https://hap.nums.ac.ir/ Healthy Aging Perspectives en daily 1 Mon, 01 Jun 2026 00:00:00 +0330 Mon, 01 Jun 2026 00:00:00 +0330 https://hap.nums.ac.ir/article_10431.html https://hap.nums.ac.ir/article_10432.html ABSTRACT Background: Due to their multidimensional care needs, older adults are highly vulnerable to disasters. However, the continuity of care for this population during crises has received relatively little attention. This review aimed to map and synthesis the existing evidence on continuity of care for older adults in disasters. Methods: This was a scoping review conducted following the PRISMA-ScR guidelines and the JBI methodological framework (2020). A systematic search of PubMed, Scopus, WHO, and SID databases was performed using keywords related to aging, disasters, and continuity of care. Web of Science was not included due to institutional access limitations. Regardless their design, studies were considered eligible if published between 2015 to 2025 in Persian and English, and examined continuity of care for older adults (aged 60 years and above) in disaster settings. Data were synthesized using thematic analysis. Results: The initial search yielded 1,365 records. After removing duplicates (n=39), 1,326 records were screened by title and abstract, of which 1,285 were excluded as irrelevant. The remaining 41 full text articles were assessed for eligibility, of which 32 were excluded with reasons (no relevance to continuity of care: 18 full text not available, 6 unclear population or 8 no age disaggregation). Finally, nine studies met the inclusion criteria. Four main themes emerged from thematic analysis: (1) barriers to accessing medications and chronic care; (2) challenges in emergency evacuation and transportation; (3) mental health needs and resilience; and (4) policy and health system gaps. Most of the included studies were descriptive, with few offering practical interventions. Conclusion: The existing literature on continuity of care for older adults in disasters remains limited and fragmented. Major gaps include a lack of context-specific and practical interventions, insufficient age-disaggregated data, inadequate training for both personnel and older adults, and failure to integrate of age-sensitive approaches into disaster management. To address future research, a conceptual model of "care resilience for older adults in disasters" is proposed. https://hap.nums.ac.ir/article_10433.html ABSTRACTBackground: Digital health and tele-nursing interventions have emerged as promising strategies to support healthy aging; however, their overall effectiveness on key geriatric outcomes remains inconclusive. The present study aimed to systematically evaluate the effects of these interventions on frailty, cognitive function, and quality of life among older adults.Method: A systematic review and meta-analysis were conducted in accordance with established methodological guidelines. Randomized controlled trials examining digital health or tele-nursing interventions in older adults were included. Three primary outcomes were analyzed: frailty, cognitive function, and quality of life. Pooled effect sizes were calculated using random-effects models, and heterogeneity was assessed using the I² statistic. Results: Twelve studies were included with a total of 2,679 participants (1,308 in intervention groups and 1,371 in control groups). Meta-analysis demonstrated that digital health interventions significantly reduced frailty (SMD = −0.355, p < 0.001) and improved quality of life (SMD = 1.046, p = 0.018). However, no statistically significant effect was observed for cognitive function (SMD = 0.126, p = 0.366). Conclusion: Digital health and tele-nursing interventions appear to be effective in reducing frailty and improving quality of life among older adults, while their impact on cognitive function remains uncertain. Future research should focus on standardized, multidomain intervention designs incorporating targeted cognitive training to enhance effectiveness across all geriatric outcomes. https://hap.nums.ac.ir/article_10434.html ABSTRACT Background: Salt-sensitive hypertension (SSHTN) is a multifactorial cardiovascular–renal disorder whose prevalence increases with aging. It contributes to cardiovascular disease, chronic kidney disease, frailty, and progressive target-organ injury. Beyond excessive sodium intake, SSHTN reflects systemic impairment of sodium homeostasis involving nephron loss, impaired pressure–natriuresis, endothelial dysfunction, arterial stiffening, immune dysregulation, mitochondrial impairment, and epigenetic remodeling. Methods: This review summarizes and integrates current evidence on aging-associated SSHTN, focusing on epidemiology, biological mechanisms, multiorgan consequences, and emerging therapeutic strategies. Results: