directed content analysis approach guided by the theory of planned behavior (TPB).

3227 primary article titles were identified. After removing duplicates, screening and final selection, 22 relevant articles remained for analysis. Factors affecting RACP were extracted based on the TPB. Attitude factors include "ACP training", "perceived experiences of health status", "Socio-demographic factors", and "psycho-spiritual readiness". Subjective norms include "social support and family participation" and "accessibility to health services". The perceived behavioral control includes "dialogue about ACP", "readiness actions", and "determining a proxy decision maker."

In this study, according to the theory of planning behavior, various factors have an effect on the RACP. Therefore, according to the collaborative and multifactorial nature of the factors affecting preparation for ACP, it is suggested that different effective dimensions should be considered according to the specific conditions of each patient and the stage of the disease. Therefore, health service providers should first measure the level of readiness of patients and families, and by understanding the factors affecting their readiness, they should conduct training or dialogue in the field of ACP.

As a large proportion of older adults are insufficiently active, it is imperative to identify ways to increase incidental physical activity. Men's Sheds, a mutual-aid, community-based organisation appear to be a promising approach for optimising wellbeing outcomes.

To investigate whether Men's Sheds attendance is associated with higher levels of physical activity, and the relationships between physical activity, health-related quality of life (HRQOL), and wellbeing in Men's Shed members.

Participants (N = 45) wore a hip accelerometer (Actigraph GTX-9) for 11 days. The majority (n = 30, Mage = 72.3 ± 9.4) also consented to complete an online questionnaire investigating HRQOL and wellbeing.

Linear mixed models revealed members, on average, spent an additional 34 min in light physical activity, had an extra six breaks in sedentary behaviour, and took an extra 1193 steps on days they attended Men's Sheds, though, these effects were small. Physical activity was not significantly associated with HRQOL and wellbeing.

Men's Sheds appear to be a valuable approach for increasing light intensity physical activity, breaks in sedentary behaviours, and step count in older adults. However, additional Men's Shed activities specifically targeting increased movement may be required to realise greater impacts on health-related quality of life and wellbeing. SO WHAT?: Men's Sheds may provide a valuable opportunity to increase some indices of physical activity, which may contribute to better overall health. While these effects may be small for active Men's Shed members, these effects may be more appreciable for more sedentary individuals.

Drug-drug interactions (DDIs) are a significant health issue that may adversely affect the health and well-being of patients. This study assesses and compares potential DDI (pDDI) patterns, severity, and associated risk factors in government and private hospitals in Dhaka, Bangladesh.

A total of 188 and 206 prescriptions were collected from various government and private hospitals' outdoor departments, respectively, by capturing pictures of the prescriptions. Bivariate analyses were performed through STATA 15. MedScape drug interaction checker was applied to identify pDDIs, while their consequences were obtained from DrugBank and MedScape.

Private hospitals had more pDDIs containing prescriptions than government hospitals (62.62% and 57.97%, respectively). The mean pDDIs cases were 3.29 in the private hospitals, while at government hospitals they were 3.02. Among the detected pDDIs, pharmacodynamic pDDIs were predominat, accounting for 63.32% and 66.23% of total events in government and private hospitals, respectively. Severity-wise, both types of hospitals had almost equal amounts of serious (10.34% vs. 9.18%), moderate (68.96% vs. 59.61%), and minor (20.06% vs. 21.79%) pDDIs. Polypharmacy was crucial in pDDI cases, responsible for 70.21% and 81.83% of pDDIs in government and private hospitals, respectively. Multiple comorbidities with pDDIs were more common in private hospitals (24.46% vs. 18.93%), while government hospitals displayed a higher frequency of pDDIs with one comorbidity (24.75% vs. 17.55%). Non-mention of comorbidities was correlated with both types of hospitals (p ≤ 0.01) in pDDIs cases. Furthermore, considerable amounts of pDDIs in prescription error categories were detected. Both types of hospitals had a prevalence of antihypertensive, antidiabetic, psychotic, and antiplatelet-related pDDIs.

