Geriatrics

Mobility Plan implementation feasible but engagement variable; step counts rose modestly

In a Swiss geriatric clinic QI project, therapists reported acceptable-to-high acceptability, appropriateness, and feasibility for a Mobility Plan, while nurses showed low acceptability and feasibility. Fidelity (median 75% days with documented mobility objective) and adoption (88% days with ≥1 recorded activity) were relatively high across 69 plans. Median daily step counts were descriptively higher during implementation, but the within-site QI design prevents causal attribution. Recommendation: strengthen interdisciplinary uptake and use controlled designs before expecting patient-level benefit. 1

AI/ML RCTs in older adults show clinical benefits but require equity safeguards

A review of RCTs of AI/ML interventions in adults ≥65 found four eligible trials showing improved postoperative rehabilitation outcomes and preventive care uptake. Interventions included algorithm-guided rehabilitation, smartphone-personalized exercise programs, and chatbot vaccine counseling with measurable clinical benefit. Caveats: older adults are underrepresented in model development and trials may select healthier, more digitally literate participants. Before clinical adoption, address digital literacy, bias, long-term outcomes, and equitable access. 2

Pragmatic prescribing for moderate–severe frailty prioritises harm reduction

People with moderate to severe frailty are underrepresented in trials, limiting expected prognostic medication benefits. The authors recommend individualized prescribing that balances likely benefit against increased medication-related harm in frailty. Use guideline-informed deprescribing and align medications with life expectancy and patient goals to reduce therapeutic burden. 3