Changes in mortality during the COVID-19 pandemic in Japan: descriptive analysis of national health statistics up to 2022.

BACKGROUND: Amidst the global coronavirus disease (COVID-19) pandemic, Japan has faced a significant public health challenge, evident from the significant increase in mortality rates since 2021. This study described the variations in all-cause and cause-specific changes in mortality up to 2022 in Japan. METHODS: This study used official Vital Statistics from the Ministry of Health, Labour and Welfare (MHLW) to assess the impact of the pandemic on mortality trends. An analysis of all-cause and cause-specific age-standardized mortality rates (ASMRs) from 1995 to 2022 was conducted, employing the 2015 Japan Standard Population. Sex- and cause-specific ASMRs for a particular year were compared with those from the preceding year to assess annual changes. RESULTS: Among men, the annual all-cause ASMR per 100,000 people increased from 1356.3 in 2021 to 1437.8 in 2022 (6.0% increase). Among women, the annual all-cause ASMR increased from 722.1 in 2021 to 785.8 in 2022 (6.5% increase). Compared with the period 2020 to 2021, COVID-19 (+29.1 per 100,000 people for men and +13.4 per 100,000 people for women), senility (+14.1 per 100,000 people for men and +12.5 per 100,000 people for women), heart disease, malignant neoplasms (for women) and "other causes not classified as major causes" substantially contributed to the increase in all-cause ASMR from 2021 to 2022. CONCLUSIONS: Further long-term monitoring from 2023 onwards is necessary, especially for conditions like senility, cardiovascular disease, and cancer, which may have long-term effects due to changes in healthcare settings, even though the strong countermeasures against COVID-19 were lifted in 2023.

[Examination of cases in which senility was determined to be the cause of death in community medicine].

AIM: In community medicine, there are many opportunities in which senility is noted as the cause of death. However, there are no clear criteria for diagnosing senility, and this decision is often left to the judgment of individual doctors. This study investigated the clinical characteristics of patients diagnosed with senility at our hospital. METHODS: The subjects included 43 patients whose cause of death was listed as senility from among the death certificates of 282 patients prepared at our hospital. The survey items included age, sex, medical history, place of death, period from the day of explanation of the condition of senility to the date of death, BMI at the time of explanation, and blood sampling test. RESULTS: The mean age of patients who died due to senility was 92.2±6.5 years old. The male to female ratio was 15: 28. The most common medical history was dementia (76.7%), followed by hypertension and orthopedic disease (74.4%), respiratory disease (66.7%), and heart disease and gastrointestinal disease (60.5%). The places of death were nursing homes and private homes, and hospitals. The overall average time from presentation until death occurred was 110.2 days. There were also considerable differences depending on the case. The average BMI was 19.7±3.0, and the blood sampling results showed that total protein and serum albumin levels were lower than the reference values. CONCLUSIONS: Although the diagnosis of senility is vague and unclear, it is important to explain such a diagnosis to the family at an appropriate time and to cooperate with multiple professionals in the treatment process.

Positioning ethnicity in dementia awareness research: does the use of senility risk ascribing racialised knowledge deficits to minority groups?

Over recent decades, the importance of increasing dementia awareness has been promoted by charities, researchers and governments. In response, a large body of research has emerged that evaluates the awareness of different populations. One such population are minority ethnic communities. Associated studies typically conclude that minority ethnic groups have a poor awareness of dementia and that interventions should be developed to better educate them. Operationalisations of awareness almost always reference senility - the traditional notion that dementia is a natural outcome of ageing - a widely held belief among many populations. Senility is considered incorrect knowledge in the research literature, and those participants who identify with it are deemed to have poor awareness. Despite the researchers' claims that senility is false, the scientific evidence is inconclusive, and the concept is contested. As such, a large body of research repeatedly positions minority ethnic communities as inferior and in need of re-education based on researchers' questionable assumptions. This issue is bound up with a racialised deficit-model of science communication and wider critiques of psychiatric colonialism. In response, researchers of dementia and ethnicity should reflect on their own awareness and the ways in which they position others in relation to it.

[Sarcopenia - unnoticed problem of aging society].