The two kinds of hospitals exhibited similar pDDI patterns, while their associations were random with the risk variables. When prescribing pharmacokinetics and pharmacodynamics pDDIs, physicians should evaluate the risk-benefit ratio.

Immunosenescence, the age-related decline in immune function, is a complex biological process with profound implications for health and longevity. This phenomenon, characterized by alterations in both innate and adaptive immunity, increases susceptibility to infections, reduces vaccine efficacy, and contributes to the development of age-related diseases. At the cellular level, immunosenescence manifests as decreased production of naive T and B cells, accumulation of memory and senescent cells, thymic involution, and dysregulated cytokine production. Recent advances in molecular biology have shed light on the underlying mechanisms of immunosenescence, including telomere attrition, epigenetic alterations, mitochondrial dysfunction, and changes in key signaling pathways such as NF-κB and mTOR. These molecular changes lead to functional impairments in various immune cell types, altering their proliferative capacity, differentiation, and effector functions. Emerging research suggests that lifestyle factors may modulate the rate and extent of immunosenescence at both cellular and molecular levels. Physical activity, nutrition, stress management, and sleep patterns have been shown to influence immune cell function, inflammatory markers, and oxidative stress in older adults. This review provides a comprehensive analysis of the molecular and cellular mechanisms underlying immunosenescence and explores how lifestyle interventions may impact these processes. We will examine the current understanding of immunosenescence at the genomic, epigenomic, and proteomic levels, and discuss how various lifestyle factors can potentially mitigate or partially reverse aspects of immune aging. By integrating recent findings from immunology, gerontology, and molecular biology, we aim to elucidate the intricate interplay between lifestyle and immune aging at the molecular level, potentially informing future strategies for maintaining immune competence in aging populations.

Background/Objectives: International studies state that older adults are at an increased risk of mental health symptoms and disorders (depression, anxiety, and stress), especially elderly women aged >65 years. The literature on this topic is scarce, and there is a need for studies that investigate the associations between mental health issues and overall health in elderly women. This study aimed to investigate depression, anxiety, and stress symptoms in elderly women in association with health status. Methods: A community-based cross-sectional study was conducted in Klaipeda, Lithuania, in 2020. The survey included elderly women (n = 306) aged 65 to 80 years studying at the Third Age University in Klaipeda city. The DASS-21 and SHSQ-25 scales were used for the survey. Associations and correlations between both scale indicators were calculated. Results: Sociodemographic factors such as age, marital status, and place of residence were not statistically significant in terms of mental health, except for women living alone, who had slightly lower levels of depressive symptoms (p = 0.015). Mental health issues were quite common; almost half of the participants had higher than normal levels of anxiety (49.0%) and depression (48.4%), and one-third (29.8%) experienced stress. A strong positive correlation was observed between mental health symptoms and physical health, with anxiety having the greatest effect size on fatigue (Cohen's d = 0.950, p < 0.001), cardiovascular symptoms (Cohen's d = 0.757, p < 0.001), and mental status (Cohen's d = 1.036, p < 0.001). Depressive symptoms had a large effect size on fatigue (Cohen's d = 0.764, p < 0.001) and mental status (Cohen's d = 0.816, p < 0.001), while stress had a moderate effect size on all health domains. Conclusions: The findings highlight that anxiety symptoms are a major contributor to mental health conditions and overall health in elderly women. This study's results emphasise the need for targeted interventions to address mental health challenges in elderly women.

