Geriatrics

Aerobic and Tai Chi improved select cognition in oldest‑old ALF residents over 24 weeks

In a 24‑week, four‑arm pilot RCT of 76 assisted‑living residents aged ≥80, aerobic and mind‑body (Tai Chi) exercise were feasible and safe with 90.1% mean attendance. Aerobic and mind‑body arms had higher MMSE versus control (aerobic Δ=3.45; mind‑body Δ=3.29; both pHolm≈0.048). Mind‑body exercise improved immediate story recall (ISR Δ=9.84, pHolm=0.0234) and aerobic exercise improved TMT‑B time (Δ=−25.66 s, pHolm=0.0137). MoCA, naming, and TMT‑A differences were not significant after correction; larger trials are needed to confirm clinical benefit. 1

GDMT use falls with age but LVEF and function improve across older HF subgroups

In a retrospective multicentre cohort of 176 patients aged ≥65, use of GDMT pillars declined with increasing age, notably RAS inhibitors and SGLT2 inhibitors. Beta‑blocker use remained high and 50% of the oldest‑old achieved three GDMT pillars at six months. LVEF and NYHA class improved across all age groups, with greater functional gains in the youngest‑old. Age, comorbidity, and LVEF did not independently predict six‑month outcomes, supporting individualized, multidisciplinary care. 2

PPI reported in 46% of pragmatic trials with older adults and was perceived as beneficial

Survey of 100 corresponding authors of pragmatic trials involving adults ≥65 found 46.0% reported patient and public involvement (PPI). Most respondents (90.7%) perceived PPI improved intervention relevance, applicability, recruitment, and research quality. Challenges included communicating trial methods (62.5%), recruiting PPI partners (50%), scheduling (45.8%), and sustaining involvement (45.8%). Interview themes highlighted needs for training, good PPI leadership, and mitigation of workload or participant burden. 3