To assess how preoperative anaemia affects surgical outcomes in elderly patients within a resource-limited setting.

Prospective cohort study.

Two comprehensive specialised hospitals in Ethiopia.

Participants consisted of 224 patients aged 65 years and older who underwent surgery between 1 December 2024 and 29 March 2025.

Perioperative blood transfusions were the primary outcome. Secondary outcomes included intensive care unit (ICU) admission, risk of postoperative complications, prolonged hospitalisation, poor recovery quality and in-hospital mortality.

The anaemic group required transfusions of three or more units more frequently than the non-anaemic group (10.5% vs 2.6%; absolute risk difference 8.0%). Their perioperative transfusion rates were significantly higher (42.3% vs 18.4%; p

Preoperative anaemia significantly increases the risk of transfusion, poor recovery, ICU admission, prolonged hospitalisation and in-hospital mortality in older patients who underwent surgery. In resource-limited settings, improving perioperative outcomes should prioritise the early detection and treatment of anaemia.

To characterise patient and medication-related patterns observed in drug-related pressure ulcers (DRPUs) and provide descriptive findings that may support future consensus-building.

Multicentre retrospective observational study.

20 hospitals across Japan participated in the study with hospital pharmacists specialised in PU care.

A total of 1113 hospitalised patients with existing PUs were included and classified into three groups (definite, probable and no-possibility of DRPUs) based on predefined criteria.

The primary outcome was the description of medication-related characteristics observed in each DRPU classification group, including polypharmacy, initiation of new medications and dose adjustments. Secondary outcomes included differences in ulcer characteristics and functional status across DRPU categories.

The definite group (n=128, 11.5%) showed a significantly higher prevalence of polypharmacy (83.6% vs 71.1% in the no-possibility group, p

Medication-related characteristics such as polypharmacy, initiation of new medications, dose modifications and use of antipsychotics were more frequently observed in the definite DRPU group. These descriptive findings may help characterise the clinical patterns of DRPUs and may inform future hypothesis generation.

Poor medication adherence is associated with poor clinical outcomes, an increase in hospitalisations and increased mortality. This is a multicentre randomised study that evaluates the effectiveness of using a manual pill organiser (MPO) and a custom-developed pill reminder app (PRA) on medication adherence, morbidity, as well as health economic outcomes among Indian elderly individuals taking multiple medications.

The primary objective of this study is to evaluate the impact of MPO and PRA alone or in combination in improving medication adherence among elderly individuals on multiple medications. The secondary objectives include the impact of interventions on the morbidity profile and health-related quality of life. The study also plans to assess the cost-effectiveness and cost-utility of improving medication adherence.

This is a community-based, open-label, factorial-design randomised controlled trial to be conducted across rural and urban populations at two geographically distinct sites in India. The study will enrol 752 elderly individuals aged 60–80 years, receiving three or more medications for at least 6 months and having access to smartphones. The participants will be randomised to receive one of the following interventions for 12 months: control group, PRA, MPO and MPO+PRA. All study groups would receive patient education about the importance of medication adherence. The study outcomes include the proportion of improvement in medication adherence (using Medication Adherence Rating System-5, 7-day point prevalence of medication non-adherence and pill count); adverse clinical outcomes; healthcare utilisation; health-related quality of life; cost-effectiveness and cost-utility outcomes.

The study protocol has been approved by institutional ethics committees at all three institutes. The study results for primary and secondary outcomes will be published in peer-reviewed journals.

CTRI/2024/01/061975 (Registered on: 29 January 2024).

To gain an in-depth understanding of the experience of elderly joint replacement patients in making surgical decisions and to identify the needs of patients in the decision-making process.

A qualitative study, semistructured interviews were used and analysed by Colaizzi’s seven-step method.

This study was conducted in the orthopaedics department of a tertiary hospital in Wuhan.

Eligible participants were aged 60 years or older, scheduled for elective joint replacement surgery, cognitively intact and voluntarily consented to participate in the study.