Background/Objectives: Sarcopenia and cognitive decline (CD) are prevalent in aging populations, impacting functionality and quality of life. The early detection of these diseases is challenging, often relying on in-person screening, which is difficult to implement regularly. This study aims to develop artificial intelligence algorithms based on gait analysis, integrating sensor and computer vision (CV) data, to detect sarcopenia and CD. Methods: A cross-sectional case-control study was conducted involving 42 individuals aged 60 years or older. Participants were classified as having sarcopenia if they met the criteria established by the European Working Group on Sarcopenia in Older People and as having CD if their score in the Mini-Mental State Examination was ≤24 points. Gait patterns were assessed at usual walking speeds using sensors attached to the feet and lumbar region, and CV data were captured using a camera. Several key variables related to gait dynamics were extracted. Finally, machine learning models were developed using these variables to predict sarcopenia and CD. Results: Models based on sensor data, CV data, and a combination of both technologies achieved high predictive accuracy, particularly for CD. The best model for CD achieved an F1-score of 0.914, with a 95% sensitivity and 92% specificity. The combined technologies model for sarcopenia also demonstrated high performance, yielding an F1-score of 0.748 with a 100% sensitivity and 83% specificity. Conclusions: The study demonstrates that gait analysis through sensor and CV fusion can effectively screen for sarcopenia and CD. The multimodal approach enhances model accuracy, potentially supporting early disease detection and intervention in home settings.

Introduction: Hospitalisation and prolonged length of stay is associated with deconditioning that risks adverse outcomes after discharge. Less is known about the psychological impact on older people after hospital discharge. The purpose of this systematic review was to elucidate factors contributing to psychological stress in older patients post-discharge to inform better discharge planning. Methods: A systematic search for studies reporting poor discharge outcomes in older people between 2010 and 2022 was performed in Medline, CINAHL, and PsycINFO. Search terms were 'older patients > 65 year', 'post-discharge', 'psychological distress', 'loneliness', 'anxiety', 'depression', and 'length of hospital stay'. Exclusion criteria included COVID-19 disease, dementia (±severe cognitive impairment), individuals aged <65, and those under palliative care services. Results: A total of 1666 records were identified, of which 878 were excluded as they were outside of our date limits or were not written in the English language, 681 were excluded after application of exclusion criteria, and 699 were excluded because of insufficient details. A total of 31 duplicates were removed, leaving 38 articles that were assessed for eligibility; 7 of these reports were found suitable, comprising 1131 patients. Three highly relevant themes identified relating to post-discharge outcomes were social isolation, lack of support, depression and anxiety. Older patients with a tendency toward depressive symptoms had an increased likelihood of death. Conclusions: It appears that the discharge process from hospital fails to address psychological factors that permit a successful transition from hospital. Pre-discharge screening of psychological symptoms and coping ability may assist in identifying older patients who are at risk of mental as well as subsequent physical deterioration. Better knowledge of positive and negative predictors of a successful transition from hospital to home would enable more holistic, effective, and inclusive discharge planning processes for older adults.

Background: Individualizing care is the essence of nursing, and its benefits have been extensively proven in older people. The changes arisen during the COVID-19 pandemic may have affected it. The aim of this study is to analyze the changes produced in the perceptions about the individualization of care, quality of life, and care environment of elderly people living in long-term care centers before and after the pandemic. Methods: A prospective cross-sectional observational study was carried out. For data collection, the Individualized Care Scale-patient, the EuroQol-5D scale, and a reduced version of the Sheffield Care Environment Assessment Matrix test were used, and a statistical analysis was performed. Results: A total of 177 people participated in the study, with 87 pre-COVID-19 and 90 post-COVID-19, 62.7% of whom were women. The average age was 83.3 years. General activities of the individualized care obtained medians of 4, 2.5, and 3 (out of 5) in clinical situation, personal life situation, and decisional control dimensions, respectively, and no substantial change was observed pre- and post-pandemic. Nevertheless, 10 out of 17 items related with the maintenance of individuality in the last shift were higher rated after COVID-19. They are mainly related to the feelings and needs of care, daily life activities, and the expression of opinions. The median of all items was 3 despite the improvement observed after the pandemic. Residents scored an average of 6.47 points (out of 10) in the life quality self-evaluation and were satisfied with the care environment (94%). Patients with higher life quality and adherence to their environment perceived better care. Conclusions: Although slight improvements were observed in the individualized care after the pandemic, the obtained results revealed that there is still room for improvement. Particularly, it is necessary to develop strategies aimed at motivating the family participation or providing individual spaces in the residences.