In the elderly, there is a reduction of the efficiency in many organs, including muscles. The weight, strength and power reduction of elderly muscles is defined as sarcopenia. The pathophysiology of sarcopenia is multifactorial, it can be influenced by intrinsic and extrinsic factors such as reduced caloric intake, denervation of muscle fibers - in the course of various neurodegenerative diseases, intracellular oxidative stress, hormonal disorders and others. The European Working Group on sarcopenia in the elderly published diagnostic criteria for sarcopenia in 2010, which should increase the recognition of this disease and speed up the treatment process. The best-confirmed methods of treatment of sarcopenia are nutritional hyperalimentation and resistance training. Pharmacological agents, i.e. selective androgen receptor modulators, and myostatin inhibitors are not sufficiently tested to be approved, by the FDA as a treatment regimen of sarcopenia.

A vision based proposal for classification of normal and abnormal gait using RGB camera.

Human gait is mainly related to the foot and leg movements but, obviously, the entire motor system of the human body is involved. We hypothesise that movement parameters such as dynamic balance, movement harmony of each body element (arms, head, thorax…) could enable us to finely characterise gait singularities to pinpoint potential diseases or abnormalities in advance. Since this paper deals with the preliminary problem pertaining to the classification of normal and abnormal gait, our study will revolve around the lower part of the body. Our proposal presents a functional specification of gait in which only observational kinematic aspects are discussed. The resultant specification will confidently be open enough to be applied to a variety of gait analysis problems encountered in areas connected to rehabilitation, sports, children's motor skills, and so on. To carry out our functional specification, we develop an extraction system through which we analyse image sequences to identify gait features. Our prototype not only readily lets us determine the dynamic parameters (heel strike, toe off, stride length and time) and some skeleton joints but also satisfactorily supplies us with a proper distinction between normal and abnormal gait. We have performed experiments on a dataset of 30 samples.

Inevitable problems of older people: presurgery information effect on anxiety levels in patients undergoing cataract surgery.

AIMS AND OBJECTIVES: This study was to determine the effect of preoperative patient training on the concern level of patients who would be undergoing cataract surgery. BACKGROUND: Cataract is one of the main causes of blindness in the world. Cataract surgery is located among the quite frequently performed surgeries today. DESIGN: This study was an experimental study. METHODS: The subject pool for this research consisted of patients admitted to the Eskisehir Osmangazi University Medical Faculty Hospital Ophthalmology Department for cataract surgery. The sampling consisted of volunteers who were able to communicate and were deemed suitable patients within the limitations of this study (a total of 100 patients; control group = 50, experimental group = 50). Patient identification forms and the State Trait Anxiety Inventory I-II scale were used as data collection tools. RESULTS: The mean State Trait Anxiety Inventory pretest score for the experimental group was significantly higher than the mean final test score (53·30 ± 7·02 and 27·54 ± 3·25, respectively, p < 0·05). The mean State Trait Anxiety Inventory pretest score of the control group was 53·82 ± 7·42 and the mean final test score was 49·22 ± 13·17; there was no significant difference between these average scores (p > 0·05). However, the mean final test scores of the experimental and control groups were significantly different (p < 0·05). CONCLUSIONS: In the experimental group in this study, informative, educational and planned nursing care had a significant impact on anxiety levels in patients who had cataract surgery. RELEVANCE TO CLINICAL PRACTICE: Although it is not implemented in most hospitals, and implementation in some hospitals is unplanned, systematically planned preoperative education should take place as part of standard nursing practices.

["Protein of senility" CCL11, "protein of juvenility" GDF11 and their role in age-related pathology].

The paper presents the latest literature data on the structure and functions of «protein of juvenility¼ - CCL11 and «protein of senility¼ - GDF11. Chemokine CCL11 injected to young animals has been shown to lead to degenerative changes in the central nervous system (CNS), disturb cognitive functions and impede tissue regeneration. CCL11 concentration increases dramatically in schizophrenia, Alzheimer's disease, neuro-inflammatory disorders, cerebral malaria, drug addiction, as well as in atherosclerosis, periodontal disease, macular degeneration, cancer and other pathologies. In contrast to CCL11, differentiation growth factor 11 (GDF11), being administered to old mice, eliminates age-associated hypertrophy of the heart, improves muscle tone and prevents degenerative changes in the CNS, improves cognitive functions and enhances tissue regeneration. Its concentration decreases in cardiovascular disease, osteoporosis, and other «diseases of old age¼. At the same time, the higher the GDF11 level in the blood, the milder myocardial infarction, stroke and other age-related diseases of the cardiovascular system.

