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1.
Preserved mitochondrial respiration in presence of oxidative stress and reduced mitochondrial mass after 10-day bed rest in older adults
Evgeniia Motanova, Lucrezia Zuccarelli, Evgenii Lysenko, Stefano Amoretti, Marco Pirazzini, Ornella Rossetto, Lorenza Brocca, Roberto Bottinelli, Maria Antonietta Pellegrino, Giovanni Baldassarre, Clarissa Gissi, Giovanna Lippe, Mladen Gasparini, Boštjan Šimunič, Rado Pišot, Bruno Grassi, Marco Vincenzo Narici, 2026, original scientific article

Abstract: Ageing affects mitochondrial integrity in skeletal muscle, and physical inactivity may further exacerbate these changes. Although mitochondrial alterations are documented in ageing and disuse independently, how disuse impacts the mitochondrial phenotype in older populations remains unclear. This work aimed to characterise how physical inactivity impacts mitochondrial function, morphology and gene expression in the skeletal muscle of older adults. Ten healthy older men (65+ years) underwent 10 days of bed rest. Skeletal muscle biopsies were collected before and after bed rest to assess mitochondrial respiration (high-resolution respirometry), H2O2 emission, mitochondrial protein expression, morphology and volume density (electron microscopy) and transcriptomic profile. Ten days of inactivity increased mitochondrial reactive oxygen species (ROS) emission under non-phosphorylating conditions but did not impair oxidative phosphorylation (OXPHOS) capacity, indicating preserved respiratory efficiency. Consistently, mitochondrial respiratory complex and supercomplex protein abundance were unchanged. Mitochondrial mass decreased, as shown by reduced mitochondrial volume density. Reduced dynamin-like protein 1 (DRP1) phosphorylation at serine 637 was observed, whereas other mitochondrial fission and fusion protein levels remained unchanged. Mitochondrial morphology remained unaltered. Transcriptomic analysis revealed >3000 differentially expressed genes, characterised by downregulation of oxidative phosphorylation genes alongside altered mitophagy, antioxidant and oxidoreductase pathways. In summary, 10-day bed rest increased mitochondrial ROS emission and reduced mitochondrial mass in older skeletal muscle despite preserved respiratory function, indicating that elevated ROS production occurs upstream of respiratory dysfunction and is potentially linked to impaired antioxidant defence and ROS clearance. These findings suggest that preserving redox balance during inactivity may be a key strategy to maintain muscle health and functional independence in ageing populations.
Keywords: skeletal muscle, mitochondria, older adults, physical inactivity, mitochondrial respiration
Published in DiRROS: 11.09.2026; Views: 56; Downloads: 40
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2.
From learning to enjoyment : virtual reality walking experiences for older adults in long-term care
Ana Hafner, Krištof Debeljak, Nika Brili, 2026, original scientific article

Abstract: Background and objectives Virtual reality (VR) technologies are increasingly being explored in long-term care (LTC) settings as tools to promote engagement and well-being among older adults, including those with cognitive impairments. However, the usability and accessibility of such technologies remain some critical concerns. This study aimed to examine how older adults in Slovenia adapted to using VR equipment for virtual walking experiences, focusing on their ability to operate the technology and their subjective evaluation of the experience. Method The study involved 31 older adults from two LTC homes in Slovenia who participated in virtual walking sessions using Google Street View, accessed through VR glasses and controlled via a joystick. Researchers observed participants' ability to use the equipment, assessed their cognitive and general health, and collected feedback on their experience via a structured questionnaire. Results Unlike prior studies that focus on VR exposure, our study quantifies learning time and links it to cognitive profiles, proposing a framework for adaptive VR interventions. The results showed that cognitive abilities significantly influenced how quickly participants could navigate the virtual environment, with those possessing higher cognitive abilities adapting more quickly. Although some participants found the navigation challenging, particularly those with dementia, this did not affect their overall enjoyment. Nearly all participants (97%) rated the experience as pleasant, and 74% expressed a desire to repeat it. Discussion and implications The study highlights the strong potential of VR to enhance residents' well-being in LTC homes. However, to ensure accessibility and maximise benefits, varying levels of support and customised technological solutions should be provided based on each resident's health status and cognitive abilities.
Keywords: older adults, virtual reality, VR glasses, Google Maps, cognitive abilities, virtual walk, dementia
Published in DiRROS: 17.08.2026; Views: 205; Downloads: 271
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3.
Study protocol : longitudinal observational study on frailty and mental health
Petra Mikolič, Branko Bregar, Katarina Vatovec, Tjaša Bertole, Suzana Oreški, Marjeta Ferlan Istinič, Lina Berlot, Matej Vinko, 2026, original scientific article

