Tire related particles (TRPs) are widely distributed and critically important vectors for coexisting antibiotics in aquatic environments. As a major source entering surface waters, TRPs from wastewater treatment plants undergo disinfection and subsequent photoaging. Accordingly, this study investigates the combined effects of chlorination (a widely used disinfection method) and photoaging on TRPs' physicochemical properties and the adsorption of tetracycline (TC). Experimental observations suggest a possible synergistic ("1 +1 >2") effect where the combined chlorination and photoaging may produce a more pronounced aging effect than either process alone. Adsorption isotherm and adsorption kinetics suggested a tendency for moderate aging enhances adsorption, while excessive aging leads to a decrease in the overall adsorption affinity. Molecular dynamics simulations demonstrated interplay between decreased compactness, increased surface heterogeneity, and hindered site accessibility, explaining the observed transition from enhanced to inhibited TC adsorption with increasing aging. Furthermore, experimental adsorption studies revealed TC adsorption may facilitate the release of some TRPs' additives. Density functional theory calculations supported this observation, indicating that when the interaction energy between the additive and the TRPs is less than that between TC and the TRPs, the additive is preferentially replaced by TC. Collectively, these findings highlight the synergistic effect of chlorination and photoaging and underscore the potential for TRPs additives to be released into the surrounding environment upon interaction with coexisting organic contaminants.
Anxiety disorders are the most common mental disorders in both young and old adults. However, most currently existing treatments, which are tailored for young patients, are not as effective in old patients. Therefore, investigating geriatric anxiety disorders would greatly benefit the mental wellbeing of the rapidly growing aged population. This study finds that innate anxiety-like behaviors elevate with aging in male mice. This study further identifies an aging-related increase in the excitatory synaptic transmission onto the glutamatergic neurons in the basolateral amygdala (BLA), which is mirrored by an increase in the expression of c-Fos, a marker of neuronal activity. Lastly, this study, by using chemogenetic intervention of BLA glutamatergic neurons, establishes a causal relationship between the aging-related increase in their neuronal activity and the aging-related elevation in innate anxiety-like behaviors in mice. Accordingly, we conclude that the aging-related microscopic physiological changes in BLA glutamatergic neurons might serve as a biological substrate underlying the aging-related elevation in innate anxiety-like behaviors. Thus, this study provides a potential intervention strategy for treating geriatric anxiety disorders, which is an urgent task given that the available treatments do not meet actual needs, while the affected population is rapidly growing.
Clinical empathy refers to a healthcare professional's ability to understand a patient's experiences and emotions through cognitive and affective perspective taking, and to communicate that understanding through compassionate and appropriate professional behaviors. Aging simulation suits are experiential educational tools designed to replicate the sensory and physical limitations associated with aging. However, evidence regarding their effectiveness in enhancing clinical empathy among active healthcare professionals remains limited. This study aimed to evaluate the effects of an aging simulation suit on clinical empathy among healthcare professionals working in long-term care settings. A randomized controlled trial was conducted with 82 healthcare professionals from four nursing homes in Madrid and Asturias (Spain). Participants were randomly assigned to an experimental group (EG) (n=41) or a control group (CG) (n=41). Both groups received the same structured educational session on empathy and aging. The experimental group additionally participated in an immersive experience using the GERT aging simulation suit, whereas the control group did not receive the simulation component. Self-reported empathy were measured pre- and post-intervention using the Interpersonal Reactivity Index (IRI) and the Jefferson Scale of Empathy-Health Professions version (JSPE-HPS). No significant differences were found between groups in IRI scores. However, the experimental group showed significant improvements in total JSPE-HPS scores and in the subscales Perspective Taking and Compassionate Care (p < 0.05), compared with the control group. These findings suggest that the immersive intervention enhanced both cognitive and affective components of clinical empathy. The use of an aging simulation suit was associated with improvements in specific dimensions of clinical empathy among healthcare professionals working in long-term care. This educational tool offers a valuable experiential approach that enhances understanding and compassion toward older adults. However, these findings are limited to short-term, self-reported measures, and no behavioral or patient outcome data were collected. Further longitudinal studies are needed to determine the long-term sustainability of these effects and their translation into clinical practice. ClinicalTrials.gov, Unique Protocol ID: 2711201916919; ClinicalTrials.gov ID: NCT07280689. Date of registration: 10/10/2025. Retrospectively registered.
