搜索结果：Gerontologist

Research has established that while most older adults use information and communication technologies (ICTs), loneliness and social isolation in later life is a pressing issue. Studies of older adults' ICT use has largely been cross-sectional, focused on their attitudes and preferences, and conducted with white, well-educated individuals who were disproportionately aged 65 to 75. Using an intersectional life course perspective, the purpose of our study was to understand the meanings that diverse older adults attributed to ICTs. We purposively recruited and conducted in-depth, semi-structured qualitative interviews with 20 diverse men and women, aged 65 to 89. They were asked about experiences of social connection, disconnection, and use of ICTs over time. Interview transcriptions were coded and analyzed using interpretative description. Participants shared stories underscored by wonder and fascination related to the arrival of ICTs into their homes and workplaces over the life course. In later life, they suggested that ICTs were important for connection and alleviating loneliness and social isolation as they allowed for instant, direct, and affordable communication. However, they also regarded ICTs as a source of disconnection as they undermined intimacy, spontaneity, and full social participation, especially for those with disabilities or limited finances. Findings illuminate the importance of examining diverse older adults' perceptions and experiences in a life course perspective. They also point to the need for training opportunities, improved technology design, and recognition from policy makers and service providers of older adults' social connection preferences.

'Ri-Medi' is a pilot project implementation of a medication review and deprescribing (MRDP) service in the primary care setting, involving two health districts of the Local Health Authority Roma 1 (Rome, Italy). General practitioners (GPs) are supported in this activity by a multidisciplinary team consisting of epidemiologists, pharmacists, statisticians, pharmacologists, geriatricians, internists, and healthcare managers. Together with GPs, the team chooses specific therapeutic focuses for which updated evidence-based information and indications on the target population are provided. The focus is on the elderly population in hyper-polypharmacy (10+ drugs). For the pilot phase, the therapeutic focus was on potentially inappropriate statin use in primary prevention in patients aged 80+ years. For each GP, the number of patients at risk was estimated. In addition, a survey among a sample of voluntary GPs was launched to investigate their interest in participating in this activity, to collect potential critical issues and impressions, and to identify areas of interest for future MRDP campaigns of interest.

In 2025, an Irish team developed the STOPPCog criteria to identify and support the deprescribing of potentially inappropriate medications (PIMs) in cognitively vulnerable older adults. The aim of this study was to provide a French adaptation of the STOPPCog criteria to facilitate their use by French healthcare professionals. The cross-cultural adaptation into French was conducted by two experts, confirmed through a forward-backward translation process, and finalized based on feedback from ten French reviewers (geriatricians and clinical pharmacists). Validation was performed by assessing inter-rater agreement using the intraclass correlation coefficient (ICC) after application of the STOPPCog criteria to five standardized clinical vignettes. The 23 criteria of the STOPPCog tool, organized into six sections, were retained with the same classification as in the original English version, while being adapted to French clinical practice. Back-translation confirmed preservation of the original clinical meaning, and good agreement among the ten reviewers was observed for the identification of PIMs (ICC = 0.791). The French adaptation of the STOPPCog criteria represents an important step toward facilitating their implementation in France. Adjustments based on recent French guidelines and the literature strengthen its relevance in the national context. Future work should focus on facilitating its implementation in clinical practice.

Amid growing concerns surrounding social isolation among older adults, AI chatbots have emerged as promising tools for providing digital companionship. While the intersection of aging and technology has been widely explored, there remains a gap in understanding the nuanced ways in which AI chatbots function as relational partners in older adults' daily lives. This study aimed to examine the roles of the AI chatbot in fostering digital companionship for adults in later life. Drawing on a qualitative research design, the study conducted in-depth, semi-structured interviews with individuals in later life who regularly engaged with AI chatbots. Thematic analysis method was used to synthesize the qualitative data. Participants described the AI chatbot as multifaceted relational agents-occupying roles such as human-like companions, supportive teachers, specialized consultants, practical assistants, and entertainment facilitators. These interactions were reported to support emotional well-being, enhance cognitive engagement, and promote a sense of self-efficacy in daily living. The findings illuminate the profound and diverse ways in which AI chatbots are integrated into the everyday lives of older users, extending far beyond utilitarian functions. As conversational AI continues to advance, designers and policymakers should acknowledge its potential to support aging in place by fostering connection, engagement, and autonomy among older populations.

