The development and integration of geriatric medicine into national health care systems vary widely across countries. While a robust care workforce requires providers from several disciplines, including nursing, social sector, rehabilitation, psychiatry, neurology, and others, a strong core of highly qualified geriatricians is essential to delivering older person-centred and integrated care. The number and professional profile of geriatricians, along with the status of the specialty, are important to informing efforts to reshape health care systems in response to the global ageing scenario. WHO developed and distributed a structured questionnaire to representatives of national geriatrics and gerontology societies beginning in March 2025. The survey collected data on the status of the geriatric medicine specialty, including its formal recognition at the country level, the estimated number of practising geriatricians, and information on training curricula, professional environments, and systemic challenges. A total of 48 national societies completed the survey. Recognition of geriatric medicine ranged widely, from full specialty status in some countries to subspecialty or non-recognition in others. The number of practicing geriatricians per 100,000 persons aged 60 years and older ranged from <0.1 to >30 across countries, illustrating marked workforce disparities and some severe shortages. Where the geriatric medicine specialty is formally available, pre-service training durations ranged from 24 to 96 months. Geriatricians worked in diverse settings, though integration into primary care and public health was limited. Training in and exposure to geriatric medicine principles during undergraduate and postgraduate medical training were minimal in many countries. Key challenges included workforce shortages, fragmentation of care, and undervaluation of the speciality's role in informing health care for older people. Strategic priorities reported by respondents included investment in training, policy development, and institutional support. The survey highlights disparities in geriatric medicine across countries and identifies several challenges and priorities. Strengthening education, policy, and workforce development is essential to meet the needs of ageing populations and support healthy ageing worldwide. At the same time, countries should also think of innovative approaches and building capacity of existing other health occupations to improve geriatric care. Future updates of this survey will provide longitudinal insights into workforce evolution. These findings provide a global evidence base to guide workforce planning and policy under the United Nations Decade of Healthy Ageing (2021-2030).

Frailty is highly prevalent in hospitalized older adults and predicts adverse health outcomes but remains under-recognized. Manual screening tools previously employed were challenging in high-volume settings and reliant on individuals' knowledge on frailty. With the development of electronic health records (EHRs), there is a potential to automate screening for frailty in hospitalized older adults. We introduce a quality improvement initiative that utilizes an EHR-automated Best Practice Advisory (BPA) alert to identify inpatients who may benefit from geriatric intervention and encourage timely Geriatric referral to a Mobile Frailty Intervention Team (MFIT). MFIT was piloted at Woodlands Hospital, an integrated acute and community hospital in Singapore. BPA was automatically triggered to encourage referral to MFIT if any of the following criteria were met a) Clinical Frailty Scale (CFS) ≥ 7 b) CFS 5-6 with presence of either of cognitive impairment / high falls risk / high readmission risk c) Age ≥60 with presence of delirium, regardless of CFS status. The MFIT team conducted Comprehensive Geriatric Assessments (CGA) as part of routine review with the diagnosed geriatric syndromes and discharge dispositions recorded. On MFIT review, 81.3 % (N = 248) of patients referred had a geriatric syndrome and 68.5 % (N = 209) had multiple syndromes. MFIT further identified syndromes which may be neglected during acute admission such as underlying dementia (87 %, N = 83), osteoporosis (13.4 %, N = 41) and urinary incontinence (9.8 %, N = 30). MFIT also provided discharge recommendations which were adhered to in 79.2 % (N = 232) of patients. 32.8 % (N = 100) were given specialized outpatient clinic follow-up with Geriatric medicine, suggesting the potential to divert patients from away from primary care services and unplanned readmissions. Further studies are needed to investigate whether this transition effectively optimizes resource allocation. A CFS-based BPA alert may be feasible in providing an automated and scalable method to identify hospitalized older adults with frailty that would benefit from timely geriatric intervention.

PurposeFrailty increases with age and is associated with negative health outcomes as falls, hospitalization, and mortality. Socio-economic situation (SES) in childhood and adulthood are associated with frailty. It is unclear how the interaction of childhood hardship and adulthood SES effects frailty.MethodsA register-based study using data from national registers and from the Lolland-Falster Health Study, involving individuals aged 50 and above. Frailty status was assessed using a modified version of Fried’s phenotype. Logistic regression models with multiple adjustments were used to analyze the odds of frailty. Causal interactions between economic hardship in adulthood, perception of childhood, self-reported stressful events in childhood, and self-reported educational level were assessed by estimating the relative excess risk due to interaction (RERI).ResultsThe study included 10,163 individuals. The percentage of individuals fulfilling 2–5 frailty criteria varied between 17 % in the 50–65 age group and 44.9 % in the 85+ age group. Women had a higher proportion of fulfilling 2–5 frailty criteria (21.5 %) compared to men (17.2 %). Socio-economic factors associated with frailty status included perception of childhood, stressful childhood events, educational attainment, and economic hardship in adulthood. A significant causal additive effect on the percentage of individuals fulfilling 2–5 frailty criteria was demonstrated for two composite outcomes: perception of childhood + educational attainment and stressful events in childhood + economic hardship in adulthood.ConclusionThe study showed that joint exposure to adverse socio-economic factors in childhood and adulthood, potentiated the odds of frailty in older adults. Our findings corroborate the theory of cumulative dis/advantage.

IntroductionSarcopenia, a progressive age-related loss of skeletal muscle mass and function, poses significant health risks in older adults. Phase angle (PhA), derived from bioimpedance analysis, has been proposed as an indicator of muscle quality and physical functioning. This study investigates the association between PhA and physical function, and its potential utility in case-finding phase of sarcopenia assessment based on EWGSOP2 functional cut-offs.MethodsThis cross-sectional observational study used baseline data from two clinical trials involving Dutch older adults (≥65 years, n=228) at risk of malnutrition or frailty. PhA was measured using multi-frequency bioimpedance vector analysis. Physical functioning was assessed through handgrip strength, knee extension strength, chair rise test, and gait speed (4m and 400-m/6-min walk tests). Associations were evaluated using linear mixed models adjusted for age, gender, height, and lean body mass. Receiver-operating characteristic (ROC) analyses identified PhA thresholds for low performance based on EWGSOP2 cut-offs.ResultsPhA was significantly associated with all performance outcomes in crude models. After adjustment, each unit increase in PhA was associated with a 43.5 ± 8.4 N increase in knee extension strength (P < 0.0001), a 1.5 ± 0.4 s reduction in chair rise time (P = 0.0004), and a 0.14 ± 0.02 m/s increase in gait speed (P < 0.0001). Associations with handgrip strength became non-significant after full adjustment. A PhA threshold of 5.4° showed high sensitivity (0.96) for detecting low physical performance via the chair rise test. However, misclassification rates exceeded 25 %.ConclusionsPhA is associated with physical function, particularly lower-body performance measures, but without muscle mass assessment, it cannot support a complete diagnosis of sarcopenia. It may be valuable as a case-finding tool in older adults at risk.