Explore the vast range of titles available.

The increasing popularity of electronic cigarettes in past decades has aroused public health concern. This study aims to review the literature on the prevalence of e-cigarette use among the general adult and young populations in Europe. We searched Medline and Google Scholar from September 2019, and included “prevalence of e-cigarettes”, “electronic cigarettes” or “e-cigarettes”, and “electronic nicotine delivery system” or “vaping”. The prevalence of current e-cigarette use ranged from 0.2% to 27%, ever-use ranged from 5.5% to 56.6% and daily use ranged from 1% to 2.9%. Current smokers of conventional cigarettes showed the highest prevalence for the use of e-cigarettes, ranging from 20.4% to 83.1%, followed by ex-smokers, with ranges from 7% to 15%. The following socio-demographic factors were associated with a higher chance of using e-cigarettes: male sex and younger age groups; results for economic status were inconclusive. In European countries, there is a higher prevalence of e-cigarette use among males, adolescents and young adults, smokers of conventional cigarettes, and former smokers.

Background Due to the demographic ageing process and the increasing number of pre-frail and frail individuals, new lifestyle interventions to enhance the quality of life (QoL) in community-dwelling older adults are necessary. Therefore, we performed a randomised controlled trial (RCT) to compare effects of a lay-led home-based physical and nutritional intervention programme with social support alone on different QoL domains in community-dwelling pre-frail and frail older adults. Methods In this analysis within a RCT (12 weeks), lay volunteers visited one-on-one pre-frail or frail older adults at home twice a week. Participants in the physical training and nutritional intervention (PTN) group performed six strength exercises and discussed main nutritional issues during each visit. The social support (SOSU) group received home visits twice a week for social exchanges. The QoL was assessed with the WHOQOL-BREF and the WHOQOL-OLD instruments. Analyses of covariance (ANCOVA) were used to examine differences between groups with baseline values as the covariate. Changes within groups were assessed with paired t-tests. Results Eighty participants ( n  = 39 in the PTN group and n  = 41 in the SOSU group) were included. No significant differences were found between the two groups except in past, present and future activities domain [β = 3.66 (95% confidence interval 0.13 to 7.18)] in favour of the PTN group. However, there was some evidence of greater within group improvements in the PTN group particularly in overall QoL, social relations and social participation. In the SOSU group, no significant effect was observed in any QoL domain. Conclusion A combination of a home-based physical and nutritional intervention was not more effective compared to social support alone, on QoL in community-dwelling pre-frail and frail older adults. However, the small but significant improvement within the PTN group suggests that a home-based physical and nutritional intervention delivered by volunteers may influence the QoL in a positive way. Trial registration The study protocol was registered on 6 November 2013 at ClinicalTrials.gov (identifier: NCT01991639 ).

This study aimed to explore the association between the impaired nutritional status and frailty in acute hospitalised elderly patients by using two tools, the MNA®-SF (Mini Nutritional Assessment® short-form) and the SHARE-FI (Frailty Instrument for Primary Care of the Survey of Health, Ageing and Retirement in Europe). Cross-sectional study. Acute hospitalised, community-dwelling elderly patients were recruited at internal medicine wards in Vienna, Austria. 133 men (39%) and women (61%) aged 74 (65–97) years. MNA®-SF was used to investigate malnutrition (<7 points) and patients at risk of malnutrition (8 to 11 points). By using the SHARE-FI, subjects were classified as frail, pre-frail or robust. A factor analysis was applied to identify overlaps between the MNA®-SF and SHARE-FI items. Internal consistency of different dimensions was assessed by using Cronbach's Alpha. Malnutrition or risk of malnutrition was found in 76.7% of the total sample and in 46.8% of robust, in 69.0% of pre-frail, and in 93.0% of frail participants. Frailty or prefrailty was found in 75.9% of the total sample and in 45.1% of the subjects with no risk of malnutrition, in 80.9% of subjects at risk of malnutrition, and in 94.1% of malnourished patients. The two used tools show overlaps in three dimensions: (1) nutrition problems, (2) mobility problems and (3) anthropometric items with a moderate to strong internal consistency (Cronbach's Alpha of 0.670, 0.834 and 0.946, respectively). 64.7% of the total sample (79.5% of frail and 87.9% of malnourished subjects) would participate in a home-based muscle training and nutritional intervention program. This study underlines the association and the overlap between frailty and impaired nutritional status. There is a high readiness to participate in a program to tackle the problems associated with malnutrition and frailty, especially in those, who would benefit most from it.

