Geriatrics, Volume 7, Issue 6 (December 2022) – 26 articles

We prototyped a new device with a soft and flexible pressure sensor to measure the force to close the mandible with or without occlusal support (jaw-closing force, JCF). This study aimed to clarify the practicality of this instrument. Healthy young and older adults with occlusal support were recruited. Intra- and inter-rater reliability of the JCF meter was examined using data from younger participants. Data regarding age, sex, body mass index, remaining teeth, and dentures of the older adults were obtained. Furthermore, the right and left JCFs were measured using a JCF meter; occlusal force was measured using an existing occlusal force-measuring device. Intra- and inter-rater correlation coefficients were significantly reproducible (0.691–0.811, p < 0.05). JCF was correlated with occlusal force (p < 0.05). Multiple regression analysis revealed that factors significantly associated with JCF included denture status (p < 0.001), age (p = 0.038), and occlusal force (p = 0.043). The prototyped JCF meter can measure JCF with high reproducibility, reliability, and validity. Further, association with occlusal force, which is an existing index, was observed. This device could be used to measure the JCF with or without occlusal support as a new method of evaluating oral function in older adults. Full article

There is little research on what aspects of quality of life (QoL) are most important to culturally and linguistically diverse (CALD) older adults. This study aimed to identify what QoL dimensions were most important to CALD older adults receiving aged care services, and therefore, how relevant a new six dimensions QoL instrument developed for use in aged care is to this population. A three-stage, mixed-methods study was undertaken. Stage 1: n = 3 focus groups with aged care providers. Stage 2: n = 30 semi-structured interviews with Italian-born older adults in ethno-specific residential aged care. Stage 3: survey of n = 63 older adults from mixed CALD backgrounds receiving community aged care services. Overall, older adults asserted the importance of the six dimensions of the new QoL instrument. The importance of ‘identity’ and ‘purpose and meaning’ were identified via the focus groups; however, the community-based CALD older adults identified these aspects of quality of life as more important than older Italians in residential care. Being in ethno-specific residential aged care where needs relating to language, food, and religion were met and they continued to live with others from their community may have meant that the meeting of cultural needs was more taken for granted. Full article

Changes in vertebral body height depend on various factors which were analyzed in isolation and not as a whole. The aim of this study is to analyze what factors might influence the restoration of the vertebral body height after vertebral augmentation. We analyzed 48 patients (108 vertebrae) with osteoporotic vertebral fractures who underwent vertebral augmentation when a conservative treatment proved to be unsatisfactory. The analyses were carried out at the time of the fracture, during surgery (pre-cementation and post-cementation), at the first medical check-up (6 weeks post-surgery) and at the last medical check-up. The average vertebral height was measured, and the differences from the preoperative values were calculated at each timepoint. A Pearson correlation coefficient and a linear multivariable regression were carried out at different timepoints. The time since the vertebral fracture was 60.4 ± 41.7 days. The patients’ average age was 73.8 ± 7 years. The total follow-up period was 1.43 ± 1 year. After vertebral cementation, there was an increase in the vertebral body height of +0.3 cm (13.6%). During the post-operative follow-up, there was a progressive collapse of the vertebral body, and the pre-surgical height was reached. The factors that most influenced the vertebral height restoration were: a grade III collapse, an intervertebral-vacuum-cleft (IVVC) and the use of a flexible trocar before cement augmentation. The factor that negatively influenced the vertebral body height restoration was the location of the thoracolumbar spine. Full article

