Geriatrics

Patient/public involvement reported in ~46% of pragmatic trials with older adults; perceived benefits and practical challenges

In pragmatic trials involving participants aged ≥65, authors reported PPI in 46% of studies, mainly via in-person discussions. Most respondents (90.7%) perceived PPI as improving intervention applicability, research quality, and recruitment/retention. Common barriers included communicating trial methods (62.5%), finding partners (50%), scheduling (45.8%), and sustaining involvement (45.8%). Interviews highlighted five themes: recruiting PPI partners, strong PPI leadership, partner training, researcher workload, and procedural barriers. 1

Digital health interventions yield modest improvements in gait, TUG, muscle mass, balance, and quality of life in frailty/sarcopenia

Meta-analysis of 16 randomized trials found DHIs improved gait speed (WMD 0.09 m/s) and TUG (WMD -0.52 s) with wide prediction intervals. DHIs also improved total skeletal muscle mass (WMD 1.01), 30CST (WMD 2.19), balance (SMD 0.61), and quality of life (SMD 0.16). No significant effects were seen for ASMI, grip strength, 6MWT, 2MWT, SPPB, or BMI, and heterogeneity was substantial. Longer interventions (≥12 weeks) showed greater ASMI gains; overall evidence certainty was limited by between-study variability. 2

PROMs in older adults with non-specific low back pain concentrate on pain and physical function

Across 57 trials, reviewers identified 74 PROMs mapped to nine domains, with physical functioning (n=80, 36%) and pain (n=57, 26%) most common. Only 23% of trials measured health-related quality of life and just 14% covered the three core domains (physical function, pain, HRQoL). No trial fully adhered to the core outcome measurement set for non-specific low back pain. Authors recommend standardising outcome measurement and validating multi-domain instruments for older adults. 3