Data from multi-national aging cohorts show dysregulated metabolic pathways in people with physio-cognitive decline.

Background: Physio-cognitive decline (PCD) represents a dual impairment of mobility and cognitive function in aging populations, significantly increasing risks of disability, dementia, and mortality. Despite its clinical importance, the underlying biological mechanisms driving PCD remain poorly understood. This study aimed to identify metabolomic biomarkers and pathways associated with PCD to elucidate potential mechanistic insights.

Healthcare utilization, pharmacotherapy prescriptions, and clinical outcomes across a 5-year duration preceding and succeeding the initiation of home health care in a nationwide population-based cohort of 187,547 older adults with disabilities.

Background: Longitudinal trajectories of healthcare utilization, medication prescription, and clinical outcomes among older adults with disabilities receiving home healthcare (HHC) holds significance but remains elusive.

Methods: People aged≥65 years who newly received Taiwan's National Health Insurance funded HHC program from January 2005 to December 2013 were identified. Healthcare utilization, life-sustaining treatment, medication prescriptions (polypharmacy, psychotropics, anticholinergic burden and antibiotics), health status (Charlson's comorbidity index, CCI), and mortality were assessed over a 10-year period spanning 5 years before and after initiating HHC.

Longitudinal non-cancer pain management patterns and risk of adverse outcomes in older adults: Insights from group-based multi-trajectory modelling.

Aims: The long-term impact of different non-cancer pain management strategies in older adults remains poorly understood. This population-based retrospective cohort study aimed to identify distinct trajectories of chronic non-cancer pain management and examine their associations with adverse clinical outcomes in older adults, stratified by frailty status.

Methods: Using Taiwan's National Health Insurance database, we included older adults (≥65 years) who initiated non-steroidal anti-inflammatory drugs (NSAIDs) in 2010 and followed them for 8 years.

Implications of comprehensive geriatric assessment and Traditional Chinese Medicine constitution types for integrative geriatric care.

Background: Complementary medicine may enhance conventional geriatric care, but clinical guidance for incorporating Traditional Chinese Medicine (TCM) therapies remains limited. This study aimed to investigate the link between TCM body constitutions and comprehensive geriatric assessment scores in older adults.

Method: This prospective observational study recruited 100 participants aged 65 and older between January 2020 and December 2021.

Diagnosis and outcomes of cachexia in Asia: Working Consensus Report from the Asian Working Group for Cachexia.

Chronic diseases often lead to metabolic disorders, causing anabolic resistance and increased energy consumption, which result in cachexia. Cachexia, in turn, can lead to major clinical consequences such as impaired quality of life, shortened life expectancy, and increased healthcare expenditure. Existing international diagnostic criteria for cachexia employ thresholds derived from Western populations, which may not apply to Asians due to differing body compositions.

Association between changes in potentially inappropriate medication use and adverse outcomes during hospitalization in older adults: A retrospective study.

Purpose: To evaluate the association between the change in the number of PIMs in older adults during hospitalization and adverse outcomes.

Methods: This retrospective cohort study was conducted in the internal medicine wards of a tertiary teaching hospital between May and December 2017. 3,460 patients (77.

Physical activity plays a crucial role in multidomain intervention for frailty prevention.

Background And Aims: Taiwan is one of the most rapidly aging countries worldwide. Both physical activity and frailty affect older adults, and multidomain interventions prevent frailty. This study investigated the associations between physical activity, frailty, and the effects of multidomain intervention.

Automated Video Analysis of Audio-Visual Approaches to Predict and Detect Mild Cognitive Impairment and Dementia in Older Adults.

Background: Early identification of different stages of cognitive impairment is important to provide available intervention and timely care for the elderly.

Objective: This study aimed to examine the ability of the artificial intelligence (AI) technology to distinguish participants with mild cognitive impairment (MCI) from those with mild to moderate dementia based on automated video analysis.

Methods: A total of 95 participants were recruited (MCI, 41; mild to moderate dementia, 54).

The association of potentially inappropriate medications, polypharmacy and anticholinergic burden with readmission and emergency room revisit after discharge: A hospital-based retrospective cohort study.