We conducted interviews with a total of 25 elderly patients who underwent joint replacement surgery. This study reveals three themes and eight subthemes regarding the surgical decision-making experiences of elderly patients undergoing joint replacement. The three themes summarise three stages of the decision-making experience, respectively, trade-offs before decisions, feelings during decision-making and expectations after the decision. In the first stage, three subthemes were identified: (1) weighing the surgical risks and benefits, (2) assessment of medical proficiency and (3) low patient involvement in decision-making. In the second stage, three subthemes emerged: (1) internal fear, (2) self-doubt and (3) a heavy burden. In the third stage, two subthemes were identified: (1) a recovery process filled with confidence and (2) a desire for improved quality of life.

This study delves deep into the experiences of elderly patients undergoing joint replacement surgery during the surgical decision-making process. It provides a theoretical basis for decision-making assistance for elderly joint replacement patients, which is conducive to reducing patients’ decision-making conflicts and enhancing their decision-making capabilities.

Music-based training programmes, such as learning how to play an instrument or sing in a choir, have been suggested as potential interventions for promoting healthy brain ageing in older adults at risk of cognitive decline because of their ability to enhance cognitive functions and potentially promote neuroplasticity. However, there is limited empirical evidence in older adults at risk of dementia, especially that evaluates both piano and singing interventions and their effects on cognition and neuroplasticity. In this protocol, we outline a study to assess the efficacy of keyboard and singing music training programmes on reducing cognitive decline and other outcomes in older adults with Mild Cognitive Impairment (MCI).

This randomised, single-blind, controlled, parallel-group trial aims to enrol 432 individuals with MCI from the community in Sydney, Australia. Participants are randomly allocated to participate in either keyboard lessons, singing lessons or a film discussion control group once a week for 3 months. The primary objective is to assess the effectiveness of two music training programmes (keyboard and choral singing) for enhancing verbal memory after 3 months compared with control. Additionally, we will examine how these music-based interventions affect other aspects of cognition, mood, sleep, overall well-being, markers of brain plasticity and blood biomarkers of Alzheimer’s disease and neurodegeneration. Tertiary objectives are to identify factors that impact the success of the interventions, such as participation rates, engagement levels and key demographic and clinical features. Outcomes are collected at baseline and at 3 and 9 months. The primary endpoint analysis will include all randomised participants to estimate the treatment effect using intention-to-treat principles. Primary and secondary outcomes will be analysed using linear mixed models and effect size measures will be calculated.

This study will be the first robust, randomised controlled trial to assess the potential and relative value of music engagement for cognitive decline in high-risk MCI individuals, as well as broader effects on other markers of mental health, well-being and neurodegeneration. Co-designed with implementation in mind, the music interventions can potentially be delivered within memory clinic or community settings.

The Sydney University Human Research Ethics Committee (2023-026) has approved this protocol. The trial findings will be shared through conferences, publications and media.

Australian and New Zealand Clinical Trials Registry (ACTRN12623000407695), Registered 21/04/2023 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385552

2.02 29/11/2024.

The global rise in the population aged over 65 has led to a corresponding increase in cognitive impairment diagnoses, with dementia as a predominant condition characterised by diverse aetiopathogenetic profiles. Behavioural and psychological symptoms of dementia (BPSD) encompass a range of psychiatric, behavioural and cognitive symptoms associated with cognitive impairment. BPSD significantly affects patients, caregivers and healthcare providers, often necessitating interventions like sedatives or physical restraints that may worsen patient outcomes. Emerging evidence underscores the need for innovative, non-pharmacological interventions to manage BPSD effectively.

The current study intends to investigate the feasibility and acceptability of customised, immersive virtual reality environments (iVRe) to reduce responsive behaviours among individuals with dementia. Building on prior findings demonstrating virtual reality (VR) potential in reducing anxiety and fostering positive emotional states, this pilot study assesses the feasibility, safety and user engagement of customised iVRe interventions.