Abstract Background Sleep disturbance and fatigue may increase the risk of falls in older adults. This study examined the individual and combined associations of subjective fatigue, objective measured muscle fatigability, physical performance and sleep disturbance with fall risk in residential care settings. Methods This study included 217 residents and assessed objective muscle fatigability and recovery using repeated handgrip strength measurements, subjective fatigue (Multidimensional Fatigue Inventory, MFI), insomnia (Athens Insomnia Scale, AIS), sleep apnoea risk (STOP-BANG) and physical performance (Short Physical Performance Battery, SPPB). Falls were documented retrospectively (12 months) and prospectively (4 months). Subgroup analyses examined combinations of these factors. Results Of 217 participants, 39.6% (n = 86) were classified as fallers, based on their 12 months fall history. Fallers were older and predominantly female. During the 4-month follow-up, 67.4% of fallers experienced a fall compared to 2.3% of non-fallers. Both objective muscle fatigability and SPPB independently increased the risk of falling (AOR=3.45 and AOR=2.75). These risks were further increased when combined with sleep disorders, showing higher associations (AOR=3.34-5.05 for muscle fatigability and AOR=3.57-4.41 for SPBB). Poor muscle recovery with sleep disorders showed the strongest associations (AOR=5.12-5.21), while MFI showed no significant associations. Conclusions The results highlight a complex interaction between muscle fatigability, sleep disturbance and physical performance in increasing the risk of falls in older adults in residential care. Objective measures of muscle fatigability and recovery proved to be better predictors of falls than subjective assessments. Targeted prevention strategies should therefore address both fatigue/recovery capacity and sleep quality. Key messages • In residential care, muscle fatigability, recovery and physical performance measures are associated with fall risk, especially when combined with sleep disorders. • Fall prevention in residential care settings must consider both physical condition and sleep health.

Abstract Background GLP-1 receptor agonists (GLP-1 RAs) and dual GIP/GLP-1 RAs induce weight loss and reduce appetite. However, their effects on taste perception remain unclear. While some studies reported increased taste sensitivity and neural activation in response to sweet stimuli, others found reduced taste function. This study examined associations between self-reported taste perception changes and appetite-related outcomes in individuals with overweight or obesity receiving incretin-based therapies. Methods A cross-sectional survey was conducted among 411 adults with overweight/obesity, 35% with type 2 diabetes. Participants were grouped by treatment: semaglutide (Wegovy, n = 217), semaglutide (Ozempic, n = 148), tirzepatide (Mounjaro, n = 46). Data on sociodemographics, anthropometrics, appetite, and sensory changes were collected online. Weight loss was compared using Kruskal-Wallis tests. Multivariable logistic regression models assessed associations between changes in sweet and salty taste perception and appetite-related outcomes (satiety, appetite, cravings). Results Median weight loss after ≤6 months: Wegovy 8.25 kg, Ozempic 7.8 kg, Mounjaro 10.25 kg (p = 0.039); after ≥12 months: Wegovy 20.15 kg, Ozempic 21.3 kg, Mounjaro 24.15 kg (p = 0.006). Reduced appetite was reported by 58.4%, increased satiety by 63.5%. Sweet taste perception increased in 20.4%, salty taste in 21.7% (no significant group differences). Increased sweet taste perception was significantly associated with increased satiety (AOR=2.04), reduced appetite (AOR=1.67), and reduced craving (AOR=1.87). Increased salty taste perception was associated with higher satiety (AOR=2.16; all p < 0.05). Conclusions Despite differences in weight loss, self-reported taste perception changes were similar across treatments. These sensory changes were significantly associated with favourable appetite-related outcomes, suggesting a possible behavioural mechanism supporting the therapeutic effects of incretin-based therapies. Key messages • Changes in taste perception may contribute to appetite suppression and craving reduction under GLP-1-based treatment. • Self-reported sensory changes could serve as patient-relevant indicators of treatment response beyond weight loss.

Abstract Background Fatigue is central to frailty but often assessed subjectively. This study evaluates whether repetitive handgrip strength (HGS) can objectively differentiate frailty levels by measuring fatigue and recovery compared to conventional testing. Methods 217 older adults were assessed using Fried's frailty phenotype, SPPB, PASE, and MFI. The HGS protocol included two sessions of ten 3-second maximal grips, one hour apart. We calculated Fatigue Ratio (maximum/mean force) and Recovery Ratio (mean force session 2/session 1) and analyzed associations with frailty. Results Participants (58 non-frail, 68 pre-frail, 91 frail) showed significant differences in Fatigue Ratio 1 (1.12, 1.23, 1.40 respectively), Fatigue Ratio 2 (1.12, 1.21, 1.45), and Recovery Ratio (1.03, 1.01, 0.90). These measures correlated more strongly with frailty (r = 0.67, 0.69, -0.68) than MFI (r = 0.50), standard HGS (r = -0.51) or single fatigue questions (r = 0.21). Fatigue Ratio (OR = 1.51) better predicted fatigue than single questions (OR = 1.15), while SPPB (OR = 0.72) and Fatigue Ratio (OR = 1.28) were strongest for predicting frailty. Conclusions The repetitive HGS protocol provides objective assessment of fatigue resistance and recovery, outperforming standard methods for identifying frailty in geriatric populations. Key messages • Repetitive handgrip testing identifies frailty-related fatigue and recovery deficits more accurately than conventional handgrip strength or subjective fatigue measures. • Fatigue and recovery ratios are strong objective biomarkers for frailty, enabling earlier detection and better differentiation across frailty stages.

