Age and Ageing

Background Older adults' walking has so far been evaluated using standardised assessments of walking capacity within a clinical setting. By taking the evaluation out of the laboratory into the real world, this study provides first evidence of the ability of Digital Mobility Outcomes (DMOs) to detect changes over time and the Minimal Important Difference (MID) in patients after proximal femoral fracture (PFF). This will guide the implementation of DMOs in research and clinical care. Methods For t...

INTRODUCTIONAgitation is a common and burdensome neuropsychiatric symptom in dementia that fluctuates from day to day, but objective tools for short-term risk stratification are limited. We examined whether nocturnal physiological signals from unobtrusive under-mattress sensors predict next-day daytime agitation and whether associations differ for agitation occurrence versus severity. METHODSWe extracted cardiorespiratory, movement, and sleep-proxy features from two long-term care cohorts (N=55...

BackgroundVestibular complaints are common in older adults and are linked to imbalance and falls. Some older adults show impaired vestibular perception despite preserved peripheral-reflex ("vestibular agnosia"). Yet it remains unclear if vestibular agnosia is independently linked to imbalance and falls in otherwise healthy older adults. We therefore investigated the prevalence of vestibular agnosia in community-dwelling older adults, and examined its association to balance and prospective falls....

BackgroundDementia affects over 57 million people worldwide. UK and international policy position personalised, conversation-based care planning as central to post-diagnostic support. However, delivery in primary care is inconsistent, and many practitioners lack dementia-specific communication training. Existing evidence focuses on single roles or settings, leaving a gap in understanding how communication operates across the primary care workforce. AimsTo identify what helps and hinders effecti...

Structured AbstractO_ST_ABSBACKGROUNDC_ST_ABSPatient reports are the standard when examining subjective cognitive decline (SCD). Recent research suggests that informant and clinician reports may also be associated with cognition. This study examined differences between patient, informant, and clinician definitions of SCD and their relationship to cognition. METHODSData from 4290 older adults (n=1690 normal controls, NC; n=840 mild cognitive impairment, MCI; n=1760 Alzheimers disease, AD) were e...

Gait variability is a critical functional indicator of dynamic balance and neurocognitive decline in health. Its translation into clinical practice is, however, challenged by a lack of age-related normative trajectories and reference values under real-world ecological settings. Furthermore, the conventional metrics used to estimate gait variability (Coefficient of Variation, CV; Standard Deviation, SD) have a fundamental methodological flaw: the inherent sensitivity of conventional metrics to th...

INTRODUCTIONDementia reflects vascular and neurodegenerative processes in late life, yet studies often examine risks and outcomes individually. This study tested whether the cumulative burden of risks relates to structural brain pathology and cognition, and whether brain markers mediate these associations. METHODSCross-sectional data were drawn from 38,414 older adults in the National Alzheimers Coordinating Center database. A composite score summed ten binary risk factors: hypertension, diabet...

BackgroundIntrinsic capacity (IC) is a key marker of healthy ageing, which captures an individuals physical and mental capacities, measured across five domains: cognitive, locomotor, psychological, vitality, and sensory. Although genetic factors are known to influence both general IC and its individual domains, existing IC indices have been developed primarily using phenotypic data, without accounting for the underlying biological architecture across domains. In this study, we developed a multi-...

BackgroundCognitive decline and dementia represent major public health challenges in aging populations. Natural language processing (NLP)-augmented clinical decision support systems (CDSS) offer promising tools for early detection, yet causal evidence on their longitudinal impact at the health system level remains sparse. This study examines whether the phased adoption of NLP-augmented CDSS across German geriatric primary care practices causally improved cognitive decline detection rates over a ...

BackgroundHip fracture remains a leading cause of morbidity and mortality among older adults in the United States. The aim of this systematic and meta-analytical review is to synthesize available evidence on predictors of one-year mortality following hip fracture among older adults, guided by a socio-ecological framework. MethodsWe searched PubMed, Embase, Web of Science, CINAHL, and Scopus for U.S.-based studies published between 2010 and 2025 reporting one-year mortality after hip fracture. S...