A longitudinal, mixed-methods design will be employed, enrolling 20 elderly participants with varying levels of cognitive impairment from the APSP ‘Margherita Grazioli’ long-term care facility in Trento. Participants undergo three VR exposure sessions featuring tailored environments adjusted in real-time for visual and auditory preferences. Data collection integrates standardised self-report questionnaires, observational tools and clinical records. Measures include the Functional Assessment Staging Tool, Neuropsychiatric Inventory and Cohen-Mansfield Agitation Inventory, as well as tools assessing pain, anxiety and emotional states before, during and after VR sessions.

The study protocol has been approved by the Comitato Etico Territoriale della Provincia Autonoma di Trento per le Sperimentazioni Cliniche, Azienda Provinciale per i Servizi Sanitari—Trento, Italy (Rep. Int. 12090, 15 May 2025). All participants or their legal representatives will provide written informed consent prior to enrolment. Deidentified data will be securely stored on institutional servers at the Fondazione Bruno Kessler and the APSP ‘Margherita Grazioli’, curated in compliance with the General Data Protection Regulation, and retained for 3 years after study completion. Any data shared externally will be provided in fully anonymised form, and only for scientific purposes, subject to prior ethical and legal approval. Study findings will be disseminated through peer-reviewed publications, conference presentations and executive summaries shared with participating institutions and stakeholders.

NCT06693193.

Older adults transitioning to nursing homes face challenges in adapting to a new environment and imposed lifestyle changes. This study aimed to identify factors associated with poor nursing home adjustment and to assess their impact on 1-year mortality.

This study is a secondary analysis of the KArukera Study of Ageing in ‘Établissement d'Hébergement pour Personnes Agées Dépendantes’ (EHPAD) (KASEHPAD) cohort, a prospective observational study conducted over 1 year in six nursing homes in the French Caribbean.

159 older adults (aged 60 years or older) living in nursing homes who were able to complete the self-administered adaptation scale.

Nursing home adjustment was assessed at baseline using the adaptation scale for older adults to their residence (EAPAR). Bivariate analysis was used to assess associations between adjustment status and sociodemographic or clinical characteristics at baseline. Poisson regressions were used to assess the relationship between 1-year mortality and adjustment status.

A total of 159 older adults (mean age: 79.6 years; male/female ratio: 84/75) were included. The mean length of stay was 4.1 years. Among older adults, 78 (49.1%) were classified as poorly adapted. Age, gender, education level, dependency, cognition and comorbidities were not significantly associated with poor adjustment. In contrast, depressive symptoms, lower social support, lower health-related quality of life, lower subjective quality of life, malnutrition and sleep disturbances were associated with poor adjustment. After 12 months, 14 deaths (17.9%) occurred in the poor adjustment group, compared with 4 (4.9%) in the no major adjustment difficulties group (adjusted relative risk for age, gender and baseline activities of daily living score=4.64 (95% CI 1.53 to 17.5; p=0011).

In a sample of older adults with moderate cognitive impairment, poor adjustment to nursing home was associated with depressive symptomatology and increased 1-year mortality. The issue of adjustment in nursing homes represents an emerging research area that warrants further investigation through dedicated interventional studies.

NCT04587466.

Cognitive impairment is considered a challenge in medication management for both the affected patient as well as their caregiver. Numerous studies have investigated interventions aiming to improve medication therapy safety in this population; however, there is insufficient knowledge on interventions which support patients and caregivers effectively. The aim of this systematic review is to (1) identify interventions to improve medication therapy safety in older patients with cognitive impairment, and (2) to evaluate their effectiveness.

We will conduct a systematic review of literature with participatory elements of public involvement in every step of the process. Five literature databases (PubMed, CENTRAL, Embase, PsycINFO and CINAHL) will be screened to identify interventions to improve medication therapy safety in older (≥65 years of age) adults with cognitive impairment. To support methodology and evidence synthesis, we will conduct expert panel discussions as well as focus group discussions of caregivers and healthcare professionals. Study selection, data extraction and bias assessment will be conducted independently by two reviewers. For data synthesis, studies will be organised by setting (eg, community setting, hospital setting, nursing home setting).