[Does Alzheimer's disease exist in all primates? Alzheimer pathology in non-human primates and its pathophysiological implications (II)]. / ¿Existe la enfermedad de Alzheimer en todos los primates? Patología Alzheimer en primates no humanos y sus implicaciones fisiopatológicas (II).

INTRODUCTION: In the ageing process there are some species of non-human primates which can show some of the defining characteristics of the Alzheimer's disease (AD) of man, both in neuropathological changes and cognitive-behavioural symptoms. The study of these species is of prime importance to understand AD and develop therapies to combat this neurodegenerative disease. DEVELOPMENT: In this second part of the study, these AD features are discussed in the most important non-experimental AD models (Mouse Lemur -Microcebus murinus, Caribbean vervet -Chlorocebus aethiops, and the Rhesus and stump-tailed macaque -Macaca mulatta and M. arctoides) and experimental models (lesional, neurotoxic, pharmacological, immunological, etc.) non-human primates. In all these models cerebral amyloid neuropathology can occur in senility, although with different levels of incidence (100% in vervets;<30% in macaques). The differences between normal and pathological (Alzheimer's) senility in these species are difficult to establish due to the lack of cognitive-behavioural studies in the many groups analysed, as well as the controversy in the results of these studies when they were carried out. However, in some macaques, a correlation between a high degree of functional brain impairment and a large number of neuropathological changes ("possible AD") has been found. CONCLUSIONS: In some non-human primates, such as the macaque, the existence of a possible continuum between "normal" ageing process, "normal" ageing with no deep neuropathological and cognitive-behavioural changes, and "pathological ageing" (or "Alzheimer type ageing"), may be considered. In other cases, such as the Caribbean vervet, neuropathological changes are constant and quite marked, but its impact on cognition and behaviour does not seem to be very important. This does assume the possible existence in the human senile physiological regression of a stable phase without dementia even if neuropathological changes appeared.

Electroacupuncture ameliorates senile osteoporosis by promoting bone remodeling and regulating autophagy.

OBJECTIVES: Osteoporosis is widely regarded as a typical aged-related disease caused by impaired bone remodeling. This research was designed to explore the protective effects of electroacupuncture (EA) on senile osteoporosis in a rat model and investigate the underlying mechanisms. METHODS: Three-month-old rats were randomly selected as the youth group, and 24-month-old rats were randomly assigned to the elderly and EA groups. Rats in the EA group received 30 min of EA at bilateral SP10, ST36, K13 and GB34 daily, 5 days a week for 8 weeks. Bone mineral density (BMD), microstructure of the bone tissue, bone turnover biomarkers and expression level of autophagy-related proteins were detected. RESULTS: Compared with the elderly group, EA treatment significantly increased BMD of the femur and ameliorated the microstructure. EA treatment increased trabecular bone volume ratio (= bone volume / total volume [BV/TV]) and trabecular number (Tb.N) and decreased trabecular separation (Tb.Sp) in senile osteoporosis rats. Compared with the elderly group, the serum N-terminal telopeptide of type I collagen (NTX1) level in the EA group was lower, and the serum procollagen type I N-terminal propeptide (PINP) concentration was higher. In addition, the expression of Beclin 1, microtubule-associated protein I light chain 3 (LC3B) and P62 was inhibited in the senile osteoporosis rats after EA treatment. CONCLUSIONS: EA can effectively alleviate aging-related bone loss and improve the microstructure of bone tissue in senile osteoporosis rats, and the regulation of autophagy might be one of the important mechanisms.

Senility deaths in aged societies: The case of Japan.

Senility is now the third largest cause of death in Japan, comprising 11.4% of the total number of deaths in 2022. Although senility deaths were common in the period before the Second World War, they declined sharply from 1950 to 2000 and then increased up to the present. The recent increase is more than what we could expect from an increasing number of very old persons or the increasing number of deaths at facilities. The senility death description in the death certificate is becoming poorer, with 93.8% of them only with a single entry of "senility". If other diseases are mentioned, those are again vague diseases or conditions. Senility, dementia and Alzheimer's disease, sequelae of cerebrovascular disease, and heart failure are the largest causes of death in which senility is mentioned in the death certificate. The period from senility onset to death is often described within a few months, but it varies. In some cases, the deceased's age was written out of a conviction that the ageing process starts from birth. As senility is perceived differently among the certifying doctors, a standardised protocol to certify the senility death is needed. On the other hand, senility death is the preferred cause of death and many people do not wish to receive invasive medical examinations before dying peacefully. Together with other causes of death related to frailty, there would be a need to capture senility as a proper cause of death, not just as a garbage code, in the aged, low-mortality population.

