Chronic obstructive pulmonary disease (COPD) is highly prevalent in later life and is a major driver of long-term care needs among older adults. In ageing societies, care for older adults with COPD is predominantly provided by spousal caregivers, many of whom are older adults themselves. This situation reflects a context of dual ageing, in which both the care recipient and the caregiver experience age-related vulnerabilities. Despite growing global efforts to promote age-friendly health and social care environments, the unmet needs of older spousal caregivers remain poorly synthesised and are often insufficiently addressed within existing geriatric care models. This scoping review aimed to map and synthesise evidence on the unmet needs of older spousal caregivers of older adults with COPD, with a specific focus on how these needs are shaped within a context of dual ageing. Following Arksey and O’Malley’s framework, we conducted a scoping review of qualitative, quantitative, and mixed-methods studies examining unmet needs among older spousal caregivers of older adults with COPD. A comprehensive search was performed across ten English- and Chinese-language databases, last searched on 30 August 2025. Data were charted and synthesised using a narrative approach, with unmet needs mapped using the International Classification of Functioning, Disability and Health (ICF) framework. Eighteen studies were included. Older spousal caregivers reported multidimensional unmet needs, including psychological and emotional support, role balance, communication with healthcare professionals, information and caregiving skills, gender-specific concerns, and systemic and social support. These needs clustered into six categories across four ICF domains and were shaped by the combined effects of caregiving demands, ageing-related vulnerabilities, and long-term spousal interdependence. Older spousal caregivers of older adults with COPD experience multidimensional unmet needs that are shaped by the context of dual ageing and extend beyond individual caregiving burden to system-level gaps in care. These findings highlight the need for caregiver-inclusive and age-sensitive approaches within age-friendly health and social care environments. The review protocol was registered on the Open Science Framework (OSF) (https://doi.org/10.17605/OSF.IO/RYF3C).

Our previous study demonstrated that a 6-month combined physical and cognitive training program improved mismatch negativity (MMN)—an event-related potential reflecting the brain’s automatic detection of environmental changes—in older adults with subjective cognitive decline (SCD). However, not all individuals benefited equally from the intervention. Identifying baseline predictors of intervention outcomes could enable the prediction of individual responsiveness and support the development of personalized, stratified intervention strategies to promote brain health in this at-risk population. This study aimed to identify baseline predictors of response to a 6-month combined cognitive and physical training program among older adults with SCD. We conducted a secondary analysis of a cluster-randomized trial involving 33 older adults with SCD who participated in twice-weekly integrated training sessions. MMN was assessed for the analytic sample (n = 21) as the primary outcome measure. Baseline predictors included age, general cognitive function, physical and cognitive activity engagement, and apolipoprotein E (APOE) genotype. Linear regression analyses were performed to examine predictors of change in MMN amplitude from baseline to post-intervention. Regression analysis indicated that APOE ε4 non-carriers showed significantly greater improvement in MMN amplitude (β = ‒0.449, p = 0.027). Additionally, lower baseline levels of physical activity demonstrated a trend toward association with greater MMN gains (β = ‒0.392, p = 0.050), suggesting that individuals with more sedentary lifestyles may derive greater benefit from the intervention. APOE ε4 carrier status and baseline physical activity levels may be associated with the effectiveness of multidomain interventions in older adults with SCD.

The prognostic value of hemoglobin-combined Geriatric Nutritional Risk Index (H-GNRI) in older adult septic patients remain unexplored. This study aimed to investigate the association between H-GNRI and both short-term and long-term mortality in older adult patients with sepsis. This retrospective cohort study analyzed older adult with sepsis from the MIMIC-IV database. Patients aged ≥ 65 years meeting sepsis-3 criteria were included, excluding those with chronic kidney disease or severe liver disease. The H-GNRI scoring system was developed by combining optimal cutoff values for GNRI and hemoglobin determined through X-tile analysis. Propensity score matching (1:1) was performed to minimize confounding. The primary outcome was 28-day mortality. Cox proportional hazards models and ROC analysis were used to evaluate prognostic performance and discriminatory ability. The 28-day mortality rates increased significantly across risk groups (45.0%, 61.7%, and 72.5% for low, intermediate, and high-risk groups, respectively; P < 0.001). This trend persisted for 180-day and 1-year mortality. After adjusting for confounders, higher-risk H-GNRI groups remained independently associated with increased mortality risk. However, H-GNRI demonstrated poor discriminatory performance with an AUC of 0.58 for 28-day mortality prediction. While H-GNRI demonstrated significant associations with mortality in older adult sepsis patients, it exhibited poor discriminatory performance, limiting its utility as a standalone risk prediction tool. Further studies are needed to develop more sophisticated nutritional risk stratification approaches for critically ill patients.

