Parque Sanitario Pere Virgili

This study aims to explore the walkability of three small areas (basic healthcare areas) of Barcelona city (Catalonia, Spain) for frail older adults. A mixed methods study design was conducted with 132 frail older adults in three primary care centers of Barcelona: Larrard, Barceloneta, and Vila Olímpica. A literature review was conducted to identify urban design indicators related to walkability and the aging population. These were then reflected in the surveys administered to the program participants, capturing information on their preferred routes, usual destinations, and walkability perceptions. Findings reveal significant mobility challenges for older adults, particularly the ones related to safety issues, the adequacy of sidewalk widths, greenery and urban furniture maintenance, and the presence/absence of commercial activities. This research underscores the importance of age-sensitive urban design in healthcare environments and provides a framework for enhancing walkability and accessibility for populations at greater risk of mobility-related health problems, such as frail older adults.

ABSTRACT The relationship between bacteria, cognitive function and obesity is well established, yet the role of archaeal species remains underexplored. We used shotgun metagenomics and neuropsychological tests to identify microbial species associated with cognition in a discovery cohort (IRONMET, n = 125). Interestingly, methanogen archaeas exhibited the strongest positive associations with cognition, particularly Methanobrevibacter smithii (M. smithii). Stratifying individuals by median-centered log ratios (CLR) of M. smithii (low and high M. smithii groups: LMs and HMs) revealed that HMs exhibited better cognition and distinct gut bacterial profiles (PERMANOVA p = 0.001), characterized by increased levels of Verrucomicrobia, Synergistetes and Lentisphaerae species and reduced levels of Bacteroidetes and Proteobacteria. Several of these species were linked to the cognitive test scores. These findings were replicated in a large-scale validation cohort (Aging Imageomics, n = 942). Functional analyses revealed an enrichment of energy, butyrate, and bile acid metabolism in HMs in both cohorts. Global plasma metabolomics by CIL LC-MS in IRONMET identified an enrichment of methylhistidine, phenylacetate, alpha-linolenic and linoleic acid, and secondary bile acid metabolism associated with increased levels of 3-methylhistidine, phenylacetylgluamine, adrenic acid, and isolithocholic acid in the HMs group. Phenylacetate and linoleic acid metabolism also emerged in the Aging Imageomics cohort performing untargeted HPLC-ESI-MS/MS metabolic profiling, while a targeted bile acid profiling identified again isolithocholic acid as one of the most significant bile acid increased in the HMs. 3-Methylhistidine levels were also associated with intense physical activity in a second validation cohort (IRONMET-CGM, n = 116). Finally, FMT from HMs donors improved cognitive flexibility, reduced weight, and altered SCFAs, histidine-, linoleic acid- and phenylalanine-related metabolites in the dorsal striatum of recipient mice. M. smithii seems to interact with the bacterial ecosystem affecting butyrate, histidine, phenylalanine, and linoleic acid metabolism with a positive impact on cognition, constituting a promising therapeutic target to enhance cognitive performance, especially in subjects with obesity.

PurposeThis study explores whether the full potential of physiotherapy is reaching cancer patients and their caregivers at all stages of the oncological process, aiming to identify gaps and opportunities for improving care.MethodsThe World Cafe co-design methodology facilitated discussions among cancer patients and caregivers. This dynamic, inclusive, and engaging approach fostered diverse perspectives and deeper insights through collaborative and flexible discussions. Sessions were recorded, transcribed, and qualitatively analyzed.ResultsSixteen participants were involved (eight cancer survivors and eight caregivers). The mean age of cancer survivors was 63.8 years, while the average age of caregivers was 59.3 years. Breast cancer was the most prevalent diagnosis among patients, and most caregivers had lost their family members to cancer. Analysis revealed two primary themes: “feeling cared for” and “the role of physiotherapy in the oncological process.” Key findings highlight the need for more humanized healthcare, with professionals providing support through effective communication and empathy. Significant gaps were detected in both systematic referrals to physiotherapists and their integration into care teams. Testimonies highlighted the lack of knowledge about the full potential of physiotherapy in oncology, hindering access. There was also a demand for recognizing specialized oncological physiotherapists.ConclusionsThese findings highlight significant gaps in physiotherapy care for cancer survivors and caregivers, including unmet needs due to the lack of information, resources, and effective communication. Future efforts should focus on increasing the visibility of physiotherapy, integrating specialized physiotherapists into oncology teams, and enhancing the emotional education of healthcare professionals to provide more humanized care.