A randomized controlled trial was performed to compare the effects of a home-based physical and nutritional intervention program carried out by lay-volunteers to home visits with social support alone. Buddies visited 80 prefrail or frail older persons at home twice a week for 12 weeks. The physical training and nutrition group (PTN, n = 39) performed two sets of six strength exercises, discussed nutritional topics and received social support. The social support group (SoSu, n = 41) received home visits with social support only. In the PTN group, handgrip strength increased significantly by 2.4 kg (95% CI: 1.0-3.8). In the SoSu group we did not see a significant improvement. However, no significant between-group difference was found. Physical performance increased in both groups, although with a higher increase of 1.0 point (95% CI: 0.1-2.0) in the PTN group. In none of the groups muscle mass changed. Further results showed that frail individuals benefit more from the intervention than prefrail individuals (OR: 2.78; 95% CI: 1.01-7.66). Handgrip strength in the intervention group increased by a clinically relevant value and this effect is comparable to that obtained by health-care professionals. Therefore, home visits with a physical training and nutritional program could offer a new perspective in the care of community-dwelling prefrail and frail older persons.

The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35) conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23) received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min-max = 2.0-10.2) to 3.0 pg/l (min-max = 2.0-20.8), and CRP rose from 0.2 mg/dl (min-max = 0.1-0.9) to 0.3 mg/dl (min-max = 0.1-3.0) after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33-15.45) were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.

Background: Little is known about the implementation of lifestyle interventions in frail, community-dwelling people. This study highlights different domains of adherence to explain an effectively delivered home-based intervention. Methods: Eighty prefrail and frail persons (≥65 years) participated in a physical training, nutritional, and social support intervention over 24 weeks. A detailed log book was kept for comprehensive documentation in order to assess adherence and further organizational, exercise, and nutritional parameters. Results: Participants reached an adherence rate (performed home visits/number of planned visits) of 84.0/80.5% from week 1–12/13–24. Out of those, 59% carried out ≥75% of the offered visits. Older age was associated with a higher adherence rate. A mean of 1.5 (0.6) visits/week (2 were planned) were realized lasting for a mean of 1.5 (0.9) hours (154% of the planned duration). Per visit, 1.2 (0.6) circuits of strength training were performed (60.5% of the planned value) and 0.5 (0.3) nutritional interventions (47%). After twelve months, 4.2% still carried out the home visits regularly and 25.0% occasionally. Conclusion: Adherence is much more than “being there”. Adherence rate and category are limited parameters to describe the implementation of a complex lifestyle intervention, therefore a comprehensive documentation is needed.

Background In elderly persons frailty and malnutrition are very common and can lead to serious health hazards such as increased mortality, morbidity, dependency, institutionalization and a reduced quality of life. In Austria, the prevalence of frailty and malnutrition are increasing steadily and are becoming a challenge for our social system. Physical training and adequate nutrition may improve this situation. Methods/design In this randomized controlled trial, 80 malnourished frail community-dwelling patients (≥ 65 years) hospitalized at wards for internal medicine are recruited. Additionally, 80 lay volunteers (≥ 50 years), named buddies are recruited and subsequently trained regarding health enhancing physical activity and nutrition in four standardized training sessions. These buddies visit the malnourished frail persons at home twice a week for about one hour during an initial period of 10–12 weeks. While participants allocated to the intervention group (n = 40) receive intervention to improve their fluid intake, protein and energy intake, perform strength training and try to increase their baseline activities, the control group (n = 40) only gets home visits without any intervention. After 10–12 weeks, both, the intervention and the control group, receive the nutritional intervention and the physical training. Health, nutritional and frailty status, physical fitness, body composition and chronic inflammation of buddies and frail persons are recorded before the intervention, after 10–12 weeks, 6 and 12 months. Discussion To your knowledge this trial is the first of its kind to provide nutritional and physical activity interventions to malnourished frail community-dwelling persons by trained lay buddies, in which an improvement of the frail persons´ and the buddies’ health status is measured. This study assesses the efficacy of such an intervention and may offer new perspectives for the management of frailty and malnutrition. Trail registration ClinicalTrials.gov, NCT01991639