As the global population ages rapidly, delaying and preventing age-related diseases have become urgent priorities in public health and biomedical research. During aging, mitochondrial dysfunction is a core molecular hallmark and a common pathogenic mechanism underlying multiple age-related disorders. Age-related mitochondrial dysfunction typically manifests as diminished metabolic capacity, impaired organelle renewal, and disrupted redox homeostasis. These factors interact to form a feedback loop constraining mitochondrial adaptability. Specifically, the interdependent decline in NAD+ availability, impaired mitochondrial biogenesis, and excessive oxidative stress render single-pathway interventions ineffective in mitigating systemic functional impairments triggered by aging. To address this complex mechanism, this review presents a novel tri-axis anti-aging model encompassing three key compounds: nicotinamide mononucleotide/nicotinamide riboside (NMN/NR), pyrroloquinoline quinone (PQQ), and l-ergothioneine (EGT). Within this framework, NMN/NR serves as a broad NAD+-dependent regulator of mitochondrial homeostasis, with its most immediate effects on metabolic activation, while PQQ and EGT may further strengthen mitochondrial remodeling and redox resilience, respectively. While each compound has distinct functional emphases, they are highly mechanistically coupled, collectively forming a closed-loop network regulating mitochondrial number, function, and homeostasis. This review synthesizes preclinical and emerging clinical evidence supporting the standalone or combined use of NMN/NR, PQQ, and EGT across various diseases. Collectively, by conceptualizing mitochondrial aging as a systemic imbalance rather than isolated molecular defects, this paper highlights a three-axis model of NMN/NR, PQQ, and EGT. This framework offers a theoretical foundation for mitochondrial-targeted anti-aging interventions while laying the groundwork for future clinical research, nutritional interventions, and the development of multi-target combination strategies.
Oxidative stress is a key factor leading to oxidative damage in cells and tissues, and is a major driving force behind aging and various age-related diseases. Epigenetic clock and oxidative balance score (OBS) serve as reliable indicators for assessing an individual's aging process and oxidative stress levels, respectively. However, no study has comprehensively assessed the association between epigenetic clock and OBS. This study analysed 1,797 subjects from the 1999-2002 National Health and Nutrition Examination Survey (NHANES). Multivariate regression models were used to assess the relationship between OBS and epigenetic age as well as epigenetic age acceleration (EAA). Restricted cubic spline (RCS) analyses were used to visualize the dose-response relationship between OBS and EAA. Subgroup analysis and interaction tests were used to investigate whether this association was stable across populations. Multiple linear regression analyses showed that higher OBS levels were significantly associated with lower epigenetic age. Further analyses showed that both the dietary OBS and the lifestyle OBS were significantly negatively correlated with epigenetic age. RCS analysis revealed a significant negative linear dose-response relationship between OBS and EAA. The association between OBS and EAA was homogeneous across subgroups. This study suggests higher OBS levels are associated with reduced epigenetic age and decelerated biological aging, and antioxidant-rich diets and lifestyles may delay biological aging.
Lipofuscin is an autofluorescent material that accrues in brain tissues with age and in Neuronal Ceroid Lipofuscinosis (NCL), a neurodegenerative disease with pediatric onset. The distribution, composition, and organellar origin of lipofuscin have remained unclear despite its widespread presence in aged tissues and involvement in neurodegeneration. Here, we elucidate lipofuscin composition in mouse and human brain and assemble a reference neuroanatomical atlas of lipofuscin accumulation with age and NCL (Type 1; CLN1) progression across 425 fine brain regions. We identify a primary role of the lysosomal-mitochondrial axis in the formation of lipofuscin pathology via multimodal mass spectrometry, ultrastructural analyses, and assays of cellular and enzymatic metabolism. We find the protein and lipid composition of lipofuscin in the aged and CLN1 brain to be remarkably similar. Dissection of implicated molecular pathways reveals protein S-acylation and unsaturated lipid homeostasis as central processes involved in lipofuscin deposition during aging and CLN1. Notably, > 95% of lipofuscin resident proteins can be S-acylated and many are substrates of the enzyme PPT1, validating a seminal hypothesis that CLN1 lipofuscin contains these lipid-modified proteins. Further, we discover deficient de-S-acylation is correlated with lipofuscin load in healthy aging, as the specific de-S-acylation enzyme activity of PPT1 is found to decline with advancing age. Finally, we identify lipid metabolite biomarkers of lipofuscin, including long-chain polyunsaturated fatty acids, bis(monoacylglycerol)phosphate (BMP), and oxidized phosphatidylethanolamine (OxPE) lipid species. Overall, we provide a comprehensive redefinition of lipofuscin neuropathology and a resource for studying aging, lysosomal storage disorders, and neurodegeneration.
