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Frailty is a common geriatric syndrome characterized by increased vulnerability and is associated with adverse clinical events such as falls, hospitalization, and death. Early diagnosis and early intervention can delay or reverse frailty and ensure the healthy aging of older individuals. At present, there are no gold standard biomarkers for the diagnosis of frailty, which mainly relies on the scale to assess frailty, and the scale has shortcomings such as lagging assessment, subjectivity, and poor consistency. Frailty biomarkers help in early diagnosis and intervention in frailty. The purpose of this review is to summarize the existing inflammatory markers of frailty and focus on novel inflammatory biomarkers of frailty that can be used to help identify frailty early and explore potential intervention targets.

Objective: Folates are essential for healthy cell division, growth and function. With the discovery that folate provides the proliferation and differentiation of muscle cells, the relationship between folate and sarcopenia has attracted the curiosity of researchers. Geriatric syndromes may have a common pathogenesis, as they are considered clinical conditions with common risk factors. Our aim in this study was to investigate the relationship of sarcopenia with geriatric syndromes and serum folate level. Materials and Methods: The study population consisted of 287 patients (202 female) who were admitted to our geriatrics outpatient clinic for the first time and underwent a comprehensive geriatric assessment (CGA) during the one year between January 2018 and January 2019. Demographic information, chronic diseases, drugs used by the participants and their current chronic diseases, CGA results and laboratory findings of patients were recorded. Diagnosis of sarcopenia was made under the guidance of the European working group on sarcopenia in older people 2. Results: Eighty-eight (31%) of the 287 patients were sarcopenic. While age, number of drugs, the frequency of chronic kidney disease and malnutrition were statistically significantly higher in patients with sarcopenia, mini-mental state examination score and serum folate levels were significantly lower (p=0.001, p<0.001, p=0.040, p<0.001, p=0.001, p=0.028; respectively). The result of univariate logistic regression analysis showed that sarcopenia was independently associated with folate [odds ratio: 0.926 (95%) confidence interval: 0.864-0.993, p=0.031]. Serum folate level in patients with malnutrition was also significantly lower (7.12±4.39, p=0.008). Conclusion: Since sarcopenia is associated with malnutrition, they should be evaluated together. As we found that serum folate levels were lower in patients with both sarcopenia and malnutrition, we recommend that risky groups be supported with folate-rich foods or folic acid supplementation. [ABSTRACT FROM AUTHOR]

Introduction: Geriatric syndromes are associated with morbidity and poor quality of life (QOL). Urinary incontinence (UI) is one of the most prevalent geriatric syndromes. However, there is little research on the association of UI and UI-related QOL with other geriatric syndromes. The aim of this exploratory study were to examine the effect and coexistence of geriatric syndromes, admission type and surgical severity on UI-related QoL in patients hospitalized in the urology clinic. Materials and methods: This study was conducted among 250 older inpatients (aged 65 years and older between October 2019 and March 2020) at Zonguldak Bulent Ecevit University department of Urology, Zonguldak, Turkey. After ethical approval and patient consent, we examined geriatric syndromes and related factors including cognitive impairment, delirium, depression, decreased mobility, multiple drug use, malnutrition, pain and fecal incontinence as well as hospitalization patterns and surgical severity of the patients. UI-related QOL was assessed using the International Consultation on Incontinence Questionnaire-Short Form. Multiple logistic regression analysis was used to evaluate these associations. Results: Geriatric syndromes and related factors were associated with UI. Moderate cognitive decline (odds ratio [OR], 3.764; 95% confidence interval [CI], 1.621- 8.742), Charlson Comorbidity Index (CCI) (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.24–5.05) and the number of medication used (odds ratio [OR], 1,33; 95% confidence interval [CI], 1.11–1.58) were associated with increased probability of having UI. Cognitive impairment, length of hospital stay had an inverse and age of patients had a direct effect on patients UI-related QoL. Conclusions: UI-related quality of life was associated with some factors. Especially in the urology clinic, evaluating the cognitive functions of elderly patients, reviewing the drugs they use and minimizing the length of stay in this patient group will contribute significantly to their quality of life.

Abstract Background Geriatric syndromes (GS) are multi‐factorial conditions that make older adults vulnerable to morbidities and poor outcomes. The main objective was to observe the frequency of GS in older patients with COPD. Methods A case‐control study was conducted in the Geriatric department of a tertiary care hospital in India to evaluate geriatric syndromes including falls, cognitive impairment, frailty, functional impairment, urinary incontinence, malnutrition, and depression in patients with COPD and controls without COPD. The factors having a significant association with the occurrence of these GS in COPD patients were observed. Results In this study, 150 cases and 150 controls were included. The mean age of the participant was 65.85±5.54, with 76% males. Functional impairment, cognitive impairment, frailty, urinary incontinence, and malnutrition were significantly higher in COPD patients. The independent variables which increased the odds of geriatric syndromes were dyspnoea (≥2 mMRC grade) (AOR:3.54,95% CI:1.06‐11.8) and low socioeconomic status (AOR: 4.14, 95% CI: 1.03‐16.54), while male gender showed inverse association (AOR: 0.08,95% CI: 0.01‐0.99). Conclusion Geriatric syndromes are common in older COPD patients, and assessment for them should be done routinely in these patients.

Diabetes self-management education (DSME) is an essential part of effective and safe treatment of chronic conditions such as diabetes mellitus (DM). Though the data on DSME effectiveness in elderly are limited, all patients should be educated regardless of age. The form of learning and education program may vary depending on the clinical situation and the patient’s characteristics. Age-related problems, so-called geriatric syndromes, determinant heterogeneity of elderly diabetic population. Geriatric syndromes should be taken into account to choose proper treatment goals and optimal education programs. Functional dependency, cognitive decline, depression, sarcopenia, malnutrition and polypharmacy seems to be most important in the education context. The development of geriatric education program with a broad focus on solving both diabetic and age-related problems and its implementation on a wider range of institutions may be useful to improve diabetes self-management education of elderly in clinical practice. It is also necessary to initiate clinical studies to evaluate DSME effectiveness in elderly not only from the generally accepted diabetological criteria, but also considering its impact on age-related problems.