Aims: While certain drug-use indicators are known to be associated with clinical outcomes, the relationship is unclear for some highly prevalent conditions in in patients aged ≥65 years. We examine correlations between 3 drug-use indicators and postdischarge healthcare services use by older patients according to the presence of dementia, advanced age and frailty.

Methods: This retrospective cohort study analysed data collected from hospital electronic health records between April and December 2017.

Factors associated with insomnia in older adult outpatients vary by gender: a cross-sectional study.

Background: Insomnia is a common sleep disturbance in older adults and is associated with many poor health outcomes. This study aimed to explore factors associated with insomnia in older adult outpatient clinics, and to further analyze the influence of gender on factors associated with insomnia.

Methods: This cross-sectional study was conducted in the outpatient clinics of a tertiary hospital in Southern Taiwan from July to September 2018.

Muscle-to-fat ratio identifies functional impairments and cardiometabolic risk and predicts outcomes: biomarkers of sarcopenic obesity.

Background: Sarcopenic obesity aims to capture the risk of functional decline and cardiometabolic diseases, but its operational definition and associated clinical outcomes remain unclear. Using data from the Longitudinal Aging Study of Taipei, this study explored the roles of the muscle-to-fat ratio (MFR) with different definitions and its associations with clinical characteristics, functional performance, cardiometabolic risk and outcomes.

Methods: (1) Appendicular muscle mass divided by total body fat mass (aMFR), (2) total body muscle mass divided by total body fat mass (tMFR) and (3) relative appendicular skeletal muscle mass (RASM) were measured.

Cost and Effectiveness of Long-Term Care Following Integrated Discharge Planning: A Prospective Cohort Study.

Little is known about the effects of seamless hospital discharge planning on long-term care (LTC) costs and effectiveness. This study evaluates the cost and effectiveness of the recently implemented policy from hospital to LTC between patients discharged under seamless transition and standard transition. A total of 49 elderly patients in the standard transition cohort and 119 in the seamless transition cohort were recruited from November 2016 to February 2018.

Differential moderation effects of ApoE and 5-HTTLPR genotypes on social vulnerability in predicting mortality among community-dwelling middle-aged and older adults: a nationwide population-based study.

Aging is a dynamic complex process involving social vulnerability over time. The social vulnerability index (SVI) was developed that predicted adverse health outcomes. This study examined effects between SVI status and two genotypes, apolipoprotein E (ApoE) and Serotonin transporter genotyping (5-HTTLPR), on all-cause mortality.

All-cause mortality, cardiovascular mortality, major cardiovascular events and hypoglycaemia of patients with diabetes onset at an older age: results from the 10-year nationwide cohort study.

Background: Longitudinal adverse outcomes are unclear among adults with diabetes according to the age of onset.

Objective: To investigate the longitudinal diabetes-related outcomes in adults with new-onset diabetes stratified by age.

Design: Retrospective cohort study.

Insomnia in older adult females is highly associated with metabolic syndrome.

Purpose: The aim of this study is to investigate the relationships between insomnia and metabolic syndrome among Taiwanese older adults.

Methods: This cross-sectional study enrolled participants aged over 60 years from outpatient clinics between July and September 2018. Demographic characteristics of all participants and questionnaire data for sleep duration, use of hypnotic agents, baseline activities of daily living, 5 items of the geriatric depression scale, comorbidities, medications, and risk of obstructive sleep apnea were obtained.

Sarcopenia is independently associated with parietal atrophy in older adults.

Introduction: As populations age, sarcopenia becomes a major health problem among adults aged 65 years and older. However, little information is available about the relationship between sarcopenia and brain structure abnormalities. The objective of this study was to investigate associations between sarcopenia and brain atrophy in older adults and relationships with regional brain areas.

Developing a predictive model for hospital-associated disability among older patients hospitalized for an acute illness: the HAD-FREE Score.

Purpose: To develop a predictive model to identify hospitalized older patients at risk of functional decline.

Methods: This retrospective cohort study recruited participants aged 65 years and over admitted to internal medicine wards of a tertiary medical center in Taiwan during May to October 2017 for developing predictive model (n = 1698) and those admitted during November to December 2017 for validation study (n = 530) of the model. Demographic data, geriatric assessments and hospital conditions (admission route and length of hospital stay) were collected for analysis.

Efficacy of Multidomain Intervention Against Physio-cognitive Decline Syndrome: A Cluster-randomized Trial.