This study examined how aging-related deficit burden relates to cancer-specific outcomes in men diagnosed at markedly different developmental periods and with different cancer experiences. A modified Deficit Accumulation Index (DAI), a multi-system measure of aging based on proportional health deficits, was computed in two cohorts. Study 1 used cross-sectional data from 171 young adult testicular cancer survivors (ages 18-29). Study 2 used longitudinal data from 114 men with localized prostate cancer (ages 51-81) assessed before treatment and six months post-treatment. In Study 1, DAI scores ranged from 0 to .73 (M = .23), with 47.7% of young adult participants exhibiting medium or high deficit burden. Higher DAI was associated with greater job problems, family disruption, sexual problems, and treatment side effects after adjusting for age and time since diagnosis (p's < .001). In Study 2, DAI scores ranged from 0 to .55 (M = .18), with 34.0% exhibiting medium or high deficit burden. Baseline DAI predicted worsening in hormonal functioning six months after treatment. Greater DAI was also associated with higher circulating interleukin-6 prior to treatment (p < .01). Across both cohorts, deficit accumulation functioned as a marker of survivorship burden; however, the specific outcomes associated with higher deficit burden differed across cohorts. Findings demonstrate the utility of the DAI as a multi-system metric for understanding vulnerability in cancer survivorship.
The human thalamus serves as a central integrative hub, facilitating the transmission of information among the cerebral cortex, subcortical structures, and the peripheral nervous system, while supporting a range of higher cognitive functions. Although significant age-related changes in thalamic volume and microstructure have been reported, the specific differences in the volumes of thalamic nuclei and their associations with cognitive functions throughout adulthood remain unclear. T1-weighted MRI scans from 314 cognitively healthy individuals were categorized into four age groups: young (20-35 years), early middle-aged (36-50 years), late middle-aged (51-65 years), and older (>65 years). Thalamus volumes and cognitive function scales were compared across age groups, and associations between thalamic volume and cognitive function with age were further analyzed. Significant atrophy was observed in all ventral thalamic nuclei in older adults, as well as in the paracentral (Pc), mediodorsal medial (MDm), lateral geniculate (LGN), and anterior pulvinar (PuA) nuclei. The volumes of thalamic subnuclei, particularly those in the ventral, posterior, medial and intralaminar groups, were positively correlated with cognitive performance, especially in executive-attentional and working memory during aging. These findings underscore the importance of thalamic subnuclei in maintaining cognitive function during healthy aging.
Ferritins are vital macromolecules that have been widely used in a number of biotechnological fields. Ferritin-based hybrid nanoparticles, composed of different types of subunits and conjugates, represent a next generation of tools, which can significantly enhance their efficiency and expand the range of existing applications. This review outlines the application landscape of these hybrids in developing recombinant vaccines, drug delivery and imaging systems. We highlight the increasing trend towards the development of ferritin-based mosaic vaccines and some of them are already in the first or second phases of clinical studies. In comparison, drug delivery research, which is mostly focused on cancer theranostics, to our knowledge, has not progressed beyond the preclinical stage. Herein, we describe the key limitations and challenges of ferritin-based drug delivery systems development, suggest strategies that address these limitations and discuss promising future research directions. We conclude that engineered ferritin hybrids hold significant potential as useful tools for immunology, theranostics and other biomedical applications.
