Older people with dementia are frequently prescribed opioids, but little is known about adverse events associated with opioid use in this population. The aim was to investigate whether opioid use was associated with an increased risk of hospitalization in older people with dementia. Matched cohort study using Danish nationwide registries. All Danish residents (≥ 65 years) diagnosed with dementia between 2008 and 2018 were included. Individuals with opioid use in the year prior to dementia diagnosis were excluded. Exposure was first redeemed opioid prescription after dementia diagnosis. Persons exposed to opioids were matched with up to two unexposed persons on age and sex. Outcome was all-cause 180-days hospitalization. Cox proportional hazards models compared rates of hospitalization within 180 days between the exposed and unexposed and adjusted for potential confounders. Forty-two percent (31,619/75,471) of older people with dementia redeemed an opioid prescription after diagnosis. Among exposed, 7,356 (23.3%) were hospitalized within 180 days, compared with 7,618 (12.1%) of unexposed, and opioid use was associated with a 4-fold increased risk of hospitalization (fully adjusted hazard ratio: 3.86 (95% confidence interval, 3.72–4.01)), and 8-fold within the first 14 days ((7.77 (7.15–8.45)). Exposed were more often admitted due to fractures, infections, and cardiovascular events. Opioid use was associated with increased risk of hospitalization, which may be due to the opioid, the indication, or both. This observation calls for further research into potential harmful effects associated with opioid use as it can have important implications for patient safety.

Climate change worry is increasingly recognized as a significant psychological response to environmental threats; however, research in older adults has largely focused on climate-related anxiety or isolated health outcomes. Studies examining climate change worry from a multidimensional health perspective are limited, particularly among older adults living in communities. This study aimed to investigate the relationships between climate change worry and multidimensional health characteristics in older adults. A cross-sectional study included 148 community-dwelling older adults in Türkiye. Participants were assessed using the Climate Change Worry Scale, Standardized Mini Mental State Examination (SMMSE), Athens Insomnia Scale (AIS), World Health Organization Well-Being Index (WHO-5), Geriatric Depression Scale–15 items (GDS-15), and International Physical Activity Questionnaire–Short Form (IPAQ-SF). Multiple linear regression analyses were performed to examine factors associated with climate change worry. The overall regression model was statistically significant (R² = 0.221, F (9,138) = 4.36, p < 0.001). Higher AIS scores (β = 0.279, p = 0.004), higher education level (β = 0.193, p = 0.027), and living in urban areas (β =-0.173, p = 0.039) were significantly associated with greater climate change worry. Age was negatively associated with climate change worry (β =-0.164, p = 0.044), indicating lower worry in older participants. SMMSE, WHO-5, GDS-15, IPAQ-SF, and sex were not significantly associated with climate change worry in the present model. Among community-dwelling older adults, climate change worry was associated with specific sociodemographic and lifestyle-related factors, including sleep quality, educational level, urban residence, and age. In the present model, cognitive status, general well-being, depressive symptoms, and physical activity were not significantly associated with climate change worry. These findings support the need for further research on climate-related concern in later life, particularly in relation to contextual factors.

Falls threaten the physical and mental health of older persons. Studies of the relationship between oral health and falls were fragmented in their selection of oral health indicators. We aimed to analyze whether and to what extent self-reported oral health was associated with falls among community-dwelling older adults in China. A cross-sectional study was conducted using data from physical examination and questionnaire survey for older adults in Tianjin, China. 2150 community-dwelling individuals aged 60 and older were included. Self-reported history of falls during the past year and oral health were collected using questionnaires. In the oral health index, fewer missing teeth, wearing dentures, no toothache, no bleeding gums, and brushing teeth at least twice a day were assigned as a score of 1, respectively. Oral health index was calculated by summing the scores of each item and ranged from 0 to 5, with higher scores indicating better oral health status. Logistic regression controlled for potential confounders was employed to analyze the association between oral health and falls. The prevalence of fall within the previous year was 12.6%. Logistic regression model showed that participants with higher oral health index (≥ 4) had a 26% lower fall rate than those with lower scores (OR = 0.71; 95% CI: 0.52 to 0.97) after adjusting for age, sex, health status and behaviors, and muscle status. Specifically, older adults who had lost 3–5 teeth (OR = 1.72; 95% CI: 1.01 to 2.69) and gingival bleeding (OR = 1.95; 95% CI: 1.20 to 3.17) had a higher fall prevalence rate compared with those losing 2 or fewer teeth and no gingival bleeding, respectively. Older adults with worse oral health, particularly more missing teeth and gingival bleeding, might be more vulnerable to falls. More attention paid to oral health may be helpful for fall prevention.