Sarcopenia is associated with various geriatric diseases, such as gait disorders, falls, malnutrition, and osteoporosis. Accordingly, interest in the prevention and treatment of sarcopenia has grown over the years. The human milk oligosaccharide (HMO) 6'-sialyllactose (6'-SL) is known to improve exercise performance, reduce muscle fatigue, and improve GNE myopathy; however, its effect on sarcopenia has not yet been reported. In this study, we aimed to investigate the efficacy of 6'-SL in dexamethasone-induced muscle atrophy, which is a widely used model for the study of sarcopenia. The effects of 6'-SL on differentiated C2C12 skeletal muscle cells and on mice were examined by treatment with 6'-SL in the presence or absence of dexamethasone. 6'-SL was found to inhibit the dexamethasone-induced decrease of MHC expression, as well as to prevent reduction in the number, length, and width of myotubes. Furthermore, the dexamethasone-induced upregulation of myostatin, muscle RING-finger protein-1 (MuRF1), and atrogin-1 were also inhibited by 6'-SL treatment. In mice, intraperitoneal administration of dexamethasone caused decreases in muscle fiber diameter, muscle weight, and exercise performance, most of which were significantly inhibited by oral treatment with 6'-SL. Therefore, utilization of 6'-SL could contribute to the prevention and treatment of muscle atrophy and sarcopenia.

The geriatric population encompasses the largest part of the health care system worldwide. Chronic medical conditions are highly prevalent in the elderly, consequently, due to their complex health needs, there is a significant rate of multi-drug therapy. Despite the high numbers of medications prescribed, geriatric patients face several barriers when it comes to successful drug delivery including alterations in cognitive and physical function. The current review highlights the impact of chronic diseases on the ageing population along with how changes in drug pharmacokinetics could impact drug efficacy and safety. Also discussed are applications of administration routes in the geriatric population and complications that could arise. A focus is placed on the traditional and upcoming drug delivery advancements being employed in seniors with a focus addressing obstacles faced by this patient category. Nanomedicines, three-dimensional printing, long-acting formulations, transdermal systems, orally disintegrating tablets, and shape/taste modification technologies are discussed. Several barriers to drug delivery in the elderly have been identified in literature and directions for future studies should focus on addressing these gaps for geriatric drug formulation development including personalised medicine, insights into novel drug delivery systems like nanomedicines, methods for decreasing pill burden and shape/size modifications.ARTICLE HIGHLIGHTSTypically, senior citizens take more medications than any other patient population, yet most drug delivery technologies are not tailored to address the specific cognitive and physical barriers that these individuals encounter.The safety of drug delivery systems in the elderly patients should be prioritised with considerations on changes in pharmacokinetics with age, use of non-toxic excipients, and selecting drugs with minimal off-target side effects.Several commercialised and upcoming drug delivery technologies have begun to address the current limitations that the ageing population faces.Future research should focus on applying novel strategies like 3D printing, personalised medicine, and long-acting formulations to improve drug delivery to elderly patients.

