JOURNAL OF GERONTOLOGY AND GERIATRICS

The relationship between fall anxiety and fall behaviors in geriatric patients undergoing orthopedic surgery with a history of falling

Sibel Altıntaş, Sema Şahiner, Sevim Çelik, Elif Karahan — Mon, 29 Sep 2025 13:56:15 +0000

Background. Falls in older adults pose significant health risks and have both physical and psychological effects. This condition is an important factor influencing fall anxiety and fall behaviors.
Aim. The aim of this study is to examine the relationship between fall anxiety and fall behaviors in geriatric patients who were admitted to the orthopedic ward and underwent orthopedic surgery due to a fall.
Method. A cross-sectional correlational study was conducted with 97 patients aged 65 and above in the orthopedic clinic of a state hospital between September 2023 and September 2024. Data were collected
through face-to-face surveys using the “Patient Identification Form”, the “International Falls Efficacy Scale”, and the “Fall Behaviors Scale for Older Adults”, and statistical analysis was performed.
Results. The average age of the patients was 72.62 ± 6.52, with 55.7% being male, 76.3% married, 86.6% unemployed, and 40.2% having completed primary school. 76.3% had chronic illnesses, and 75.3% had a history of surgery. 85.6% of the patients reported fall anxiety, and 78.4% had a fall history. High levels of fall anxiety and risk were found, and demographic factors were found to be associated with these behaviors.
Conclusions. A strong relationship between fall anxiety and fall risk was observed in older individuals. To reduce this, it is suggested to implement physical activity programs, educational interventions, environmental adjustments, and psychosocial support. Additionally, the need for multidisciplinary research is emphasized.

Association of waist-calf circumference ratio with frailty by Fried Frailty Phenotype questionnaire in older adults from Japan

Mon, 29 Sep 2025 14:22:44 +0000

Objective. The waist circumference (WC) to calf circumference (CC) ratio (WCR), a measure of visceral fat, was calculated from WC and CC, measures of abdominal obesity and skeletal muscle mass, respectively.
In this study, we investigated the relationship of WCR with pre-frailty and frailty using the Fried Frailty Phenotype Questionnaire (FFPQ).
Methods. A total of 175 community-dwelling older adults in Wakasa-cho, Kaminaka-Mikata-gun, Fukui Prefecture, Japan were included in this study. Frailty was determined by the FFPQ scores, with those
who scored 0, 1-2, and ≥ 3 on the FFPQ being considered robust, pre-frailty, and frailty, respectively.
Results. Pre-frailty and frailty were diagnosed in 90 (51.4%) and 18 (10.3%) patients, respectively, using the FFPQ (p = 0.001). CC was not significantly different between the groups (p = 0.415). WCR was significantly higher in the pre-frailty and frailty groups than in the robust group (p < 0.001). The FFPQ scores were significantly positively correlated with WCR (r = 0.364, p < 0.001). Pre-frailty and frailty diagnosed by FFPQ were analysed in relation to WCR, WC, and CC by ordinal logistic regression analysis, which showed that WCR and CC were associated with pre-frailty and frailty after adjustment (WCR: odds ratio (OR) 5.72, 95% confidence interval (CI) 1.43-23.70, p = 0.015; CC: OR 0.81, 95% CI 0.69-0.94, p = 0.006).
Conclusions. This study investigated the association of WCR with prefrailty and frailty diagnosed using the FFPQ in community-dwelling older adults. High abdominal fat and low lower leg muscle mass were significantly associated with frailty and WCR during the pre-frailty stage.