The use of technological methods that encourage cognitive-motor skills with the help of visual information has become increasingly widespread. This study compares sensor-based lower extremity reaction times, walking speeds, balance performance, and activity fear between older adults with and without a history of falls. Thirty older adults (65 or over) with a history of falls and 32 with no such history were recruited into this cross-sectional study. A simple response task (SRT) and choice response task (CRT) were evaluated with three Blazepod™ pods. These supplied the essential visual cues for participants to either reply as swiftly as possible in the SRT or to make judgments among several possibilities in the CRT. Walking speed was measured using the Time Up & Go (TUG) and 10 m Walking (10MY) tests. The Five Time Sit o Stand (FTSS) test and Berg Balance Test (BBS) were applied to assess functional performance. Fear of falling was assessed with the Falls Efficacy Scale (FES). Group differences were analyzed using the Mann–Whitney U test, and correlations were assessed with Spearman’s test (p < 0.05). SRT and CRT values were lower in older adults with a history of falls compared to the controls (p < 0.001). Older adults with a history of falls showed slower Timed Up and Go performance (15.2 vs. 9.5 s, p < 0.001) and greater activity fear (p < 0.001) compared to those without a history of falls. Significant correlations were observed between reaction time and almost all factors (p < 0.05). Sensor-based reaction time assessments using the BlazePod™ system revealed that older adults with a history of falls exhibit slower lower-extremity reaction times. Furthermore, they demonstrate lower physical performance, reduced walking speed, impaired balance, and a greater fear of movement compared with their non-faller counterparts. Future research should focus on developing targeted, sensor-based interventions to improve reaction times and reduce fall risk in older adults.

The changes of circadian rhythm are very common in older adults, which can lead to decreased quality of life and jeopardize the brain health in the long run. Among all the types of sleep disturbances, poor sleep quality, as a modifiable condition, can greatly affect the daily activities, cognitive functions, quality of life, and even be implicated as a key potential contributing factor in the development of accelerated cognitive decline and prodromal dementia. Consequently, research efforts to understand, and thus potentially model, the effects of sleep quality on cognition and brain during ageing are of great pragmatic values. The Hong Kong Cohort of Abnormal Sleep in Ageing Population (HK-ASAP) project is a prospective cohort study recruiting 244 older adults with sleep disturbances. The HK-ASAP study plans to measure sleep quality, brain reserve and cognition at baseline and 2 years. Subjective sleep quality will be assessed by the Pittsburgh Sleep Quality Index (PSQI). Global cognition and domain-specific cognitive functions will be assessed by a comprehensive neuropsychological battery. High-resolution structural magnetic resonance imaging (MRI) data will be acquired and used to quantify the brain reserve, including gray matter volume, cortical thickness and brain age matrices. Saliva samples will be collected for measuring the levels of Aβ40 and Aβ42, and Aβ42/40 ratio. Using the data, we will estimate and compare the sleep quality and its associations with cognition, salivary Aβ, and brain reserve in older adults. The bidirectional relationship between subjective sleep quality and cognitive functions in older adults presents an urgent need to elucidate how poor sleep quality affects cognition and its potential interplay with brain reserve and neuropathological factors. The HK-ASAP study will be a valuable resource for both epidemiological and clinical research, as it will provide fundamental information to identify the individuals at risk of developing cognitive decline. Findings from the HK-ASAP study will inform the development of targeted interventions to enhance sleep quality, cognition, and healthy longevity in older adults. ClinicalTrials.gov Identifier: NCT06170073 (registered on 01/10/2023).