(1) Introduction: Cardiovascular disease is associated with high mortality, especially in older people. This study aimed to characterize the evolution of combined multimorbidity and polypharmacy patterns in older people with different cardiovascular disease profiles. (2) Material and methods: This longitudinal study drew data from the Information System for Research in Primary Care in people aged 65 to 99 years with profiles of cardiovascular multimorbidity. Combined patterns of multimorbidity and polypharmacy were analysed using fuzzy c-means clustering techniques and hidden Markov models. The prevalence, observed/expected ratio, and exclusivity of chronic diseases and/or groups of these with the corresponding medication were described. (3) Results: The study included 114,516 people, mostly men (59.6%) with a mean age of 78.8 years and a high prevalence of polypharmacy (83.5%). The following patterns were identified: Mental, behavioural, digestive and cerebrovascular; Neuropathy, autoimmune and musculoskeletal; Musculoskeletal, mental, behavioural, genitourinary, digestive and dermatological; Non-specific; Multisystemic; Respiratory, cardiovascular, behavioural and genitourinary; Diabetes and ischemic cardiopathy; and Cardiac. The prevalence of overrepresented health problems and drugs remained stable over the years, although by study end, cohort survivors had more polypharmacy and multimorbidity. Most people followed the same pattern over time; the most frequent transitions were from Non-specific to Mental, behavioural, digestive and cerebrovascular and from Musculoskeletal, mental, behavioural, genitourinary, digestive and dermatological to Non-specific. (4) Conclusions: Eight combined multimorbidity and polypharmacy patterns, differentiated by sex, remained stable over follow-up. Understanding the behaviour of different diseases and drugs can help design individualised interventions in populations with clinical complexity. Full article

The safe integration of Automated Driving Systems (ADS) into the nation’s on-road transportation system, particularly in rural areas, could vastly improve overall quality of life for a rapidly growing segment of the US population. This paper describes findings from the first half (i.e., three of six phases) of a demonstration project called “ADS for Rural America”. The goal of this project is to conduct a series of demonstrations that utilizes an autonomous shuttle to show how older adults (≥65 years old) could be transported from their rural homes to other locations in rural areas, as well as an urban center. This paper examines older adults’ perceptions of automation before and after riding in an autonomous shuttle and their ratings of anxiety throughout the ride as they experience particular road types and maneuvers. After riding in the shuttle, older adults expressed decreased suspicion, increased trust, and increased reliability of ADS compared to baseline. Older adults reported low levels of anxiety during the 90 min ride in the shuttle. To promote the adoption and acceptance of ADS, older adults should be exposed to this technology. Full article

Alexithymia is a critical global public health concern. This questionnaire-based cross-sectional study explored the risk factors of alexithymia in older adults living in nursing homes with chronic diseases. It also developed and evaluated an alexithymia risk-prediction model. A total of 203 older adults with chronic diseases were selected from seven nursing homes in Changsha, China, using simple random and cluster sampling. The participants were surveyed using the Toronto Alexithymia Scale (TAS-20), Geriatric Depression Scale-15 (GDS-15), Connor-Davidson Resilience Scale (CD-RISC), Perceived Social Support Scale (PSSS), and a socio-demographic characteristics questionnaire. The alexithymia total score was 43.85 ± 9.570, with an incidence rate of 8.9%. Alexithymia had a partial mediating effect on the relationship between social support and psychological resilience (the effect value was 0.12), accounting for 19.04% of the total effect. Gender, depression, and psychological resilience were the main independent influencing factors of alexithymia (p < 0.05). The area under the receiver operating characteristic (AUC-ROC) curve of the risk-prediction model was 0.770. The participants, especially those who were male and depressed, exhibited a certain degree of alexithymia. Additionally, it partially mediated the association between social support and psychological resilience, which is a protective factor against alexithymia. The risk-prediction model showed good accuracy and discrimination. Hence, it can be used for preliminary screening of alexithymia in older adults with chronic diseases living in nursing homes. Full article

Ukraine imposed a COVID-19 lockdown in March 2020. From April to June 2020, we surveyed 123 older people with HIV (OPWH) by phone to assess their mental health, engagement in HIV and other healthcare, and substance use using standardised scales. Variables of key interest were symptoms of depression and symptoms of anxiety. Univariate and multivariable Firth logistic regression models were built to assess factors associated with: (1) symptoms of depression, and (2) symptoms of anxiety. Findings indicated high suicidal ideation (10.6%); 45.5% met the screening criteria for moderate to severe depression; and 35.0% met the criteria for generalised anxiety disorder (GAD). Independent correlates of having moderate to severe depression included being female (AOR: 2.83, 95%CI = 1.19–7.05), having concerns about potential barriers to HIV treatment (AOR: 8.90, 95%CI = 1.31–104.94), and active drug use (AOR: 34.53, 95%CI = 3.02–4885.85). Being female (AOR: 5.30, 95%CI = 2.16–14.30) and having concerns about potential barriers to HIV treatment (AOR: 5.33, 95%CI = 1.22–28.45) were independently correlated with GAD, and over half (58.5%) were willing to provide peer support to other OPWH. These results highlight the impact of the COVID-19 restrictions in Ukraine on mental health for OPWH and support the need to screen for psychiatric and substance use disorders, potentially using telehealth strategies. Full article