The responsible Ethics Committee of the Medical Faculty of Heidelberg granted approval for the public involvement strategies in this project (S-562/2024). Results will be presented by publication in an academic journal and at scientific conferences.

CRD42024623352.

Physical activity (PA) has considerable benefits for older adults, yet they often face various barriers that hinder participation. Peer-led or peer-supported PA interventions represent a promising strategy to address barriers, such as cost and lack of motivation. Although existing reviews suggest that these interventions improve PA adherence, combining randomised controlled trials (RCTs) with other study designs may weaken their validity. Furthermore, their effects on PA levels and physical function are inconsistent, and their impacts on cognitive abilities, psychosocial well-being and social support, as well as the influence of peer characteristics and programme design, remain unexamined. This review aims to synthesise evidence regarding the effectiveness of peer-led or peer-supported PA interventions across multiple health outcomes and identify possible influencing factors.

The search will encompass six English and three Chinese databases, namely, PubMed, Web of Science, Embase, Cumulative Index to Nursing and Allied Literature, PsycINFO, CENTRAL, China National Knowledge Infrastructure, Wanfang Data and the Chinese Biomedical Literature Database. It will cover literature from inception to December 2025. Trial registries will be searched, and a manual search of relevant studies will also be conducted. RCTs that focus on community-dwelling older adults participating in peer-led or peer-supported PA interventions will be included. Outcomes include PA levels, physical function, cognitive function, psychosocial well-being, self-efficacy, social support, health-related quality of life (HRQoL) and programme adherence. Two reviewers will independently screen the literature, extract data and evaluate the risk of bias by using the Cochrane Risk of Bias Tool 2.0. Meta-analyses will be conducted for outcomes reported in at least two studies, and narrative analyses will be performed for others. Subgroup analyses, metaregression, sensitivity analyses and assessments of publication bias will be conducted as appropriate. The Grading of Recommendations, Assessment, Development and Evaluations approach will be used to assess the certainty of evidence.

Ethical approval is not required because only published data will be used. Results will be disseminated through peer-reviewed publications and conference presentations.

CRD420251112127.

Exercise-based interventions are well-established in reducing falls and fall-related injuries, but adherence and accessibility remain key challenges, particularly in rural areas. While conventional in-person training is widely used, digital interventions may offer scalable solutions to enhance engagement and reach. However, pragmatic trials evaluating the real-world effectiveness of conventional and digitally supported fall prevention interventions are lacking, limiting the evidence base for their implementation in routine healthcare settings. The SURE-Footed into the Future Fall Intervention Trial (SURE-FIT) aims to compare the effectiveness of two structured fall prevention interventions—a conventional centre-based exercise programme and a hybrid telemedical programme combining in-person and tablet-supported training—against a wait-list control group in reducing falls and fall-related injuries among community-dwelling older adults.

This study is a pragmatic three-arm, parallel-group, randomised controlled superiority trial with a 1:1:1 allocation ratio. Participants (≥65 years, community-dwelling, planned n=2778) will be randomly assigned to (1) conventional centre-based training supplemented with printed materials for home-based continuation (conventional group), (2) a hybrid model integrating centre-based and tablet-supported training for continuation (tablet group) or (3) a wait-list control group. The intervention includes a 9-week supervised phase followed by 43 weeks of independent home-based training. The primary outcomes are the incidence rate of falls and fall-related injuries over 12 months. Secondary outcomes include physical functioning, physical activity, concerns about falling, loneliness and the risk of low protein intake. A process evaluation will assess intervention feasibility and implementation. Additionally, qualitative interviews will be conducted with participants, course instructors and municipal stakeholders to explore experiences, facilitators and challenges related to programme participation and implementation. A health-economic evaluation will be conducted to assess the cost-effectiveness of the structured fall prevention interventions. Data collection will take place at baseline and every 3 months via standardised questionnaires, with a subgroup undergoing physical performance testing and sensor-based activity monitoring. Analyses will follow an intention-to-treat approach.