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Dendrobium officinale Kimura et Migo (Tiepi Shihu), a yin-nourishing tonic in traditional Chinese medicine, has been historically used for health maintenance and longevity promotion. We evaluated the anti-aging effects of D. officinale whole powder (DOP) and a non-polysaccharide fraction (DOE) and explored underlying mechanisms focusing on conserved PI3K-AKT signaling. Network pharmacology was applied to predict aging-related targets and enriched pathways. Anti-aging activity was assessed in yeast (Saccharomyces cerevisiae) and female flies (Drosophila melanogaster) using lifespan and healthspan assays, a high-sugar diet challenge, and pathway readouts via qRT-PCR and Western blotting. In RAW264.7 macrophages, the PI3K inhibitor LY294002 and the AKT inhibitor MK-2206 were used to evaluate pathway dependence. Network pharmacology identified 355 overlapping targets, enriched in PI3K-AKT, MAPK, Ras, and HIF-1 pathways. We found that dihydroconiferyl alcohol, homovanillyl alcohol, and taxifolin extended yeast lifespan, and these effects were abolished in yeast mutants defective in key aging-related genes. In flies, DOP extended female lifespan, improved climbing performance, and mitigated high-sugar diet-induced lifespan loss and hyperglycemia, accompanied by reduced AKT phosphorylation under dietary stress and enhanced FOXO-associated responses. DOE also extended lifespan, increased AKT/S6K phosphorylation and reduced FOXO in flies. D. officinale was associated with context-dependent modulation of innate immune-related gene expression. However, DOE suppressed AKT activity and increased FOXO in RAW264.7 cells; co-treatment with MK-2206 abolished DOE-induced changes. D. officinale exerts anti-aging effects in yeast and Drosophila models, while mammalian macrophages support a mechanistic role for context-dependent PI3K-AKT signaling regulation. Its distinct fractions act in a context-dependent manner, with AKT serving as a central regulatory node and FOXO-associated responses, supporting its ethnopharmacological use as a longevity-promoting herb.
We aimed to evaluate the global burden, spatial disparities, and risk factors of early-onset ischemic stroke (EOIS). Using data from the Global Burden of Disease Study 2021, we estimated incidence, mortality, and DALYs. Health inequality was measured with Slope Index of Inequality (SII) and Concentration Index (CII). Frontier analysis assessed national efficiency. Age-period-cohort and decomposition models analyzed trends and drivers. Between 1990 and 2021, global age-standardized incidence, mortality, and DALYs for EOIS declined, but absolute cases rose due to population growth and aging. Males and populations in Central Asia and Eastern Europe had the highest burden. East Asia saw rising age-standardized incidence. Health inequalities widened globally, with countries like Nauru and Kiribati showing the largest gaps. High-SDI countries such as Lithuania and the U.S. demonstrated unmet healthcare efficiency. Incidence and mortality increased with age, especially in men over 35. Population aging and growth were key drivers. Leading risk factors included high LDL and hypertension, while high BMI, high ambient temperature, and sugar-sweetened beverages emerged as growing risks. Low whole grain intake was a major dietary risk. The absolute burden of EOIS has increased due to demographic shifts. Significant socio-demographic and regional disparities persist, with men and certain regions facing disproportionately high risks. Metabolic risks remain central, while emerging factors are gaining importance.