Consistent growth in the number of older adults in the United States has led many health systems to evaluate their capacity for supporting an aging population. Delaware needs to identify priorities and action areas to support the state's increasingly older population. Using publicly available data from national surveillance systems and state reports, this analytic essay compared demographic aging trends, age-related chronic disease prevalence, and public health infrastructure across Delaware, Maryland, Pennsylvania, Rhode Island, and Vermont. These states were chosen given their similar geographical location or population size. Between 2015 and 2024, the proportion of Delaware residents aged 60 years and older grew from 23.7 percent to 29.3 percent, placing Delaware as second among comparison states in the proportion of older adults. Relative to the comparison states, Delaware had the highest proportion of older adults moving into the state, with 18.8 percent of adults aged 60 years and older relocating from another state in 2024. In 2024, Delaware had the highest prevalence of several age-related health conditions, including diabetes (13.3%), stroke (3.5%), arthritis (26.2%), and neurological difficulties (15.8%). Delaware had the highest disparities relative to the comparison states on measures of economic hardship, food instability, and uninsured populations. Despite these demographic, economic, and disease trends, Delaware had the second-lowest geriatric healthcare workforce capacity, reporting 39.3 geriatricians and nurse practitioners per 100,000 adults aged 65 years and older in 2025, compared with 74.1 in Rhode Island. These findings suggest that Delaware's aging population is growing rapidly, and that the state may be facing substantial preparedness gaps related to meeting the needs of older Delawareans. Strategic investments in workforce development, economic supports, community-based services, healthcare access, and dementia preparedness will be critical to ensuring Delaware is prepared to meet the evolving needs of its growing older adult population.

Housing needs for older people wishing to age in place and university students are different, yet both groups face unmet needs. To support older adults to remain in their homes longer, many countries have policies for ageing in place with in-home support. Housing affordability, a growing issue globally, leaves older adults and students vulnerable to homelessness or precarious housing. This scoping review aimed to explore the concept of intergenerational homesharing, where older adults share their home with a student. Using the JBI scoping review methodology, we searched peer-reviewed and grey literature describing homesharing arrangements between people aged 50+ and university students. Searches across six databases identified 1092 publications between 1985 to 2024. Of these 63 sources were eligible for inclusion. A range of programs have been developed internationally. Older adult participants were more often female, experiencing social isolation, and were apprehensive about the matching process, student behaviour, and financial impacts of programs. Interested students, also more often female, held concerns about loss of independence and differences in expectations. Homeshare participants reported decreased loneliness and isolation, and having enjoyed the experience more than anticipated. Of the few negative outcomes reported, students found support obligations higher than expected. Homeshare programs are one solution to housing concerns for older adults and university students. Recommendations for homeshare organisations include careful consideration of the matching and relationship development phases, establishing clear written agreements of boundaries and expectations, supporting participants throughout their agreement, and agreement-ending processes.

Advances in voice recognition and artificial intelligence (AI) could soon yield digital conversation companions-software that combines conversational AI with health monitoring and promotion. We describe how this technology, once developed and deployed, could transform the way older adults age and receive care. By obviating the need to read or type, the software could be used by individuals with reduced dexterity, vision, or literacy. Repeated conversations could facilitate the consistent longitudinal tracking of mental acuity and sentiment. Over time, the conversations could be tailored to strengthen cognitive reserve, physical resilience, and social lives. By continuously recording and relaying changes in cognitive function, digital conversation companions could offer older adults unprecedented visibility into their own aging trajectories. Drawing on three well-known conceptualizations of aging, we explore how older adults might respond to this new dimension, a process we term "reflected aging." Digital conversation companions could support caregivers by monitoring care recipients' mental health, explaining treatment options, and automating documentation. They also might engender an atmosphere of constant surveillance and discount caregiver expertise and judgment. As digital conversation companions could lead to anthropomorphism, delusion, or social withdrawal in users of any age, these risks should be monitored closely in vulnerable older adults.