Understanding socioeconomic inequalities in non-communicable disease prevalence and preventive care usage can help design effective action plans for health equality programs among India’s aging population. Hypertension (HTN) and diabetes mellitus (DM) are frequently used as model non-communicable diseases for research and policy purposes as these two are the most prevalent NCDs in India and are the leading causes of mortality. For this investigation, data on 31,464 older persons (aged 60 years and above) who took part in the Longitudinal Ageing Survey of India (LASI: 2017–2018) were analyzed. The concentration index was used to assess socioeconomic inequality whereas relative inequalities indices were used to compare HTN, DM, and preventive care usage between the different groups of individuals based on socioeconomic status. The study reveals that wealthy older adults in India had a higher frequency of HTN and DM than the poor elderly. Significant differences in the usage of preventive care, such as blood pressure/blood glucose monitoring, were found among people with HTN or DM. Furthermore, economic position, education, type of work, and residential status were identified as important factors for monitoring inequalities in access to preventive care for HTN and DM. Disparities in non-communicable diseases can be both a cause and an effect of inequality across social strata in India. Full article

We assessed the association between polypharmacy and cardiovascular autonomic function among community-dwelling elderly patients having chronic diseases. Three hundred and twenty-one patients from an urban municipality area of Kolkata, India were studied in August 2022. The anticholinergic burden and cardiac autonomic function (Valsalva ratio, orthostatic hypotension, change in diastolic blood pressure after an isometric exercise, and heart rate variability during expiration and inspiration) were evaluated. Binary logistic regression analysis was performed to find out the association of polypharmacy and total anticholinergic burden with cardiac autonomic neuropathy. A total of 305 patients (age, 68.9 ± 3.4; 65.9% male) were included. Of these patients, 81 (26.6%) were on polypharmacy. Out of these 81 patients, 42 patients were on ninety-eight potential inappropriate medications. The anticholinergic burden and the proportion of patients with cardiac autonomic neuropathy were significantly higher among patients who were on polypharmacy than those who were not (8.1 ± 2.3 vs. 2.3 ± 0.9; p = 0.03 and 56.8% vs. 44.6%; p = 0.01). The presence of polypharmacy and a total anticholinergic burden of > 3 was significantly associated with cardiac autonomic neuropathy (aOR, 2.66; 95% CI, 0.91–3.98 and aOR, 2.51; 95% CI, 0.99–3.52, respectively). Thus, polypharmacy was significantly associated with cardiac autonomic neuropathy among community-dwelling elderly patients. Full article

Globally the population of older adults is the fastest growing age group. Estimated glomerular filtration rate (eGFR) is an estimation of true kidney function with lower eGFR associated with higher mortality. However, few studies explore eGFR’s prognostic value in the nonagenarian. We investigated the association between eGFR on admission and mortality among the nonagenarians hospitalised with acute illness. A retrospective analysis of a prospective cohort study included patients aged ≥ 90 admitted into three acute medical assessment units or acute geriatric wards in England and Scotland between November 2008 and January 2009. Association between eGFR and all-cause mortality was evaluated using the Cox proportional hazard models controlling for potential confounders including frailty. 392 patients with mean (SD) 93.0 ± 2.6 years (68.45% women) were included. The median (IQR) eGFR was 26.61 (18.41–40.41) mL/min/1.73². 63 died in in hospital. Low eGFR was not associated with mortality (Hazard ratio (HR) 1.00 (95% CI 0.98–1.02) overall or in sub–group analysis by frailty (HR 0.96 (0.92–1.01)) or by eGFR of ≤30 (HR 1.01 (0.95–1.06). We found no evidence of prognostic value of eGFR in predicting in–hospital mortality in the acutely unwell hospitalised nonagenarians. Full article

