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Fragility fractures occur because of low-impact trauma or even spontaneously in individuals with osteoporosis. Caring for older persons with fragility fractures can present several challenges due to the unique needs and vulnerabilities of this population. Older individuals commonly have multiple medical conditions, such as osteoporosis, arthritis, cardiovascular diseases, and diabetes. These comorbidities can complicate fracture management and increase the risk of complications. Fracture repair through surgery may be more complex in older patients due to poor bone quality, decreased tissue elasticity, and higher chances of anesthesia complications. In addition, mobility and functional limitations post-fracture are highly prevalent in this population, affecting their independence and increasing their risk of institutionalization. Addressing these challenges requires a multidisciplinary approach involving orthopedic surgeons, geriatricians, physical and rehabilitation physicians, physiotherapists, occupational therapists, dieticians, social workers, and caregivers. Preventive measures, such as fall prevention strategies and osteoporosis management, can also play a vital role in reducing the incidence of fragility fractures in older persons.

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ABSTRACT BACKGROUND: A bibliometric analysis covering only the production of original studies or considering world production until 2022 has yet to be conducted. The creation and advancement of vaccines have also influenced research priorities, demonstrating the need for a new approach to this subject. OBJECTIVES: To analyze worldwide scientific production related to coronavirus disease 2019 (COVID-19) and the aged and to describe what has already been produced. DESIGN AND SETTING: Bibliometric analysis with a quantitative approach. METHOD: The search terms "COVID-19," "SARS-CoV-2," "Aged," and "Elderly" were used to retrieve articles from the Web of Science database. A total of 684 articles were included in the analysis. Data were imported into RStudio Desktop Software and linked to R Software. The Bibliometrix R package and VOSviewer software were used for analysis. RESULTS: Most articles were published in 2020. These were produced by 4,937 authors and published in 379 journals. The keyword most used by the authors was "COVID-19." Publications from 77 countries were obtained. China had the highest article production ranking, and Spain collaborated the most. The articles addressed the implications of the pandemic on the aged, the relationship between vaccination in the aged, and the implications for the disease itself. CONCLUSION: Further research should be conducted, mainly concerning vaccines and vaccination of the aged, owing to the need for and importance of immunization in this risk group, including assessing the long-term effects of vaccines.

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Resumen Objetivo: Estimar la prevalencia del maltrato y de la multimorbilidad, así como, analizar si el maltrato con la presencia de multimorbilidad está asociado con la autopercepción de la calidad de vida relacionada con la salud en personas mayores de Xalapa, Veracruz. Material y métodos: Este es un estudio transversal a partir de datos recolectados en una encuesta representativa de las personas mayores (≥60 años) de Xalapa, Veracruz. La encuesta se realizó de septiembre de 2018 a enero de 2019 (n = 993). Se utilizó un cuestionario para recolectar datos demográficos, socioeconómicos y de salud. El maltrato se evalúo mediante la Escala Geriátrica de Maltrato (EGM-22 ítems) y la calidad de vida relacionada con la salud mediante el cuestionario de salud Short Form 36 (SF-36). Se realizaron análisis descriptivos para estimar las prevalencias y modelos de regresión logística para analizar la asociación. Resultados: La prevalencia del maltrato de personas mayores fue 16,2%. Los tipos de maltrato fueron: psicológico (13,6%), económico (4,8%), físico (3,2%), negligencia (2,3%) y abuso sexual (0,5%). La prevalencia de multimorbilidad fue 43.2%. Las personas mayores con maltrato y multimorbilidad presentaron menor calidad de vida en las dimensiones de rol físico (OR 2,362 IC: 1,254-4,452), dolor corporal (OR 2,278 IC: 1,277-4,065) y salud mental (OR 2,94 IC: 1,499-5,766). Conclusiones: El maltrato y la multimorbilidad son problemas comunes en las personas mayores de Xalapa, Veracruz, la presencia de estos dos eventos se asocia con una menor calidad de vida relacionada con la salud. La investigación futura debería concentrarse en mejorar la comprensión de las relaciones familiares de las personas mayores con multimorbilidad y, los servicios sociales y de atención médica deben tomar en cuenta estos hallazgos para atender el maltrato de personas mayores con multimorbilidad antes de que ocurran más situaciones adversas que impacten en su calidad de vida.

Abstract Objective: To estimate the prevalence of elder abuse and multimorbidity, as well as to analyze if elder abuse in the presence of multimorbidity is associated with self-perceived health-related quality of life in older adults from Xalapa, Veracruz. Material and methods: Material and methods: This is a cross-sectional study based on data collected in a representative survey of older people (≥60 years) from Xalapa, Veracruz. The survey was conducted from September 2018 to January 2019 (n = 993). A questionnaire was used to collect demographic, socioeconomic, and health data. Elder abuse was assessed using the Geriatric Mistreatment Scale (GMS-22 items) and health-related quality of life using the short form 36 health survey questionnaire (SF-36). Descriptive analyzes were performed to estimate the prevalence and logistic regression models to analyze the association. Results: The prevalence of elder abuse was 16.2%. The types of elder abuse were psychological (13.6%), economic (4.8%), physical (3.2%), neglect (2.3%) and sexual abuse (0.5%). The prevalence of multimorbidity was 43.2%. Older people with both elder abuse and multimorbidity presented lower health-related quality of life in the dimensions of physical role (OR 2,362 IC: 1,254-4,452), body pain (OR 2,278 IC: 1,277-4,065) and mental health (OR 2,94 IC: 1,499-5,766). Conclusions: Elder abuse and multimorbidity are common problems in the older population in Xalapa, Veracruz, Mexico; the presence of these two events is associated with lower health-related quality of life. Future research should focus on improving understanding of the family relationships of older people with multimorbidity, and health care and social services should take these findings into account to address the elder abuse with multimorbidity before further adverse situations occur that impact their health-related quality of life.

