The objective of this study was to culturally adapt the Thriving of Older People Assessment Scale (TOPAS) instrument and evaluate its psychometric properties. The study was carried out in two phases: cross-cultural adaptation and psychometric validation and refinement through a cross-sectional study conducted between 2018 and 2020 with 314 participants. The refinement resulted in an abbreviated version of TOPAS, maintaining the original 5 factors with 16 items. Cronbach alpha was 0.91. Composite reliability (0.72-0.89) and average variance extracted (0.57-0.81), supporting discriminant validity. Maximum shared variance for the factors (0.22-0.50) and average shared variance (0.16-0.31), demonstrating discriminant validity. The abbreviated version of TOPAS showed evidence of being a valid and reliable instrument for measuring the adaptability of elderly residents in institutions. Implementing this instrument in Spanish nursing homes allows for a continuous evaluation of residents\' well-being in relation to their environment, a construct not previously assessed with available scales.

Using three waves of the China Health and Retirement Longitudinal Study, this paper examines whether financial transfers from adult children to elderly parents affect the latter\'s mental health. Both OLS and instrumental variable (IV) estimates show that financial transfers significantly attenuate depressive symptoms of elderly individuals, with a much larger size of the IV estimates. We also examine the income and cultural channels through which intergenerational transfers work and further discuss the explanatory powers of these two channels through a decomposition analysis. The results suggest the cultural channel accounts for a larger proportion of the financial transfer effect. This means that the unique beneficial impact of intergenerational financial transfers on the mental health of older adults cannot be fully substituted in the foreseeable future.

BACKGROUND: Knowing the prevalence of potentially avoidable hospitalizations (PAH) and the factors associated with them is essential if preventive action is to be taken. Studies into PAH mainly concern adults, and very few have been carried out in South America. To the best of our knowledge, there has been no study of PAH in French Guiana, particularly among older adults. This case-control study aimed to estimate the prevalence of PAH in the Guianese population aged over 65 and to analyze its associated factors.
METHODS: We used 2017-2019 data from the French National Health Service database (Système National des Données de Santé, SNDS). The patients were age- and sex-matched 1:3 with controls without any PAH in 2019. Factors associated with PAH were investigated through two conditional logistic regression models (one including the Charlson comorbidity index (CCI) and one including each comorbidity of the CCI), with calculation of the adjusted odds ratio (aOR) and 95% confidence interval (CI).
RESULTS: The PAH incidence was 17.4 per 1,000 inhabitants. PAH represented 6.6% of all hospitalizations (45.6% related to congestive heart failure or hypertension). A higher CCI was associated with PAH (aOR 2.2 (95%CI: 1.6,3.0)) and aOR 4.8 (95%CI: 2.4,9.9) for 1-2 and ≥3 comorbidities, respectively, versus 0), as was immigrant health insurance status (aOR 2.3 (95%CI: 1.3,4.2)). Connective tissue disease, chronic pulmonary disease, congestive heart failure, diabetes and peripheral vascular disease were comorbidities associated with an increased risk of PAH.
CONCLUSIONS: While the prevention of PAH among immigrants is probably beyond the reach of the Guianese authorities, primary care and a public health policy geared towards prevention should be put in place for the French Guianese population suffering from cardiovascular disease in order to reduce PAH.

Understanding the interaction between dietary patterns and nutritional status in influencing health outcomes is crucial, especially in vulnerable populations. Our study investigates the impact of adherence to the Mediterranean diet (MD) and nutritional status on inflammatory markers (CRP) and the length of stay (LOS) in hospitalized frail elderly patients.
METHODS: We conducted two-way ANOVA and multiple regression analysis to evaluate the effects of nutritional status and MD adherence on the CRP levels and LOS in a cohort of 117 frail elderly patients aged 65 years or older. Patients with cancer or acute infection were excluded. Adherence to the MD was assessed using the 14-item PREDIMED questionnaire.
RESULTS: Significant interactions were found between nutritional status and MD adherence for both the CRP and LOS. The patients with low-level MD adherence and a poor nutritional status exhibited higher CRP levels and longer hospital stays compared to those with high MD adherence. Specifically, a statistically significant interaction was observed for the CRP (F (1, 113) = 7.36, p = 0.008) and LOS (F (1, 113) = 15.4, p < 0.001), indicating the protective effect of high-level MD adherence. Moderation analysis confirmed that high-level MD adherence mitigates the adverse effects of malnutrition on both the inflammatory response and LOS.
CONCLUSIONS: These findings highlight the importance of promoting the MD, particularly in malnourished elderly patients, to improve health outcomes and reduce hospitalization duration. Further longitudinal studies are warranted to establish causality and explore the underlying mechanisms.