Early institutional rearing is associated with adverse biological and health outcomes in later life, including accelerated cellular aging as measured by telomere length. However, the extent to which foster care intervention can mitigate these risks, and whether telomere dynamics predict cardiometabolic health in young adulthood remains unclear. The present study aimed to estimate the association between early institutional care, randomization to foster care (intent-to-treat), and longitudinal changes in telomere length from ages 12-22 years among participants of the Bucharest Early Intervention Project (BEIP), and to determine whether the rate of telomere shortening predicts cardiometabolic health in early adulthood. The study included 156 BEIP participants who had been randomly assigned to either foster care or care-as-usual, with an additional comparison group of never-institutionalized peers. Buccal DNA was collected, and telomere length (T/S ratio) was measured at two to five timepoints between the ages 12 and 22. Cardiometabolic health at age 22 was assessed using metabolic z-scores and criteria for metabolic syndrome. Participants assigned to foster care exhibited a significantly slower decline in telomere length over the 10-year period compared to those in care-as-usual. Ever-institutionalized and never-institutionalized groups had similar overall patterns of telomere decline. Sex-specific analyses indicated that among the foster care group, males had shorter telomere length at age 12 than females, but rates of telomere shortening were similar between sexes over time. The rate of telomere attrition between ages 12 and 22 was not associated with cardiometabolic outcomes at age 22. Foster care intervention during early childhood may protect against telomere shortening among previously institutionalized children, highlighting its role in buffering the long-term impact of early adversity on cellular aging. However, variation in telomere shortening during adolescence and young adulthood did not predict cardiometabolic risk at age 22.
Alzheimer's disease and related dementias (ADRD) are major public health concerns. DNA methylation (DNAm)-based biomarkers such as GrimAge and PhenoAge predict aging and health risk, but were not designed to optimize prediction of cognitive function or decline. Epigenetic g-a DNAm-derived index of general cognitive ability-is a promising marker of cognitive function that has not been assessed in a racially and socioeconomically diverse population. We used data from the 2016 Venous Blood Study of the Health and Retirement Study (HRS), a nationally representative cohort of U.S. adults aged ≥ 51 years (N = 3575 with high-quality DNAm). Epigenetic g scores were computed using CpG weights from a BayesR+ model of general cognitive ability developed in Generation Scotland. Cognitive function was measured with a modified version of the Telephone Interview for Cognitive Status (TICS) at each interview wave. Linear regression estimated associations with cognitive scores; mixed-effect growth curve models estimated the association with cognitive change. Models were adjusted sequentially for demographics, education, parental education, APOE ε4 status, and blood-based neurodegeneration markers (NfL, GFAP, Aβ42/40, pTau181). Higher epigenetic g was associated with better baseline cognition (β = 2.55, 95% CI 1.80-3.30)) and cognition at the time DNAm was measured (β = 2.30, 95% CI 1.47-3.13) after demographic adjustment. Associations were attenuated but remained significant with education and parental education (β = 1.23-1.89). In growth curve models, Epigenetic g was associated with higher cognitive performance but did not have a statistically significant association with decline over a 6-year period. Results were robust to adjustment for APOE ε4 and neurodegeneration biomarkers. Epigenetic g is a scalable, blood-based marker of cognitive function, and potentially or cognitive reserve, that adds predictive value beyond demographics, socioeconomic indicators, APOE, and neuropathology. Its validation in a diverse, nationally representative U.S. cohort underscores its potential for early risk profiling and for research on social determinants of cognitive aging in cross-national samples.
Vitamin K2 is a fat-soluble vitamin that has been reported to exhibit significant anti-stress activity. Anti-stress properties are considered to be closely associated with lifespan extension. Therefore, we investigated the effects of vitamin K2 on the lifespan and stress resistance of Caenorhabditis elegans, as well as the underlying mechanisms. In the present study, we found that the effects of Vitamin K2 on C. elegans are concentration-dependent. High concentrations (10 μM) of Vitamin K2 are toxic to C. elegans, whereas lower concentrations (5 μM) are beneficial. Treatment with 5 μM Vitamin K2 can extend the lifespan of C. elegans, enhance its physiological functions, protect the intestinal barrier, and reduce the accumulation of lipofuscin associated with aging. Furthermore, Vitamin K2 enhanced the stress resistance of C. elegans by maintaining mitochondrial morphology, alleviating mitochondrial stress, reducing ROS levels, and improving mitochondrial membrane potential and ATP production. Vitamin K2 activates the JNK-1/SIR-2.1/DAF-16 signaling pathway and upregulates the expression of downstream target genes such as ctl-1, ctl-2, sod-1, sod-3, and hsp-16.2. We conclude that appropriate doses of Vitamin K2 protect C. elegans from senescence by activating the JNK-1/SIR-2.1/DAF-16-mediated anti-mitochondrial oxidative stress pathway. These findings suggest that Vitamin K2 may have beneficial effects on lifespan and mitochondrial health in C. elegans, providing a basis for further investigation into its potential relevance for aging and age-related diseases in more complex model systems.