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Resumo O objetivo é estimar prevalência de componentes da sarcopenia e associações com variáveis socioeconômicas em idosos de população rural do Ceará. Estudo transversal com 274 idosos. Massa muscular foi determinada por Índice de Massa Muscular (IMM) por bioimpedância elétrica e por circunferência da panturrilha; força muscular (FM) por teste de preensão palmar; e desempenho físico por testes da caminhada (VC) e Timed-up-and-go. Provável sarcopenia foi caracterizada por diminuição da FM, sarcopenia quando associada a diminuição do IMM, e sarcopenia grave quando estes dois foram acompanhados de baixa VC. Foram estimadas associações entre condições sociodemográficas, hábitos de vida e componentes da sarcopenia. Na regressão logística, foi observada frequência mais elevada: i) no sexo masculino, idade>69 anos, e nos que não trabalham, entre os idosos com FM diminuída; ii) com idade>69 anos, nos que não moram com o cônjuge, e nos que não praticam atividade física num nível adequado, entre os idosos com IMM diminuído; iii) com idade>69 anos, nos que residem na zona rural há menos que 30 anos, e nos que não trabalham, entre os idosos com VC diminuída.

Abstract The aim is to determine the prevalence of sarcopenia components and associations with socioeconomic variables in older persons living in rural areas in the state of Ceará, Brazil. We conducted a cross-sectional study with 274 older adults. Muscle mass was assessed using muscle mass index (MMI), measured by bioelectrical impedance analysis and calf circumference. Muscle strength (MS) was assessed using the handgrip test. Physical performance was measured using the walk test to calculate gait speed (GS) and the timed up-and-go test. Probable sarcopenia was defined as the presence of low MS, while confirmed sarcopenia was defined as the presence of low MS and low MMI. Severe sarcopenia was defined as the presence of the latter two criteria and slow GS. We tested for associations between sociodemographic characteristics and lifestyle habits and the components of sarcopenia. The logistic regression produced the following results: i) prevalence of low MS was higher among men, individuals aged >69 years, and in those not working at the time of the study; ii) the prevalence of low MMI was higher in individuals aged >69 years, those not living with a spouse, and those with an inadequate level of physical activity; iii) the prevalence of slow GS was higher in individuals aged >69 years, those who had lived in rural areas for less than 30 years, and those not working at the time of the study.

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BACKGROUND: The anti-saccadic (AS) error-rate is used to diagnose neurological disorders. The natural aging process could generate difficulty in carrying out parallel neural processes of conscious motor inhibition and eye movement. Therefore, if balance control is imposed on an elderly person in biped positions during an AS movement, an increase in the AS error-rate is expected. OBJECTIVE: To study the effects of postural control on the AS error-rate in older people. METHODS: An intra and intergroup comparison was made of AS error-rate in an experimental group of older people (PM) and another control group of young people (PJ). For this, blocks of AS and pro-saccadic movements (control) were used randomly in four different postures: (1)sitting (SENT), (2)standing normally (NORMAL), (3)feet together (REDUC), and (4)feet in line (TANDEM). RESULTS: The PM group, compared to the PJ group, showed a progressive increase in the AS error-rate from the sitting position to all standing positions, with the maximum AS error-rate in more complex vertical postures. In contrast, the PJ group did not present significative variability of this AS error-rate in all positions. CONCLUSIONS: It is confirmed that the aging process is associated with an increase in the AS error-rate. This study reveals for the first time a significant increase in the AS error-rate when control of body balance is required for PM, implying a decrease in the multiple processing capacity in PM for the execution of complex and parallel tasks.

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Walking provides numerous benefits to older persons, but its practice is hindered by social factors and the built environment. This article aims to understand the factors that encourage or discourage older people's walking behaviors, as well as the policies influencing those factors in Chile. It does so by reporting the analysis of twenty-five semi-structured interviews with Chilean policymakers and local leaders. The experts consistently represented walking as a beneficial activity for older persons that, nonetheless, occurs in adverse built environments. They asserted that the absence of older people in the public discussion and a top-down policy-making structure hamper its promotion.