The interest in aging and anti-aging research has increased significantly in recent years, leading to rapid expansion in the anti-aging market. Aging is associated with gradual physiological changes and an elevated risk of age-related ailments, and is divided into three categories: usual aging, successful aging, and pathological aging. Each category is associated with distinct implications for health and well-being. Middle-aged women who experience accelerated physiological changes that are intensified by hormonal changes during menopause are particularly vulnerable to chronic diseases. The importance of anti-aging tests is increasing since they enable early identification and intervention. Telomere length, oxidative stress markers, DNA repair markers, RNA profiles, inflammatory markers, hormone levels, and epigenetic changes are some molecular parameters studied to test for aging. In addition, a thorough review of middle-aged women's anti-aging profiles also includes monitoring the vitamin D levels and assessing the effects of endocrine-disrupting substances on ovarian aging. The application of personalized medicine paradigms, utilizing various diagnostic methods, will enable accurate risk prediction and the implementation of focused therapies, ultimately promoting the extension of health span and the improvement of quality of life in middle-aged women.

An imbalance between reactive oxygen species (ROS) production and antioxidant defense driven by oxidative stress and inflammation is a critical factor in the progression of neurodegenerative diseases such as Alzheimer's and Parkinson's. Coriander (Coriandrum sativum L.), a culinary plant in the Apiaceae family, displays various biological activities, including anticancer, antimicrobial, and antioxidant effects. Herein, neuroprotective properties of three major bioactive compounds derived from coriander (i.e., linalool, linalyl acetate, and geranyl acetate) were investigated on hydrogen peroxide-induced SH-SY5Y neuroblastoma cell death by examining cell viability, ROS production, mitochondrial membrane potential, and apoptotic profiles. Moreover, underlying mechanisms of the compounds were determined by measuring intracellular sirtuin 1 (SIRT1) enzyme activity incorporated with molecular docking. The results showed that linalool, linalyl acetate, and geranyl acetate elicited their neuroprotection against oxidative stress via protecting cell death, reducing ROS production, preventing cell apoptosis, and modulating SIRT1 longevity. Additionally, in silico pharmacokinetic predictions indicated that these three compounds are drug-like agents with a high probability of absorption and distribution, as well as minimal potential toxicities. These findings highlighted the potential neuroprotective linalool, linalyl acetate, and geranyl acetate for developing alternative natural compound-based neurodegenerative therapeutics and prevention.

There is a gap in evidence about medical outcomes in oldest-old patients (aged 85 and older) with vertebral fractures (VFs). The aim of this study was to evaluate the impact of patient and fracture characteristics on "short-term" hospital outcomes.

All patients aged ≥ 85 presenting an acute or subsequent VF at our single level I spine center between 2019 and 2021 requiring hospital treatment were included. The data collection was conducted retrospectively. The primary parameters of interest were length of stay (LOS) and in-hospital mortality. Further outcome parameters were the occurrence of general (non-operative) complications and Intensive Care Unit (ICU) admission. For statistical analysis, linear and binary logistic regression modeling were performed.

A total of 153 patients with an average age of 88.5 (range 85 to 99) met the inclusion criteria. Our patients were mostly female (68.6%) and moderately comorbid according to a Charlson Comorbidity Index (CCI) of 2.9. 58.8% had diagnosed osteoporosis. Fracture morphologies represented as "Osteoporotic Fracture" (OF) classification types were of central importance for undergoing operative treatment (OP) (p < 0.001), necessity for intensive care (p = 0.023), LOS (p = 0.014), and mortality (p = 0.018). 38.6% had OP. We recorded a complication rate of 59.5%, which highly influenced (p < 0.001) both primary outcome parameters. Overall, patients stayed 14.6 days with a mortality of 11.1%.

VFs are a severe event in oldest-old patients with a crucial risk of poor medical outcomes during hospitalization. The fracture morphologies are of central importance. However, little is known about the hospital stay of oldest-old inpatients with VFs. Considering an aging population, further investigations would be recommended.

Chronic diseases, including cardiovascular disease, diabetes, cancer, and chronic respiratory diseases, are a growing public health concern in low-and middle-income countries (LMICs) among the older population. The current review aimed to identify the main barriers that impede researchers from sharing research data on the prevention of chronic diseases in older adults living in LMICs). The review included both older women and men from these countries.