Background: To verify the effects in terms of feasibility, strength and functional abilities of a standardized exercise training method that is partially supported (home training), with the aim of improving motor abilities and well-being. Methods: A total of 67 participants underwent two sessions per week for 12 weeks for the program, based on 8 sequences with specific body part targets, with each sequence made up of 9 exercises. Outcome measures: Recording of training session data, Chair Test, Hand Grip Test, Timed Up-and-Go Test, Stork Balance Test, Sit-and-Reach Test, VAS, Perceived Physical Exertion. Results: In total, 97% of the sample were “adherent” (more than 70% of the prescribed treatments performed). The rate of adverse events was infrequent (only 8). Chair Test +31%, Hand Grip Test +6%, Timed Up-and-Go Test −17%, Stork Balance Test +65%, Sit-and-Reach Test +55%, VAS −34%, Perceived Physical Exertion −69%. Conclusions: Home training has good feasibility (adherence, tolerability, safety) and cost-effectiveness ratio and improves both strength and functional abilities, which, in turns, helps to improve motor abilities and well-being. Full article

Background: The bone health of patients with locally advanced and metastatic prostate cancer is at risk from treatment-related bone density loss and skeletal-related events from metastatic disease in bones. Evidence-based guidelines recommend using denosumab or zoledronic acid at bone metastasis-indicated dosages in the setting of castration-resistant prostate cancer with bone metastases and at the osteoporosis-indicated dosages in the hormone-sensitive setting in patients with a significant risk of fragility fracture. For the concerns of jaw osteonecrosis, a dental evaluation is recommended before starting bone-modifying agents. The literature review suggests a limited evidence-based practice for bone health with prostate cancer in the real world. Both under-treatment and inappropriate dosing of bone remodeling therapies place additional risks to bone health. An incomplete dental work up before starting bone-modifying agents increases the risk of jaw osteonecrosis. Methods: We created an algorithm-based clinical practice tool to minimize the deviation from evidence-based guidelines at our center and provide appropriate bone health care to our patients by ensuring indication-appropriate dosing and dental screening rates. This order set was incorporated into the electronic medical record system for ordering a bone remodeling agent for prostate cancer. The tool prompts the clinicians to follow the appropriate algorithm in a stepwise manner to ensure a pretreatment dental evaluation and use of the correct dosage of drugs. Results: We analyzed the data from Sept 2019 to April 2022 following the incorporation of this tool. 0/35 (0%) patients were placed on inappropriate bone modifying agent dosing, and dental health was addressed in every patient before initiating treatment. We compared the change in the practice of prescribing and noted a significant difference in the clinician’s practice while prescribing denosumab/zoledronic acid before and after implementation of this tool [incorrect dosing: 24/41 vs. 0/35 (p < 0.00001)]; and an improvement in pretreatment dental checkup before and after implementation of the tool was noted to be [missed dental evaluation:12/41 vs. 0/35 (p < 0.00001)]. Conclusion: We found that incorporating an evidence-based algorithm in the order set while prescribing bone remodeling agents significantly improved our institutional clinical practice of indication-appropriate dosing and dental screening rates, and facilitated high-quality, evidence-based care to our patients with prostate cancer. Full article

Background: Despite the well-known health benefits of adopting a healthy lifestyle, older adults’ self-determination, goals, and motivation, as well as other personality factors, are known to influence their healthy lifestyle behaviors, yet these interactions have rarely been discussed. Method: The literature that investigated and discussed the interaction of personality, goals, and healthy lifestyle behaviors among older adults was reviewed. In addition, interview responses from older adults regarding their experiences in participating in a real-life physical activity intervention and its relationship with their personality traits and goal setting were synthesized using content analysis. Results: The current review highlights the relationship between healthy living practices, goal setting, and personalities, and it is backed up and expanded upon by interviews with participants. People with different personality types are likely to have diverse views on HLBs. Individuals who are more conscientiousness or extraverted are more likely to adopt HLBs than those who are not. Discussion: It is suggested that a meta-analysis should be conducted on the relationship between personality, goal setting, and physical exercise or other specific HLBs. In addition, future research should focus on various types of HLB therapies that take into account personality and goal setting. Full article