Migration can occur at any age and has long-term repercussions on health and well-being later in life. This study aims to assess cognitive functioning ability in later life and its association with age at migration among older adults in India. For the analysis, 30,800 respondents aged 60 and above were selected from LASI (Longitudinal Ageing Study in India) data, wave 1. Cognitive functioning ability was measured through five global domains (memory, orientation, arithmetic function, executive function, and object naming). The overall score ranged between 0 and 43, and the higher scores indicate better cognitive functioning. Descriptive statistics, along with mean cognitive scores, were presented by bivariate analysis. Multivariable linear regression models were applied to show the association between age at migration and the cognitive functional abilities of older adults, and results from regression were presented by a beta coefficient (β) with a 95% confidence interval (CI). Over half of the older persons (55.9%) were growing older as migrants in India. The migrants showed a lower cognition mean score (23) than non-migrants (25). Compared to the non-migrant group, the cognitive score was worse for those who migrated at an age between 0 and 14 years in both the unadjusted (β = -1.93; 95%CI: -2.10 to -1.75) and the adjusted (β = -0.41; 95%CI: -0.56 to -0.26) models. Further, migration during midlife was not found to be significantly associated with cognitive functioning, while migration at age 60 and above shows a significantly lower cognitive score. Similar results were found among male and female cognitive association with age at migration. The findings of our study reveal that persons with migration status had lower cognitive ability than non-migrants. The age at migration influences cognitive functioning. However, this study predicts that migrants, especially, need attention in cognitive ageing as they have worse cognition than non-migrants.

To protect older adults and their rights, social distancing, isolation and quarantine were the key measures put in place to slow down the spread of COVID-19. Yet several studies have highlighted the importance of contact and emotional support from families for residents of long-term care facilities. The purpose of the study was to elicit the experiences and perceptions on the COVID-19 epidemic preventive measures and gain insights into the perspective of people who had family members in Slovenian nursing homes during the pandemic. A qualitative descriptive research paradigm with social constructivist approach was employed. Due to COVID-related restrictions, the method of formal natural group interview was used to conduct a single group interview. The interview guide comprised five open-ended questions with prompts. A purposive sample of relatives was invited to participate, with 25 out of 34 invited relatives confirming participation. Participants were 50–85 years old and had relatives in nursing homes—most often their parents or, alternatively, their spouses/partners. Three experts facilitated the group interview which was recorded. Transcripts were coded using thematic analysis. Ethical approval was obtained by the lead investigator’s home institution. Data synthesis yielded seven sub-themes and three themes: “Paternalism of authorities and health professionals” (medicine, nursing) towards residents and their relatives; “Negative impact on the health of residents and relatives”; and “The ethics of triage in relation to residents’ hospital access”. Overall, the approaches of those in charge of long-term care facilities were perceived as paternalistic and detrimental to the health and quality of life of nursing home residents during the pandemic. Our findings corroborate other international studies on the issues experienced in long-term care facilities for older adults during the pandemic. Relatives should not be a burden for the nursing home residents and should not feel like a controlling authority, but should be an important factor for the vitality and quality of residents’ lives. Our findings highlight the key role of health professionals in nursing care homes, particularly in terms of taking responsibility for protecting the autonomy and rights of residents and their relatives. Not applicable.

Medication management at hospital discharge is particularly complex for older patients with multimorbidity, with additional communication challenges arising from both patient and healthcare-related factors. Breakdowns in communication can lead to medication-related problems after hospital transfer. Little is known about the experiences and perspectives of older patients with multimorbidity in this context. The aim of the study was to explore the experiences and perspectives of older patients with multimorbidity and their families, regarding medication communication and management during discharge with models aimed at improving transitional communication. A qualitative multi-method study was conducted across two public hospitals (Victoria, Australia) with older patients (≥ 65 years) with ≥ 2 chronic conditions and their family members, alongside observations of pharmacist-patient discharge communication. Participants were recruited from subacute and At Home units (Hospital-at-Home), with the latter providing multidisciplinary inpatient care in patients’ homes. Patients were interviewed face-to-face pre- and post-discharge, with an additional home interview for At Home care patients following pharmacist–patient observations. Data analysis involved an inductive approach followed by deductive analysis. Thirty-two semi-structured interviews were conducted with 16 patients and 5 family members, along with 325 min of observation during 21 pharmacist discharge interactions. Patients reported greater comfort, privacy, focus, and time for medication discussions with At Home pharmacists compared to subacute or acute care settings. Patients and families received varying levels of medication information, ranging from basic to detailed explanations. Cognitive and physical challenges, including poor eyesight, hearing difficulties, and managing multiple medications, were major barriers to engagement. When pharmacists tailored and simplified information to patients’ understanding, satisfaction appeared improved, reflected in patient feedback suggesting this resulted in better understanding, reassurance, and confidence in medication use. Older people with multimorbidity face complex health needs that complicate discharge medication communication for patients, families, and pharmacists. Medication communication at hospital discharge is mostly one-way, with pharmacists informing rather than engaging older patients. The care environment and delivery approach significantly influence how these communications occur. Multiple conditions hinder understanding and involvement, but personalised information and Hospital-at-Home care may improve effective communication.