Search Results (2,487)

Background and Objectives: Sex differences are unclear in geriatric sleep medicine, and most evidence comes from inference from preclinical bases or clinical studies conducted on younger people. The aim of this study is to explore sex differences in sleep quality and daytime sleepiness in a cohort of elderly people. Materials and Methods: This cross-sectional study involved subjects aged 65 years or older undergoing multidimensional evaluation, including sleep quality and daytime sleepiness assessment with validated tools. Results: This study included 226 subjects (69.5% women), the majority of whom showed poor sleep quality (64.2%). A logistic regression model put one before the other sleep quality and gender. It initially showed that men were about half likely as women to have poor sleep quality (OR 0.48, 95%CI 0.27–0.86). Nonetheless, after adjusting for cognitive status and mood, the difference became smaller and insignificant (OR 0.72, 95%CI 0.38–1.38). Conclusions: Sex differences in elderly people’s sleep quality seem to not be independent, appearing to be affected by alterations in cognitive status and mood. Full article

Immunization is a challenge for the elderly population and can leave this group more vulnerable to opportunistic pathogens such as SARS-CoV-2. Due to this situation, while vaccines were in the development phase, hypotheses were raised about the role of vitamins and minerals in immunization. In Brazil, there was a controversy regarding the well-known COVID-19 Kit, a standardized prescription for positive cases that contained zinc, and vitamin D, and anti-parasitic drugs. There was great controversy in scientific circles, since COVID-19 brought a major challenge for health professionals and public authorities: misleading information. In this study, we evaluated the role of vitamin D and zinc in the production of anti-SARS-CoV-2 neutralizing antibodies (NAbs) in a group of elderly residents in a nursing home in northeastern Brazil. Serum levels of COVID-19 NAbs were assessed, along with vitamin D and zinc, in two phases. The first (T1) was in August 2022 with 26 elderly people, and the second (T2) was in March 2023 with 21, due to the death of five participants. Overall, we observed satisfactory levels for vitamin D, with no participants showing a deficiency in either test, and zinc, with only two participants having a negative result at T1 and three at T2. However, a drop in the average number of NAbs was observed, especially in women (T1 = 89 ± 19 vs. T2 = 57 ± 44), highlighting the importance of monitoring this immunological parameter in the population studied. Based on the results, we suggest that there is no synergism between the micronutrients studied and NAbs (p > 0.05). Further studies are needed to consolidate the findings of an absence of synergism between vitamin D and zinc in the maintenance of NAbs. Full article

Background/Objectives: Numerous European countries, including Romania, are facing the concern of rapid ageing of their populations. Moreover, Romania’s life expectancy ranks among the lowest in the European Union. In light of this, it is imperative that the assessment of medication-related harm be given national priority in order to secure and enhance pharmacotherapy and the medical act. In this study, we sought to describe and evaluate the under-prescribing practices among the Romanian elderly population. Methods: We conducted a cross-sectional study in urban areas of two counties in Western Romania (Timis and Arad) from November 2017 to February 2019. We collected chronic electronic prescriptions issued for elderly patients (>65 years old) with chronic conditions. The medication was prescribed by generalist or specialist physicians for periods ranging between 30 and 90 days. To assess inappropriate prescribing behaviours, a multidisciplinary team of specialists applied the Screening Tool of Older Persons’ Prescriptions/Screening Tool to Alert to Right Treatment (STOPP/START) v.2 criteria to the collected prescriptions. Results: Within the 1498 prescriptions included in the study, 57% were issued to females, the mean age was 74.1 ± 6.95, and the average number of medicines per prescription was 4.7 ± 1.51. The STOPP criteria most commonly identified were the (1) long treatment duration (23.6%) and (2) prescription of neuroleptics (14.6%) or zopiclone (14.0%) as medications that increase the risk of falls. According to START criteria, the following medicines were under-prescribed: (1) statins (47.4%), (2) beta-blockers (24.5%), (3) antiresorptive therapy (10.0%), and (4) β2-agonists and muscarinic antagonists for chronic obstructive pulmonary disease (COPD) (4.5%). Within our study group, the prevalence of potentially inappropriate medications was 18.58%, whereas the prevalence of potential prescribing omissions was 49.2%. Conclusions: To decrease medication-related harm and morbid-mortality, and to increase the quality of life for elderly people in Romania, immediate actions are needed from national authorities. These actions include reinforcing primary care services, providing periodic training for physicians, implementing medication review services by pharmacists, and utilising electronic health records at their full capacity. Full article