Current evidence suggests that attitude towards older people may be associated with sociodemographic and educational variables; hence, a positive attitude towards older people is key when training new university professionals. However, there is little evidence of this association in Chilean university students. The objective was to analyze students from a Chilean university’s attitudes towards older people, according to sociodemographic and educational variables. Analytical and cross-sectional study; 515 students from a Chilean university were consulted online about their attitude towards older people using Kogan’s Attitudes towards Old People scale. Additionally, sociodemographic and educational variables were recorded. The average score for positive attitude was 70.8 (±9.7), while the negative attitude score was 68.3 (±11.6). The total score was 139.1 (±16.6). Mostly, university students perceive themselves with a low-level positive attitude (61.2%). Additionally, older university students (26–42 years old); women; Chileans; students of law, speech therapy, and occupational therapy; students in their final years of the programs; and those who had training in older people outside the university have a more positive attitude towards older people. In Conclusion, a profile of sociodemographic and educational characteristics of students with a lower and higher attitude towards older age was investigated. These results are relevant since the way of seeing the aging process could regulate the training of future professionals and consequently generate changes in dealing with older people. Young people’s perception of ageing would affect the treatment and incorporation of the older people in society and the adaptation of policies in this age group. Full article

Oropharyngeal dysphagia (OD) impacts the safety and efficacy of the swallowing function. The aim was to uncover the effect of chin tuck against resistance (CTAR) exercises compared to standard care in relation to the swallowing function in citizens with OD. Ninety-two citizens (46% male, median age 78 years (IQR 71, 84)) with OD confirmed by the Volume-Viscosity Swallow Test and/or Minimal Eating Observation Form version II were randomised to standard care with the addition of CTAR daily for six weeks or standard care only. The participants were included from seven Danish municipalities from March 2019 to October 2020. A nonsignificant effect on dysphagia of CTAR training combined with standard care versus standard care alone was documented. Both CTAR training combined with standard care and standard care alone had a significant effect on the swallowing function in citizens with OD, with the best effect in the group receiving CTAR training combined with standard care. A significant effect compared to baseline was observed in all participants (p = 0.03) after 12 weeks. Participants in both groups had a significant reduction in problems with manipulating food in the mouth (p = 0.005), swallowing (p = 0.005), and chewing (p = 0.03) but an increased appetite (p = 0.01). The reported quality of life scored with DHI-DK was significantly improved in both groups. Full article

The maintenance and improvement of balance and walking function in patients with Parkinson’s disease (PD) is essential. Toe dysfunction in patients with PD is related to balance and walking. Recently, insoles have been developed to improve toe function, but their effects on the physical functions of patients with PD remain unclear. In this randomized controlled study, we investigated the effects of insoles with a toe-grip bar on balance and walking function in such patients. Twenty-nine patients with PD in Hoehn and Yahr stages II–IV were randomly assigned to an intervention or control group. Patients in the intervention and control groups wore shoes having insoles with and without a toe-grip bar for 4 weeks, respectively. The center of gravity sway of standing posture (total trajectory length, envelope area, and maximum anterior–posterior center of pressure [AP-COP] distance) and walking parameters at normal and fast speeds were measured pre- and post-intervention in the rehabilitation room. All measurements were performed with the participants being barefoot. The maximum AP-COP distance and step length of the fast-walking condition were significantly improved in the intervention compared to the control group (p < 0.05). Thus, insoles with a toe-grip bar may improve balance and walking function in patients with PD. Full article

Background: Frailty predisposes individuals to stressors, increasing morbidity and mortality risk. Therefore, this study examined the impact of frailty defined by the Hospital Frailty Risk Score (HFRS) and other characteristics in older hospitalized patients with Obstructive Sleep Apnea (OSA). Methods: We conducted a retrospective study using the National Inpatient Sample 2016 in patients ≥65 years old with OSA. Logistic regression was used to evaluate the impact of frailty on inpatient mortality. A Kaplan-Meier curve with a log-rank test was used to estimate survival time between frailty groups. Results: 182,174 discharge records of elderly OSA were included in the study. 54% of the cohort were determined to be a medium/high frailty risk, according to HFRS. In multivariable analysis, frailty was associated with a fourfold (medium frailty, adjusted odd ratio (aOR): 4.12, 95% Confidence Interval (CI): 3.76–4.53, p-value < 0.001) and sixfold (high frailty, OR: 6.38, 95% CI: 5.60–7.27, p-value < 0.001) increased odds of mortality. Hospital survival time was significantly different between the three frailty groups (Log-rank test, p < 0.0001). Comorbidity burden defined by Charlson comorbidity Index (CCI) was associated with increased mortality (p < 0.001). Conclusion: More than half of the whole cohort was determined to be at medium and high frailty risk. Frailty was a significant predictor of in-hospital deaths in hospitalized OSA patients. Frailty assessment may be applicable for risk stratification of older hospitalized OSA patients. Full article