暂无摘要（点击查看详情）

Multidisciplinary collaboration between traumatologists and geriatricians has gained international recognition for improving outcomes for older patients after fragility fractures through various models of care delivery. To inform decisions about harmonizing existing models, a deeper understanding of their delivery and impact on patient-relevant and health-economic outcomes is needed. We analyzed health insurance claims data from patients aged ≥ 80 years hospitalized with hip fractures between 2014 and 2019 at 121 certified German orthogeriatric centers. We defined hospital-level orthogeriatric care models by the geriatricians' integration into the surgical wards (geriatric consult service (GCS) vs. integrated care model (ICM)), their weekly patient visit frequency in hospitals with GCS (> 2 (high) vs. 2 (low)), and the network structure between hospitals (single-site institution vs. multisite network cooperation). Outcomes included survival time, direct inpatient medical costs, length of stay (LOS), delivery of early complex geriatric rehabilitation (EGR), and transfer patterns. The four care models observed in [Formula: see text] hospitals were low-frequency GCS (26 hospitals, 1479 patients), high-frequency GCS (46 hospitals, 3451 patients), hospital networks (42 hospitals, 1832 patients), and ICM (7 hospitals, 457 patients). Covariate-adjusted death hazards revealed the lowest 30-day hazard in ICM hospitals and the lowest 30-to-180-day hazard in hospital networks. Statistically significant differences were found when comparing these hazards with those in low-frequency GCS hospitals, showing respective reductions of 28% and 20%. Although the care models involved different individual treatment paths, such as varying timings and rates of EGR or transfers to external wards or subacute facilities, their overall costs remained similar. Our findings indicate that health outcomes in orthogeriatric care models depend not only on the availability of geriatricians but also on the extent of their involvement in patient management, whereas mean costs were similar across all models.

The rapid global expansion of digital technologies has reshaped everyday life across generations, yet the role of smartphones in older immigrants' social well-being remains insufficiently understood. Drawing on the sociotechnical perspective that ageing and technology are co-constituted, our study examines how Mandarin-speaking older immigrants in Canada use smartphones to overcome social isolation and sustain social participation. Data were obtained from 102 qualitative interviews conducted across seven Canadian cities as part of the Inclusive Communities for Older Immigrants (ICOI) project. The data were analysed using a hybrid deductive-inductive thematic analysis. Three overarching themes were identified: experiences of social isolation, shaped by linguistic, cultural, and seasonal barriers; smartphones as tools for social connection; and smartphones as facilitators of social participation, enabling both online engagement and the coordination of in-person activities. Study findings demonstrate that smartphones operate not merely as communication devices but as sociotechnical infrastructures that sustain belonging, enable local and transnational connectivity, and support mutual aid among older immigrants. At the same time, they complement rather than replace in-person interaction, with many participants preferring face-to-face social engagement when feasible. This study contributes to critical gerontology and migration scholarship by illustrating how digital technologies address social isolation among older immigrants and highlights the need for culturally and linguistically tailored digital inclusion initiatives that promote equitable ageing in diverse societies.

Primary hyperparathyroidism (PHPT) is a frequent endocrine disorder, with prevalence increasing with age, affecting approximately 1.5% of adults aged over 65. While management is well codified before the age of 50, with surgery being preferred, recommendations for older individuals are less clear. In this population, however, surgery is still the only curative option, and several studies demonstrated improvement in cognitive and neuropsychiatric symptoms, following parathyroidectomy. However, this indication must be weighed against the patient's co-morbidities, frailty and wishes. Drug-based alternatives are a valid option for patients unable or unwilling to undergo surgery. The fundamental question, however, is to evaluate the suitability of one treatment over another, depending on the patient's phenotype. A transdisciplinary approach involving endocrinologists, endocrine surgeons and geriatricians can ensure personalized care. A robust older patient may benefit from surgery, just like a younger patient, whereas a frail patient would benefit more from conservative management. In what are known as "pre-frail" patients, comprehensive geriatric assessment can optimize of the patient's general condition prior to surgery, and help anticipate postoperative complications. The present article firstly describes the clinical and biological specificities of PHPT in older adults, secondly compares the therapeutic strategies available, and thirdly identifies geriatric markers to guide the therapeutic decision.