We aimed to search the relationship of sarcopenia with chronic diseases, geriatric syndromes and neutrophil/lymphocyte ratio (NLR). Our study included 258 patients who were admitted to Cerrahpaşa Medical Faculty geriatrics outpatient clinic for the first time between March 2018 and February 2019, and underwent comprehensive geriatric evaluation. Patients under 65 years of age, with active infection, terminal illness, diagnosis of malignancy, presence of trauma and infection in the last month were excluded from the study. Sarcopenia was present in 77 (30%) of the 258 participants involved in the study. Frequency of diabetes mellitus, dementia, delirium, polypharmacy and malnutrition was statistically significantly higher in patients with sarcopenia compared to patients without sarcopenia (p=0.020, p=0.024, p=0.016, p=0.018 and p [Med-Science 2022; 11(2.000): 645-50]

Song-Seng Loke,1 Chien-Te Lee,2 Shan Huang,3 Chao-Tung Chen4 1Division of Geriatric Medicine, Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan; 2Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan; 3Department of Management, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan; 4Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, TaiwanCorrespondence: Song-Seng Loke, Division of Geriatric Medicine, Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Dapi Road, Niaosong District, Kaohsiung City, 833, Taiwan, Tel +886-7-7317123, Email loke@cgmh.org.twPurpose: To evaluate the effect of comprehensive geriatric assessment performed by an inpatient aging consultation team on older patients with geriatric syndromes.Methods: Fifty-nine patients with ≧65 years, Barthel Index score ≦60, at least one geriatric syndrome, and admitted to non-geriatric wards were enrolled. By their preference, 16 were in the intervention group with comprehensive geriatric assessment and instructions from the consultation team. And 43 were in the control group, receiving standard care from non-geriatric-specialist physicians. Outcomes were readmission and mortality within one year after discharge.Results: The mean age of the intervention and control groups was 78.35 (8.54) and 80.23 (6.36) years (p = 0.36), with female of 62.5% and 60.5%, respectively. Compared to control, intervention is not significantly associated with attenuated risk for readmission (adjusted hazard ratio (aHR): 0.256, 95% confidence interval (CI): 0.12– 1.78, p = 0.256) and mortality (aHR: 2.13, 95% CI: 0.29– 15.7, p = 0.457) within one year after discharge. Multivariate analysis showed that patients with a fall history ≧1 in the past one year had a lower risk of readmission (aHR: 0.28, 0.07– 0.6, p = 0.004) or mortality (aHR: 0.11, 95% CI: 0.01– 0.97, p = 0.047), and disability is associated with mortality (aHR: 5.37, 95% CI: 0.87– 33.12, p = 0.07).Conclusion: Intervention is not significantly associated with outcomes in our pilot study. But fall history ≧1 in the recent one year is associated with a lower risk of readmission and mortality among all included patients. More participants and longer follow-up are needed for better elucidation.Keywords: comprehensive geriatric assessment, inpatient geriatric consultation team, geriatric syndrome, readmission rate, mortality rate

BackgroundCurrent studies on chronic obstructive pulmonary disease (hereinafter referred to as COPD) mostly focus on the lung itself, while studies on the extrapulmonary manifestations of COPD are still lacking. Many studies in China and at abroad have shown that COPD is closely related to geriatric syndrome, but it has not been further confirmed.ObjectiveTo investigate the prevalence of COPD in senile inpatients in several hospitals in Yunnan Province in the past three years, and to explore the influencing factors of elderly COPD from the aspect of geriatric syndrome.MethodsA total of 2 182 newly admitted elderly patients (≥60 years old) in several hospitals of Yunnan Province from September 2018 to June 2021 were selected as the research objects and divided into COPD group and non-COPD group according to whether the patients had COPD. The software platform of "Comprehensive Geriatric Assessment System" independently developed by the Geriatrics Department of the First People's Hospital of Yunnan Province was used to collect general data from the patients. At the same time, the scales in the system were used to conduct a comprehensive geriatric evaluation of the patients, including the assessment of anxiety and depression by 15-item geriatric depression scale (GDS-15) , the assessment of insomnia situation by athens insomnia scale (AIS) , the assessment of family support by PAGAR scale, the assessment of fall risk by Morse fall scale, the assessment of cognitive function by mini-mental state examination (MMSE) , the assessment of nutrition status by mini nutritional assessment scale, the assessment of the patients' daily living ability by the basic activities of daily living (BADL) scale, the assessment of frailty state by the Fried Scale, the assessment of swallowing (choking) by swallowing function assessment scale, the assessment of urinary incontinence by incontinence questionnaire simple form (ICI-Q-SF) , the assessment of constipation by Roma Ⅲ scale, the assessment of pain by visual analogue scale (VAS) . The influencing factors of COPD in the elderly hospitalized patients were analyzed by binary Logistic regression.ResultsThere were 1 558 cases (71.4%) in the non-COPD group and 624 cases (28.6%) in the COPD group. The results of binary Logistic regression analysis showed that age ≥75 and

Background: Guillain-Barré syndrome (GBS) is an inflammatory disease of the peripheral nervous system characterized by rapidly evolving polyneuropathy caused by autoimmune demyelination and/or axonal degeneration. Since SARS-CoV-2 outbreak, several GBS cases following exposure to coronavirus disease-2019 (COVID-19) have been reported in literature, raising the concern of the latter being a potential trigger event for GBS. Case presentation: We report the case of a 90-year-old Caucasian woman who was admitted to our hospital because of fatigue, worsening gait and leg strength, dysphonia, dysarthria and dysphagia, started 3 weeks after being exposed to COVID-19. Based on clinical presentation GBS was suspected, so she performed a lumbar puncture and electromyography, which confirmed the diagnosis of acute motor and sensory axonal neuropathy (AMSAN) variant. We administered high dose of intravenous immunoglobulin with slight neurological improvement. However, after 2 weeks of hospitalization with maximization of care, her physical condition worsen, manifesting severe frailty. The patient was discharged with home support services for managing parenteral nutrition and intense scheduled physiotherapy. A few days later, the patient experienced a further decline in her clinical condition and died at home. Conclusions: To the best of our knowledge, we report the oldest woman with GBS AMSAN variant after COVID-19 described in the existing literature. Our case supports further research aimed at improving recognition, characterization and prompt management of neurological diseases related to COVID-19 in older patients. [ABSTRACT FROM AUTHOR]