BACKGROUND: Globally, the demographic shift towards an aging population leads to significant challenges in healthcare systems, specifically due to an increasing incidence of multimorbidity resulting in polypharmacy among the elderly. Simultaneously, sleep disorders are a common complaint for elderly people. A treatment with pharmacological therapies often leads to side effects causing a high potential for dependency. Within this context, there is a high need to explore non-pharmacological therapeutic approaches. The purpose of this study is to evaluate the effectiveness of acupuncture and music therapy, both individually and combined as a multimodal therapy, in the treatment of sleep disorders in individuals aged 70 years and older.
METHODS: We conduct a confirmatory randomized controlled trial using a two-factorial study design. A total of n = 100 elderly people receive evidence-based standard care information for age-related sleep disorders. Beyond that, patients are randomly assigned into four groups of n = 25 each to receive acupuncture, receptive music therapy with a monochord, multimodal therapy with both acupuncture and music therapy, or no further therapy. The study\'s primary outcome measurement is the improvement in sleep quality as assessed by the Pittsburgh Sleep Quality Index (PSQI) (global score), at the end of intervention. Additionally, depression scores (Geriatric Depression Scale), health-related quality of life (Short-Form-Health Survey-12), neurovegetative activity measured via heart rate variability, and safety data are collected as secondary outcomes. Using a mixed-methods approach, a qualitative process evaluation will be conducted to complement the quantitative data.
CONCLUSIONS: The study is ongoing and the last patient in is expected to be enrolled in April 2024. The results can provide valuable insights into the effectiveness of non-pharmacological interventions for sleep disorders among the elderly, contributing to a more personalized and holistic approach in geriatric healthcare.
BACKGROUND: German Clinical Trials Register (DRKS00031886).

BACKGROUND: Improving pelvic floor muscle training (PFMT), balance and functional activity is recommended in the treatment of urinary incontinence (UI) in the elderly people. The aim of this study is to examine whether PFMT combined with Otago exercises is effective on symptoms, balance and functional status in elderly people with UI compared to PFMT alone.
METHODS: This study is an assessor-blinded, randomized controlled trial. Participants with UI aged 65 and over living in a nursing home were randomly assigned to the intervention (IG) and control groups (CG). The intervention group attended an exercise program that included Otago exercises combined with PFMT. The control group was included in the PFMT program with different positions. The duration of exercise for both groups was 45-60 min per session three times a week for 12 weeks. UI symptoms and severity (Pelvic Floor Distress Inventory-20, bladder diary), PFM muscle function (superficial electromyography), balance (Berg Balance Scale), functional status (Senior Fitness Test) and fear of falling (Falls Efficacy Scale) were measured at baseline and after the intervention.
RESULTS: The median age of the IG (n: 22) and CG (n: 21) was 73.5 and 77 years, respectively. At baseline and after the intervention within the group, a significant improvement was observed in the PTDE-20 score (IG and CG, p: 0.00) and the 2-min step test in the IG (p: 0.02) and CG (p: 0.01). A significant decrease was found in the 2.45 m get up-and-go test, PFM work average onset, and PFM rest MVC EMG values (p: 0.01, p: 0.01, p: 0.00) in the IG. The PFM rest average value decreased (p: 0.04) in the CG.
CONCLUSIONS: The findings of this study show that combining PFMT with Otago exercises, two evidence-based interventions, is beneficial for effectively treating incontinence symptoms, balance and functional status in elderly people. Thus, a triple effect can be achieved with a single exercise training in the same treatment session and for the same duration.
BACKGROUND: Clinical trial number: NCT06331039.