Studies were selected from 11 databases, including Web of Science, Scopus, PubMed, Taylor and Francis, Biomedical Central, BioOne, CINAHL, EBSCOHost, ScienceDirect, Wiley Online, and Google Scholar, were then transferred to CADIMA, an online tool for screening purposes, and a total of 1,305,316 studies were identified through a robust search strategy. CADIMA also ensured the quality of all studies in this review. The sampling techniques were performed by selecting and screening studies per this review's eligibility criteria. Ultimately, 13 studies were found to meet these criteria. A PRISMA flow chart was used to map out the number of studies that were identified, included, and excluded.

Five main barriers were consistently highlighted, including a lack of necessary resources (9, 69%), dealing with complex and sensitive research data (2,15%), lack of policies, procedures, guidelines (5,38%), medical big data processing and integration (2,15%), and inadequate ethical considerations, legal compliance, and privacy protection (6,46%). Discussion: By shedding light on these obstacles, researchers can develop strategies to overcome the identified barriers and address areas requiring further investigation. The registration details of this review can be found under PROSPERO 2023 CRD42023437385, underscoring the importance of this review in advancing our collective understanding of chronic disease prevention among older adults worldwide.

PROSPERO, identifier CRD42023437385, available at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023437385.

Parkinson's disease is a pathology with a wide range of in vivo and in vitro models available. Among these, the SH-SY5Y neuroblastoma cell line is one of the most employed. This model expresses catecholaminergic markers and can differentiate and acquire various neuronal phenotypes. However, challenges persist, primarily concerning the variability of growth media, expression of dopaminergic markers, and a wide variety of differentiation protocols have been reported in the literature without direct comparison between them. This lack of standardized differentiation conditions impacts result reproducibility and it makes it very difficult to compare the results obtained from different research groups. An alternative cellular model is the neuroblastoma BE (2)-M17 which exhibits a high basal expression of numerous dopaminergic markers such as tyrosine hydroxylase (TH), vesicular monoamine transporter 2 (VMAT2), and dopamine transporter (DAT). The BE (2)-M17 cells show neuronal properties, grows rapidly in conventional media, and can easily be differentiated to increase their dopaminergic phenotype. In this review, we will thoroughly explore the properties of the BE (2)-M17 cell line and discuss its potential as an excellent model for studying Parkinson's disease.

Depressive symptoms have become a global public health problem, with a predominant effect on the older adults. The studies on mental health status of older adults in Nepal are quite limited. In this study, we aim to assess the prevalence of depressive symptoms and associated factors among the older adults living in public aged care homes of Kathmandu Metropolitan City in Nepal. A cross-sectional study was conducted among 142 older adults; aged 60 years and above recruited through proportional simple random sampling from six aged care homes. The 15 item-Geriatric Depression Scale (GDS) was used to assess the depressive symptoms among the participants. Associated factors were tested using Chi-square test; and a p-value of less than 0.05 with a confidence interval of 95% was used for statistical significance. More than half of the study participants, 58.5% (95% CI: 49.9%-66.7%) were found to have depressive symptoms. Among them, 38.7% had mild symptoms, 16.2% had moderate symptoms and 3.5% had severe symptoms. Age (OR = 2.25, 95% CI: 1.08-4.66), sex (OR = 2.36, 95% CI: 1.17-4.75), past family type (OR = 0.44, 0.22-0.89), chronic physical health problem (OR = 0.34, 95% CI: 0.12-0.98) and feelings of loneliness were found to have significant association with depressive symptoms among the older adults' population. The prevalence of depressive symptoms among the older adults in aged care homes in Kathmandu Metropolitan City is quite high and is found to be associated with age, sex, past family type, chronic physical health problems and feeling of loneliness. It is a concerning issue that requires targeted mental health programs and interventions in order to bring about a positive shift in their mental health condition. It also demands a robust collaboration between the local bodies, health institutions, administrators, private as well as nonprofit institutions to bring desirable change.