Copyright of Basic & Clinical Medicine is the property of Editorial Office of Basic & Clinical Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Syncope is a common clinical condition in the elderly, associated with significant morbidity and risk of recurrence. Recurrent syncope causing a repeated reduction in the cerebral blood flow can predispose to progressive neurodegeneration, a decline in overall health and functionality. Hence, this study was conducted to study the common causes of recurrent syncope and its association with various geriatric syndromes. Methodology: This case–control study recruited 50 cases of recurrent syncope and 50 controls, aged 75 years and older. A detailed history and sequential evaluation for aetiologies of recurrent syncope were done. Cognition, frailty, activities of daily living, depression, and nutrition were assessed using various scales. Results: Most (80%, 80/100) of the participants were males and the mean age was 80.04 ± 4.3 years. In the syncope group, 42% (21/50) of patients had arrhythmia, and 30% (15/30) had valvular heart disease. Recurrent syncope was significantly associated with lower scores on Montreal cognitive assessment scale (OR: 6.47 P < 0.001), four or more comorbidities (OR: 6.29 P < 0.001), and hearing impairment (OR: 6.21 P < 0.004) on multivariate logistic regression analysis. Conclusion: Recurrent syncope is significantly associated with cognitive impairment, the presence of four or more comorbidities, and hearing impairment. Conduction abnormality was the most common etiology of recurrent cardiovascular syncope. Structured evaluation and appropriate management of recurrent syncope might reduce the decline in physical, cognitive, and psychological reserve. A follow‐up longitudinal study is needed to establish this. [ABSTRACT FROM AUTHOR]

Key Summary Points: Aim: To describe the clinical features and geriatric syndromes in newly diagnosed dementia with Lewy bodies (DLB). Findings: Functional impairment, urinary incontinence, polypharmacy, depressive symptoms, and fall history were found in more than half of the DLB participants. Women had more functional impairment than men. Message: Even in the mild stages of DLB, most of participants functionally impaired, indicating high comorbidity and geriatric syndrome burden. A comprehensive geriatric assessment is needed to help establish treatment strategies and interventions in DLB patients. Purpose: Identifying the associated clinical conditions in patients with newly diagnosed dementia with Lewy bodies (DLB) may contribute to the disease management. This study aimed to examine the clinical features and coexisting geriatric syndromes of patients with newly diagnosed DLB. Method: This cross-sectional study included newly diagnosed DLB participants who were admitted to a tertiary geriatric outpatient clinic. Of the 857 patients with dementia, 116 DLB diagnoses were eligible for analysis. The core and supportive clinical features of DLB were recorded. Geriatric syndromes including polypharmacy, depression, insomnia, dependency, a history of delirium, falls, malnutrition, urinary incontinence, functional impairment, and living alone, were assessed and recorded at baseline. Results: The mean age was 79.0 ± 6.9 years, and 50.9% of the participants were female. The majority (63.8%) had mild dementia, 31.9% had moderate, and 4.3% had severe disease. Cognitive fluctuations (78.4%), visual hallucinations (77.6%), and Parkinsonism (73.3%) were the most common clinical features. Functional impairment (59.5%) and urinary incontinence (59.5%) were the leading geriatric syndromes, followed by polypharmacy (56.9%), depressive symptoms (54.7%), falls (52.6%), insomnia (49.1%), malnutrition (24.3%), and delirium (6.0%). Women had more functional impairment and depressive symptoms than men. Conclusion: Although most patients had mild dementia, three-quarters of the DLB cohort had hallucinations, and nearly two-thirds were functionally impaired. The proportion of other serious health conditions also increased, indicating a high comorbidity and geriatric syndrome burden. Comprehensive geriatric assessment is strongly recommended for DLB patients from the time of diagnosis until death to reduce disability and comorbidities. The Clinical Trial registration number: NCT05052450. [ABSTRACT FROM AUTHOR]

Background. A low hemoglobin level in older adults impairs cognitive ability and functional status and associates with risk of falls and fractures, sarcopenia, malnutrition, depression, frailty, and decreased autonomy. Epidemiological data on the anemia prevalence in the geriatric population in our country is not available. Aim. To assess the prevalence of anemia and analyze its associations with geriatric syndromes (GS) in subjects aged 65 years. Materials and methods. 4308 subjects (30% of men) aged 65107 years, living in 11 regions of the Russian Federation, were examined and divided into age groups (6574 years, 7584 years and 85 years). All the participants underwent a comprehensive geriatric assessment and determined hemoglobin level. Results. The anemia prevalence in older adults was 23.9%. It has been shown that with an increase in age per 1 year, the risk of anemia detection increases by 4%. The incidence of anemia was higher in males than females (28.1% versus 22.1%; p0.001). In most cases, anemia was mild. The results of a comprehensive geriatric assessment show that patients with anemia had lower hand grip force, Barthel Index, the sum of points on Lawton instrumental activities of daily living scale, Mini Nutritional Assessment scale, the Mini-Cog test and higher the sum of points on the Geriatric Depression Scale (GDS-15) and the Age Is No Barrier scale. Patients with anemia were more likely to use hearing aids, absorbent underwear, and assistive devices during movement. Patients with anemia had a higher incidence of all GS, except for orthostatic hypotension and chronic pain syndrome. The presence of GS is associated with an increased risk of anemia by 1.33.4 times. Conclusion. EVKALIPT study obtained domestic data on the prevalence of anemia in older patients and examined its associations with other GS.