Since sarcopenia is a progressive condition that leads to decreased muscle mass and function, especially in elderly people, it is a public health problem that requires attention from researchers. This review aims to highlight drug delivery systems that have a high and efficient therapeutic potential for sarcopenia. Current as well as future research needs to consider the barriers encountered in the realization of delivery systems, such as the route of administration, the interaction of the systems with the aggressive environment of the human body, the efficient delivery and loading of the systems with therapeutic agents, and the targeted delivery of therapeutic agents into the muscle tissue without creating undesirable adverse effects. Thus, this paper sets the framework of existing drug delivery possibilities for the treatment of sarcopenia, serving as an inception point for future interdisciplinary studies. Full article

This study investigates the impact of the attitudes of the elderly on the acceptance of Thailand’s high-speed rail technology according to the technology readiness index (TRI) and technology acceptance model (TAM) theories as guidelines for policies or strategies to enhance passengers’ intentions to use high-speed rail. A self-administered questionnaire was used to collect data from 3200 elderly people aged over 60 years in the surveyed areas along high-speed rail routes in Thailand, before the use of statistical analysis and multigroup structural equation modeling (SEM) to analyze variations in the participants’ attitudes toward urban and rural areas. The results that were thus obtained from both groups showed their differing attitudes toward the acceptance of technology. The TAM theory considers the attitude toward high-speed rail use in urban areas to be important, while, in rural areas, attitudes and perceived usefulness are important. With respect to the ease of use of high-speed rail, the most important factors were attitudes toward use and perceived usefulness. For the TRI theory, innovativeness features as the most positive influence on the perceived ease of high-speed rail use in both groups. Optimism and innovativeness were positive influences, but discomfort and insecurity carried a negative influence with respect to the perceived ease of use and usefulness. Full article

Background: Digital educational technologies in health have been an important instrument for promoting learning, self-care, self-esteem, and security regarding prevention and health promotion actions that lead to changes in behavior, mainly for non-communicable disease patients, such as type 2 Diabetes Mellitus (DM 2). Objective: This study aimed to describe a protocol for evaluating the effect of an app for cell phones and tablets on the blood glucose of older adults with DM 2. Methods: The protocol will be used to compare the effectiveness of an application for mobile devices concerning the educational booklet in reducing Glycated Hemoglobin in older adults with DM 2 in Primary Health Care. This protocol is part of a Randomized Clinical Trial project entitled Effectiveness of a Mobile Device Application on Glycated Hemoglobin in Elderly People with Type 2 Diabetes Mellitus: a Randomized Clinical Trial. Results: The protocol was structured in the following phases: (i) sample calculation, (ii) invitation to participate in the study according to the eligibility criteria; (iii) participant registration; (iv) randomization and allocation of participants into groups (double blinding); (v) application of the intervention; (vi) post-intervention procedures (post-test); (vii) data analysis. Conclusion: It is expected that encouraging studies on the impact of a mobile application will improve and enhance health education focused on self-care for older adults with DM 2, potentially influencing the local health system by reducing hospitalizations due to conditions that are sensitive to primary care, since health promotion and prevention of DM-related illnesses will be the main focus of the application and booklet developed. Full article

In this paper, the concept of symmetry is used to design the efficient inference of a fall-detection algorithm for elderly people on embedded processors—that is, there is a symmetric relation between the model’s structure and the memory footprint on the embedded processor. Artificial intelligence (AI) and, more particularly, Long Short-Term Memory (LSTM) neural networks are commonly used in the detection of falls in the elderly population based on acceleration measures. Nevertheless, embedded systems that may be utilized on wearable or wireless sensor networks have a hurdle due to the customarily massive dimensions of those networks. Because of this, the algorithms’ most popular implementation relies on edge or cloud computing, which raises privacy concerns and presents challenges since a lot of data need to be sent via a communication channel. The current work proposes a memory occupancy model for LSTM-type networks to pave the way to more efficient embedded implementations. Also, it offers a sensitivity analysis of the network hyper-parameters through a grid search procedure to refine the LSTM topology network under scrutiny. Lastly, it proposes a new methodology that acts over the quantization granularity for the embedded AI implementation on wearable devices. The extensive simulation results demonstrate the effectiveness and feasibility of the proposed methodology. For the embedded implementation of the LSTM for the fall-detection problem on a wearable platform, one can see that an STM8L low-power processor could support a 40-hidden-cell LSTM network with an accuracy of 96.52%. Full article