Abstract: Introduction: Frailty is a dynamic condition associated with increased vulnerability to adverse health outcomes in older adults. While previous research has primarily focused on deficit-based mental health factors, such as depression and loneliness, less is known about the role of positive mental health determinants, including wellbeing, resilience and social connectedness, in the development and progression of frailty. Understanding both risk and protective factors is essential for informing public health strategies aimed at promoting healthy aging. This study aims to examine the longitudinal relationship between mental health and frailty in a nationally sampled population of adults aged 50 years and older in Slovenia.Methods and analysis: This longitudinal observational cohort study will collect data at four time points over a 2-year period (January 2026-March 2028). A stratified random sample of community-dwelling adults aged 50–84 years will be drawn from the national population registry, with 5,000 individuals invited to participate in the first wave. Frailty, mental health and a set of social, psychological, and health-related factors will be assessed. Data will be analyzed using a combination of descriptive, inferential and longitudinal statistical methods to examine associations between frailty and mental health over time. Potential explanatory factors will also be explored within the longitudinal framework, and additional analyses will assess the impact of attrition. 1 Introduction
Keywords: frailty, adverse health outcomes, older adults, healthy aging
Published in DiRROS: 14.07.2026; Views: 273; Downloads: 119
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4.
Stereophotometric facial changes in edentulous older adults after rehabilitation with complete dentures
Zala Skomina, Milan Kuhar, Miha Verdenik, Nataša Ihan Hren, 2025, original scientific article

Abstract: Objectives: To evaluate the facial characteristics of edentulous older adults who underwent rehabilitation using complete dentures, and to compare them with dentate individuals. Background: Edentulism rehabilitation with complete dentures aims to restore occlusion and facial aesthetics. Materials and methods: The study included 102 edentulous participants needing prosthodontic rehabilitation with complete dentures and 30 with a natural dentition (aged >65). The 3D facial scans were performed using an Artec optical scanner. Superficial facial landmarks were identified, and 16 parameters were calculated. Regional analysis with the superimposition of two scans was used to calculate the average distances and percentage of non-matching surfaces in the 11 regions. Paired and independent t-tests (α = .05) were used to test for group differences, as appropriate. Results: After rehabilitation with complete dentures, facial changes were most noticeable in the perioral region: wider rima oris, longer upper lip, wider upper vermilion, and more protruded profile. The comparison of facial regions without and with dentures showed fuller and curvier cheeks, with no direct influence of dentures. The edentulous faces with dentures appeared shorter and more retruded than those of dentate individuals. A narrower lower vermilion, retruded upper lip, and more flattened facial profile were observed in females with dentures than in their dentate peers. Conclusion: Besides the expected positive influence of rehabilitation with complete dentures on facial appearance in the perioral region, there are some unexpected changes, such as fuller cheeks, but there is still deficiency in vertical facial dimensions and a more flattened facial profile.
Keywords: complete dentures, edentulism, facial characteristics, gerondontology, older adults, prosthodontics rehabilitation
Published in DiRROS: 14.04.2026; Views: 320; Downloads: 329
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5.
Association between TMG-derived contractile muscle parameters and MRI-based muscle structure in sarcopenia
Katarina Puš, D. A. Madrid Fuentes, Ashley Weaver, Miloš Kalc, Jeannette R. Mahoney, Boštjan Šimunič, 2026, original scientific article

Abstract: Background: Muscle fat fraction (MFF) obtained through magnetic resonance imaging (MRI) is the gold standard for assessing muscle quality, but it is expensive and time consuming. Portable methods to examine muscles such as tensiomyography (TMG) are emerging and could enable broader screening. This study aims to examine associations between TMG-derived muscle contractile parameters and MFF in older adults with and without sarcopenia. Methods: A sample of 51 Slovenian older adults (53% females) were scanned with Dixon MRIs to evaluate muscle MFF and contractile parameters were assessed with TMG estimating delay time (Td), maximal displacement (Dm) and radial contraction velocity (Vc). Right leg vastus lateralis (VL) and biceps femoris (BF) were analyzed. Sarcopenia was defined using both European Working Group on Sarcopenia in Older People (EWGSOP2) and Sarcopenia Definition and Outcomes Consortium (SDOC) criteria. Regression models adjusted for age and sex were used to assess associations between TMG-derived contractile parameters and MFF. Results: Age- and sex-adjusted models revealed associations between increased MFF and reduced Dm (R2 = .29, p = .003) and Vc (R2 = .32, p = .002) for the VL. SDOC-classified sarcopenic individuals showed increased VL MFF (27.2% vs 22.5%, p = .019),while EWGSOP2 classified sarcopenia displayed no differences. Discussion: The study reveals that increased MFF is associated with reduced muscle contractility in VL. MFF differs between sarcopenic and non-sarcopenic groups using only SDOC criteria. Since the TMG Dm increase is regularly found in atrophic muscles after bed rest, in sarcopenic muscle MFF explains lowering of the Dm, highlighting the TMG potential for early detection of changes in aging muscle.
Keywords: sarcopenia, contractile parameters, tensiomyography, muscle fat fraction, muscle function, older adults
Published in DiRROS: 23.03.2026; Views: 417; Downloads: 337
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Tensiomyography-derived contractile parameters in sarcopenic and non-sarcopenic older adults
Katarina Puš, Miloš Kalc, Boštjan Šimunič, 2026, original scientific article