Backgrounds: To investigate the efficacy of a community group-based intervention among community-dwelling older adults with physio-cognitive decline syndrome (PCDS).

Methods: A prospective cluster randomized controlled trial included 733 community-dwelling older adults with adjusted Montreal Cognitive Assessment (MoCA adj) scores >18 from 40 community-based sites across Taiwan. PCDS was defined as the concomitant presence of physical declines, i.

Developing an Integrated Electronic Medication Reconciliation Platform and Evaluating its Effects on Preventing Potential Duplicated Medications and Reducing 30-Day Medication-Related Hospital Revisits for Inpatients.

The aims were to develop an integrated electronic medication reconciliation (ieMR) platform, evaluate its effects on preventing potential duplicated medications, analyze the distribution of the potential duplicated medications by the Anatomical Therapeutic and Chemical (ATC) code for all inpatients, and determine the rate of 30-day medication-related hospital revisits for a geriatric unit. The study was conducted in a tertiary medical center in Taiwan and involved a retrospective quasi pre-intervention (July 1-November 30, 2015) and post-intervention (October 1-December 31, 2016) study design. A multidisciplinary team developed the ieMR platform covering the process from admission to discharge.

Effects of modified version of the Hospital Elder Life Program on post-discharge cognitive function and activities of daily living among older adults undergoing total knee arthroplasty.

Objectives: This study aimed to investigate the effects of a modified Hospital Elder Life Program (mHELP) on post-discharge cognition and physical function among older adults undergoing total knee arthroplasty (TKA), and to evaluate the incidence of postoperative delirium.

Design: Non-randomized intervention trial.

Setting And Participants: A total of 140 patients aged 60 years and older scheduled for elective orthopedic surgery at our institution between August 2017 and December 2018 were included.

Barthel Index, but not Lawton and Brody instrumental activities of daily living scale associated with Sarcopenia among older men in a veterans' home in southern Taiwan.

Background: Older adults are more likely to experience the disorder of skeletal muscles.

Objective: This study aimed to examine the prevalence of sarcopenia using the diagnostic procedures of sarcopenia recommended by the Asian Working Group for Sarcopenia in 2019. The association of sarcopenia with physical activity and other factors was also explored.

The Trend of Aggressive Treatments in End-of-Life Care for Older People With Dementia After a Policy Change in Taiwan.

Objectives: We evaluated the trend of end-of-life healthcare utilization and life-sustaining interventions for older adults with dementia 3 to 4 years after the change in hospice policy.

Design: Population-based retrospective cohort study.

Setting And Participants: We used the National Health Insurance Research database of enrolled patients ≥65 years of age diagnosed with dementia who died in 2010-2013 (n = 2062).

COVID-19 and older people in Asia: Asian Working Group for Sarcopenia calls to actions.

The coronavirus disease 2019 (COVID-19) pandemic has casted a huge impact on global public health and the economy. In this challenging situation, older people are vulnerable to the infection and the secondary effects of the pandemic and need special attention. To evaluate the impacts of COVID-19 on older people, it is important to balance the successful pandemic control and active management of secondary consequences.

Clinical characteristics and 10-year outcomes of diabetes in adults with advancing age at onset: A population cohort.

Purpose: The risk of diabetes mellitus increases with age but its characteristics, treatment patterns, and outcomes in people with onset at different ages are little studied. The aim of this study is Investigate longitudinal clinical characteristics, complications, anti-diabetes medication usage, and diabetes-related outcomes among people diagnosed at different ages.

Methods: This retrospective cohort study using Taiwan National Health Insurance Research Database claims data from 2000 to 2013, recruited 123,172 ≥ 40-year-olds with newly diagnosed diabetes, stratified by age at diagnosis: 40-64 years (62.

A national study on long-term osteoporosis therapy and risk of recurrent fractures in patients with hip fracture.

Objective: The study aimed to evaluate the impact of osteoporosis (OP) medication persistence on subsequent fractures and all-cause mortality in patients with hip fracture.

Methods: In this retrospective cohort study, we included patients aged ≥ 40 years with fragility hip fracture from the Taiwan's National Health Insurance Research Database. OP medication persistence was categorized as yes (≥ 12 months) or no (< 12 months).