Background: With an aging population and the continuous advancement of smart technology, the Chinese government is exploring smart elderly care models to address the challenges posed by aging. Although smart home systems are viewed as a promising solution, their adoption rate among older people remains low. Objectives: This study aimed to investigate the factors influencing the behavioral intention to use smart home systems among older people in Linyi City, Shandong Province, China. Methods: A literature review revealed a lack of quantitative research on older people’s behavioral intention toward smart home systems based on the Innovation Diffusion Theory. This study developed an extended model based on the Innovation Diffusion Theory, Technology Acceptance Model, and external variables, incorporating eight variables: intergenerational technical support, perceived cost, self-reported health conditions, compatibility, observability, trialability, perceived usefulness, perceived ease of use, and behavioral intention. Results: Analysis of 387 valid questionnaires showed that compatibility and trialability significantly and positively affect perceived ease of use, while self-reported health conditions, perceived ease of use, and perceived usefulness have significant effects on behavioral intention. In addition, perceived cost had a negative influence on behavioral intention. Contributions/Significance: These findings highlight the importance of considering these factors in the design of smart home systems to improve user experience and provide valuable practical guidance to smart home system developers, R&D institutions, and policymakers. Full article

Background/Objectives: Life expectancy for people in their 60s is 24.3 years in high-income countries. Health systems face the burden of disease in the elderly population and must assess the impact of treatments such as major surgery. The aim of this study is to quantify the impact of advanced age on short-term postoperative outcomes after resective colorectal surgery (RCRS). Methods: All patients who underwent RCRS at our institution between July 2022 and November 2023 were entered into a database. Preoperative, perioperative, and early (within 30 days) postoperative data were recorded. Patients were categorized into a young group (under 75 years, YG) and an elderly group (over 75 years, EG). A retrospective comparative analysis of postoperative outcomes was performed between the two groups; postoperative complications were graded according to the Clavien classification. Results: Fifty-three and ninety-five patients were in the EG and YG, respectively. Indications for RCRS was cancer in 83% of EG patients and 61.1% of YG patients (p = 0.006), and the clinical presentation, localization, and rate of neoadjuvant treatment in oncological patients were comparable. Another indication for RCRS was complicated diverticular disease (17% of EG patients and 38.9% of YG patients; p = 0.006). With respect to the baseline characteristics, the ASA and CCI scores were worse in the EG (p = 0.001). No significant differences in the surgical approach, mini-invasive approach, conversion rate, definitive stoma creation, or number of harvested lymph nodes were found between the two groups. Overall, EG reported a higher relative risk (RR) of short-term postoperative complications (1.64, CI: 1.03–2.63), but no significant differences were found in terms of grade ≥3 complications (RR: 0.9, CI: 0.23–3.44). In the EG, a higher risk of ICU admission (RR:2.69, CI: 1.5–4.8) and a one-day longer postoperative hospital stay (6 vs. 5 days) were reported. Conclusions: Advanced age does not seem to contraindicate RCRS, especially in colorectal cancer patients. The impact of elderly age on short-term outcomes seems to be minimal and acceptable. Full article

Background: The prevention and treatment of bone loss and osteoporotic fractures is a public health challenge. Combined with normobaric hypoxia, whole-body vibration has a high clinic potential in bone health and body composition. The effect of this therapy may be mediated by its action on bone marrow mesenchymal stem cells (MSCs). Objectives: Evaluate the effects of cyclic low-vibration stimuli and/or hypoxia on bone marrow-derived human MSC differentiation. Methods: MSCs were exposed four days per week, two hours/day, to hypoxia (3% O₂) and/or vibration before they were induced to differentiate or during differentiation into osteoblasts or adipocytes. Gene and protein expression of osteoblastic, adipogenic, and cytoskeletal markers were studied, as well as extracellular matrix mineralization and lipid accumulation. Results: early osteoblastic markers increased in undifferentiated MSCs, pretreated in hypoxia and vibration. This pretreatment also increased mRNA levels of osteoblastic genes and beta-catenin protein in the early stages of differentiation into osteoblasts without increasing mineralization. When MSCs were exposed to vibration under hypoxia or normoxia during osteoblastic differentiation, mineralization increased with respect to cultures without vibrational stimuli. In MSCs differentiated into adipocytes, both in those pretreated as well as exposed to different conditions during differentiation, lipid formation decreased. Changes in adipogenic gene expression and increased beta-catenin protein were observed in cultures treated during differentiation. Conclusions: Exposure to cyclic hypoxia in combination with low-intensity vibratory stimuli had positive effects on osteoblastic differentiation and negative ones on adipogenesis of bone marrow-derived MSCs. These results suggest that in elderly or frail people with difficulty performing physical activity, exposure to normobaric cyclic hypoxia and low-density vibratory stimuli could improve bone metabolism and health. Full article