Evidence indicates that aging links sodium excess to vascular and renal injury through several interconnected pathways, including non-osmotic tissue sodium accumulation, endothelial glycocalyx disruption, inflammaging, immunosenescence, cellular senescence, clonal hematopoiesis, gut microbiome remodeling, and mitochondrial dysfunction. Genetic and epigenetic alterations further contribute to impaired sodium handling, vascular dysfunction, and renal injury. These findings support the concept that SSHTN is a systems-level manifestation of biological aging rather than a purely renal disorder. Emerging therapeutic strategies include RNA therapeutics, senotherapeutic approaches, microbiome- and mitochondria-targeted interventions, regenerative cell-based therapies, and precision medicine frameworks. Conclusion: Aging-associated SSHTN represents a multisystem disorder driven by impaired sodium handling and age-related biological changes across the kidney, vasculature, immune system, and metabolic networks. Available evidence underscores the need for mechanism-driven, biologically informed, and precision-guided strategies to improve prevention and treatment in older adults. https://hap.nums.ac.ir/article_10435.html ABSTRACT Background: Despite controlling for other risk factors of coronary artery disease (CAD), the risk of myocardial infarction (MI) due to vitamin D deficiency is increased. In addition to lipid-lowering effects of statins in CAD prevention and heart failure, these drugs exhibit many pleotropic effects. Part of these beneficial results may be due to the effect of statins on vitamin D levels. The current clinical trial aimed to explore the possible effects of high-intensity statin therapy on the levels of vitamin D metabolites in patients with acute myocardial infarction. Methods: Patients in the Coronary Care Unit (CCU) with a cardiologist's diagnosis of myocardial infarction for the first time (i.e., typical chest pain greater than 20 min and ST-segment elevation greater than 1 mm in two adjacent leads on ECG) were included in the study. Then patients were divided into two equal groups using a block randomization method, who received atorvastatin 80 mg or rosuvastatin 40 mg as a secondary prevention once daily, plus a routine treatment regimen for 8 weeks. Following an overnight fast of 12 h, a venous blood sample (10 ml) was collected from study subjects within the first 24 h and 8 weeks after the patients were admitted to the hospital. The primary endpoint was the between-group difference in the change of serum vitamin D. Results: In terms of baseline lipid levels, there was no significant difference between the two groups. In both groups, TC, TG, and LDL-C were decreased and HDL-C levels were increased after 8 weeks of treatment, but no significant difference between two groups was detected (p=0.792, p=0.418, p=0.514, p=0.456 respectively). In the rosuvastatin group, the mean values of hemoglobin A1C (HbA1C) and AST were increased significantly (P<0.05). In both groups, initial vitamin D levels were lower than normal and increased after statin consumption, but it was not statistically significant. The variation of ejection fraction after intervention was more increased after rosuvastatin than atorvastatin treatment (P=0.05). Conclusion: Atorvastatin and rosuvastatin had no significant effects on 25-hydroxyvitamin D levels. Ejection fraction increased in the rosuvastatin group, but it was not statistically significant (p-value of exactly equal to 0.05). This increase could be due to various factors such as medication use and lifestyle changes. https://hap.nums.ac.ir/article_10436.html ABSTRACT Background: Plum peel, the major by-product of plum processing, is a valuable source of vitamins, minerals and antioxidant activity. Using this material, a nutrient-rich syrup as a potential healthy food for older adults can be produced. This study aimed to optimize the formulation of black plum peel syrup with black plum peel puree (40–60%) and pectin (0–0.5%) using response surface methodology (RSM). Methods: Mixture of black plum peel was prepared from plum processing factories and different formulations of black plum peel syrup were produced. Optimization of the formulation was done using RSM based on chemical composition, antioxidant activity, phenolic compounds and rheological behavior of the products. Results: Increasing the proportion of black plum peel puree increased antioxidant activity and total phenolic compounds. Higher pectin concentration was associated with reduced acidity and increased total phenolic compounds. Increasing black plum peel puree up to 50% decreased acidity, flow behavior index, and apparent viscosity, whereas further increases (50-60%) cause increasing values of these parameters. When the pectin increased up to 