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Family relationships play a central role in wellbeing among older adults in Chile. Based on the theory of social production functions, this study examined the relationship between perceived social support from children, partners and relatives, family functioning, self-perceived health and quality of life (QoL) among Chilean older adults. The study used a multi-ethnic sample of Chilean older adults living in rural areas in the regions of Arica and Parinacota (north) and Araucanía (south). A model was analyzed that emphasizes relationships differentiated by the source of support, family functioning and self-perceived health in the explanation of QoL. The results obtained from the structural equation modelling (SEM) analysis showed the existence of indirect relationships of social support from children, partners and other family members via family functioning, while self-perceived health was directly associated with QoL. The findings indicate that family functioning is a main variable in the contrasted model, in addition to confirming the importance of distinguishing the role of the various sources of support. Research is needed to examine in detail intergenerational relationships and other relationships with family members who are significant in the wellbeing of older adults. This research corroborates that family relationships have a specificity that needs to be addressed in gerontological social intervention, as well as continuing along the lines of strengthening or improving existing family ties (more quality) over the quantity of social relationships.

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This study follows up on the article 'Walkability Index for Elderly Health: A Proposal', published in 2020, as well its validation in the Historic Center of Porto, published in 2021. The 2020 article presented the theoretical and methodological bases relating qualities of public spaces, the walkability of older adults, and the direct benefits on health. The 2021 article validated the applicability of the index in the Historic Center of Porto, Portugal. Both articles incorporated the factor 'slope', solving a criticism evidenced in related literature about the slope being ignored in older adults' walking conditions studies. The present study, however, aims to validate the conceptual design of the Walkability Index for Elderly Health (WIEH) in the Brazilian context at the historic center of Vitória. The methodology included the analysis and evaluation of public spaces regarding the pedestrian network-urban fabric, urban scene, and safety-and the presence of slopes and/or stairways. Subsequently, these spaces were classified according to the WIEH, ascertaining their level of adequacy for older adults' walkability. The results show that paths friendly to older adults are rare and that the problems encountered focus primarily on the low quality of the pedestrian network and not on the existence of slopes and stairways.

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Resumo O objetivo deste artigo é avaliar o risco nutricional e cardiovascular segundo medidas antropométricas em idosos quilombolas do estado do Maranhão. Trata-se de estudo transversal realizado em 11 comunidades remanescentes de quilombolas do município de Bequimão, Maranhão, Brasil. Realizou-se censo da população idosa que representou 205 pessoas. Foram estimados os riscos nutricional e cardiovascular por meio dos indicadores antropométricos segundo sexo e idade. Realizou-se Testes de Qui-quadrado de Pearson ou Exacto de Fisher e análises de variância. Diferenças foram consideradas estatisticamente significantes quando p<0,05. Idosos quilombolas vivem em precárias condições de moradia e de infraestrutura sanitária, com elevado risco nutricional e cardiovascular, mas com diferenças entre sexo e idade. O excesso de peso foi mais prevalente em mulheres e idosos mais jovens, enquanto os homens e idosos com 80 ou mais anos apresentaram-se mais desnutridos e com maior perda de massa corporal. O risco cardiovascular foi maior entre as mulheres e em todas as faixas etárias. Idosos quilombolas vivem em vulnerabilidade socioeconômica e apresentaram alta prevalência de baixo peso, perda de massa muscular e alto risco cardiovascular, sendo maior risco entre mulheres e idosos do grupo de maior idade.

Abstract This article aims to assess nutritional and cardiovascular disease (CVD) risk based on anthropometric measures among older persons living in Quilombola communities in the state of Maranhão, Brazil. We conducted a cross-sectional study with 205 older persons living in 11 Quilombola communities in Bequimão, Maranhão. Nutritional and CVD risk were estimated according to sex and age group based on anthropometric indicators using Pearson's chi-square or Fisher's exact tests and analysis of variance, adopting a significance level of p<0.05. The study participants suffer precarious housing, basic sanitation and social conditions. Prevalence of nutritional and CDV risk was high across the sample, showing differences between sexes and age groups. Prevalence of excess weight was higher in women and the youngest age group, while prevalence of malnourishment and loss of muscle mass was higher in men and individuals aged 80 years and over. Prevalence of CVD risk was high across all age groups and higher in women than men. The older persons living in the Quilombola communities investigated by this study are socially vulnerable and showed high prevalence of low weight, loss of muscle mass and CDV risk. The prevalence of CVD risk was higher among women and the oldest age group.

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Given the expected increase in the proportion of older persons and evidence of poverty among persons with disabilities in general, well-being among older persons with disabilities is an important issue. Using Sen's capability approach, this article examines well-being among older persons with disabilities in Trinidad. A multiphase mixed-methods design with three phases was employed. In the initial exploratory phase, functionings which are things people value doing or being were identified via 11 interviews. These functionings were used in the subsequent phase to develop an instrument with both closed- and open-ended questions. The instrument was then administered in the third phase to measure well-being and to identify its hindering factors. Responses from 31 participants revealed moderate-to-severe deprivations among older persons with disabilities in Trinidad including for functionings related to food, healthcare, information and transportation. The integrated findings suggested changes to social care and healthcare systems to promote well-being among older persons with disabilities in Trinidad, as well as the need to develop community interactions and public services regarding transportation, supportive devices, and therapy.

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