Background: Over one billion people worldwide suffer from neurological conditions that cause mobility impairments, often persisting despite rehabilitation. Chronic neurological disease (CND) patients who lack access to continuous rehabilitation face gradual functional decline. The International Classification of Functioning, Disability, and Health (ICF) provides a comprehensive framework for assessing these patients. Objective: This study aims to evaluate the outcomes of a non-hospitalized neuromotor rehabilitation project for CND patients in Italy using the Barthel Index (BI) as the primary outcome measure. The rehabilitation was administered through an Individual Rehabilitation Plan (IRP), tailored by a multidisciplinary team and coordinated by a physiatrist. The IRP involved an initial comprehensive assessment, individualized therapy administered five days a week, and continuous adjustments based on patient progress. The secondary objectives include assessing mental status and sensory and communication functions, and identifying predictive factors for BI improvement using an artificial neural network (ANN). Methods: A retrospective observational study of 128 CND patients undergoing a rehabilitation program between 2018 and 2023 was conducted. Variables included demographic data, clinical assessments (BI, SPMSQ, and SVaMAsc), and ICF codes. Data were analyzed using descriptive statistics, linear regressions, and ANN to identify predictors of BI improvement. Results: Significant improvements in the mean BI score were observed from admission (40.28 ± 29.08) to discharge (42.53 ± 30.02, p < 0.001). Patients with severe mobility issues showed the most difficulty in transfers and walking, as indicated by the ICF E codes. Females, especially older women, experienced more cognitive decline, affecting rehabilitation outcomes. ANN achieved 86.4% accuracy in predicting BI improvement, with key factors including ICF mobility codes and the number of past rehabilitation projects. Conclusions: The ICF mobility codes are strong predictors of BI improvement in CND patients. More rehabilitation sessions and targeted support, especially for elderly women and patients with lower initial BI scores, can enhance outcomes and reduce complications. Continuous rehabilitation is essential for maintaining progress in CND patients. Full article

In the last few decades, major progress has been made in the medical field; in particular, new treatments and advanced health technologies allow for considerable improvements in life expectancy and, more broadly, in quality of life. As a consequence, the number of elderly people is expected to increase in the following years. This trend, along with the need to improve the independence of frail people, has led to the development of unobtrusive solutions to monitor daily activities and provide feedback in case of risky situations and falls. Monitoring devices based on radar sensors represent a possible approach to tackle postural analysis while preserving the person’s privacy and are especially useful in domestic environments. This work presents an innovative solution that combines millimeter-wave radar technology with artificial intelligence (AI) to detect different types of postures: a series of algorithms and neural network methodologies are evaluated using experimental acquisitions with healthy subjects. All methods produce very good results according to the main parameters evaluating performance; the long short-term memory (LSTM) and GRU show the most consistent results while, at the same time, maintaining reduced computational complexity, thus providing a very good candidate to be implemented in a dedicated embedded system designed to monitor postures. Full article

Background: The association between mortality and heatwaves is well documented. Heatwaves frequency, intensity, and duration increase with global climate change. The most vulnerable group for dying during heatwaves is older people. Knowing which diseases contribute to a higher number of deaths during heatwaves is important for planning appropriate public health preventive measures. Methods: We assessed the short-term association between the number of deaths for older adults (75+ years) and heatwaves in the years 1999 to 2020 in Slovenia. We estimated the relative risks (RR) with a 95% confidence interval for the number of deaths for the observed diagnosis (all causes, circulatory, respiratory) and urban vs. rural areas associated with heatwaves in Slovenia for each year, comparing the number of deaths during heatwaves with reference days. Results: Most years showed no significant increase in deaths during heatwaves for those aged 75 and older. However, in 2006, 2007, 2014, and 2015, there was a significant increase in deaths during heatwaves. For the general population, heatwaves were associated with an increase in deaths due to all causes: 10% more in 2006 and 26% more in both 2007 and 2014. For those aged 75 and older, heatwaves were associated with an increase in deaths due to all causes: 22% more in 2007, 27% more in 2014, and 28% more in 2015. For those aged 75 and older, heatwaves were associated with an increase in deaths due to circulatory system diseases: 25% more in 2006, 33% more in 2007, 30% more in 2014, and 27% more in 2015. Regarding urban vs. rural areas, in 2006 and 2012, the elderly in urban areas were more affected, with 33% and 26% more deaths, respectively. In contrast, in 2007, 2014, and 2015, old age population in rural areas was more affected, with 29%, 26%, and 31% more deaths, respectively. Conclusions: According to the literature data, older adults are most susceptible to the effects of extreme heat due to physiological changes that occur with aging, chronic diseases, certain medications, a sedentary lifestyle, and social isolation. The results of our study will help in planning appropriate preventive public health measures to better protect older adults during the next heatwaves in Slovenia. Full article