Background: Driving cessation is difficult for persons living with cognitive decline (PLWCD) and their caregivers (CG). Physicians are often required to notify authorities of driving risks, and typically base decisions on paper-based cognitive assessments and on-road tests. This study examines experiences surrounding cessation and CG’s views regarding simulators in the process. Methods: Semi-structured virtual interviews were conducted with CGs of PLWCD from an academic memory clinic. Experiences around cessation were explored first, followed by discussions regarding the simulator. Framework analysis was applied to transcribed interviews. Results: Six females and two males, three children and five spouses participated. PLWCD viewed driving cessation negatively, often had difficulty understanding why, and believed cessation was temporary. CGs experienced relief and/or shock. Cessation negatively impacted the relationships between the PLWCD and both the physician and CG. Isolation, coping challenges and loss of independence were experienced by the PLWCD. The lives of caregivers were adversely affected, especially regarding driving burden and worsening mental health. CGs were generally supportive of simulators. Positives included: measurement of driving skills, method of testing, and providing an understanding regarding the driving suspension. Potential drawbacks included difficulty using the machine, testing anxiety and stress induced by a crash. Caregivers were concerned about: PLWCD’s disappointment of failure, requesting to retest, and reluctance to accept the decision. Conclusion: PLWCD and caregivers had negative experiences related to the driving cessation. Generally, caregivers viewed implementing driving simulators positively, in a context of a practice session and support for PLWCD’s potential reactions to the decision. Full article

As the global population ages, frailty, which has been shown to affect and predict the quality of life (QoL) of older adults, has become a central issue. The aim of this study was to explore the mediating effects of daily physical activity (DPA) and healthy life self-efficacy (HLSE) on the relationship between frailty and QoL in older adults using a serial multiple mediation model. The cross-sectional study was conducted among 210 community-dwelling older adults in Taiwan. Data were collected using the Taiwanese version of the Tilburg Frailty Indicator, the EuroQoL visual analog scale, the Kihon Checklist, and the Chronic Disease Self-Efficacy Scales. The PROCESS macro for SPSS based on the bootstrap method was used to determine the mediating effects of DPA and HLSE on the relationship between frailty and QoL. The results showed that frailty was found to have both direct and indirect effects on QoL. As predicted, DPA and HLSE partially mediated the relationship between frailty and quality of life (DPA: B = −0.71, p < 0.001; HLSE: B = −0.32, p < 0.001). In addition, serial mediation analyses indicated that the association between frailty and QoL was partially mediated by DPA and HLSE in a sequential manner (B = −0.16, p < 0.001). The serial mediation has a causal chain linking DPA and HLSE, with a specified direction of causal flow. According to the results of the serial multiple mediation model, the elderly should be encouraged to continue their activities in daily life, which not only improves self-efficacy and confidence in maintaining health but also reduces the negative impact of frailty on QoL. Full article

Aging is a global phenomenon, and the use of exercise technology by older adults can help them to prevent disease, achieve good health, and ultimately achieve successful aging. In the past, there literature compilation studies have been conducted on sports technology and young people or on the use of technology by the older adults; however, no studies have determined the attitudes of older adults toward sports technology. This review applied a systematic literature analysis to determine the factors that correlate the technology acceptance model with the older population’s exercise attitudes. A total of 10 studies were identified as contributing to the use of exercise technology by older adults. The main findings of this review are that, of the 28 factors identified in the 10 studies, only 18 were identified as factors influencing older adults’ use of sports technology in the technology acceptance model (TAM). Among these, fifteen factors affected intention, four factors affected perceived ease of use, three factors affected perceived usefulness, and two factors affected attitudes. Finally, discussing the related factors affecting TAM allows us to provide suggestions for future research directions. Full article