Objective: The burden of cardiovascular diseases (CVDs) is highest among the older adults, who are often carriers of various geriatric syndromes. Studies evaluating CVDs among the old adults in the low- and middle-income countries are limited. This study was conducted to assess the frequency of CVDs and their risk factors among the older population and their association with geriatric syndromes. Subjects and Methods: In this cross-sectional study, 200 health-care seeking adults aged ≥75 years were subjected to routine comprehensive geriatric assessment (assessment for functionality, cognition, depression, frailty, and various geriatric syndromes) and a detailed cardiovascular evaluation using electrocardiography, chest X-ray, echocardiogram, HbA1c level, fasting lipid profile, thyroid function test, serum homocysteine level, and serum NT-pro-BNP. Results: The overall frequency of CVDs in this study was 76%. Polypharmacy, multi-morbidity, cognitive impairment, depression, frailty, and impairment of basic and instrumental activities of daily living were present in 50.5%, 91.5%, 6.5%, 10%, 30.5%, 24.5%, and 55% individuals, respectively. CVDs were significantly associated with increased risk of geriatric syndromes (multi-morbidity [odds ratio (OR) 3.61, confidence interval (CI) 1.13 – 11.54, P = 0.030], polypharmacy [OR 5.46, CI 2.23 – 13.34, P = 0.001] and frailty [OR 3.29, CI 1.01 – 10.64, P = 0.047]). Conclusion: The prevalence of CVDs and their risk factors among the older population was high and significantly associated with increased risk of geriatric syndromes. These observations further strengthen the need for routine geriatric assessment and integrated management of geriatric syndromes in older patients with CVDs.

BackgroundMalnutrition is prevalent among hospitalized older patients. Therefore, this study aimed to investigate the association between nutritional status [assessed using the Mini Nutritional Assessment (MNA) and serum albumin levels] and adverse outcomes in hospitalized older patients. We also aimed to compare the predictive utility of our findings.MethodsThis retrospective cohort study was conducted between January 2016 and June 2020. In total, 808 older patients (aged ≥ 65 years, mean age 82.8 ± 6.70 years, 45.9% male) admitted to the acute geriatric unit were included in our sample. Comprehensive geriatric assessments, including the MNA, were performed. Malnutrition and risk of malnutrition were defined as MNA < 17, albumin < 3.5 g/dL and 17 ≤ MNA ≤ 24, 3.5 g/dL ≤ albumin < 3.9 g/dL, respectively. The primary outcome was that patients could not be discharged to their own homes. The secondary outcomes were overall all-cause mortality, 3-month all-cause mortality, and incidence of geriatric syndrome, including delirium, falls, and newly developed or worsening pressure sores during hospitalization.ResultsPoor nutritional status was associated with older age; female sex; admission from the emergency room; high risk of pressure sores and falls; lower physical and cognitive function; higher depressive score; and lower serum albumin, protein, cholesterol, and hemoglobin levels. In the fully adjusted model, malnutrition assessed using the MNA predicted discharge to nursing homes or long-term care hospitals [odds ratio (OR) 5.822, 95% confidence interval (CI): 2.092–16.199, P = 0.001], geriatric syndrome (OR 2.069, 95% CI: 1.007–4.249, P = 0.048), and 3-month mortality (OR 3.519, 95% CI: 1.254–9.872, P = 0.017). However, malnutrition assessed using albumin levels could only predict 3-month mortality (OR 3.848, 95% CI: 1.465–10.105, P = 0.006). The MNA predicted 3-month mortality with higher precision than serum albumin levels (P = 0.034) when comparing the areas under the receiver operating characteristic curve.ConclusionNutritional risk measured by the MNA was an independent predictor of various negative outcomes in hospitalized older patients. Poor nutritional status assessed by serum albumin levels, the most widely used biochemical marker, could predict mortality, but not the development of geriatric syndrome or discharge location reflecting functional status.

IntroductionGeriatric syndrome (GS) increases risk of disability and mortality in older adults. Sarcopenia is a predominant illness of GS and accelerate its progression. This study aimed to investigate associations between mortality, emergency department (ED) re-visits and GS-related illnesses among older adults who visited the ED.MethodThis retrospective observational study enrolled elderly patients who visited the ED in our hospital between January 2018 and October 2020. Patients were evaluated for potential sarcopenia, which was defined by both low handgrip strength and calf circumference. Follow-up was at least 6 months. Data of age, gender, mortality, ED re-visits, and GS-related illnesses were collected and analyzed for associations.ResultsA total of 273 older adults aged 74 years or older were included, of whom 194 were diagnosed with possible sarcopenia. Older adults with possible sarcopenia also had significantly lower body mass index (BMI); a higher proportion needed assistance with daily activities; more had malnutrition, frailty, and history of falls (all p < 0.001) and acute decline in activities of daily living (p = 0.027). Multivariate analysis showed that possible sarcopenia [adjusted hazard ratio, aHR): 9.89, 95% confidence interval (CI): 1.17–83.81, p = 0.036], living in residential institutions (aHR: 2.85, 95% CI: 1.08–7.50, p = 0.034), and frailty (aHR: 7.30, 95% CI: 1.20–44.62, p = 0.031) were associated with mortality. Aged over 85 years (adjusted odds ratio: 2.44, 95% CI: 1.25–4.80, p = 0.02) was associated with ED re-visits.ConclusionSarcopenia is associated with mortality among older adults who visit ED. Initial screening for sarcopenia and relevant risk factors among older adults in the ED may help with early intervention for those at high-risk and may improve their prognosis.

As the population ages, the global cardiovascular disease burden will continue to increase, particularly among older adults. Increases in life expectancy and better cardiovascular care have significantly reshaped the epidemiology of cardiovascular disease and have created new patient profiles. The combination of older age, multiple comorbidities, polypharmacy, frailty, and adverse noncardiovascular outcomes is challenging our routine clinical practice in this field. In this review, we examine noncardiovascular factors that statistically interact in a relevant way with health status and quality of life in older people with cardiovascular disease. We focused on specific geriatric conditions (multimorbidity, polypharmacy, geriatric syndromes, and frailty) that are responsible for a major risk of functional decline and have an important impact on the overall prognosis in this patient population.

