The growing number of individuals aged 95 years and older poses new clinical and social challenges in primary care. Despite its relevance, data on their characteristics in community settings remain scarce.The primary objective was to describe clinical, functional, and social features of individuals aged ≥95 in 2022, with a secondary aim to explore comorbidity, polypharmacy, and family support patterns.We conducted an observational, cross-sectional, descriptive study based on clinical records from CAP Casanova, an urban primary care center in Barcelona. Participants aged ≥95 years during 2022 were included, and those with unavailable data were excluded. No sample size calculation was required, as this was a population-based study. Variables included demographics, family history, lifestyle, comorbidity, medications, health status, home care, hospitalizations, and function. Data were anonymized, and ethics approval was obtained from the Ethics Committee of Hospital Clínic de Barcelona (HCB.2022.0366_).Of 32,154 registered patients, 204 met inclusion criteria, and 182 were analyzed. The sample included 46 men (25.3%) and 136 women (74.7%), with a mean age of 97 years and mean Charlson index of 1.67. Regarding comorbidities, 73.6% had hypertension, 83.5% dyslipidemia, 85.1% were non-diabetic, 71.4% had no chronic kidney disease, 93.37% had no ischemic heart disease, 99.4% had never had a stroke, and 81.87% did not have dementia. Smoking prevalence was 10.8%, with 9.6% former smokers; 69.89% abstained from alcohol. Polypharmacy affected 25.82%, 39.01% used psychotropic drugs, and 64.3% had relatives aged ≥90. Overall, the cohort showed moderate comorbidity, low medication burden, preserved function, and strong family support.The predominance of women and low smoking rates align with known longevity patterns. Moderate comorbidity, limited polypharmacy, and moderate psychotropic use suggest a relatively healthy, community-dwelling oldest-old population with preserved functional independence. High familial longevity highlights genetic and shared environmental influences. Excluding participants with missing data was a limitation. Overall, the profile reflects typical healthy aging in this age group.Adults aged ≥95 years in our population maintain functional independence and a low prevalence of modifiable risk factors. Recognizing these profiles may guide care strategies tailored to the needs of extreme aging.

Older adults living in Nursing Homes (NHs) have complex healthcare needs that require close coordination with primary care teams (PCTs). In Catalonia, recent policies have promoted closer collaboration between  primary care teams (PCTs) and NHs, although integration levels remain heterogeneous. Understanding whether higher integration translates into better resident outcomes is essential for guiding service planning and resource allocation.To evaluate whether greater primary care integration with nursing homes is associated with improved resident health outcomes and reduced healthcare utilization.This cross-sectional study analyzed 612 nursing homes for older adults in Catalonia. Primary care integration was measured using a composite integration maturity score derived from paired surveys completed by each NH and its corresponding PCT. Homes were categorized into quintiles (Q1–Q5), with Q5 representing the highest integration. Outcomes included hospital admissions, polypharmacy (≥10 medications), emergency hospital visits, primary care emergency consultations, mortality, days at home, and continuity of care. Multivariable mixed-effects models accounted for clustering at the PCT level and were adjusted for residents’ age, sex distribution, socioeconomic status, clinical complexity (GMA), and the number of residents per NH and per PCT.Integration levels varied widely across nursing homes. Compared with Q1, the highest integration group (Q5) demonstrated significantly fewer hospital admissions (−14.4%, p=0.019), lower rates of polypharmacy (−17%, p=0.047), and fewer emergency hospital visits (−6.8%, p=0.020). Improvements were already detectable at intermediate integration levels, particularly from Q3 onward. No significant associations were observed for mortality, days at home, primary care emergency visits, or continuity of care.While causality cannot be determined from this cross-sectional study, the consistency of effects across outcomes  suggest that higher integration contributes to more proactive and coordinated care, reducing avoidable healthcare use. Further longitudinal research is needed to determine whether integration leads to long-term reductions in healthcare use.Higher levels of integration between primary care teams and nursing homes are associated with reductions in healthcare utilization and polypharmacy, suggesting that more coordinated care models may enhance proactive management and improve resident outcomes. Strengthening integrated care strategies could support more efficient, resident-centered care for institutionalized older adults in Catalonia.

