Background: There is evidence that sarcopenia and functionality are closely related. However, the association between geriatric syndromes, such as dependence, on instrumental activities and sarcopenia could be affected by the presence of certain comorbidities, such as overweight, obesity, diabetes, and chronic obstructive pulmonary disease (COPD). Therefore, the present study aimed to determine the association between instrumental activities of daily living and muscle mass in the elderly and evaluate the impact of certain comorbidities on this association. Methods: This was a retrospective analytical observational study, including 1,897 patients. Muscle mass was measured with calf circumference, and instrumental activities were measured with the Lawton index. Results: Among different parameters studies, a statistical correlation was found in a stratified regression analysis between the Lawton index score and muscle mass in patients who were overweight (p=0.001, β coefficient=0.08), obese (p=0.001, β coefficient=0.05), had diabetes (p=0.012, β coefficient=0.03), and had COPD (p=0.001, β coefficient=0.03). Conclusion The correlation between muscle mass and instrumental activities of daily living should be evaluated individually according to the needs of each participant and according to their comorbidities, promoting patient-centered geriatric medicine.

Background: The effect of sarcopenia on depressive mood during geriatric rehabilitation remains unclear. This study investigated the potential influence of sarcopenia on depressive mood among geriatric patients in a rehabilitation setting. Methods: This observational cohort study enrolled 204 patients aged ≥65 years (mean age, 78.8±7.6 years; women, 45.1%) admitted to a rehabilitation unit between April 2020 and July 2021. Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment criteria, which include low handgrip strength and muscle mass. Depressive mood was defined as a 15-item Geriatric Depression Scale score of ≥6 points. We applied logistic regression models to examine the influence of sarcopenia on depressive mood at discharge. Results: We observed sarcopenia in 58.3% of patients. The logistic regression model showed that sarcopenia negatively influenced depressive mood at discharge (odds ratio=5.460; 95% confidence interval, 2.344–13.415). Of the 68 patients without depressive mood at admission, those with sarcopenia (n=31) had a significantly higher incidence of depressive mood at discharge compared with patients without sarcopenia (n=37) (41.9% vs. 16.2%, p=0.037). Conclusion Sarcopenia at admission negatively affected depressive mood at discharge from geriatric rehabilitation. Thus, early and routine assessment of sarcopenia is vital for patients undergoing geriatric rehabilitation.

Background: Nursing home residents engage in lower levels of physical activity, primarily remaining seated or lying down, except for routine activities of daily living (ADLs). Since ADLs, particularly toileting, require effort. This study investigated the relationship between physical activity and toileting activity during the daytime among older nursing home residents. Methods: The study involved 30 participants, including a group of healthy community-dwelling older individuals and two groups of nursing home residents with independent and non-independent toileting behavior, respectively. The physical activity of participants was measured with an accelerometer, and estimated metabolic equivalents, duration, and amount of physical activity were calculated. Results: The amount of physical activity associated with toileting was significantly higher in the independent and non-independent groups than in the community group. Moreover, the amount of non-sedentary physical activity associated with toileting positively affected the amount of non-sedentary physical activity during the daytime. These findings suggest that toileting activity can contribute significantly to the physical activity of older nursing home residents. Conclusion Interventions focusing on improving toileting behavior among nursing home residents may positively impact overall physical activity and functional abilities.

Background: This study aimed to validate the Geriatric Trauma Outcome Score (GTOS) for predicting mortality associated with trauma in older Korean adults and compare the GTOS with the Trauma and Injury Severity Score (TRISS). Methods: This study included patients aged ≥65 years who visited the Chungbuk National University Hospital Regional Trauma Center between January 2016 and December 2022. We used receiver operating characteristic curves and calibration plots to assess the discrimination and calibration of the scoring systems. Results: Among 3,053 patients, the median age was 77 years, and the mortality rate was 5.2%. The overall GTOS-predicted mortality and 1–TRISS were 5.4% (interquartile range [IQR], 3.7–9.5) and 4.7% (IQR, 4.7–4.7), respectively. The areas under the curves (AUCs) of 1–TRISS and GTOS for the total population were 0.763 (95% confidence interval [CI], 0.719–0.806) and 0.794 (95% CI, 0.755–0.833), respectively. In the Glasgow Coma Scale (GCS) ≤12 group, the in-hospital mortality rate was 27.5% (79 deaths). The GTOS-predicted mortality and 1–TRISS in this group were 18.6% (IQR, 7.5–34.7) and 26.9% (IQR, 11.9–73.1), respectively. The AUCs of 1–TRISS and GTOS for the total population were 0.800 (95% CI, 0.776–0.854) and 0.744 (95% CI, 0.685–0.804), respectively. Conclusion The GTOS and TRISS demonstrated comparable accuracy in predicting mortality, while the GTOS offered the advantage of simpler calculations. However, the GTOS tended to underestimate mortality in patients with GCS ≤12; thus, its application requires care in such cases.