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Physical activity reduces the risk of mortality and age-related chronic diseases, yet its association with biological age measured by DNA methylation (DNAm) clocks remains unclear. This systematic review and meta-analysis aims to evaluate the association between physical activity and biological age measured by DNAm clocks. In this systematic review and meta-analysis, we conducted a systematic search of Embase, Cochrane Central Register of Controlled Trials, PubMed, Ovid, Scopus, and Web of Science from Jan 1, 2011, to June 6, 2025, to identify articles on the associations of physical activity and DNAm age, epigenetic age acceleration (EAA), or epigenetic age deviation in humans. Studies were included if they were peer-reviewed, published in English, included a study population with a mean or median age of 18 years or older, and investigated the association between DNAm clocks and physical activity in humans. Studies were excluded if the study population was a disease-specific population without controls. We evaluated risk of bias using an adapted Newcastle-Ottawa Scale and Cochrane Risk of Bias scale. We then performed a random-effects meta-analysis using reported or estimated standardised β coefficients and SEs. We also conducted a publication bias analysis and influence analysis. The study was registered with PROSPERO, CRD42024499021. We identified 34 437 articles and, after removal of duplicates and screening, 44 studies were included in the systematic review comprising 145 465 participants: 62 887 (43·2%) females and 82 578 (56·8%) males, with mean ages ranging from 24·1 years to 78·5 years. Across studies, higher levels of physical activity were generally associated with lower DNAm age, although many individual associations did not reach statistical significance. Seven cross-sectional studies contributed to the meta-analysis. Each one SD higher in metabolic equivalent of tasks-min per week was associated with 0·03 SD lower Horvath EAA (β=-0·03 [95% CI -0·05 to -0·01]) and 0·09 SD lower GrimAge EAA (-0·09 [-0·12 to -0·05]). No statistically significant association was observed for Hannum EAA or PhenoAge EAA. Higher physical activity is significantly associated with lower biological age as measured by Horvath EAA and GrimAge EAA. However, evidence is predominantly from cross-sectional studies, limiting causal inference. Future longitudinal studies and clinical trials using standardised, objectively measured physical activity are warranted to clarify dose-response relationships, and to determine whether physical activity can causally modify ageing trajectories, thereby informing precision strategies for healthy longevity. The National University of Singapore and the National Medical Research Council of Singapore.
Skin aging in midlife women is influenced by intrinsic aging processes, hormonal transitions, and systemic factors that affect skin structure, hydration, and elasticity. Increasing interest has emerged in oral interventions targeting the gut-skin axis as a complementary strategy to topical skincare. However, clinical evidence linking postbiotic supplementation to objective changes in skin appearance remains limited. In this randomized, double-blind, placebo-controlled trial, 34 healthy women aged 40-55 years were assigned to receive either an oral postbiotic supplement (VMK223, 500 mg/day) or placebo for 12 weeks. Objective skin appearance parameters, including pore appearance, melanin levels, acne severity, wrinkle depth, hydration, and elasticity, were assessed at baseline and at weeks 4, 8, and 12 using a standardized, noninvasive skin analysis device. A composite skin quality score integrating pores, melanin, acne, and wrinkles was developed as an exploratory outcome. Overall, 29 participants completed the study (VMK223: n = 16; placebo: n = 13). Compared with placebo, VMK223 supplementation was associated with significantly greater improvements across multiple skin parameters over time. At week 12, the VMK223 group showed greater reductions in wrinkle depth (28.0% versus 4.4%, p < 0.001), pore appearance (22.0% versus 8.2%, p < 0.001), acne severity (15.9% versus 7.0%, p < 0.01), and melanin levels (11.5% versus 0.9%, p < 0.05), alongside greater increases in skin hydration (28.3% versus 11.0%, p < 0.001), and elasticity (26.8% versus 5.8%, p < 0.001). The composite skin quality score improved by 20.9% in the VMK223 group compared with 5.6% in the placebo group (p < 0.001). Improvements were progressive and most pronounced after 8-12 weeks. Oral postbiotic supplementation for 12 weeks was associated with significant improvements in multiple objective skin appearance parameters in healthy women aged 40-55 years. These findings support the potential role of postbiotics as a systemic, adjunctive approach for improving visible skin quality. Further studies incorporating biological markers are warranted to elucidate underlying mechanisms. Infographic available for this article. NCT04267731.
