Background: Upper limb functional recovery after stroke remains a major challenge. While rehabilitation is essential, delivering conventional therapy at adequate intensity places a substantial burden on healthcare systems. Self-guided, home-based rehabilitation has emerged as a promising alternative. This review evaluated the efficacy of self-guided, non-technological, home-based interventions for upper limb recovery in people with stroke (PwS).

Methods: A systematic search was conducted across PubMed, CINAHL, Web of Science, and PEDro. Studies were included if they involved PwS aged ≥18 years and used self-guided, home-based upper limb rehabilitation without technological assistance. Methodological quality was assessed using standardized tools. Due to heterogeneity in interventions and outcomes, meta-analysis was not feasible.

Results: Of 2,165 studies identified, 11 met the inclusion criteria, comprising 503 participants, with 336 receiving self-guided rehabilitation. Included studies consisted of eight RCTs, one feasibility study, one prospective study, and one case report. Interventions included task-specific training (n = 8), reach-to-grasp exercises (n = 4), joint mobilization (n = 3), bilateral training (n = 2), and motor imagery (n = 1). Intervention durations ranged from 4 weeks to 4 years, with daily sessions lasting 1–3 hours. Outcome measures varied, with the Nine-Hole-Peg-Test most used (n = 4). Of the seven studies with between-group comparisons, only one reported significant differences favouring home-based therapy at three and four months (p = 0.003; p = 0.05).

Conclusion: Self-guided home-based rehabilitation may offer benefits comparable to conventional therapy for PwS, with the added advantage of reducing healthcare costs. Further high-quality research is needed.

Background: ICare.IT – AvereCura is a longitudinal study aimed to monitoring the well-being of family caregivers of people with dementia, focusing on physiological, psychological, socio-relational, and occupational aspects.

Materials and Methods: A volunteer sample of caregivers is recruited to assess care burden via online questionnaires and wearable sensors to monitor physical activity, sleep, and heart rate for one week. Data are collected at three time points (baseline, six months, and twelve months).

Main Results: This abstract presents preliminary findings from 47 participants consecutively recruited at baseline. The participants had a median age of 59 yrs, were predominantly female (35/47), and mostly adult children or partners of the care-receivers. Most care-receivers had moderate-to-severe dementia, demonstrating good autonomy in basic tasks but poor autonomy in complex instrumental tasks. Caregivers dedicated a median of 42 hours weekly to care, experiencing decreased social interaction, increased isolation, and low social support. The care burden was moderate (ZBI median = 38.5), positively correlated with anxiety, depression and age, and negatively correlated with caregiver-care receiver relationship quality, perceived quality of life, and life satisfaction. Perceived sleep quality was poor (PSQI median = 9), correlating with higher caregiving burden and anxiety, and with fewer weekly steps. Objectively (wrist actigraphy and chest patch electrocardiography), caregivers slept a median of 6.4 hours per night; median heart rate was 73 bpm during daytime wakefulness and, decrease to 62 bpm during nighttime sleep. None of these variables correlated significantly with the care burden.

Research Implications: This preliminary analysis of the ICare.IT – AvereCura data suggests that increased caregiver burden is linked to worse mood symptoms, greater social isolation, and poorer perceived sleep quality. Further data, obtained by expanding the sample and through follow-ups, will help us to confirm and refine these associations.

Frailty is increasingly recognized as a multidimensional syndrome encompassing physical, psychological, and social vulnerabilities. While physical frailty is well studied, social frailty – marked by declines in social resources, participation, and perceived support – remains less explored, particularly in Europe. This work synthesizes findings from two studies (based on SHARE data) conducted within WP5 of Spoke 4 of the Age-It PNRR project.

To advance understanding of the social dimension of frailty, we develop a multidimensional indicator for individuals aged 50+, based on five theoretically grounded markers: living alone, low social participation, limited social network, insufficient daily support, and perceived loneliness. Individuals meeting at least three criteria are classified as socially frail. Our analysis shows a prevalence of social frailty of 19%, which increases with age and varies across countries, reflecting the influence of socio-cultural contexts.

Second, we assess whether the social frailty indicator predicts the onset of physical frailty over time. Using a four-year longitudinal design (SHARE Waves 6-8), we include individuals aged 60+ not physically frail at the baseline. Results show that socially frail individuals have over twice the risk (RR = 2.3) of becoming physically frail. Structural equation models, adjusting for confounders and indirect effects (e.g., multimorbidity), confirm this relationship.

These findings highlight the predictive power of social frailty and its critical role in driving age-related functional decline. Integrating social frailty measures into public health systems and geriatric assessments can foster earlier, more targeted interventions – ultimately supporting more resilient, inclusive, and sustainable models of ageing across Europe.

Background

Current evidence on Animal Assisted Interventions (AAI) in older persons is scarce, particularly in cognitively unimpaired individuals. Preliminary data suggested potential benefits on loneliness, depression and anxiety. This study investigated the feasibility and effects of an AAI programme for older residents of an assisted living facility (ALF).

Methods

Older residents of an ALF in Florence, Italy, participating in a 3-month AAI programme involving dogs were included in an observational pilot study. Data from a comprehensive geriatric assessment conducted before (T0) and after (T1) the AAI were analysed, including loneliness (De Jong Scale, ≥2), quality of life (SF-36), depression and anxiety (HADS subscales, >7). Minimal clinically important improvements (MCII) were also assessed.

Results

Among 15 residents, 12 (mean age 88, 83% female) completed the AAI. Two residents left the facility during the intervention and one died of medical causes. No adverse events were observed during AAI sessions.

Loneliness was reported by 7 (58%) participants at T0 and 5 (41%) at T1. Anxiety was reported by 6 (50%) at T0 and confirmed by 1 resident at T1. Seven residents showed a ≥2-point MCII in HADS (anxiety subscale). Depressive symptoms were reported by 4 (33%) participants at both T0 and T1. Items in the SF-36 questionnaire relating to “general health”, “social functioning”, “vitality” and “mental health” showed an MCII at T1 vs T0.

Main Implication

AAI programmes are feasible in older residents of ALFs. Prevalence of loneliness, anxiety and depressive symptoms is significant in this setting and residents might benefit from AAIs.