Background: Muscle weakness in older adults elevates mortality risk and impairs quality of life, with the phase angle (PhA) indicating cellular health. Polypharmacy, common in geriatric care, could influence PhA. This investigates whether the number of medications and polypharmacy with PhA as a biomarker of muscle quality in older inpatients aged ≥65 and determines the extent to which multiple medications contribute to the risk of reduced muscle quality. Methods: This retrospective cross-sectional study analyzed data from older inpatients requiring rehabilitation. PhA was measured using bioelectrical impedance analysis. The number of medications taken by each patient was recorded at admission. Polypharmacy was defined as the concurrent use of five or more medications at admission. Results: In this study of 517 hospitalized older adults (median age 75 years; 47.4% men), 178 patients (34.4%) were diagnosed with sarcopenia. Polypharmacy was present in 66% of patients. The median PhA was 4.9° in men and 4.3° in women. Multivariate linear regression analysis was performed separately for men and women. In men, PhA was negatively correlated with the number of medications (β=–0.104, p=0.041) and polypharmacy (β=–0.045, p=0.383). In women, PhA was negatively correlated with the number of medications (β=–0.119, p=0.026) and polypharmacy (β=–0.098, p=0.063). Analyses were adjusted for age, body mass index, sarcopenia, C-reactive protein, and hemoglobin levels. Conclusion The number of medications at admission negatively impacted PhA in older inpatients, highlighting the importance of reviewing prescribed drugs and their interactions.

Background: Functional dependency may serve as a marker for positive SARC-F screen (Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls) among older adults at the Emergency Department (ED). We compared functional dependency between SARC-F– (<4) and SARC-F+ (≥4) groups at the ED. Methods: A secondary analysis of cohorts from two quasi-experimental studies among patients aged ≥65 years old presenting to the ED of a 1,700-bed tertiary hospital. We compared both groups for baseline characteristics using univariate analyses, and performed multiple linear regression to examine the association between Modified Barthel Index (MBI) and Lawton’s instrumental activities of daily living (IADL) against SARC-F, and binary logistic regression to examine the associations between individual ADL domains and SARC-F+. We compared the area under receiver operating characteristic curves (AUC) to detect SARC-F+ for MBI, IADL, frailty, age, cognition and comorbidity. Results: SARC-F+ patients were older (86.4±7.6 years), predominantly female (71.5%) and frail (73.9%), more dependent on walking aids (77.2%), and had lower premorbid MBI (median 90.0 [interquartile range 71.0–98.0]) and IADL (4.0 [2.0–5.0]) (both p<0.001). MBI (β=–0.07, 95% confidence interval [CI] –0.086 to –0.055) and IADL (β=–0.533, 95% CI –0.684 to –0.381) were significantly associated with SARC-F. Dependency in finances (odds ratio [OR]=14.7, 95% CI 3.57–60.2, p<0.001), feeding (OR=12.4, 95% CI 1.45–106, p=0.022), and stair-climbing (OR=10.49, 95% CI 4.96–22.2, p<0.001) were the top three functional items associated with SARC-F. MBI (AUC=0.82, 95% CI 0.77–0.84) and IADL (AUC=0.78, 95% CI 0.72–0.84) showed superior discrimination for SARC-F+ compared to other measures (AUC=0.58–0.70). Conclusion Functional dependency is strongly associated with positive SARC-F screen among older adults at the ED. This highlights the need for increased vigilance, especially in the presence of dependency in relevant domains such as managing finances, feeding, and stair-climbing.

Background: Impaired executive function is common in older adults. This study examined the causal relationship between the use of information and communication technology (ICT) and executive function in older adults over time.Method: This study performed a secondary analysis of data from four waves (2016–2019) of the National Health and Aging Trends Study. A fixed-effect analysis was conducted to examine the effects of ICT on the executive function of older adults without dementia aged ≥65 years. This study analyzed data from 3,334 respondents. Results: We observed significant positive effects of ICT use on executive function over time (standardized β=0.043–0.045; 95% confidence interval, 0.001–0.043; p<0.05). Conclusion The current findings support the use of ICT as a protective approach to prevent decline in executive function in community-dwelling older adults.

Background: Falls pose a significant risk to older adults, often leading to severe injury and disability. One potential contributing factor to falls is footwear, particularly shoes with destabilizing features. This systematic review assessed the effects of destabilizing shoes on stability control and fall prevention in older adults, highlighting their effectiveness in balance control and fall prevention, and the detailing the specific review methodology. Methods: We thoroughly searched relevant databases and meticulously screened the identified studies based on predetermined inclusion and exclusion criteria. We then extracted data from 30 eligible studies with various study designs and shoe types and synthesized this information to assess the impact of destabilizing shoes on balance and gait measures, fall incidence, and other relevant outcomes. Results: While certain types of destabilizing shoes may improve specific aspects of balance and proprioception, they can also adversely affect steadiness control and potentially increase the risk of falls if not appropriately used. Therefore, the use of destabilizing shoes should be carefully considered and tailored to individual needs, with proper guidance and training to minimize fall risk. Conclusion The findings of this review significantly inform footwear design and selection in older adults and emphasize the need for additional research. By synthesizing the available evidence, this review highlights the potential benefits and risks associated with destabilizing shoes and suggests the need for careful evaluation of their use on a case-by-case basis. This review serves as a basis for future guidelines on the use of destabilizing shoes in older adults with the aim of developing effective fall prevention interventions.