0.3%, antioxidant activity and viscosity increased and reduced when pectin was increased from 0.3% to 0.4%. Overall, black plum puree had the strongest effect on physicochemical properties of syrup. The optimal formulation consisted of 40.62% black plum peel puree and 0.2% pectin. Conclusions: Using black plum peel to produce syrup as a food with high nutritional value can be a good way to reduce environmental pollution. This product can be suitable for the older adults due to its nutritional, antioxidant activity, and useful texture and flavor. https://hap.nums.ac.ir/article_10437.html ABSTRACT Background: Background: Diabetes is a major risk factor for cardiovascular disease and is associated with increased morbidity and mortality. Controlling for confounding factors is essential when estimating its relationship with coronary artery disease. This study aimed to estimate the magnitude of the association between diabetes and coronary artery obstruction using propensity score–matched controls in a case-control study. Methods: This case-control study was conducted on 903 patients admitted to Imam Reza Hospital in 2015, including 288 cases who underwent CABG due to coronary artery obstruction and 615 controls from non-cardiac departments. Propensity score matching was used to control for confounding variables such as age, sex, triglycerides, and blood pressure. After matching, 270 cases were matched with 270 controls. Univariate and multivariable conditional logistic regression analyses were performed on the matched data, and standard logistic regression was applied to the unmatched data. Statistical analysis was carried out using R software, version 4.0.1. Results: Before matching, significant differences were observed between cases and controls in diabetes status, sex, age, triglycerides, and blood pressure. In the unmatched data, diabetes was strongly associated with coronary artery obstruction (OR = 4.962, 95% CI: 3.550–6.936, P < 0.0001). After propensity score matching, the odds ratio for diabetes remained significant but decreased in magnitude in the conditional logistic regression model (OR = 2.74, 95% CI: 1.888–3.9849). The marginal logistic regression model on the matched data also showed a significant association (OR = 2.51, 95% CI: 1.502–3.804). Conclusion: Propensity score matching improved comparability between the case and control groups and provided a more accurate estimate of the association between diabetes and coronary artery obstruction. The findings indicate that diabetes remains an important risk factor for coronary artery disease, though effect estimates are smaller after adjustment for confounding. https://hap.nums.ac.ir/article_10438.html ABSTRACTBackground: Falls are a major cause of disability, loss of independence, hospitalization, and mortality among older adults. Despite the growing burden of falls in Iran, population-based evidence on their prevalence and associated factors remains limited. To determine the prevalence of falls and identify factors associated with fall occurrence in the Neyshabur Longitudinal Study on Ageing (NeLSA).Methods: This cross-sectional study used baseline data from the NeLSA cohort. A total of 3,452 adults aged ≥60 years were included, of whom 3,319 had available information on falls during the previous 12 months. Standardized questionnaires and clinical assessments were used to assess demographic, socioeconomic, clinical, and psychological measures. Multivariable logistic regression analyses were performed to identify factors independently associated with falls.Results: Among 3,319 participants, 744 reported at least one fall during the previous 12 months, corresponding to a prevalence of 22.4%. In the model excluding fear of falling, older age (AOR=1.022, 95% CI: 1.008–1.037), urinary incontinence (AOR=1.589, 95% CI: 1.086–2.326), poorer sleep quality (AOR=1.047, 95% CI: 1.023–1.072), depressive symptoms (AOR=1.081, 95% CI: 1.039–1.125), and lower income status were independently associated with falls. After adjustment for fear of falling, model fit improved, and fear of falling showed the strongest independent association with fall occurrence. Participants with some fear (AOR=1.646, 95% CI: 1.338–2.025) and high fear (AOR=2.414, 95% CI: 1.847–3.155) were significantly more likely to fall. Older age, urinary incontinence, poor sleep quality, depressive symptoms, and lower income status remained significant factors in the fully adjusted model.Conclusions: Falls affected more than one-fifth of participants in the NeLSA and were associated with a combination of clinical, psychological, and socioeconomic factors. Fear of falling showed the strongest independent association with fall occurrence, supporting the integration of psychological assessment into routine fall-risk screening and prevention programs.