Abstract: Background: Sarcopenia, the progressive decline in skeletal muscle mass and function, is a major public health concern linked to falls, hospitalization and loss of independence among older adults. Initially defined by reduced muscle mass, later also by reduced muscle strength and function, it is now recognized that standard diagnostic tools do not fully capture complexity of sarcopenia. Tensiomyography (TMG) is a non-invasive method that assesses skeletal muscle contractile parameters, which undergo change with aging and sarcopenia. The aims of this exploratory study are to determine whether TMG could be a method for contractile parameters assessment in sarcopenia classification and to evaluate the relationship between TMG-derived parameters and sarcopenia classification tests. Methods: We included 654 older adults (70.6% women) and included demographics, sarcopenia classification (EWGSOP2, SDOC), muscle strength (handgrip strength, five sit-to-stand), TMG of three leg muscles, muscle mass (bioimpedance), and physical performance (gait speed, timed up-and-go). MANOVA was used to analyze contractile properties and due to low agreement between classifications, we used both classifications. A partial correlation for each sex was conducted to determine the associations between sarcopenia classification tests and TMG-derived parameters of delay time (Td), contraction time (Tc), radial displacement (Dm) and contraction velocity (Vc), controlling for age. Results: One-way MANOVA confirmed difference between sarcopenic and nonsarcopenic participants according to EWGSOP2 and SDOC classifications in TMG-derived contractile parameters in all three muscles, Td was consistently longer and Dm consistently lower in sarcopenic individuals. Post-hoc univariate tests further demonstrated specific differences due to sarcopenia presence. Ageadjusted partial correlations were weak to moderate, ranging between −0.430 and 0.369. Conclusion: Sarcopenic individuals exhibited longer Td and Tc, and smaller Dm, though not consistently across all muscles. Td was longer in all three muscles, reflecting electromechnical delays linked to aging. Dm was consistently lower, suggesting increased muscle stiffness. Correlations between TMG parameters and sarcopenia classification tests indicated that shorter Td and Tc, higher Dm, and greater Vc were associated with higher muscle volume, muscle strength and performance. The findings indicate that TMG parameters may be associated with neuromuscular degeneration and sarcopenia, supporting further exploration of muscle- and sex-specific differences.
Keywords: tensiomyography, muscle function, older adults, sarcopenia, seniors
Published in DiRROS: 04.02.2026; Views: 797; Downloads: 378
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8.
9.
Evidence-based exercise recommendations to improve functional mobility in older adults - A study protocol for living systematic review and meta-analysis
Bettina Wollesen, Tamar Yellon, Antoine Langeard, Vera Belkin, Anna Wunderlich, Eleftheria Giannouli, Guoping Qian, Rafael A. Bernades, Zbigniew Ossowski, Uroš Marušič, Rajesh Sighdel, Claudia Voelcker-Rehage, 2025, original scientific article