In an aging human population, osteoporotic vertebral compression fracture (OVCF) frequently occurs. We conducted this retrospective study to analyze the clinical characteristics of elderly people with OVCF who underwent percutaneous vertebroplasty or kyphoplasty over a 12-year period at a single medical center in Korea. Between 2007 and 2019, A total of 868 patients (n = 868) were treated at our institution. We assessed 600 of these patients as eligible for study purposes and divided them into three groups: Group A (spine and hip T-scores ≤−2.5; n = 332); Group B (spine T-scores ≤−2.5; n = 189); and Group C (hip T-scores ≤−2.5; n = 79). The baseline characteristics of the patients included age, sex, body mass index (BMI), past history of steroid use, alcohol consumption, use of osteoporosis therapy, smoking, and treatment for OVCF. We compared these characteristics between the three groups. We found that the mean patient age was significantly higher in Group A, compared with Group B, and significantly lower in Group B, compared with Group C. We also found significant differences in the male-to-female ratio and mean body mass index between the three groups. In conclusion, we suggest that special attention should be paid to factors closely associated with spine and hip T-scores when evaluating elderly people with OVCF and determining appropriate treatment. Full article

Many older adults consider driving a crucial aspect of their daily routine and the prospect of driving cessation to be disruptive to their current lifestyle. Driving cessation is associated with multiple adverse consequences, including poorer health trajectories, and increased depressive symptoms. Research suggests that driving cessation may be disruptive to identity. This study aimed to explore the characteristics that are associated with driver identity and whether identity impacted people’s readiness for mobility changes. Of interest was whether stopping driving was perceived as either a positive or negative event. Participants, (N = 410) older adults recruited via Prolific survey panel between July and November 2021, responded to questions about transport and travel behaviors, driver identity, and perceptions of mobility changes. Driving cessation was generally perceived as a negative change. However, individuals with self-reported low readiness for mobility change also had higher overall scores for Identity, and for the subscales, Centrality and Ingroup Affect. These findings suggest that people with more concerns for mobility transition may think about and have more of an emotional investment regarding driving. The findings provide novel insight into the psychosocial dynamics of driving and the factors that influence driver identity, however further research, co-designed with older drivers and retired drivers is required. Full article

Sarcopenia is a well-known highly prevalent muscle disease that severely impairs overall physical performance in elders, inducing a massive health-related economic burden. The widespread screening, diagnosis and treatment of sarcopenia are pivotal to restrain the disease progression and constrain its societal impact. Simple-to-use, portable, and reliable methods to evaluate sarcopenia are scarce, and sarcopenia-related assessments are typically done in several time-consuming stages. This study presents a portable digital system that enables a simple and intuitive method to evaluate sarcopenia—based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) algorithm—including the four Find-Assess-Confirm-Severity (FACS) steps. The system comprises a mobile application (app); two wireless devices: a dynamometer (Gripwise) and a skinfold caliper (Lipowise); and a back-end website. To find cases, the SARC-F questionnaire is applied. To assess sarcopenia, the handgrip strength and the sit-to-stand tests are performed with the Gripwise and an application-embedded stopwatch, respectively. To confirm cases, anthropometric measures are performed, and muscle quantity is estimated with Lipowise. Finally, to assess severity, the app stopwatch grants the gait speed test application, evaluating physical performance. This step-by-step sarcopenia assessment results in a final grading according to the cut-off points of the EWGSOP2 criteria. All data is automatically encrypted and exported into a GDPR-compliant cloud platform, in which healthcare professionals can access and monitor their patients through the internet. Full article

Dog walking is a physical activity (PA) with many health benefits for older adults. Dog behavior issues can be a barrier to dog walking. This study piloted leash manners training as a PA intervention for dog owners ages 60+ years. Fourteen dog owners (mean age = 65 years, female = 71%) enrolled in a leash manners training course. Process evaluation data were collected to determine feasibility and acceptability of the intervention and study procedures. Twelve of fourteen enrolled participants (86%) completed the course, and most were highly engaged with the program, as evidenced by high class attendance (92% of participants who completed the course attended ≥5 of 6 classes) and a majority (64%) reporting frequent skills practice at home. Further, most participants (73%) reported their leash walking skills improved. The PA assessment protocol (7 days of 24 h data collection using activPAL monitors) was well tolerated, with all participants who completed assessments at each time point (pre-program, post-program, 4-week follow-up) providing ≥6 valid days of data. In sum, the intervention approach and study procedures were feasible and acceptable in this sample of older adults. More research is needed to determine the effectiveness of leash manners training for increasing PA in this population. Full article