Population ageing is associated with an increased risk of falls. Balance impairments and fear of falling further exacerbate this risk. This systematic review and meta-analysis aimed to assess the effect of FallProof exercise program on balance, fear of falling, and quality of life in older adults. PubMed, Web of Science, Scopus, and Google Scholar were searched from inception to November 6, 2025. Eligible studies were randomized controlled trials (RCTs) investigating the effects of FallProof in older adults and reporting outcomes on balance, fear of falling, or quality of life. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the ROB-2 tool. Random-effects meta-analyses were conducted to estimate pooled effect size. Statistical heterogeneity (I²), small-study effects, and certainty of evidence (Grading of Recommendations, Assessment, Development and Evaluation, GRADE) were assessed. Analyses were performed using R version 4.1. Eleven RCTs (n = 338; mean age 69.3 ± 5.9 years; age range 60.0-81.7 years; 26.3% female) were included. FallProof produced large and statistically significant improvements in static balance (SB; ES = 1.82, 95% CI 1.12–2.51; I² = 27%; GRADE: high), quality of life (ES = 1.33, 95% CI 0.64–2.02; I² = 56%; GRADE: low), and a large reduction in fear of falling (ES = − 2.40, 95% CI − 5.20 to − 1.28; I² = 84%; GRADE: low). Improvements in dynamic balance were not statistically significant (ES = 1.01, 95% CI − 1.12 to 2.51; I² = 91%; GRADE: very low), and evidence of publication bias was detected. FallProof exercise programs are associated with large improvements in static balance, fear of falling, and quality of life in older adults. However, high certainty of evidence was observed only for static balance, while evidence for fear of falling, quality of life, and dynamic balance remains limited due to small sample sizes, heterogeneity, and risk of bias. Overall, the findings are promising but preliminary. Larger, multicenter RCTs with long-term follow-up are required before FallProof can be routinely integrated into fall-prevention strategies. Prospective registration on PROSPERO (CRD420251107632), on 1 August 2025.

The aging and disability of China’s rural population have a huge impact on the long-term care system, and the intrinsic capacity and healthy aging of the disabled older adults in rural areas need to be improved urgently. To investigate the current status of intrinsic capacity of the disabled older adults in rural areas, analyze the decline level and influencing factors of their mobility, vitality, cognition, sensory and psychological ability, and further verify the quantitative accuracy and sensitivity of the intrinsic capacity assessment system in the Chinese elderly population. Using the Intrinsic Capacity Assessment System, a questionnaire survey was conducted among 343 disabled rural older adults from 32 conveniently selected villages under Henan Province, China. The average score of intrinsic capacity among disabled rural older adults was (5.68 ± 1.62), and the scores of each dimension were as follows: mobility (4.51 ± 2.72), vitality (22.27 ± 4.02), cognition (17.31 ± 7.09), psychology (6.68 ± 5.69), sensory ability (1.22 ± 0.52), mobility (99.1%) and cognitive (91.0%) ability impairment rates were higher, and the disability level (Cramer’s V 0.444) and frailty status (Cramer’s V = 0.408) were moderately correlated with the level of intrinsic capacity. The results of multiple linear regression analysis showed that age, education level, type of medication, disability level, grip strength level and BMI grade were the influencing factors of intrinsic capacity of the disabled older adults in rural areas (P < 0.05). The intrinsic capacities such as mobility and cognition of disabled rural older adults are severely impaired, and these impairments are influenced by multiple factors including sociodemographic characteristics and personal health status. Subsequently, a multi-domain integrated care plan can be formulated targeting the declining trends in various areas, supplemented by multi-component exercises and a diverse diet to enhance the intrinsic capacity level.