Despite differences in housing experience across people from different racial and ethnic groups in the United States, race and ethnicity are not frequently emphasized in aging in place literature. This review cataloged the approach to race and ethnicity (active or passive) taken by quantitative aging in place research articles. This review also tested whether structural research elements were associated with the approach taken. This study included original research articles with samples of noninstitutionalized older U.S. residents. Included articles addressed an aspect of aging in place related to the physical home, used statistical modeling, and were published between 2014 and 2023. Because an initial database search in this interdisciplinary field did not produce a comprehensive list of articles, the review sample was constructed through manual review of journal tables of contents. Approximately one third (35.16%) of the 91 sample articles took an active approach to race and ethnicity. The regression model did not detect statistically significant associations between structural research elements and active approaches; however, wide confidence intervals indicate that meaningful effects cannot be ruled out. Even in the presence of a strong and historic association between race and ethnicity and housing, a passive approach to race and ethnicity was most common. This presents a gap in the existing body of aging in place literature. Practical suggestions for addressing this gap through future research are presented. A multidisciplinary symposium to develop more formal suggestions is recommended.

Psychosocial interventions support informal caregivers of people with dementia, but their impact on anticipatory grief and related health outcomes remains unclear. This review examines the effectiveness of different psychosocial approaches in addressing these outcomes. A systematic review and meta-analysis were conducted following PRISMA guidelines and registered in PROSPERO (CRD42024629388). Eight databases were searched from inception to 10th Jan 2025. Two reviewers independently screened studies, assessed bias, and extracted data. Leave-one-out sensitivity and subgroup analyses addressed heterogeneity. Evidence quality was assessed using the GRADEpro Guideline Development Tool. Eleven interventional studies were included. Psychosocial interventions (n&#x2009;=&#x2009;6) had no significant short-term (< 1 month: SMD = -0.57, 95% CI:[-1.14, 0.01], p&#x2009;=&#x2009;0.05, I2 = 85%) or medium-term (1-6 months; SMD = -0.76, 95% CI:[-1.99, 0.46], p&#x2009;=&#x2009;0.22, I2 = 88%, n&#x2009;=&#x2009;3) effect on anticipatory grief but showed improvement in long-term (&#x2265; 6 months; MD = -0.41, 95% CI:[-0.62, -0.20], p&#x2009;=&#x2009;0.0001, I2 = 0%, n&#x2009;=&#x2009;2). Short-term reductions in depression were also observed, with no significant effects in other outcomes. Subgroup analyses did not identify frameworks or delivery methods linked to better outcomes. The GRADEpro rated the evidence as 'Low' to 'Very Low'. Overall, psychosocial interventions have limited short- and medium-term impact on anticipatory grief. Individual, technology-mediated cognitive-behavioural approaches may improve anticipatory grief in long-term, but evidence is limited. Further research should clarify the concept of anticipatory grief and evaluate interventions in large, rigorous RCTs.