Rural areas of Crete are experiencing population ageing, social disadvantage, and growing isolation among older adults. Access to health and social care services is limited, and primary care often operates with few staff and resources. As a result, general practitioners are frequently required to manage depression, and early-stage dementia under challenging conditions and with little external support. In this setting, our community primary care practice aimed to involve the local social and cultural environment in addressing mental health and cognitive problems among older adults.Recognizing the presence of cultural associations and informal community networks, the primary care team collaborated with local groups, volunteers, and residents to mobilize the community and create inclusive spaces for older adults.The intervention included memory walks, creative workshops (ceramics, loom weaving, knitting), choir singing, traditional dance, music lessons, and a weekly “memory café” with cognitive exercises, games, and social interaction. All activities were culturally familiar, locally organized, and low-cost.Participants were assessed at baseline and after six months using validated tools: the Geriatric Depression Scale (GDS-13), the Greek version of the Instrumental Activities of Daily Living (IADL) scale, and the Mini-Mental State Examination (MMSE).The experience showed that rural communities have the ability to support healthy ageing when properly engaged. Future steps may include longer follow-up and closer integration with routine primary care services.Participants who consistently engaged in the activities demonstrated improvements in mood, cognitive performance, and functional independence. Social connection and meaningful engagement appeared to mitigate loneliness and depressive symptoms, supporting non-pharmacological approaches in early cognitive decline.Community solidarity and mobilization can represent powerful tools in addressing depression and early-stage dementia in limited resources rural settings. This case demonstrates the potential for community driven interventions to complement clinical care and expand the therapeutic role of primary care practice.

The significance of frailty in the field of respiratory diseases has been recognized recently. Patients with chronic lung disease (CLDs) demonstrate elevated frailty prevalence and this condition strongly predicts adverse outcomes. However, evidence regarding the association between long-term frailty trajectories and mortality in this population remains limited.To examine the association between dynamic frailty trajectories and all-cause mortality in community-dwelling adults with CLDs.This cohort study analyzed data from the China Health and Retirement Longitudinal Study (CHARLS) and Health and Retirement Study (HRS) in the US. The group-based trajectory model (GBTM) was used to identify potential frailty trajectories. To analyze the association between frailty trajectories and mortality,  Cox proportional hazards regression models was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). The subgroup analyses and several sensitivity analyses were used to confirm the main result.The study included 1716 CHARLS participants  and 1668 HRS participants. Three frailty trajectories were identified: low level group, moderate level group, and high level group. During follow-up, there were 255 deaths in the CHARLS and 633 deaths in the HRS. Compared with low level group, high level group showed the highest mortality risk (HR, 2.51; 95% CI, 1.77-3.56), followed by moderate level group (HR, 1.54; 95% CI, 1.09-2.18). In the HRS, similar results were observed. Participants in moderate and high level groups had 54% (HR=1.54; 95% CI=1.22-1.95) and 143% (HR=2.43; 95% CI=1.92-3.07) higher mortality risk, respectively.In this analysis of two prospective cohorts, we observed a strong association between frailty trajectories and mortality risk among individuals with CLDs. Those with a trajectory characterized by high baseline frailty and rapid progression faced a significantly higher risk of mortality compared to individuals with low and stable frailty. These findings underscore that the dynamic change in frailty is a powerful indicator of mortality risk. Early screening and proactive management of frailty are crucial in this vulnerable population.Frailty trajectories demonstrated significant associations with mortality risk among adults with CLDs. Implementing frailty screening in CLDs management may help identify high-risk patients for targeted interventions.

The WHO’s Integrated Care for Older People (ICOPE) program is being implemented worldwide to promote healthy ageing. It aims to preserve intrinsic capacities (mobility, cognition, nutrition, mood, vision, and hearing) in adults aged 60 and over. Structured into five steps (screening, comprehensive assessment, personalized care plans, follow-up and community engagement) ICOPE places multidisciplinary primary care practices (MPCPs) at the forefront in France. Organizational and interprofessional collaboration challenges remain barriers to effective implementation. The ongoing INEPPS study uses a mixed-methods design to assess completed Personalized Care Plans (PCPs) and evaluate models of interprofessional cooperation and PCP negotiation. This work presents initial INEPPS results and focuses on interprofessional dynamics, hypothesizing their impact on ICOPE rollout and outcomes in primary care.The study objective was to analyze the characteristics, organizational structure, and modes of communication of MPCP teams involved in the ICOPE program.A cross-sectional study examined multidisciplinary organization and communication within the ICOPE program. MPCPs implementing ICOPE in Occitanie and included in the INEPPS study were surveyed with a standardized 32-item electronic questionnaire, assessing team characteristics, organizational structure, and communication methods. Descriptive analysis, mapping, and profiling of teams were performed.Fourteen multidisciplinary practices were surveyed (mean staff: 25; mean patients: 6,529).  General practitioners (GPs) were most frequently cited as the driving force behind program adoption. All practices used shared health IT systems, with most interprofessional communication occurring via this system. For Step 1, 57% of practices involved a nurse and 57% a physical therapist; for Step 2, nurses led in 64% of practices versus 14% for physical therapists. GPs were the main contributors to PCPs (57%), though active negotiation with the GPs occurred in only 35% of practices. Systematic follow-up was organized by half of practices.This study offers new insights into multidisciplinary team organization and real-world ICOPE implementation, however, its cross-sectional design and limited sample size remain important limitations. Further research is needed to link organization and communication to patient outcomes.This study found variability in ICOPE implementation, particularly in team structures and professional roles. Systematic follow-up was inconsistently organized across practices. Understanding different multidisciplinary approaches could help enhance the program.