Procalcitonin as a predictor of length of stay in patients with odontogenic infections.

Aging brings concurrent declines across cognitive, sensory, postural, and muscular systems that together threaten independent living in older adults [,]. Frailty is increasingly understood not as disability or comorbidity but as a biologic syndrome of decreased physiologic reserve and reduced resistance to stressors, arising from cumulative declines across multiple systems and conferring vulnerability to falls, disability, and loss of independence []. This study addresses 2 interrelated aspects of this syndrome. Cognitive frailty denotes the co-occurrence of physical frailty and cognitive impairment in the absence of Alzheimer disease or other dementia—a potentially reversible, pre-neurodegenerative state distinct from physiologic brain aging and, thus, a target for early intervention []. Its sensorimotor counterpart, here termed sensorimotor frailty, comprises age-related deficits in proprioception, balance, postural control, and skeletal muscle function that increase the risk of falls and functional dependence [,]. It is closely linked to cognitive decline, sarcopenia, and increased fall risk [,]. Critically, these 2 aspects are interrelated rather than independent. This interdependence provides the rationale for integrated interventions that simultaneously engage cognitive, sensory, and motor systems rather than targeting each domain in isolation. The relationship between sensorimotor decline and cognitive aging is bidirectional. Executive subdomains such as attention, sensory integration, and motor planning are strongly associated with postural instability and gait dysfunction [], while age-related loss of proprioception and sarcopenia independently compromise both mobility and cognitive function [,]. Sarcopenia—the progressive loss of skeletal muscle mass and strength with aging—further compounds these vulnerabilities, as lower limb muscle mass is a critical determinant of balance confidence and functional independence in older adults, and sarcopenia is associated with increased risks of falls, fractures, cognitive impairment, and mortality [-]. Integrated dual-task approaches that simultaneously engage cognitive and sensorimotor systems may therefore be more effective than targeting either domain alone [,]. Such approaches may be particularly relevant for older adults experiencing preclinical functional decline—those who remain independently ambulatory but show individualized deterioration below their own functional baseline. Network meta-analyses have confirmed that exercise interventions significantly reduce both the number of fallers (risk ratio 0.83, 95% CI 0.77-0.89) and the rate of falls (risk ratio 0.79, 95% CI 0.73-0.86), with emerging evidence favoring combined physical-cognitive training []. In South Korea, where adults aged 65 years and older constitute 19.2% of the population [], preserving functional independence through early detection and recovery from these preclinical declines represents a pressing public health priority. While the number of Koreans with dementia is projected to exceed 1 million by 2026 [,], up to 45% of dementia cases may be attributable to modifiable risk factors, including sensory loss, physical inactivity, sarcopenia, and depression [], underscoring the value of interventions that target the functional precursors of cognitive and sensorimotor decline before irreversible impairment occurs. Exergaming—physically active video gaming that requires whole-body movements—has emerged as a promising approach for delivering integrated cognitive-motor training. Recent randomized controlled trials (RCTs) have demonstrated that exergaming can improve executive function [,], dual-task performance [], and global cognition [,] in older adults, with a landmark trial by Sturnieks et al [] showing that home-based step exergaming and cognitive training reduced fall rates by 26% over 12 months. However, most exergaming research has used commercially available gaming systems—primarily Nintendo Wii, Microsoft Xbox Kinect, or stationary cycling platforms [,,]—which may present significant barriers for older adults with limited technology experience, cognitive impairment, or balance deficits that require postural support during exercise [].