IntroductionThis clinical trial investigates the efficacy and safety of a personalized 15-day accelerated intermittent theta-burst stimulation (aiTBS) protocol, targeted at either the default mode network (DMN) or the fronto-parietal network (FPN), in individuals with mild Alzheimers disease (AD). Methods45 patients with mild AD were randomized 1:1:1 to receive 15 consecutive days of high-dose aiTBS (7200 pulses/day) targeting the DMN or FPN, or sham. The primary outcome was the change in ADAS-...

Biomarkers of aging, particularly DNA methylation-based clocks, have shown promise as tools to assess whether interventions may impact the rate of biological aging. Among possible interventions physical exercise has shown protective effects against many age-associated diseases, while time-restricted feeding (TRF), has shown metabolic benefits in preclinical models. The combined effect of exercise and TRF on aging biomarkers remains largely unexplored. In this 52-week four-armed, randomized, cont...

BACKGROUNDFall injuries in older adults are devastating and often caused by impaired reactive balance to unexpected trips and slips, which conventional exercise programs do not target. This study examined whether a low-dose perturbation balance training (PBT) program among older adults can improve balance recovery following trips and slips and reduce falls and fall injuries. METHODS111 older adults (65+ years) were randomised into an intervention or control group. The intervention group underto...

BackgroundPeople with hip or knee joint arthroplasties are commonly advised to avoid high-impact physical activities, despite increasing demand to return to sport and vigorous exercise. Current implant testing standards do not reflect real-world loading during high-impact tasks, and few studies have quantified implant loads in high-functioning individuals who have returned to such activities. MethodsHigh-functioning adults with a total hip arthroplasty (THA, n = 11), total knee arthroplasty (TK...

Adaptation to physiological stress is fundamental to health but varies widely among individuals. In humans, this heterogeneity is evident in markedly different gains in fitness in response to identical exercise training. The molecular determinants of this variable "trainability" remain poorly understood. Here we identify insulin-like growth factor binding protein-7 (IGFBP7), a senescence-associated secreted protein, as a circulating constraint on exercise adaptation. Plasma proteomics in older a...

BackgroundBehavioral telemetry--the analysis of clinical actions NOT taken--may identify care process failures associated with adverse outcomes. While missed nursing care predicts outcomes in survey-based studies, objective EHR-derived measures are lacking. We hypothesized that missing routine cognitive assessment in ICU patients with low acute physiologic derangement would predict mortality independent of illness severity. MethodsRetrospective cohort study using MIMIC-IV (2008-2022, Beth Israe...

BackgroundWhen creating risk prediction models for time-to-event data, methods that incorporate time are typically used. Random survival forests (RSF), an extension of random forests (RF), are one such class of models. We compared RSF to RF in the context of time-to-event outcomes in the ASPirin in Reducing Events in the Elderly (ASPREE) randomized controlled trial. We hypothesize that RSF will have superior discrimination and calibration versus RF. MethodsParticipants from ASPREE residing outs...

ObjectivesGrowth Mindset and Grit have been proposed as key psychological resources for resilience and adaptation, yet their manifestation and social distribution in later life remain underexplored. This study examines the structure, distribution, and correlates of Growth Mindset and Grit in older adulthood using proxy indicators in the English Longitudinal Study of Ageing (ELSA). MethodsProxy indicators reflecting learning behaviour, personality traits, affect, and beliefs were used to derive ...

BackgroundSmoking, unhealthy nutrition, alcohol consumption, and physical inactivity (SNAP behaviours) are major risk factors for multimorbidity but are often studied in isolation. Using longitudinal data, Suhag et al. identified clusters of older adults (aged [≥]50) with common SNAP behaviour patterns and distinct sociodemographic profiles and multimorbidity prevalence; whether and how these patterns generalise across adulthood remains unclear. AimTo conceptually replicate Suhag et al. acro...

BACKGROUNDDelirium is common in critically ill adults but often goes unrecognized and undertreated. Little is known about the perceptions of ICU nurse and physician leaders regarding ICU delirium detection and management and the potential role of objective continuous delirium monitoring to facilitate ICU delirium care. RESEARCH QUESTIONWhat are the perceptions of ICU leaders regarding the current challenges associated with delirium recognition and management and the potential benefits of contin...