Copyright of Indonesian Journal of Gastroenterology, Hepatology & Digestive Endoscopy is the property of Indonesian Society of Gastroenterology/Assoc for the Study of the Liver/Soc. for Digestive Endoscopy and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: to assess the structure and influence of chronic pain (CP) on the functional status of patients with geriatric syndromes.Patients and methods. The study included 370 geriatric patients who were divided into two groups. Group A included 300 patients (mean age 75.1±8.25 years) with CP, and group B – 70 subjects of comparable age (75.1±7.75 years) without CP. All study participants were found to have polymorbidity: the Charlson index was 5.55±1.59 points in group A and 5.56±1.64 points in group B (p=0.963). All patients underwent a comprehensive geriatric assessment (CGE) to determine the functional status and diagnose geriatric syndromes.Results and discussion. According to the CGE data, senile asthenia syndrome was detected in 127 (42.3%) patients with CP and in 20 (28.6%) patients without CP (p=0.035). The average number of geriatric syndromes in group A was 7.06±2.68, in group B – 5.2±1.8 (p

Background: Visual impairment (VI) was associated with cognitive impairment. However, different visual trajectories might contribute to different risks of cognitive decline in the elderly. Aims: This study aimed to evaluate the association between visual trajectories and cognitive impairment. Methods: Four thousand two hundred eight community-dwelling elder adults were identified from Waves IV–VII (1999–2011) survey of the Taiwan Longitudinal Study on Aging (TLSA). Cognitive function was determined using the Short Portable Mental Status Questionnaire (SPMSQ) scores. Visual impairment was self-reported and visual trajectories were assessed in at least two waves of the survey. Ordinal logistic regression was performed to estimate adjusted odds ratios (adjORs) and 95% confidence intervals (CIs). Results: Participants with visual trajectory from no VI to VI had significantly higher risk of cognitive impairment with an adjOR of 1.69 (95% CI 1.12–2.57) than participants without VI. Compared to participants without VI, participants with persistent VI (adjOR 1.32; 95% CI 0.89–1.96) and with visual trajectory from VI to no VI (adjOR 1.25; 95% CI 0.83–1.88) were not associated with cognitive impairment. A protective association between eyeglasses use and cognitive impairment (adjOR 0.69; 95% CI 0.55–0.87) was found in this study. Importantly, cataract was associated with higher risk of cognitive impairment (adjOR 1.34; 95% CI 1.10–1.62). However, nonsurgical cataract treatment did not show protective effect on cognitive impairment in patients with cataract. Conclusions and discussion: Visual trajectory from no VI to VI is a significant risk factor for cognitive impairment that physicians should pay special attention during community screening. [ABSTRACT FROM AUTHOR]

As the aging population increases, the number of elderly diabetic patients continues to increase. Elderly diabetic patients are more likely to develop cardiovascular and cerebrovascular diseases than other age groups because of the increased susceptibility to other diseases caused by diabetes. As a result, the quality of life is reduced and the death rate is increasing, which is considered a social problem. Therefore, in order to manage such patients, it is necessary to understand the characteristics of the elderly and solve problems that can occur in elderly diabetic patients. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the present study was to assess the effect of a specific oral nutritional supplement among patients recovered from COVID-19 but suffering symptoms of fatigue. Methods: This is an observational case–control study involving a sample of 66 COVID-19 survivors divided in two groups, 33 subjects in the intervention group who received the nutritional supplement and 33 subjects in the control group. The nutritional supplement received by subjects in the active group was based on amino acids; vitamin B6 and B1; and malic, succinic and citric acids. After an 8-week follow-up, the main outcomes considered were skeletal muscle index (measured by bioelectrical impedance analysis), physical performance measures (handgrip strength, one-minute chair–stand test, six-minute walking test), and quality of life (using EuroQol visual analogue scale). Results: All the considered areas increased significantly in the subjects receiving the active treatment with oral nutritional supplement in comparison with the baseline values. After adjusting for age, gender, and baseline values, skeletal muscle index, handgrip strength test, the one-minute chair–stand test, and six-minute walking test values were higher among participants in the treatment group compared with subjects in control group. The oral nutritional supplement significantly improved the handgrip strength; similarly, participants in the active group showed a higher improvement in skeletal muscle index, the one-minute chair–stand test, the six-minute walking test, and in quality of life. Conclusion: The nutritional supplement containing nine essential amino acids plus cysteine; vitamin B6 and B1; and malic, succinic and citric acids had a positive effect on nutritional status, functional recovery, and quality of life in COVID-19 survivors still suffering from fatigue. Additional controlled clinical trials are required to corroborate these results. [ABSTRACT FROM AUTHOR]

We aimed to search the relationship of sarcopenia with chronic diseases, geriatric syndromes and neutrophil/lymphocyte ratio (NLR). Our study included 258 patients who were admitted to Cerrahpaşa Medical Faculty geriatrics outpatient clinic for the first time between March 2018 and February 2019, and underwent comprehensive geriatric evaluation. Patients under 65 years of age, with active infection, terminal illness, diagnosis of malignancy, presence of trauma and infection in the last month were excluded from the study. Sarcopenia was present in 77 (30%) of the 258 participants involved in the study. Frequency of diabetes mellitus, dementia, delirium, polypharmacy and malnutrition was statistically significantly higher in patients with sarcopenia compared to patients without sarcopenia (p=0.020, p=0.024, p=0.016, p=0.018 and p<0.001, respectively). In multivariate logistic regression analysis, only malnutrition was found to be independently associated with sarcopenia [odds ratio (OR) 5.455 (95%) con- fidence interval (CI) 2.981--9.984, p<0.001]. Patients with sarcopenia had statistically significantly higher NLR, sedimentation and C-reactive protein (CRP) values than patients without sarcopenia (p=0.030, p=0.002 and p=0.015, respectively). Area under the ROC curve (AUC) of NLR was found to be 0.60 [odds ratio (OR) 1.214 (95%) confidence interval (CI) 1.016--1.451, p=0.033]. The significant relationship between sarcopenia and malnutrition revealed that these two geriatric syndromes should be evaluated together. In addition, increased CRP, sedimentation and NLR in sarcopenia support the idea of mild chronic inflammation in sarcopenia. More comprehensive studies are required to evaluate the usability of NLR in screening for sarcopenia. [ABSTRACT FROM AUTHOR]

