Geriatrics

Outpatient Age-Friendly 4Ms implementation improves processes, not yet patient outcomes

This systematic review identified 12 U.S. outpatient studies implementing all 4Ms of Age-Friendly Health Systems. Across studies, AFHS interventions improved process measures such as 4Ms screening, documentation, and care-plan alignment. Patient-centered outcomes and structural metrics were infrequently reported, limiting conclusions about effectiveness and value. Heterogeneous designs, unclear implementation strategies, and poor reporting reduced generalizability. The authors urge standardized, outcomes-oriented AFHS measurement and fidelity assessment before broad outpatient policy or payment expansion. 1

CNS medication exposure is pervasive in Korean long-term care residents

In this national cross-sectional study of 134,718 Korean LTC residents, 86.2% receiving outpatient prescriptions used at least one CNS drug. Higher CNS use correlated with male sex, lower income, greater functional independence, higher comorbidity, longer residence, and dementia diagnoses. Residents aged ≥90 had lower odds of CNS prescribing than those <80 years. Privately operated facilities showed higher CNS use than public facilities, indicating strong institutional influences. Findings support systematic CNS prescribing surveillance and structured medication review in LTC stewardship programs. 2

Common cardiometabolic drugs associate with lower 1-year mortality in geriatric rehab

This RESORT cohort of geriatric rehabilitation inpatients (mean age 82.6 years) examined several potential gerotherapeutic drugs. Use of metformin, ACEi/ARBs, aspirin, and beta-blockers each associated with significantly lower 1-year post-discharge mortality after comorbidity adjustment. Patients taking three or more of these agents also had lower 1-year mortality compared with nonusers. Drug exposure was not linked to improved physical function or reduced 90-day readmissions. Observational design and confounding by indication preclude causal claims but justify further mechanistic and interventional work. 3

Age- and sex-specific muscle thresholds sharpen mortality prediction in heart failure

This nationwide registry analysis included 9,693 patients aged ≥65 hospitalized for heart failure. Investigators derived age- and sex-specific cutoffs for arm and calf circumference, handgrip strength, gait speed, and SPPB across three age bands. These tailored thresholds strongly predicted 1-year all-cause mortality, with adjusted hazard ratios from 1.44 to 3.25. They consistently outperformed fixed 2019 Asian Working Group for Sarcopenia criteria on discrimination and reclassification metrics. Results support using individualized muscle-health thresholds for prognostication and risk stratification in older heart-failure patients. 4