Ethical approval has been granted by the Ethics Committee of Ulm University (271/23). Written informed consent will be obtained from all participants before enrolment. Study findings will be disseminated through peer-reviewed publications, scientific conferences and national fall prevention initiatives. Additionally, results will be shared with key municipal representatives, and the German National Association of Senior Citizens’ Organisations (BAGSO). A publicly accessible website will provide ongoing access to study information and findings in plain language.

DRKS00032878, German Clinical Trials Register

Racialised older adults living with dementia face various challenges and barriers in receiving culturally sensitive care in hospital settings. Stigma, discrimination and healthcare provider bias toward racialised older adults living with dementia infringe on their right to access quality care services in acute hospital settings and can negatively affect their quality of life. Despite the growing need to integrate culturally sensitive dementia care into acute hospital care, little research has been done in this area. Therefore, the aim of this scoping review is to summarise and map what is known about the hospitalisation experience of racialised older adults with dementia in receiving care and identify research gaps.

We will use Arksey and O’Malley’s framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist to conduct and write the review. The search strategy will use keywords and index terms across selected databases: Google Scholar, PubMed, Scopus, Medline, PsycINFO and Cumulative Index for Nursing and Allied Health Literature, and hand-searching the reference lists from chosen literature. Grey literature will be searched using Google and the Alzheimer Society websites to find further evidence and literature. Two researchers will screen the titles and abstracts independently by referring to the inclusion criteria. Data from the extracted studies will be reported in tabular and narrative form that answer the scoping review’s questions. Research gaps and recommendations for future research will be identified and summarised. The review’s results will be shared with stakeholders, policymakers, healthcare professionals and community organisations working with the racialised community and dementia care.

This scoping review does not require ethics approval because it collects data from publicly available resources. The results will be disseminated through peer-reviewed scientific journals, professional conferences and with community organisations and healthcare providers.

This review is registered in the Open Science Framework registration link: osf.io/7rfje

Drug-related hospital admissions (DRAs) are prevalent among older adults, with a substantial proportion deemed preventable. Despite their frequency, little is known about the prognosis of DRAs in this population, particularly concerning mortality and hospital readmissions. The objectives were to assess the prognosis of DRAs in older patients, focusing on 6-month mortality and unplanned readmissions.

Prospective cohort study.

A 20-bed acute-care geriatric unit within an academic hospital.

All patients aged 75 years or older hospitalised in the unit during 2023.

The primary outcome was 6-month all-cause mortality. The secondary outcome was the rate of unplanned hospital readmissions, including emergency department visits, within 6 months. DRAs were identified using a two-step standardised review process. Kaplan–Meier survival curves and Cox proportional hazards models were used to estimate hazard ratios (HRs) for mortality. Fine and Grey competing risk models were applied for the analysis of unplanned readmissions. Multivariable models adjusted for age, sex, Charlson Comorbidity Index, medication count, activities of daily living score, long-term care residency and prior hospitalisations.

Among 483 patients included (median age 86 years [IQR 81–91]), 207 (43%) were admitted for a DRA. At 6 months, mortality was significantly lower in patients with DRAs compared with those without (19% [n=39] vs 37% [n=102]; p

DRAs have a distinct prognosis as compared with other causes of admission among older patients. Identifying and managing DRAs are crucial for minimising preventable complications in this vulnerable population.

Falls are a critical problem for older people, including those from ethnically diverse communities, who are under-represented in research. The aim of this pilot trial is to evaluate (1) the implementability of a co-designed intervention developed to support the sustained uptake of tailored exercise to reduce falls (MOVE Together: Reduce Falls) and (2) the feasibility of conducting a randomised controlled trial (RCT) in older people from Italian, Arabic, Cantonese or Mandarin-speaking communities.