Background: Geriatric syndromes (GS) are multi‐factorial conditions that make older adults vulnerable to morbidities and poor outcomes. The main objective was to observe the frequency of GS in older patients with COPD. Methods: A case‐control study was conducted in the Geriatric department of a tertiary care hospital in India to evaluate geriatric syndromes including falls, cognitive impairment, frailty, functional impairment, urinary incontinence, malnutrition, and depression in patients with COPD and controls without COPD. The factors having a significant association with the occurrence of these GS in COPD patients were observed. Results: In this study, 150 cases and 150 controls were included. The mean age of the participant was 65.85±5.54, with 76% males. Functional impairment, cognitive impairment, frailty, urinary incontinence, and malnutrition were significantly higher in COPD patients. The independent variables which increased the odds of geriatric syndromes were dyspnoea (≥2 mMRC grade) (AOR:3.54,95% CI:1.06‐11.8) and low socioeconomic status (AOR: 4.14, 95% CI: 1.03‐16.54), while male gender showed inverse association (AOR: 0.08,95% CI: 0.01‐0.99). Conclusion: Geriatric syndromes are common in older COPD patients, and assessment for them should be done routinely in these patients. [ABSTRACT FROM AUTHOR]

Objective: The burden of cardiovascular diseases (CVDs) is highest among the older adults, who are often carriers of various geriatric syndromes. Studies evaluating CVDs among the old adults in the low- and middle-income countries are limited. This study was conducted to assess the frequency of CVDs and their risk factors among the older population and their association with geriatric syndromes. Subjects and Methods: In this cross-sectional study, 200 health-care seeking adults aged ≥75 years were subjected to routine comprehensive geriatric assessment (assessment for functionality, cognition, depression, frailty, and various geriatric syndromes) and a detailed cardiovascular evaluation using electrocardiography, chest X-ray, echocardiogram, HbA1c level, fasting lipid profile, thyroid function test, serum homocysteine level, and serum NT-pro-BNP. Results: The overall frequency of CVDs in this study was 76%. Polypharmacy, multi-morbidity, cognitive impairment, depression, frailty, and impairment of basic and instrumental activities of daily living were present in 50.5%, 91.5%, 6.5%, 10%, 30.5%, 24.5%, and 55% individuals, respectively. CVDs were significantly associated with increased risk of geriatric syndromes (multi-morbidity [odds ratio (OR) 3.61, confidence interval (CI) 1.13 - 11.54, P = 0.030], polypharmacy [OR 5.46, CI 2.23 - 13.34, P = 0.001] and frailty [OR 3.29, CI 1.01 - 10.64, P = 0.047]). Conclusion: The prevalence of CVDs and their risk factors among the older population was high and significantly associated with increased risk of geriatric syndromes. These observations further strengthen the need for routine geriatric assessment and integrated management of geriatric syndromes in older patients with CVDs. [ABSTRACT FROM AUTHOR]

The administration of oral anticoagulants in elderly patients with geriatric syndromes such as senile asthenia syndrome, falls and high risk of falls, dementia, polymorbidity, polypharmacy are discussed in the article. The evidence base for the anticoagulants taking in patients with atrial fibrillation aged ≥75, ≥80, ≥85 and ≥90 years, in patients with atrial fibrillation and various geriatric syndromes, as well as in elderly patients with venous thromboembolic complications and frailty syndrome is presented. Most studies indicate significant advantages of direct oral anticoagulants (dabigatran, rivaroxaban, apixaban, and edoxaban) over the vitamin K antagonist warfarin in elderly patients with geriatric syndromes. An updated version of the FORTA consensus document, which aims to optimize the prescription of medicines for the elderly, is also presented. Apixaban has a FORTA-A safety class and is the safest oral anticoagulant in elderly patients.

Abstract Background Evidence is lacking on the differences between hospitalisation of people with dementia living in nursing homes and those living in the community. The objectives of this study were: 1) to describe the frequency of hospital admission among people with dementia in eight European countries living in nursing homes or in the community, 2) to examine the factors associated with hospitalisation in each setting, and 3) to evaluate the costs associated with it. Methods The present study is a secondary data analysis of the RightTimePlaceCare European project. A cross-sectional survey was conducted with data collected from people with dementia living at home or who had been admitted to a nursing home in the last 3 months, as well as from their caregivers. Data on hospital admissions at 3 months, cognitive and functional status, neuropsychiatric symptoms, comorbidity, polypharmacy, caregiver burden, nutritional status, and falls were assessed using validated instruments. Multivariate regression models were used to investigate the factors associated with hospital admission for each setting. Costs were estimated by multiplying quantities of resources used with the unit cost of each resource and inflated to the year 2019. Results The study sample comprised 1700 people with dementia living in the community and nursing homes. Within 3 months, 13.8 and 18.5% of people living in nursing homes and home care, respectively, experienced ≥1 hospital admission. In the nursing home setting, only polypharmacy was associated with a higher chance of hospital admission, while in the home care setting, unintentional weight loss, polypharmacy, falls, and more severe caregiver burden were associated with hospital admission. Overall, the estimated average costs per person with dementia/year among participants living in a nursing home were lower than those receiving home care. Conclusion Admission to hospital is frequent among people with dementia, especially among those living in the community, and seems to impose a remarkable economic burden. The identification and establishment of an individualised care plan for those people with dementia with polypharmacy in nursing homes, and those with involuntary weight loss, accidental falls, polypharmacy and higher caregiver burden in the home care setting, might help preventing unnecessary hospital admissions.