BACKGROUND: Recent studies have shown that SARS-CoV-2 can have neuropsychiatric consequences and has the ability to penetrate the blood-brain barrier. If SARS-CoV-2 has a specific route of entry into the brain, it may leave imprints in the form of specific changes in brain morphology. Older individuals are most vulnerable to the neuropsychiatric COVID-19 complications. This study aims to compare regional brain volumes in older adults individuals with and without COVID-19 history (COVID+ and COVID-, respectively).
METHODS: Individuals over 65 years old who applied for treatment to the Memory Clinic (Mental-Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia) were assessed between October 2020 and April 2021. Their COVID-19 history was determined by the self-report and COVID-19 certificate. Individuals with severe neuropsychiatric or acute or severe chronic somatic or infectious disease and those taking medications potentially affecting cognitive functioning were excluded. All participants underwent MRI examinations followed by image segmentation and morphometric quantitative analysis. Regional brain volumes were compared in COVID+ and COVID- people.
RESULTS: 207 participants were included in the study. The COVID+ group consisted of 24 participants. The comparison between groups revealed statistically significant differences in left amygdala area (median 1199.3 mm3 in COVID+ vs. 1263.7 mm3 in COVID-) and right postcentral gyrus volumes (median 8055.5 mm3 in COVID+ vs. 8434.0 mm3 in COVID-). Then case-control analysis was performed in individuals matched for gender, age and common somatic causes of structural brain changes (hypertension and/or diabetes mellitus type 2) for 22 subjects in each group. Statistically significant differences in regional brain volumes between groups were absent.
CONCLUSIONS: We did not find strong evidence for any regional brain volumes changes in people older than 65 years with a history of COVID-19 in comparison to those without history of COVID-19. Though, given study limitations, these results cannot be generalized to other people who recovered from COVID-19.
UNASSIGNED: В недавних исследованиях было показано, что SARS-CoV-2 может иметь нейропсихиатрические последствия и обладает способностью проникать через гемато-энцефалический барьер. Если коронавирус имеет специфический путь проникновения в головной мозг, то это может оставлять отпечатки в виде характерных изменений морфологии мозга. Лица старшей возрастной группы являются наиболее уязвимой популяцией в отношении последствий COVID-19. Данное исследование нацелено на сравнение морфологии головного мозга у лиц пожилого возраста, перенесших (COVID+) и не перенесших (COVID-) новую коронавирусную инфекцию.
UNASSIGNED: В период с октября 2020 по апрель 2021 года отбирались лица старше 65 лет, обратившиеся в Клинику памяти (Москва), у которых путем анкетирования определялся статус перенесенного COVID-19. Не включались лица, имеющие тяжелые нейропсихиатрические и соматические заболевания и принимающие лекарственную терапию, потенциально сказывающиеся на когнитивном функционировании. Всем участникам проведено МРТ-обследование с последующей сегментацией изображений и количественным анализом морфометрических данных. Сравнивались региональные объемы головного мозга.
UNASSIGNED: 207 участников включено в исследование. COVID+ группу составили 24 участника, из которых 4 были госпитализированы вследствие COVID-19. Сравнение выявило наличие статистически значимых различий объемов левого миндалевидного тела (медиана 1199.3 мм3 у COVID+ vs. 1263.7 мм3 у COVID-, U=1839.0, p=0,044, тест Манна-Уитни) и правой постцентральной извилины (медиана 8055.5 мм3 у COVID+ vs. 8434.0 мм3 у COVID-, U=1821.5, p=0,045, тест Манна-Уитни). При проведении анализа методом случай-контроль у лиц, сопоставленных по полу, возрасту и распространенным соматическим причинам структурных изменений головного мозга, не было выявлено статистически значимых различий между COVID+ и COVID− группами.
UNASSIGNED: Мы не обнаружили значимых свидетельств изменений региональных объемов головного мозга у лиц, перенесших и не перенесших COVID-19. Однако, учитывая имеющиеся ограничения исследования, эти результаты не могут быть перенесены на всех пациентов после COVID-19.

Depression is a prevalent mental health issue among elderly people residing in nursing homes, with significant implications for quality of life. From an initial pool of 175 articles, seven met the inclusion criteria, including four longitudinal studies, two controlled trials, and one systematic review. The findings indicate mixed outcomes regarding the impact of institutionalization on the trajectory of depression, underlining the complexity of its support. A number of risk factors appear to be associated with depression, such as gerontopsychiatric disorders, functional impairment, chronic illness and gender. Interventions such as increased exposure to natural light and psycho-educational programmes could be relevant therapeutic tools. This review emphasizes the need for more robust longitudinal research, and uniform depression assessment methods to better manage depression at the entrance of the nursing home.

Vitamin D deficiency (VDD) is associated with increased risk of type 2 diabetes mellitus (T2DM) and insulin resistance (IR). We aimed to investigate the association between the triglyceride-glucose (TyG) index that represents IR and VDD in elderly patients with T2DM. We enrolled 572 elderly participants with T2DM in this study. TyG index was calculated as ln [fasting triglyceride (TG, mg/dL) × fasting blood glucose (mg/dL)/2]. Serum 25-hydroxyvitamin D [25(OH)D] level below 50 nmol/L was defined as VDD. The association between the TyG index and the VDD risk was evaluated by multivariate logistic regression analysis. We observed a significant decreased 25(OH)D level with the increase of the TyG index in elderly diabetic patients, and a negative correlation between the TyG index and 25(OH)D level. The participants in the highest TyG quartile had a 2.40-fold higher risk of VDD than those in the lowest TyG index quartile [OR 2.40; 95% CI 1.47-3.92; P < 0.001]. The association persisted after adjustments for age, sex, smoking, obesity, insulin therapy, hypoglycemic agents\' medication, and some biochemical parameters. TyG index may be involved in the pathophysiology of VDD, which could be a predictor for VDD in elderly diabetic patients.

Refusal of care is a frequent occurrence in geriatric medicine, especially among people with neurocognitive diseases, particularly in the advanced stages. These refusals of care are a daily burden, not only for the patients themselves, but also for their carers and caregivers. Although they can be prevented, the absence of a single, simple strategy for overcoming them is a real challenge for professionals and carers alike. Their management calls for an approach that is essentially non-pharmacological, always interdisciplinary, humanistic and ethically grounded.