Abstract: Background and objectives This is a protocol for a living systematic review and meta-analysis. This review will assess the effects of state-of-the-art exercise interventions designed to promote functional mobility. Therefore, after identifying all potential interventions, we will use the F.I.T.T. principles (frequency, intensity, time, type) as well as the physical and health status of the participants as moderators to analyse the mechanisms for the positive benefits of exercise interventions. The main research questions are: Which exercise types are most beneficial for improving functional mobility in various populations of older adults? Which physical exercise characteristics in terms of frequency, intensity, time and duration will achieve the greatest benefit in terms of the defined outcomes, i.e, the functional mobility of older adults? Methods The systematic literature research according to PRISMA guidelines will search databases like MEDLINE, APA Psych-Info and Web of Science. Inclusion criteria are: healthy older people ≥ 50 years, randomized-controlled trials including exercise intervention and a walking or mobility assessments (eg., TUG, SPPB) as an outcome measure. A preliminary search revealed more than 33,000 hits that will be screened by pairs of independent reviewers. The results will be summarized according to the effects regarding functional mobility and potential dose-response relations via respective meta-analysis. Conclusion The systematic review will comprise the knowledge of the existing literature with regards to the effects of the physical activity interventions compared to an active or inactive control group. We will summarize the effects with respect to the F.I.T.T.. They provide a foundation for structuring an optimal exercise training program. If possible, we will also compare interventions from the different categories (eg. cardiovascular, resistance, motor-coordinative, multicomponent or mind-body exercise) as a network analysis and report the influence of moderator variables. Based on the results evidence-based guidelines following GRADE for physical exercise interventions to improve functional mobility in older adults will be provided. Functional mobility of older adults is a crucial determinant of health and independence. Mobility can reverse or delay age-related health issues and promote independence, while immobility or limitations in mobility (such as difficulty rising from a chair, balance problems, or reduced walking capacity) can cause or increase dependency. This underscores the significance of fostering mobility among the growing population of older adults. The development of tailored exercise programs targeting the independence of older adults is one of the motivators for the improvement of crucial policy action areas described by WHO in the Equity Policy Tool, namely ʻliving conditionsʼ and ʻsocial and human capitalʼ (WHO, 2019). The key outcomes related to functional mobility in older age include gait, walking capacity, and balance. Additionally, aspects of life-space mobility, such as the overall walking distance within the environment, are significant factors that characterize mobility in older adults. Exercise can be seen as a preventive measure, so that, without adequate physical activity levels, the ageing process may be associated with premature development of disease and dysfunction. However, different training types will enhance outcomes of functional mobility via specific pathways. For example, walking capacity has an endurance and a strength component. Accordingly, aerobic training will improve walking capacity by enhancing cardio-respiratory fitness, as shown within different clinical trials with older patient cohorts. Resistance training helps to increase muscle strength in the lower limb, which increases gait stability. However, recent literature reviews showed that a combination of both interventions might be more sufficient to gain most benefits on walking capacity. This review will systematically assess the effects of state-of-the-art exercise interventions designed to promote mobility. The ultimate aim is to provide evidence-based guidelines for the optimal type and dose of exercise to preserve and enhance functional mobility in diverse populations of older adults
Keywords: functional mobility, older adults, exercise programs, systematic review
Published in DiRROS: 10.03.2025; Views: 1170; Downloads: 787
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10.
Effects of chronic physical exercise on executive functions and episodic memory in clinical and healthy older adult populations : a systematic review and meta-analysis protocol
Soledad Ballesteros, Andreea Badache, Vera Belkin, Christoforos D. Giannaki, Antonia Kaltsatou, Uroš Marušič, Mohammad Mosaferi Ziaaldini, Manca Peskar, José M. Reales, Jennifer A. Rieker, 2024, review article

Abstract: Background Executive functions (EFs) and episodic memory are fundamental components of cognition that deteriorate with age and are crucial for independent living. While numerous reviews have explored the effect of exercise on these components in old age, these reviews screened and analyzed selected older adult populations, or specific exercise modes, thus providing only limited answers to the fundamental question on the effect of exercise on cognition in old age. This article describes the protocol for a systematic review and multilevel meta-analytic study aiming at evaluating the effectiveness of different types of chronic exercise in improving and/or maintaining EFs and long-term episodic memory in older adults. Methods and analysis The study protocol was written in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Several databases will be searched. Randomized controlled trials (RCTs) conducted in older adults aged ≥ 60 years providing any kind of planned, structured, and repetitive exercise interventions, and EFs and/or episodic memory measures as outcomes, published in English in peer-reviewed journals and doctoral dissertations will be included. Two independent reviewers will screen the selected articles, while a third reviewer will resolve possible conflicts. The Cochrane risk-of-bias tool will be used to assess the quality of the studies. Finally, data will be extracted from the selected articles, and the formal method of combining individual data from the selected studies will be applied using a random effect multilevel meta-analysis. The data analysis will be conducted with the metafor package in R. Discussion and conclusion This review will synthesize the existing evidence and pinpoint gaps existing in the literature on the effects of exercise on EFs and episodic memory in healthy and unhealthy older adults. Findings from this meta-analysis will help to design effective exercise interventions for older adults to improve and/or maintain EFs and episodic memory. Its results will be useful for many researchers and professionals working with older adults and their families.
Keywords: diseased older adults, healthy older adultsi, episodic memory, executive functions, exercises, three level meta analysis, tri-nivojska meta-analiza
Published in DiRROS: 03.04.2024; Views: 1782; Downloads: 906
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