Investigator and assessor-blinded pilot two-arm parallel RCT. 60 older people at risk of falls from Italian, Arabic, Cantonese or Mandarin speaking communities will be recruited, with the option to enrol on their own or with another participant (dyad). Participants or dyads will be randomly assigned to the experimental or control arm. The experimental arm will receive MOVE Together: Reduce Falls, which provides up to 12 sessions with a physiotherapist over 12 months and supports participants to engage in individualised exercises. Both arms will receive educational resources in the participant’s preferred language. The primary outcome is implementability of the co-designed intervention, MOVE Together: Reduce Falls; operationalised as fidelity (>70% of intended sessions delivered), feasibility (> 95% of sessions delivered with no serious adverse events related or likely related to the intervention) and acceptability (>50% acceptability score). The secondary outcome is feasibility of the RCT protocol, which will be evaluated quantitatively (eg, recruitment and retention rates, completion of clinical outcome data including prospective collection of falls data for 12 months via falls calendars) and qualitatively (eg, barriers and enablers to data collection).

Ethical approval has been granted for this study (HREC/106010/MH-2024). Study findings will be published in peer-reviewed journals and presented at relevant conferences and community forums.

ACTRN12624000658516.

Older age is one of the greatest risk factors of dementia, and the rural demographic is ageing in Canada. Compared with their urban counterparts, rural older adults often face unique challenges in accessing cognitive healthcare, which is exacerbated by a shortage of healthcare specialists, public transportation, finances, education, services and dispersed geography. This scoping review protocol outlines the methodology that will be used to examine the literature about the care priorities, service needs and lived experiences from the perspectives of rural older adults living with cognitive impairment and dementia in Canada.

Our scoping review protocol will follow the guidance of Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extensions for Scoping Reviews checklist. Our search strategy will identify relevant peer-reviewed literature in databases including Cumulated Index in Nursing and Allied Health Literature (CINAHL), EMBASE, PsycINFO, PubMed, Web of Science and Scopus. The database search dates for this scoping review will be from 1 January 2015 to 1 January 2025. The data will be charted by two reviewers using a standardised data extraction table. Inductive content analysis will be performed using a three-step process.

Given this scoping review will be an examination of the published literature, human subjects will not be included in this research. Therefore, ethics approval is not required. Knowledge mobilisation and dissemination strategies will include peer-reviewed journal articles, conference presentations, community workshops, newsletter articles and webinars. This study may provide valuable information for healthcare practitioners, community leaders and policymakers working to support people living with cognitive impairment and dementia in rural communities.

The Clinical Frailty Scale is an ordinal scale from 1 (very fit) to 9 (terminally ill) commonly used to assess frailty in older patients. It is simple for clinicians to apply and can help identify patients who may benefit from discussions around end-of-life care. We externally validated the Scale to assess its performance for predicting 90-day mortality in a cohort of admitted older patients who had screened positive for being at risk of nearing the end of life.

We used data from a randomised controlled trial assessing a tailored feedback loop for reducing non-beneficial care. Our study included patients aged 75 and above admitted between May 2020 and June 2021 from 3 Australian hospitals. We assessed whether the Scale could be used in a frail population to identify patients who were at risk of short-term mortality. Predictive performance was assessed using the c-statistic, smoothed calibration curves and decision curves. Models were tested for coefficient stability.

Our dataset contained 4639 patients and 956 deaths within 90 days. The Clinical Frailty Scale had a c-statistic of 0.62 (95% CI 0.60 to 0.64) or 0.63 (95% CI 0.61 to 0.65) by adding age and transforming the Scale using a cubic spline. Risks were underestimated without a non-linear transformation as scores of 8 and 9 had a higher risk that diverged from a linear association. The net benefit of using the tool was greatest between 5 and 8 on the Scale.

The utility of the Clinical Frailty Scale may be as a flag to encourage clinicians to become more comfortable with discussing ageing and death, rather than as a highly discriminating model to classify patients as high risk or low risk. Statistical uncertainty over mortality should not be a barrier to initiating end-of-life care discussions with frail older patients.