This 90 minute workshop is a collaboration between IFICs Intermediate Care and Ageing and Frailty SIGs. It will provide practical insights into the challenge of evaluating new models of care across the dimensions of the Quadruple Aim. The session will interest policy makers, researchers, advocates, patients, carers and professionals who plan, commission, fund, provide or evaluate anticipatory care or intermediate care for people with multimorbidity or frailty. Anticipatory Care is a shift from reactive, fragmented, episodic care to proactive, personalised and coordinated team based care that starts with what matters to the individual and takes an enablement and strength based approach. Transitional and intermediate care are time-limited services that ensure continuity and quality of care, promote recovery, restore independence and confidence at the interface between home and acute services. Both models are best delivered by interdisciplinary teams where a single contact point optimises service access, communication and coordination. They are complex multi-dimensional interventions that often prove challenging to evaluate. As more health and care systems implement these new models of care there is a need to understand and communicate the associated benefits for patients, carers, professionals, organisations and health and care systems. This session will enable the SIG members to identify and understand the range of tools and methods that they can apply in practice in order to measure what matters for individuals, professionals and systems. Structure Welcome and Scene setting - 15 minutes Participants will hear short insights on evaluation work underway in Catalonia to evidence personal and system outcomes associated with implementing different Anticipatory Care and Intermediate care models. Examples will describe using mixed methods and realist methodologies including recording of PROMS/ PREMS. Facilitated world café style discussion in small groups - 60 minutes. Table hosts will discuss specific tools or methods for evaluating the various components and outcomes of care: care coordination processes; patient and carergiver experience; care quality and safety; level of functional ability, activation and self management; team dynamics and wellbeing; cost avoidance; and use of logic models and contribution analysis to illustrate system impact. Participants will rotate around tables to explore these methods and understand the added value from applying both quantitative and qualitative methods in evaluating anticipatory care and intermediate care service models. Table facilitators will summarise the discussions and invite each new group to add insights and highlight tools and good practices relating to each methodology. Wrap up – 15 minutes Participants will be invited to vote on the most useful tools for the purpose of evaluating anticipatory and intermediate care services in their system. Knowledge gaps and key required actions will be identified. The workshop outputs will prepare the SIG task and finish group researchers and practitioners to take the next steps - collating the most useful tools as an Evaluation Toolkit that can be applied by SIG members in practice.

There is no published evidence on the possible differences in multimorbidity, inappropriate prescribing, and adverse outcomes of care, simultaneously, from a sex perspective in older patients. We aimed to identify those possible differences in patients hospitalized because of a chronic disease exacerbation. A multicenter, prospective cohort study of 740 older hospitalized patients (≥65 years) was designed, registering sociodemographic variables, frailty, Barthel index, chronic conditions (CCs), geriatric syndromes (GSs), polypharmacy, potentially inappropriate prescribing (PIP) according to STOPP/START criteria, and adverse drug reactions (ADRs). Outcomes were length of stay (LOS), discharge to nursing home, in-hospital mortality, cause of mortality, and existence of any ADR and its worst consequence. Bivariate analyses between sex and all variables were performed, and a network graph was created for each sex using CC and GS. A total of 740 patients were included (53.2% females, 53.5% ≥85 years old). Women presented higher prevalence of frailty, and more were living in a nursing home or alone, and had a higher percentage of PIP related to anxiolytics or pain management drugs. Moreover, they presented significant pairwise associations between CC, such as asthma, vertigo, thyroid diseases, osteoarticular diseases, and sleep disorders, and with GS, such as chronic pain, constipation, and anxiety/depression. No significant differences in immediate adverse outcomes of care were observed between men and women in the exacerbation episode.