Introduction/Objective: The relationship between chronic obstructive pulmonary disease (COPD) and overweight is complex and multifaceted, as these conditions can interact in terms of symptoms, severity and clinical management. To analyse the clinical and therapeutic management of patients suffering from COPD and overweight. Methods: This systematic review was carried out, in accordance with the PRISMA statement, during November 2024, following a search of the Medline/PubMed databases. The search equation used, with MESH descriptors, was: “(Pulmonary Disease, Chronic Obstructive OR COPD) AND (obesity OR overweight)”. Both inclusion and exclusion criteria were applied, focusing on the selection of clinical trials. The studies were classified into two main groups: by their focus on the relationship between overweight/obesity and COPD; and by the benefits provided by physical exercise to patients with these conditions. A random-effects meta-analysis was performed on the data obtained. The protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews (CRD42024576389). Results: The search produced nine relevant clinical trials with a total of 1345 COPD patients. Four of the trials incorporated obesity (BMI ≥ 30) as an inclusion criterion, while the other five had mixed samples, with patients presenting either overweight or obesity (four patients with BMI ≥ 25 and one with BMI ≥ 27). The risk of bias tool for randomised trials showed that all nine studies had a low risk of bias. Overall, these studies highlight the importance of overweight management and reject the use of extreme measures. Furthermore, they confirm the association between overweight/obesity and COPD, for which this condition is a risk factor, to a degree depending on the BMI. Four studies reported significant improvements in the clinical management of COPD patients following appropriate physical exercise. Specifically, one study observed that supervised exercise improved cardio-vascular performance; another, that observed that aquatic exercise increased maximal capacity, endurance and quality of life; another, that found cycling improved ventilatory performance; and the fourth, that observed exercise complementary to standard therapy in hospitalised obese COPD patients improved strength, exercise capacity and other perceived variables such as anxiety, mobility and dyspnoea. Conclusions: The therapeutic management of overweight COPD patients should include weight control, physical exercise and appropriate pharmacological treatment. Physical exercise is associated with improvements in endurance, exercise capacity, cardio-vascular performance, ventilatory performance and strength. In addition, the participants in these studies self-perceived clinical improvement. These findings justify the performance of further RCTs examining the role of physical exercise in patients with COPD and overweight/obesity, in order to improve their clinical outcomes and quality of life.

Background: Acute confusional state, or delirium, is a common neuropsychiatric disorder in older adults, particularly in emergency departments. It is associated with high morbidity and mortality, as well as difficult detection. Its early identification is crucial to prevent complications and improve prognosis. This study aims to identify and analyze available strategies for the early diagnosis of delirium in geriatric patients in emergency departments. Methods: A literature review and meta-analysis were conducted between 2020 and 2026 using the PubMed, Scopus, Web of Science, CINAHL, and Cochrane databases (PRISMA 2020). To estimate the prevalence of patients with delirium in emergency departments, a meta-analysis was performed using Stats Direct statistical software (Version 4). Methodological quality was evaluated according to the Oxford Centre for Evidence-Based Medicine levels of evidence. Results: Eleven studies were included, demonstrating that delirium in emergency departments is highly prevalent among older adults, particularly those with dementia, polypharmacy, or functional impairment. The 4AT scale was the most frequently used screening tool, notable for its strong sensitivity. Hypoactive delirium emerged as the most common subtype and carried the poorest prognosis. Furthermore, its presence was associated with longer hospital stays, increased complications, and higher mortality rates, while a lack of training among healthcare staff continues to limit early detection. The meta-analysis detected no publication bias and revealed a 20.6% prevalence of delirium among patients in emergency departments. Conclusions: One in five patients attending the emergency department presents with delirium. Delirium in geriatric emergency care demands a structured clinical response grounded in prevention, early detection, and professional training. Integrating validated diagnostic tools and reinforcing the role of nursing professionals are key to improving patient outcomes and safety.