Studies suggest that interactions with animals may promote health and successful aging; however, the evidence remains mixed in community-dwelling older adults. This study assesses longitudinal evidence on the associations between pet ownership and successful aging and mortality among community-dwelling older adults. We conducted a systematic search across six databases for peer-reviewed studies and gray literature. After removing duplicates (1,214 of 3,615 records) 2,401 studies were independently screened by two authors using predefined eligibility criteria. Study quality was assessed using the 9-point Newcastle-Ottawa Scale for Cohort Studies. Of the remaining 26 studies from 21 countries and regions, 20 reported a positive association between pet ownership, successful aging, and lower all-cause mortality rates. Positive associations were found for physiological functioning (3/7), cognitive functioning (3/4), physical functioning (6/9), being actively engaged in life (2/3), being psychologically well adapted (3/7), lower all-cause mortality rates (2/6), cardiovascular disease (CVD) mortality rates (2/3), and cancer mortality rates (0/1). Negative associations were observed for physical functioning (1/9), being psychologically well adapted in later life (1/7), and having lower mortality rates (2/8). No associations were found for physiological function (5/7), cognitive functioning (4/4), physical functioning (4/9), being actively engaged in life (1/3), all-cause mortality (4/6), CVD mortality (2/3), and cancer mortality (1/1). Pet ownership may be a modifiable factor that supports healthy aging, though its impact is context-dependent. Therefore, future research should prioritize longitudinal, mixed-method designs to clarify causal mechanisms and optimize targeted interventions for diverse aging populations.

Preventing falls in older adults is a public health priority. The 2022 World Falls Guidelines (WGs) provide a validated algorithm to stratify fall risk (low, -intermediate, or high) and guide tailored prevention strategies. However, large-scale implementation of the WGs faces major barriers, including limited healthcare resources. A prescreening self-administered tool could optimize resource use by identifying individuals at potential moderate or high risk who warrant HCP assessment, while empowering older adults in their own care. To describe the development process of a self-administered questionnaire (APP-Chutes&#xae;) designed to pre-screen adults aged 65 and over for moderate or high fall risk, as defined by the WGs algorithm, with the aim of subsequent digitalization as a mobile application. A multidisciplinary expert group - including WGs contributors, geriatricians, a physiotherapist, a patient's representative, and methodologists - met over three days across six months. Inspired by the MASK-air&#xae; mHealth app model, the group defined the required qualities of the questionnaire, established an item development methodology, and designed a two-stage validation strategy (development and validation studies). For each WGs algorithm parameter, the group selected the most appropriate self-question(s) format - binary or visual analogue scale (VAS) - prioritizing simplicity, caregiver-assisted completion, and future digitalization. The group developed a self-questionnaire comprising binary questions and VAS items replacing WGs physical tests (walking speed, Timed Up and Go, grip strength). Key innovations include splitting ambiguous questions, applying VAS for subjective parameters (unsteadiness, fear of falling, fatigue, physical activity), and defining VAS thresholds to align with WGs binary outcomes. A two-stage prospective validation methodology, using weighted Gwet coefficient and ROC analyses, was defined. APP-Chutes&#xae; represents a novel, patient-centered pre-screening tool designed to facilitate the large-scale roll-out of the World Falls Guidelines. Validation studies will determine its accuracy and support its digitalization as a mobile application.

Chronic kidney disease (CKD) prevalence increases with age and is frequently associated with geriatric syndromes. These situations may require close collaboration between nephrologists and geriatricians. However, in France, little is known about the current state of such collaborations or the training needs expressed by geriatricians regarding nephrological care for older adults. To identify nephrogeriatric collaborations and geriatricians' wishes for training in this field, a questionnaire was developed by the Action Group in Nephrology of Older Persons (Granpa) of the Soci&#xe9;t&#xe9; fran&#xe7;aise de g&#xe9;riatrie et g&#xe9;rontologie (SFGG) and was disseminated through its constitutive societies between March and May 2025. Among 252 geriatricians, 89% reported having access to a nephrologist and 37% identified someone to refer to for nephrogeriatric questions. Geriatricians reported referring to nephrologists more frequently than the reverse. The most frequent need of geriatricians was the discussion of care plan for stages 4/5 CKD without prior follow-up. The most frequent reason for referral to geriatricians by nephrologists was neurocognitive disorders, delirium and then shared decision about dialysis. Geriatricians with previous advanced training in nephrology were more frequently involved in shared decision-making process about dialysis. Training in nephrology was desired by 75% of geriatricians, in particular on metabolic, bone and cardiovascular complications of CKD (60%), non-stage 5 CKD (46%) and drug management in renal failure (38%). This survey highlights frequent nephro-geriatric collaborations in France, but also a significant need for geriatrician training, particularly on CKD care.