Chronically elevated inflammation is implicated in many conditions, including obesity, metabolic syndrome, and cardiovascular disease, and has been associated with increased mortality risk. Whole-body cryotherapy (W-BC) is a promising modality to treat inflammation with demonstrated benefits for clinical subpopulations including those with arthritis, obesity, and type 2 diabetes. However, it is unclear whether the benefit from W-BC extends to healthy individuals prior to chronic disease-related inflammation. In addition, the long-term durability of W-BC effect is unknown.

This study investigates the inflammatory response to W-BC in healthy adults with a biomarker of inflammation, high-sensitivity C-reactive protein (hsCRP), and clinical biomarkers of metabolism including fasting glucose, hemoglobin A1c (HbA1c), low-density lipoprotein (LDL) and high-density lipoprotein (HDL), and triglycerides.

Fifteen individuals (n=9 female) participated in frequent recreational W-BC (3 minutes of cold exposure at -110 ℃) over approximately 9 months and had blood draws at baseline plus follow-up visits. Biomarkers were modeled as linear functions of W-BC sessions received in the month prior to blood draw.

The mean amount of W-BC received was 6.78 (SD 4.26) times per month with the cumulative total ranging from 13 to 157 W-BC sessions over the course of the study. On average, participants completed 1-2 sessions per week throughout the intervention. The number of W-BC sessions were associated with decreased hsCRP (-0.14 mg/L in hsCRP per W-BC session; P<.01) and with durability of up to 9 months. Increased W-BC was also associated with a downward trend in fasting glucose. This trend failed to reach significance at 1 month (-0.73 mg/dL in fasting glucose per W-BC session; P<.10) but was significant for 2- and 3-month windows (P<.05). HbA1c was increased significantly after 9 months (P<.01); however, the change occurred within normal ranges (difference=0.13% and <5.7%) and was not clinically significant. There was no association between W-BC and LDL cholesterol, HDL cholesterol, or triglycerides (P>.10), although LDL trended lower over the time period examined (P=.07).

These results suggest that W-BC beneficially impacts systemic inflammation by lowering hsCRP levels in healthy individuals and may also have some modulating effect on fasting glucose.

Caregiver burden can impact the mental health of family caregivers, but self-compassion may help reduce this impact. Brief self-compassion interventions have been shown to be useful but have not been tested in family caregivers of older adults.

This study aimed to test the effects of a brief self-compassion intervention and its components (self-kindness, common humanity, and mindfulness) on mental well-being and mood when reflecting on difficult family caregiving experiences.

British caregivers were recruited through a web-based panel. Three experimental studies manipulated the self-compassion intervention. In study 1 (n=206) and study 2 (n=224), participants wrote about a difficult caregiving experience while focusing on 1 self-compassion component (self-kindness, common humanity, or mindfulness). In study 3 (n=222) participants focused on all components. Self-compassion, serenity, guilt, and sadness were measured.

In studies 1 and 2, condition effects showed mindfulness unexpectedly lowered mood. Inconsistent and modest benefits to affect were achieved by engagement in self-kindness and common humanity in study 1 (guilt [lowered]: P=.02 and sadness [lowered]: P=.04; serenity [nonsignificantly raised]: P=.20) and also in study 2 (sadness [nonsignificantly lowered]: P=.23 and guilt [nonsignificantly lowered]: P=.26; serenity [raised]: P=.33); significant benefits for self-compassion and mood were found in study 3 (serenity [raised]: P=.01, kindness [raised]: P=.003, and common humanity [raised]: P≤.001; guilt [lowered]: P<.001 and sadness [lowered]: P≤.001). More intensive efforts should be made to promote self-compassion in caregivers of older adults, with caution advised when relying primarily on mindfulness approaches.

Self-compassionate writing may be beneficial for family caregivers, but more intensive interventions are needed. Further research is needed to determine the optimal dosage and content for achieving the greatest effects.