The prognosis of older patients with postoperative differentiated thyroid cancer (DTC) is influenced by multiple factors. This study aimed to develop a nomogram to predict overall survival (OS) in older DTC patients. Data for 11,283 DTC patients aged 60 or older, diagnosed between 2000 and 2020, were extracted from the SEER database. Patients were randomly split into training and validation cohorts. Clinical variables associated with OS were selected using Least Absolute Shrinkage and Selection Operator (LASSO) regression with cross-validation. Model performance was assessed with the concordance index (C-index), calibration curves, and time-dependent area under the receiver operating characteristic curve (AUC). The nomogram’s clinical value was compared to the TNM staging system using decision curve analysis (DCA), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). K-fold cross-validation was applied to validate model robustness, and Kaplan–Meier analysis compared survival across risk groups. Ten variables were used to construct the nomogram. The nomogram achieved a C-index of 0.763 in the training and 0.739 in the validation cohorts, with AUCs over 0.75. Calibration showed good prediction alignment. NRI and IDI values demonstrated the nomogram’s superiority over TNM staging (P < 0.05). DCA suggested strong clinical applicability. This nomogram provides a robust tool for assessing OS in older postoperative DTC patients. Further studies should refine models with updated prognostic factors.

This retrospective cohort study aims to describe the treatment patterns and evaluate survival outcomes in patients aged 70 years or older with metastatic non-small cell lung cancer (mNSCLC), and to identify independent prognostic factors for overall survival (OS). We retrospectively reviewed medical records of 298 patients aged ≥70 years with mNSCLC diagnosed between June 2021 and December 2024. Patients were categorized into an active anti-tumor therapy (ATT) group and a best supportive care (BSC) group for descriptive purposes. Key clinical data, including molecular biomarker status (EGFR, ALK, PD-L1) and Geriatric Nutritional Risk Index (GNRI), were collected for a subset of patients. A multivariate Cox proportional-hazards model was used to identify independent prognostic factors for OS across the entire cohort. Of the 298 patients, 93 (31.2%) received ATT and 205 (68.8%) received BSC. The decision for ATT was significantly associated with better baseline ECOG performance status (ECOG-PS) and fewer comorbidities, indicating profound selection bias. The median OS was 18.0 months in the ATT group and 6.0 months in the BSC group. This difference is descriptive and cannot be interpreted as a treatment effect due to the baseline imbalances. Within the ATT group, treatment modalities included chemotherapy (n = 54), targeted therapy (n = 11), and combination therapy (n = 28). In the multivariate analysis of the entire cohort, better ECOG PS (0–1 vs. 4: HR = 0.28, P < 0.01), fewer comorbidities (0 vs. ≥3: HR = 0.17, P < 0.001), higher GNRI (≥ 98 vs. <92: HR = 0.55, P = 0.02), and adenocarcinoma histology (vs. non-adenocarcinoma: HR = 0.68, P = 0.04) were independent predictors of longer OS. In this real-world cohort of elderly mNSCLC patients, treatment selection was heavily influenced by baseline health status. Independent prognostic factors for longer survival were better performance status, lower comorbidity burden, better nutritional status (higher GNRI), and adenocarcinoma histology. These findings underscore the importance of comprehensive geriatric and nutritional assessment in this population and highlight the need for prospective trials to guide treatment decisions.