Dementia is potentially preventable and deferrable yet remains a major cause of disability, dependency and mortality worldwide. The 2024 Lancet Commission on dementia identified 14 modifiable dementia risk factors and estimated that addressing these could reduce dementia cases by up to 45%. The aim of this study is to assess dementia risk factor prevalence in adults ≥50 years participating in a nationally representative longitudinal study on ageing, providing crucial context for the delivery of dementia prevention.

The Irish Longitudinal Study on Ageing (TILDA) is a population-based prospective cohort study, representative of community-dwelling adults ≥50 years living in Ireland.

All participants from waves 1 (2009–2010): n=8171, 3 (2014–2015): n=6615 and 6 (2021–2023): n=4318 of TILDA were analysed over a 10.93 (±0.37) years of follow-up.

70.6%, 61.1% and 54.2% of the population had ≥4 modifiable risk factors for dementia at consecutive waves, amounting to over 500 000 people with ≥4 modifiable risk factors for dementia on weighted population analysis at wave 6. 77% of those with severe decline in cognitive performance during follow-up had ≥4 risk factors at baseline. An estimated 32 480 cases of severe decline in cognitive performance during follow-up were potentially preventable if risk factors were addressed.

In a nationally representative sample of older European adults, there is a high prevalence of modifiable dementia risk factors. This highlights the need for greater attention on educating people on the concept of brain health through public health messaging as well as the development of a clinical framework focused on delivering on the opportunity of dementia prevention. Preventing and delaying dementia onset can have a significant impact on the compression of morbidity and increasing healthy lifespan in older age.

Neurogranin (Ng) has a role in synaptic plasticity and is considered a biomarker of synaptic dysfunction, a process hypothesised to be important in delirium. Few studies examining Ng in delirium exist, with mixed findings. This study aimed to investigate associations between cerebrospinal fluid (CSF) Ng concentrations and delirium in acutely admitted hip fracture patients.

Cross-sectional study.

Acutely admitted orthopaedic patients with hip fracture recruited from four participating hospitals in eastern Norway, representing secondary and tertiary care settings.

This study included 392 hip fracture patients. All admitted hip fracture patients operated in spinal anaesthesia were, regardless of age, considered for inclusion.

An in-house ELISA was used to measure CSF Ng concentration in patients acutely admitted with a hip fracture (n=392). Delirium status was evaluated daily according to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Editions criteria independently by two experienced geriatricians. A value > 3.44 on The Informant Questionnaire on Cognitive Decline in the Elderly was used as a surrogate marker of probable dementia.

180 patients (46 %) developed delirium and 70% of these had dementia. CSF Ng concentration did not differ significantly between those with and without delirium (176 pg/mL vs 164 pg/mL), with an estimated difference in medians of 12 (95% CI –5.8 to 29.8), p=0.185. Analyses adjusted for age, gender and dementia status did not show a statistically significant difference in Ng concentrations between the patients.

We did not find an association between delirium and CSF concentrations of Ng. This could imply that synaptic dysfunction and degeneration, involving Ng, are not key processes in the development of delirium. Further studies on other synaptic proteins are warranted to better explore synaptic dysfunction’s potential role in the pathophysiology of delirium.

To investigate the knowledge, attitude and willingness (KAW) towards hospice care among older adult patients and their family members within the geriatric department of Hubei province, and to situate these findings within the broader context of public awareness and the health system’s multidisciplinary approach to end-of-life care.

A cross-sectional survey.

Demographic information and KAW scores were collected through a self-made questionnaire. Data were analysed using descriptive statistics, t-tests, ANOVA and path analysis.

This study was conducted across five tertiary hospitals in Hubei province between June and December 2023.

Willingness towards hospice care.

Knowledge and attitude towards hospice care, and their relationships with demographic factors.