Over the past few years, life expectancy has increased significantly. However, elderly individuals living independently often require assistance due to mobility issues, symptoms of dementia, or other health-related challenges. In these situations, high-quality elderly care systems for the aging population require innovative approaches to guarantee Quality of Service (QoS) and Quality of Experience (QoE). Traditional remote elderly care methods face several challenges, including high latency and poor service quality, which affect their transparency and stability. This paper proposes an Edge Computational Intelligence (ECI)-based haptic-driven ECI-TeleCaring system for the remote caring and monitoring of elderly people. It utilizes a Software-Defined Network (SDN) and Mobile Edge Computing (MEC) to reduce latency and enhance responsiveness. Dual Long Short-Term Memory (LSTM) models are deployed at the edge to enable real-time location-aware activity prediction to ensure QoS and QoE. The results from the simulation demonstrate that the proposed system is proficient in managing the transmission of data in real time without and with an activity recognition and location-aware model by communication latency under 2.5 ms (more than 60%) and from 11∼12 ms (60∼95%) for 10 to 1000 data packets, respectively. The results also show that the proposed system ensures a trade-off between the transparency and stability of the system from the QoS and QoE perspectives. Moreover, the proposed system serves as a testbed for implementing, investigating, and managing elder telecaring services for QoS/QoE provisioning. It facilitates real-time monitoring of the deployed technological parameters along with network delay and packet loss, and it oversees data exchange between the master domain (human operator) and slave domain (telerobot). Full article

Objectives: Controlling the lifestyle associated with dementia risk can delay the process of cognitive decline. Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are early states in the development of dementia and are also the window period for early intervention in dementia. The purpose of this study was to explore the association between multi-domain lifestyle and objective cognitive impairment in elderly people with SCD and MCI in Chinese communities and to provide reference for effective implementation of precise health management measures to reduce the risk of dementia. Methods: A total of 265 middle-aged and elderly volunteers recruited from the community were divided into SCD group (107 cases), MCI group (80 cases), and healthy control (HC) group (78 cases). All participants received clinical interview, examination, and cognitive assessments. Results: The total Dementia Risk Reduction Lifestyle Scale (DRRLS) scores in the HC, SCD, and MCI groups [110.00 (11.25) vs. 101.00 (10.00) vs. 79.50 (20.75)] exhibited statistically significant differences among them. The total score of the DRRLS showed a significant negative correlation with the Trail-Making Test (TMT), and significant positive correlations with both the Verbal Fluency Test (VFT) and Auditory Verbal Learning Test (AVLT) scores (p < 0.05). After adjusting for confounding factors, such as age and years of education, multiple linear regression analysis revealed several points. In the SCD group, brain-strengthening exercise and interpersonal relationship scores were negatively correlated with TMT scores (β = −11.257, −15.077; all p < 0.05), while health responsibility, smoking control behavior, and interpersonal relationship scores were positively correlated with AVLT scores (β = 0.485, 0.344, and 0.406; all p < 0.05). In the MCI Group, brain-strengthening exercise, brain-healthy diet, and interpersonal relationship were negatively correlated with TMT (β = −22.011, −16.206, −11.696; all p < 0.01), whereas health responsibility, mental activity, smoking control behavior, interpersonal relationship, and stress management were positively correlated with AVLT (β = 0.450, 0.435, 0.308, 0.256, 0.607; all p < 0.05). Conclusions: In Chinese communities, the unhealthy lifestyle of elderly individuals with SCD and MCI is significantly associated with cognitive function impairment. The greater their unhealthy lifestyle habits, the more pronounced the scope and severity of cognitive function impairment becomes. Furthermore, different dimensions of lifestyle have varying impacts on cognitive domains. Full article