As people age, declines in physiological functions can lead to changes in sleep and dietary patterns, potentially influencing cognitive function. However, longitudinal evidence examining how food consumption mediates the relationship between sleep parameters and cognitive function in Chinese older adults remains limited. Examining these longitudinal trajectories, beyond single-timepoint measurements, is crucial for understanding their dynamic nature and impact on cognitive function. Therefore, this study aimed to assess the longitudinal trajectories of sleep and food consumption in older adults, and to examine the mediating role of food consumption patterns in the sleep-cognition relationship. The sample population included 8724 older adults who derived from waves 4 to 7 (2005 to 2014) in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Self-reported sleep duration, sleep quality, and food consumption were evaluated in face-to-face interviews. The main outcomes were global cognitive composite z scores. Group-based trajectory modeling (GBTM) identified distinct long-term change patterns of sleep duration, sleep quality and food consumption, and generalized estimating equations (GEE) evaluated their prospective associations with global cognitive scores. Additionally, structural equation modeling (SEM) was performed to assess the mediating role of food consumption in the relationships between sleep duration, sleep quality, and cognitive function. Food consumption mediated the associations between sleep duration, sleep quality, and cognitive function in older adults. After adjusting for confounders, decreasing low fruit and vegetable consumption mediated a negative impact on cognition, with both shortened (0.024, 95%CI: 0.003 to 0.048) and excessive sleep duration (0.076, 95%CI: 0.040 to 0.117) linked to decreasing low fruit and vegetable consumption. A rapid decline in meat, fish, egg, and bean consumption also mediated the negative effect of shorter sleep duration on cognition (mediation effects: -0.009, 95%CI: -0.014 to -0.005), whereas increased milk consumption acted as a complete mediator, positively influencing cognition. No mediating effect was observed for nuts consumption. Furthermore, stable, high-quality sleep promoted increased consumption of fruit and vegetable (0.039, 95%CI: 0.020 to 0.058), meat, fish, egg, and bean (-0.011, 95%CI: -0.133 to -0.088), milk (0.022, 95%CI: 0.001 to 0.043), and nuts (0.043, 95%CI: 0.021 to 0.065), all positively associated with cognitive levels. This study illustrates that food consumption can improve the decline in cognitive levels in older adults that may be undermined by unhealthy sleep habits. Our research findings are of great importance to both clinical practice and public health policy.

Bloodstream infections in older persons are associated with greater morbidity and mortality. Older individuals often present with atypical symptoms, such as lethargy, poor oral intake, or falls, rather than classical signs like fever or localized symptoms. This study aims to evaluate the clinical characteristics of older persons admitted with bacteraemia and identify predictors of in-hospital mortality. A retrospective observational cohort study was conducted at a tertiary hospital. Patients admitted to the geriatric ward with bacteraemia over a 1.5-year study period were included in the study. Demographic, clinical, and laboratory data were collected and analyzed to identify independent predictors for in-hospital mortality. A total of 185 older patients were included in this study. Presentations were frequently non-specific, with 33.5% of the patients not fulfilling Systemic Inflammatory Response Syndrome (SIRS) criteria on admission. Advanced age (≥ 76 years old), hypalbuminaemia (< 20 g/L), elevated lactate (> 2 mmol/L), delirium, and absence of SIRS criteria were independently associated with increased in-hospital mortality of the older patients with bacteraemia. Due to immunosenescence and age-related physiological changes, older persons often present atypically and may have normal vital signs or laboratory values despite severe infection. Clinicians should maintain a high index of suspicion for sepsis in older patients, even in the absence of classical symptoms, to enable timely diagnosis and management.

To identify the determinants of 28-day perioperative mortality and postoperative length of hospital stay among geriatric patients. A prospective, two-center follow-up study conducted at two tertiary referral hospitals in Ethiopia. A total of 1014 consecutive geriatric patients who underwent surgery between January 2019 and January 2022 were included. This study documented a 28-day perioperative mortality rate of 2.86% (95% CI: 1.9–4.0) and a median postoperative length of hospital stay of six days. Multivariable analyses identified independent determinants for each outcome. For 28-day perioperative mortality, Cox proportional hazards regression revealed significant associations with the presence of comorbidities (aHR = 3.10) and the use of general anesthesia (aHR = 6.12). Determinants of extended postoperative length of hospital stay, evaluated using negative binomial regression, included the following: comorbidities (aIRR= 1.31), emergency surgery (aIRR = 1.28), and higher American Society of Anesthesiologists (ASA) physical status classification (ASA II: aIRR = 1.31; ASA ≥ III: aIRR = 1.38), each additional 60 minutes of anesthesia duration (aIRR = 1.15), and intraoperative blood loss (>500 mL; aIRR = 1.27). Conversely, each 1 g/dL increase in preoperative hemoglobin was found to be protective (aIRR = 0.97). This study identifies key modifiable determinants of adverse postoperative outcomes in geriatric surgical patients. The 28-day perioperative mortality was strongly associated with general anesthesia and preexisting comorbidities. The postoperative length of hospital stay was influenced by a broader set of variables, including patient factors, surgical urgency, and procedural complexity. These findings highlight critical targets for quality improvement in low-resource settings.