A total of 390 patients participated in this study, with 205 (52.56%) being male with a mean age of 69.75±8.01 years. The KAW scores were 4.88±5.14 (range: 0–14), 33.04±4.60 (range: 11–55) and 20.59±2.70 (range: 9–45), respectively. Family members scored 7.04±5.20 (range: 0–14) for knowledge, 37.20±3.61 (range: 11–55) for attitude and 22.35±3.59 (range: 6–30) for willingness. Path analysis revealed that in patients, knowledge (β=0.33, p

Both older adult patients and their family members demonstrated insufficient knowledge, yet a moderate attitude and willingness towards hospice care. Family members manifested a more proactive willingness to engage in hospice care. Based on these findings, targeted educational interventions are recommended, particularly focusing on improving hospice care knowledge among patients with lower education levels and those residing in rural areas. Additionally, involving family members more actively in care discussions may enhance acceptance and utilisation of hospice care services.

To investigate the mediating role of psychological resilience between job satisfaction and work engagement in geriatric psychiatric nursing assistants.

A cross-sectional study.

This study enrolled nursing assistants who had worked in the Department of Geriatric Psychiatry of a tertiary psychiatric hospital between January 2023 and March 2024. Recruitment and data collection were conducted in April–May 2024 after ethics approval was obtained on 3 April 3, 2024.

A total of 206 nursing assistants were included, with 137 females (66.5%) and 147 individuals (71.4%) aged 50–59 years.

Utrecht Work Engagement Scale, Connor–Davidson Resilience Scale and Minnesota Satisfaction Questionnaire were used to measure work engagement, psychological resilience and job satisfaction, respectively. Pearson correlation analysis was used to analyse the relationships among work engagement, job satisfaction and psychological resilience. The structural equation model was established, and the intermediary effect was verified.

The scores of psychological resilience, job satisfaction and work engagement were 70.2 (14.7), 72.2 (10.7) and 38.1 (10.7), respectively. There were positive correlations between psychological resilience and work engagement (r=0.512, p

Our findings suggest that psychological resilience may act as an intermediary between job satisfaction and work engagement in geriatric psychiatric nursing assistants. Nursing managers should carry out intervention strategies based on the path of influencing psychological elasticity, improving job satisfaction and work engagement, and ensuring the quality of care of nursing assistants in geriatric psychiatry.

With the global population ageing rapidly, older adults face increased risks of physical and cognitive decline. Despite the well-documented benefits of physical activity (PA), many older adults fail to meet PA guidelines. Mobile health (mHealth) apps offer promising tools to promote PA, but user engagement remains a challenge. In response, the MIA app was co-created with older adults using the Behavior Change Wheel framework to enhance usability, relevance and sustained engagement. A feasibility study showed promising results in usability and user satisfaction, supporting further evaluation. The goal of this study is to evaluate the effectiveness of MIA on PA promotion in older adults.

A randomised controlled trial conducted in Belgium at a university college will assess the effectiveness of the MIA app in promoting PA in older adults. Participants will be randomly assigned in a 1:1 ratio to either the intervention group (MIA app use) or the control group (no use of MIA) for 8 weeks. The primary outcome is moderate-to-vigorous PA, measured via Garmin wearable devices. Secondary outcomes include self-reported measures (PA, well-being, user satisfaction), clinical assessments (physical and cognitive functioning) and time series assessments (daily steps). A total of 75 participants will be recruited to ensure sufficient power, accounting for dropout. Eligible participants must be ≥65 years, medically stable, have no significant cognitive or physical limitations, understand and speak Dutch and have access to a smartphone and/or computer. Exclusion criteria include an active lifestyle, participation in other exercise programmes or clinical trials, or any condition deemed by a healthcare professional to compromise safety or study validity.

The study was approved by the UHasselt Medical Ethics Committee (B1152025000012) and complies with Belgian legislation on human research. Written informed consent will be obtained from all participants prior to enrolment. Data will be securely stored for up to 25 years. Results will be disseminated via peer-reviewed publications and conference presentations.

NCT06983574.