Older adults represent most patients with cancer, yet geriatric expertise remains underrepresented in oncology practice. This review explores practical strategies to integrate geriatricians throughout the continuum of cancer care, from diagnosis to survivorship and palliative care. We discuss models of interdisciplinary collaboration, optimal timing of geriatric involvement, and innovative solutions to address the global shortage of geriatricians. Evidence demonstrates that comprehensive geriatric assessment enhances treatment tolerance, quality of life, and survival among older adults with cancer [1-5]. Despite widespread endorsement, implementation barriers persist due to workforce limitations, time constraints, and lack of institutional support. Emerging strategies include task-shifting, telehealth-enabled assessments, and education programs that empower oncologists and allied health professionals to apply geriatric principles in daily practice [6-10]. Integrating geriatricians into multidisciplinary oncology teams is essential to deliver equitable, personalized, and value-based care for aging populations. We advocate for structured collaboration models, institutional prioritization of geriatric oncology, and policy-level initiatives that reinforce the indispensable role of geriatricians in modern cancer care.

Adult children increasingly provide care to parents from varying distances, yet the relationship between proximity and caregiver mental health is not well understood. This study characterizes caregiving activities of adult-child caregivers based on residential proximity to their parent and examines associations with depression and anxiety symptoms. Data from the 2021 National Health and Aging Trends Study Round 11 was linked with National Study of Caregiving IV. The sample included adult-child caregivers of Medicare beneficiaries aged 71 and older. Bivariate and multivariable logistic regression models assessed associations between proximity (travel time between the caregivers and their parents), caregiving activities, and symptoms of depression and anxiety. Analyses were weighted to produce nationally representative estimates. Among 932 caregivers representing more than 9 million caregivers nationwide, 26.3% co-reside with care-recipients, 47.4% live 1-20&#x2009;min away, 13.1% live 21-59&#x2009;min away, and 13.2% are long-distance caregivers living &#x2265;1&#x2009;hr away. Co-residing caregivers were more likely to perform health management, health care, Activities of Daily Living, and Instrumental Activities of Daily Living tasks. However, proximity was not associated with differences in health system logistics, patient advocacy, and financial support activities. Proximity did not predict of depression or anxiety in adjusted models. Adult children engage in diverse caregiving activities regardless of distance, especially in logistics, advocacy, and financial support. Factors beyond proximity likely influence caregiver mental health. Findings highlight the need for tailored policies and services supporting both distance and proximal caregivers of older adults.

Frailty is a common condition in older adults which becomes more prevalent and more severe with age. Health and care services designed to meet the needs of older adults living with frailty are expanding in number and scope, but information on the workforce needed to deliver services both now and in the future is lacking. To understand the service design and staffing configurations for frailty services through gathering data on the setting and purpose of services; target population; referral methods into the service; specific activities delivered; frailty assessment tools; key service and patient outcomes; staff involved; future service priorities and anticipated future workforce requirements. National survey, circulated electronically via national networks and organisations involved in the care of patients with frailty (n=26). England health and care settings. Health and care professionals delivering services for people living with frailty. There were 93 survey responses from frailty services across England, of which 82 contained usable information. Respondents included clinicians and managers in a range of health and care sectors and the voluntary sector. Frailty services across settings commonly prioritised reducing frailty-associated risks but few focused on prevention. Staff teams included representation across professions, with specialists in older people's care (eg, geriatricians, advanced practitioners) present in most teams, but non-specialist team members (eg, therapists, social workers and care co-ordinators) comprised a large proportion of the total workforce. All respondents identified similar priorities for their service in future, including reducing frailty progression, and specified needs for additional staff which broadly reflected the current team configurations. However, staff vacancies or unmet patient need due to low capacity was highlighted, and all respondents identified the need for additional staff in future. Services designed to identify and manage people with frailty are complex and require a workforce with specialist training to assess, plan and deliver care. Current services are understaffed with insufficient capability to prevent frailty onset or slow progression, thereby failing to address unmet need. Workforce planning and resourcing to address frailty-related needs is urgently required.