BackgroundSarcopenia and osteoporosis are important health issues faced by older people. These are often associated with each other and share common risk factors and pathologic mechanisms. In the recently revised consensus of the European Working Group on Sarcopenia in Older People, low muscle strength has been defined as the first characteristic of sarcopenia rather than a loss in muscle mass, and walking speed has been stated as an indicator of the severity of sarcopenia. It is believed that these markers of muscle function can be potentially reversed via exercise-based interventions. The purpose of this study was to evaluate the effects of kickboxing exercise training on the parameters of sarcopenia and osteoporosis in community-dwelling adults.MethodsIn total, one hundred eligible subjects were randomized into an intervention group (n = 50) with 76% women and control group (n = 50) with 86% women. Both the intervention and control groups were provided with classroom lectures and personal consultations pertaining to sarcopenia and osteoporosis, whereas a 12-week kickboxing exercise training was arranged only for the intervention group. All anthropometric, physical performance, body composition, and bone mineral density measurements along with participant completed questionnaires were conducted before and after the training period.ResultsAfter 12 weeks, 41 participants in the intervention group and 34 participants in the control group completed the final assessments. There was no difference between the intervention and control groups in terms of basic demographic data. The BMI (+1.14%) of the control group increased significantly during the study period. The waist circumference (−6.54%), waist-to-height ratio (−6.57%), waist–to–hip ratio (−4.36%), total body fat (−1.09%), and visceral fat area (−4.6%) decreased significantly in the intervention group. Handgrip strength (+5.46%) and gait speed (+5.71%) improved significantly in the intervention group. The lean body mass increased by 0.35% in the intervention group and by 0.9% in the control group. The femoral neck bone mineral density (−1.45%) and T score (−3.72%) of the control group decreased significantly. The intervention group had more improvement in the status of sarcopenia (OR 1.91) and osteoporosis over the control group. Finally, the intervention group had less deterioration in the status of sarcopenia (OR 0.2) and osteoporosis (OR 0.86) compared with the control group.ConclusionOur study demonstrated that a 12-week kickboxing exercise training program is effective for improving sarcopenic parameters of muscle strength and function, but not muscle mass in adults, aged 50–85 years. Furthermore, markers of osteoporosis also showed improvement. These findings suggest that a 12-week kickboxing program is effective for muscle and bone health among community-dwelling older individuals.

In recent decades, Latin America and the Caribbean region have experienced accelerated aging. However, despite the significant progress of gerontology in the region, the number of geriatricians and professionals trained in the field is low; a notable gap in the training related to the assessment of older adults can also be observed. Therefore, in this literature review, we update the concept of Comprehensive Gerontological Assessment (CGA) for its application in the region. We compile the characteristics, validity, and reliability of CGA tools, and their usage in government documents across countries in the region. We also analyze the adaptations made to CGA during the COVID-19 pandemic, and discuss challenges related to CGA administration, academic training, research, innovation, and management. This study is particularly relevant as it proposes lines of action for decision-makers, academics, researchers, university students, and the general community, which will allow for more tailored interventions aimed at meeting the needs of older adults, their families, and caregivers. Such actions will positively impact functionality, autonomy, and quality of life, while promoting healthy, active, and successful aging in the region.

Purpose of Review: Potent, well tolerated and simple to administer antiretroviral therapy (ART) has resulted in significant improvement in life expectancy for people with HIV. The increased lifespan does not necessarily equate to improved healthspan with increased rates of comorbidities, frailty and geriatric syndrome experienced by older people with HIV. This review explores the challenges in prevention and management of multimorbidity and geriatric syndrome with the ultimate goal of improving health and quality of life through holistic care., Recent Findings: Recent studies have drawn attention to the multifactorial nature of most comorbidities experienced by people with HIV. Adverse effects of contemporary ART, combined with lifestyle factors of smoking, excess alcohol and other substance use, chronic immune activation and inflammation associated with chronic HIV infection and other co-infections, all impact multimorbidity and geriatric syndromes. The complex healthcare needs of the aging population of people with HIV will require comprehensive, multidisciplinary integrated models of care., Competing Interests: Declarations. Human and Animal Rights and Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors. Competing Interests: JH’s institution received reimbursement for her time on Advisory Boards for Gilead Sciences and ViiV Healthcare., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Studies addressing frailty in the context of multiple sclerosis (MS) are emergent. This study explores cognitive function in older adults with MS as a function of frailty status., Methods: This cross-sectional study used baseline data from a feasibility randomized controlled trial of a home-based exercise program for older adults with MS. Frailty was verified using performance scores from the Short Physical Performance Battery (SPPB) and cut points available in the literature. Cognitive function was assessed using the Brief International Cognitive Assessments for Multiple Sclerosis (BICAMS). Data were analyzed using inferential statistics adopting a significance of P < .05., Results: Data from 26 older adults with MS (≥60 years) were analyzed. The majority of the participants were women, and over 85% of the sample had the relapsing-remitting form of MS. Participants reported a mean of more than 20 years of disease and a moderate level of disability (Expanded Disability Status Scale score = 4). Nearly 58% of the sample was classified as frail based on SPPB scores. Univariate analysis demonstrated that frail older adults performed significantly worse ( P < .05) on all 3 BICAMS tests. However, after controlling for age and disability level, only visuospatial memory remained significant between frailty groups ( P = .043)., Conclusions: Our findings suggest reduced cognitive function in frail older adults with MS compared with their nonfrail counterparts. This highlights the need to develop interventions to improve cognitive function and to reverse frailty for older adults with MS., Competing Interests: CONFLICT OF INTEREST: The authors declare no conflict of interest related to this work., (© 2024 Consortium of Multiple Sclerosis Centers.)

Aging is a complex process of physiological and social changes that leads to various diseases. The number of elderly people in the world is increasing dramatically and it should be noted that rapid population aging represents a major public health burden. On the other hand, providing an appropriate and low-cost approach to control and prevent complications such as chronic diseases, physical dysfunction, and the geriatric syndrome is necessary. Also, numerous studies have shown that participation in physical activity and exercise training reduces the incidence of dysfunctional capacity, cardiovascular and metabolic disease, as well as the premature death rate in older adults. After plenty of precise observations about the role of exercise on aging-related diseases and geriatric syndromes articles, the benefits of exercise and physical activity in older adults will be more tangible. Therefore, the first purpose of the present review was to investigate the mechanisms of PA and exercises that are involved in the prevention of aging-related diseases and GS using current evidence (from 2015 onwards). Also, the purpose of this study was to provide an exercise guideline (aerobic and resistance training) based on recent evidence (from 2015 onwards).