A review on Klotho: FGF23 mediated pathway integration and aging

Shareshtha Devi — Mon, 29 Sep 2025 14:23:27 +0000

Aging is driven by interconnected genetic, metabolic, and environmental factors that manifest as hallmarks including genomic instability, telomere attrition, epigenetic drift, and altered intercellular signaling. The Klotho-FGF23 axis has emerged as a critical regulator linking mineral metabolism to systemic aging processes. Membrane-bound Klotho, primarily in the kidney and parathyroid, acts as an obligate co-receptor for FGF23 to regulate phosphate and vitamin D homeostasis, while soluble Klotho exerts hormone-like effects that modulate Wnt, IGF-1, NF- κB, and TGF-β pathways, influencing oxidative stress, inflammation, and tissue regeneration. Deficiency of Klotho or FGF23 in animal models results in hyperphosphatemia, vascular calcification, and premature aging phenotypes, whereas Klotho overexpression or supplementation extends lifespan and enhances stress resilience. Beyond its renal role, FGF23 can activate Klotho-independent FGFR4 signaling in cardiomyocytes, promoting hypertrophy and contributing to cardiovascular risk.
This review integrates current mechanistic insights on Klotho-FGF23 signaling within the framework of aging hallmarks, differentiating protective Klotho-dependent pathways from maladaptive Klotho-independent effects. We evaluate therapeutic strategies including recombinant Klotho protein, gene therapy, dietary phosphate restriction, FGFR4 inhibition, and senolytics approaches that restore Klotho expression. Key translational challenges remain assay variability and poor standardization of soluble Klotho measurement, limited longitudinal human data, and differences between murine models and human aging. Addressing
these barriers will be essential to advancing Klotho-FGF23 targeted interventions as a viable strategy to extend health span and delay age-related pathologies.

New approaches to ending skin problems in persons with fecal incontinence: a systematic review

Dilek Aygin, Hilal Kaynak Aydoğmuş, Cansu Kubilay, Büşra Ecem Kumru — Mon, 29 Sep 2025 14:27:17 +0000

Objective. To conduct a systematic review of the current literature on products used in preventing and managing skin problems in individuals diagnosed with fecal incontinence.
Methods. The Medline Complete, Cochrane Library, Ovid, Google Scholar, PubMed, Scopus, Science Direct and Taylor & Francis databases along with Ethos, Open Dissertation and Openthesis databases were used to scan the literature. The methodology for the study was structured in the PICOS format and according to the PRISMA checklist.
Results. This systematic review included a total of 10 articles published between 2012 and 2022 that met the predefined inclusion criteria for Randomized Controlled Trials (RCTs), Quasi-Experimental Studies (QES), and Interventional Studies. Absorbent products were chosen to prevent and manage the skin problems of most of the patients. In addiction bsorbent products, creams, barrier films, barrier cloths, barrier sprays, incontinence briefs containing a spiral-shaped fiber moistened with an alkaline solution, silicone-bordered foam dressings and onepiece drainable fecal pouches were used.
Conclusions. The investigations showed that over-hydration of the epidermis can be controlled with absorbent products, which are also effective in preventing and managing incontinence-associated dermatitis (IAD). The use of new absorbent products or increasing awareness of frequent pad changes may have a positive impact. Additionally, cleansing agents, barrier creams, films, cloths, sprays, incontinence briefs with spiral-shaped fiber moistened with alkaline solution, silicone-bordered foam dressings, and one-piece drainable fecal pouches were found to be effective.

A rare case of oral myiasis in a severely frail older patient

Jayachandran Sadaksharam, Archana Muralidharan — Mon, 29 Sep 2025 14:33:19 +0000

Background. Myiasis, derived from the Greek “myia” (fly) and “iasis” (disease), refers to infestation by dipterous larvae. First coined by Hope in 1840 and later defined by Zumpt, myiasis involves larvae feeding on live or necrotic tissues. Oral myiasis, a rare condition first described by Laurence in 1909, typically affects individuals with compromised oral hygiene, necrotic lesions, or systemic debilitation.
Case presentation. We report a case of oral myiasis in a 73-year-old non-ambulatory female with multiple comorbidities. The patient presented with pain and swelling in the maxillary anterior region, accompanied by severe halitosis, poor oral hygiene, and live larvae emerging from necrotic oral tissues. Clinical and entomological examination identified the larvae as Chrysomya bezziana. Necrotic tissue was surgically debrided, mobile teeth extracted, and the patient was followed up after anti helminthic medications. Post-operative care included oral hygiene instruction and follow-up. The patient responded well to the treatment.
Conclusions. Oral myiasis is an uncommon yet serious condition, predominantly affecting debilitated or geriatric patients with poor oral hygiene. Awareness and early intervention are crucial for effective management. Preventive strategies such as routine oral care and regular follow-up are essential, especially in vulnerable populations.