Non-surgical treatment of the aging lower face remains a therapeutic challenge. Tissue Micro-Coring Technology (MCT) is a novel technology that permits the non-surgical removal of skin as micro-cores, tightening skin and inducing collagen and elastin. To evaluate safety and efficacy of MCT for the treatment of the aging lower face. This retrospective, single-site study assessed outcomes for subjects treated with MCT. Assessments included the change from baseline in Lemperle Wrinkle Severity Scale (LWSS) assessed for the nasolabial folds (NLF), marionette lines, lip lines, and global esthetic improvement scale (I-GAIS). A total of 10 patients met the study criteria. Mean (SD) I-GAIS was 1.7 (0.36), and mean (SD) change from baseline in LWSS for NLF, marionette lines, and lip lines were 1.1 (0.46), 1.3 (0.3), and 0.6 (0.35), respectively. Most subjects had some improvement in LWSS across all three treatment areas, with many experiencing > 1-point improvements. Limitations include the retrospective study design, small study population, and single-sex population. In the real-world setting, MCT leads to improvements in global appearance and wrinkle severity. MCT is an effective alternative to injectable fillers for the treatment of nasolabial fold and marionette and perioral lines.
Geriatric syndromes (GSs) such as cognitive decline, malnutrition, and mobility impairment are common among older adults and associated with adverse health outcomes. Traditional paper-based assessments are often resource-intensive and difficult to implement in primary care. The World Health Organization's Integrated Care for Older People (ICOPE) framework emphasizes early detection, yet evidence on the implementation of self-administered online screening in Southeast Asia is limited. This study aimed to (1) determine the prevalence of GSs in primary care, (2) identify associated factors, and (3) evaluate preliminary process indicators of an online self-administered geriatric screening tool based on the ICOPE framework and Thai national guidelines. A cross-sectional study was conducted between April and December 2024 across seven primary care units in Bangkok, Thailand. Older adults aged ≥ 60 years were randomly selected from daily clinic lists. Participants completed an online questionnaire covering demographics, comorbidities, health behaviors, and 10 geriatric screening questions. Those screening positive underwent in-depth assessments by trained nurses using validated tools (e.g., Mini-Cog, Snellen chart, Timed Up and Go test). Associations between participant characteristics and GSs were examined using multivariable logistic regression. Preliminary process indicators were assessed through completion rates, need for caregiver assistance, acceptability, and completion time. A total of 374 participants (mean age 76.4 years, 63.6% female) were included. Multimorbidity was present in 76.7% and polypharmacy in 58.6%. The most prevalent GSs were limited mobility (49.7%), vision impairment (43.6%), and undernutrition (34.8%). Significant risk factors for GSs included older age for hearing loss (adjusted odds ratio [OR] 2.37, 95% CI 1.19-4.72), low education for limited mobility (aOR 8.14, 95% CI 2.25-29.52) and urinary incontinence (aOR 3.48, 95% CI 1.36-8.89), multimorbidity for urinary incontinence (aOR 3.12, 95% CI 1.34-7.29), and polypharmacy for cognitive decline (aOR 2.70, 95% CI 1.25-5.81) and depressive symptoms (aOR 3.40, 95% CI 1.31-8.84). Protective factors included regular physical exercise and normal body mass index against multiple GSs. Regarding preliminary process indicators, 81.5% completed the online screening independently, the average completion time was 12.8 min, and 88.9% reported the system was easy to use. A self-administered online geriatric screening tool adapted from the ICOPE framework is feasible, acceptable, and effective in detecting GSs in primary care. The high prevalence of GSs highlights the urgent need for scalable digital solutions. Integrating online screening into primary care workflows could facilitate early identification, optimize resource use, and promote healthy aging in resource-constrained settings.