In current clinical practice, when a fall occurs in a long‐term care facility, it is often treated as an accident. Falls are classified as one of the most commonly prevalent geriatric syndromes. As their causes are extremely diverse and complex, their occurrence rate depends on individual susceptibility, even if appropriate fall prevention measures are taken. Falls are common among older adults, and fractures and intracranial hemorrhage resulting from falls can lead to the deterioration of activities of daily living and death. For this reason, it is recommended that the risk of falls is assessed in the general population of older adults, and that appropriate interventions are carried out for those at high risk. In response to this situation, the Japan Geriatrics Society and the Japan Association of Geriatric Health Services Facilities have issued the following statements on falls as a geriatric syndrome based on scientific evidence, especially considering the frequent occurrence of falls in long‐term care facilities. Geriatr Gerontol Int 2022; 22: 193–205. [ABSTRACT FROM AUTHOR]

Objective: Age‐related brain symptoms (gait, speech and swallowing difficulties, and dementia) increase the risk of aspiration pneumonia (AP). It is not known which types of brain disease underlie AP most closely. Our neurogeriatric team addressed this issue herein. Patients and Methods: We retrospectively analyzed the cases of in‐patients diagnosed with AP at our multi‐faculty university hospital within a 12‐month recruiting period, with a 3.0 ± 2.5‐week follow‐up and ≥1×/week visits. We determined the patients' organic and neural disorders with neuroimaging to the extent possible. Results: The AP patients (n = 136) were generally old (mean age 75 years, range 3‐98 years) and male‐dominant (81 males, 55 females). All patients showed gait and attention/cognitive problems at admission, suggestive of encephalopathy/delirium. They were treated in 11 hospital wards: neurology (N) or non‐N (ratio ~1:1.3). The ratio of organic disorders (esophageal carcinoma, etc) vs neural disorders was ~1:30. Most of the neural disorders were age‐related brain diseases, eg, a combination of white matter disease (WMD) and Alzheimer's disease (AD), followed by dementia with Lewy bodies (DLB). In total, they were WMD in 111, AD in 102, DLB in 20. Conclusion: A combination of premorbid age‐related brain diseases (a combination of WMD and AD, DLB, etc) with encephalopathy/delirium (and intrinsic brain diseases) might lead to AP. [ABSTRACT FROM AUTHOR]

Copyright of Osmangazi Journal of Medicine / Osmangazi Tip Dergisi is the property of Eskisehir Osmangazi University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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The use of artificial intelligence in geriatrics is very promising and relevant, as the diagnosis of a geriatric patient is a complex, experience-based, and time-consuming process that involves a variety of questionnaires and subjective and inaccurate patient responses. This paper proposes the explainable artificial intelligence-based (XAI) clinical decision support system (CDSS) to assess nutrition-related factors (symptoms) and to determine the likelihood of geriatric patient health risks associated with four syndromes: malnutrition, oropharyngeal dysphagia, dehydration, and eating disorders in dementia. The proposed system's prototype was tested under real conditions at the geriatric department of Lithuanian University of Health Sciences Kaunas Hospital. The subjects of this study were 83 geriatric patients with various health conditions. The assessments of the nutritional status and syndromes of the patients provided by the CDSS were compared with the diagnoses of the physicians obtained using standard assessment methods. The results show that proposed CDSS can efficiently diagnose nutrition-related geriatric syndromes with high accuracy: 87.95% for malnutrition, 87.95% for oropharyngeal dysphagia, 90.36% for eating disorders in dementia, and 86.75% for dehydration. The research confirms that the proposed XAI-based CDSS is an effective tool, able to assess nutrition-related health risk factors and their dependencies and, in some cases, makes even a more accurate decision than a less experienced physician. [ABSTRACT FROM AUTHOR]

This case study reviews the pharmacotherapy of a resident in a long-term care facility being treated for poststroke seizure, hallucinations, and dementia, a geriatric syndrome that is both common in regard to its prevalence and severe in regard to its impact on the individual, families, caregivers, and health care system. This case describes the past medical history of an older resident in a skilled nursing facility that was receiving pharmacological therapy for auditory hallucinations and for poststroke seizure prophylaxis, was noted to be having side effects from drug therapy, and how the nursing staff communicated with the consultant pharmacist to resolve these issues. [ABSTRACT FROM AUTHOR]

Objectives: Among older women, the clinical presentation of urinary incontinence (UI) is heterogeneous; presenting as a pelvic floor condition or geriatric syndrome. We aimed to characterize the geriatric incontinence syndrome (GIS) to establish its foundation in clinical practice. Design Prospective study. Setting: Geriatric Clinical Research Unit. Participants: Sixty‐one community‐dwelling women aged 70 and older with bothersome UI symptoms. Measurements UI symptom type and severity were determined by 3‐day bladder diary. UI severity was defined; moderate UI defined as <2 UI episodes/day and severe UI defined as ≥2 UI episodes/day. Subjective assessment of physical performance was determined using the Short Physical Performance Battery (SPPB) score. Total SPPB scores >9 define normal physical performance and scores ≤9 defined impaired physical performance. Results: The average age was 77.1 ± 5.8 (mean ± SD) years; 69% of women had severe UI and 31% had moderate UI. Demographic characteristics were similar between groups. Daytime voiding frequency was 7.1 ± 2.9 and nocturia was present equally between groups. The majority of women (59%) with severe UI had SPPB ≤9 compared with 26% among women with moderate UI (p = 0.02); featuring significantly slower chair stand scores (2.3 ± 1.4 vs 3.3 ± 0.9, p = 0.007) and gait speed (0.08 ± 0.2 m/s compared with 1.0 ± 0.2 in women with moderate UI). Conclusions: A multifactorial GIS may be present in older women evidenced by the co‐existence of severe UI, physical disability, slower chair stand pace, and gait speed. Prospective studies are needed to understand how these clinical features may impact the clinical care of older incontinent women. [ABSTRACT FROM AUTHOR]

Copyright of Dokuz Eylül Üniversitesi Hemsirelik Fakültesi Elektronik Dergisi is the property of Dokuz Eylul Universitesi Hemsirelik Fakultesi Elektronik Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article offers information on evaluating a 68-year-old patient experiencing diabetes symptoms and unintended weight loss. Topics discussed include diagnostic approaches for age-related diabetes complications; the importance of distinguishing between different causes of weight loss; and strategies for effective diabetes management in older adults.

The article offers information on adapting diabetes care strategies to accommodate aging patients in diverse settings. Topics discussed include methods for personalizing diabetes management for older adults; adjusting treatment approaches for various environments; and addressing specific challenges related to aging and diabetes care.