Background/Objectives: Vitamin B12 deficiency can cause variable symptoms, which may be irreversible if not diagnosed and treated in a timely manner. We aimed to develop a widely accepted expert consensus to guide the practice of diagnosing and treating B12 deficiency. Methods: We conducted a scoping review of the literature published in PubMed since January 2003. Data were used to design a two-round Delphi survey to study the level of consensus among 42 experts. Results: The panelists agreed on the need for educational and organizational changes in the current medical practices for diagnosing and treating B12 deficiency. Recognition of clinical symptoms should receive the highest priority in establishing the diagnosis. There is agreement that the serum B12 concentration is useful as a screening marker and methylmalonic acid or homocysteine can support the diagnosis. Patient lifestyle, disease history, and medications can provide clues to the cause of B12 deficiency. Regardless of the cause of the deficiency, initial treatment with parenteral B12 was regarded as the first choice for patients with acute and severe manifestations of B12 deficiency. The use of high-dose oral B12 at different frequencies may be considered for long-term treatment. Prophylactic B12 supplementation should be considered for specific high-risk groups. Conclusions: There is a consensus that clinical symptoms need to receive more attention in establishing the diagnosis of B12 deficiency. B12 laboratory markers can support the diagnosis. The severity of clinical symptoms, the causes of B12 deficiency, and the treatment goals govern decisions regarding the route and dose of B12 therapy.

One of the most important lifestyle risk factors for many chronic conditions in the older age, low physical activity has shown to have significant impact on the sustainability of national welfare in many developed countries. Technology-based assisted living solutions can effectively be used to enable older adults to optimise their health-related quality of life, as well as to promote an active and healthy longevity. This paper describes vINCI—an interdisciplinary research project to actively support assisted living for older adults via state-of-the-art assistive technologies—which seamlessly deploys an ambient intelligence environment to integrate wearable devices, networking, software, and personalised services. It entails clinical validation and feedback at home and residential care facilities via a cloud microservices platform. Underpinned by blockchain technologies, multiple wearable devices, apps, and cameras securely capture the anonymised facets of different life events, whilst machine learning models create individualised user profiles to analyse any decrease in the perceived health-related quality of life typically associated with old age. Two controlled pilots are being conducted with 80 participants at older adult facilities in Romania and Cyprus. By incorporating clinical validation and feedback from specialised practitioners, the vINCI technologies enable older adults not only to self-evaluate their physical activity level, but also to change their behaviours and lifestyle in the long-term.

Purpose: Chronic low-grade inflammation and oxidative stress are present in most of the pathologic mechanisms underlying non-communicable diseases. Inflammation and redox biomarkers might therefore have a value in disease prognosis and therapy response. In this context, we performed a case-control study for assessing in whole blood the expression profile of inflammation and redox-related genes in elderly subjects with various comorbidities. Patients and Methods: In the blood of 130 elderly subjects with various pathologies (cardiovascular disease, hypertension, dyslipidemia including hypercholesterolemia, type 2 diabetes mellitus), kept under control by polyvalent disease-specific medication, we investigated by pathway-focused qRT-PCR a panel comprising 84 inflammation-related and 84 redox-related genes. Results: The study highlights a distinctive expression profile of genes critically involved in NF-kappa B-mediated inflammation and redox signaling in the blood of patients with cardiovascular disease, characterized by significant down-regulation of the genes NFKB2, NFKBIA, RELA, RELB, AKT1, IRF1, STAT1, CD40, LTA, TRAF2, PTGS1, ALOX12, DUOX1, DUOX2, MPO, GSR, TXNRD2, HSPA1A, MSRA, and PDLIM]. This gene expression profile defines the transcriptional status of blood leukocytes in stable disease under medication control, without discriminating between disease- and therapy-related changes. Conclusion: The study brings preliminary proof on a minimally invasive strategy for monitoring disease in patients with cardiovascular pathology, from the point of view of inflammation or redox dysregulation in whole blood.

Introduction: Geriatric Medicine (GM) has evolved in Europe over the past few decades, although variably across countries. The aim of this paper is to explore the GM specialty status, postgraduate and undergraduate education for medical students, nurses and Allied Health Professionals (AHPs), academic development and GM clinical services in Europe. Methods: We collected cross-sectional data from 38 European countries as listed by the World Health Organization with an online quantitative survey. This study is part of the PROGRAMMING COST Action, which stands for PROmoting GeRiAtric Medicine in countries where it is still eMergING and is funded by the European Cooperation for Science and Technology. Results: GM is recognised as a distinct specialty in 24 countries (63.15%), while specialty training is available in 21 countries (55.26%). Principles of GM are included in the undergraduate curricula for medical students in all or most medical universities in 24 countries (63.15%), for nurses in 26 countries (68.42%) and for AHPs in 19 countries (50%). Geriatric hospital wards are present in 28 countries (73.68%), and in eight countries, there are no GM clinical services available, especially in Southern Europe. GM is a standalone academic discipline in 20 countries (52.63%), and advanced academic doctoral study is available in 18 countries (47.36%). GM is more established in Northern and Western Europe. Conclusion: Our study highlights the inconsistent development of GM across European countries. It provides a foundation for policy development and educational reform to meet the needs of Europe’s ageing population.