The human microbiome and benign prostatic hyperplasia: Current understandings and clinical implications.

The research of the human microbiome in the preceding decade has yielded novel perspectives on human health and diseases. Benign prostatic hyperplasia (BPH) is a common disease in middle-aged and elderly males, which negatively affects the life quality. Existing evidence has indicated that the human microbiome, including urinary, intra-prostate, gut, oral and blood microbiome may exert a significant impact on the natural progression of BPH. The dysbiosis of the microbiome may induce inflammation at either a local or systemic level, thereby affecting the BPH. Moreover, metabolic syndrome (MetS) caused by the microbiome can also be involved in the development of BPH. Additionally, alterations in the microbiome composition during the senility process may serve as another cause of the BPH. Here, we summarize the influence of human microbiome on BPH and explore how the microbiome is linked to BPH through inflammation, MetS, and senility. In addition, we propose promising areas of investigation and discuss the implications for advancing therapeutic approaches.

Use of artificial hydration in patients diagnosed with senility as the cause of death by home care physicians: A cross₋sectional study.

Background: The aim of this study was to investigate the frequency, effectiveness, and reasons for the use of artificial hydration (AH) in senile patients in the last week, and patient-related factors associated with its usage. Methods: Between April and May 2023, I conducted a cross₋sectional study among medical institutions affiliated with the Japan Network of Home Care Supporting Clinics. Eligible cases included those in which senility was listed as the cause of death on the death certificate from January 1, 2022, to December 31, 2022. The questions asked use of AH, reasons for AH, and symptoms that improved or worsened with AH. Patient characteristics, including age, gender, place of death, length of treatment, and complication of dementia, were also asked. Descriptive statistics were performed. Univariate and multivariate analyses were conducted to examine the association between patient characteristics and the use of AH. Results: Eighty-three medical institutions (12.5%) provided responses, contributing a total of 714 cases. AH was administered in 236 cases (33.1%). The most common reason was "due to family preference" in 110 cases (46.6%). One hundred thirty-five cases (57.2%) reported "no improved symptoms," while symptom worsening was reported as "no worsened symptoms" in 176 cases (74.6%). Multivariate analysis on 699 cases using complete-case analysis identified age (risk ratio [RR]:0.98, 95% confidence interval [CI]: 0.96-0.99) and female (RR:0.73, 95% CI:0.58-0.92) as factors associated with the use of AH. Conclusion: This study revealed that AH was commonly used based on family preferences and to alleviate psychological burdens on the family.

Effects of Senility on Disease Burden: Panel Analysis Using 2010 to 2019 OECD Health Data.

Background: In this study, the geniatric status of OECD (Organisation for Economic Co-operation and Development) countries was measured, and the effects of aging status on disease patterns in each country were quantitatively assessed. A theoretical model explaining the effects was suggested, and the implications were discussed. Methods: Data used in this study were the OECD Health Statistics data and WHO Global Burden of Disease data. The values for each country were paired with disability-adjusted life years (DALYs) presented by the WHO and Institute for Health Metrics and Evaluation (IHME). A cross-country panel analysis was conducted to analyze the effects of senility on the burden of disease in OECD countries. Results: Geniatric status had effects on the burden of disease (P = .048). Total health expenditure significantly reduced the burden of disease (P = .001). In the panel model with YLL (Year of Life Lost) as the outcome variable, geniatric status had twice greater effects on the burden of disease than that in the model with DALY (P = .003). Conclusions: In medical insurance-related policies, the characteristics of the disease should be considered. In particular, chronic diseases have not received much attention compared to their risk. However, the disease that actually affects the burden of disease is a disease that becomes chronic and requires long-term treatment rather than a disease with a high fatality rate. And, as a result of this study, the higher the level of resource consumption for treatment in OECD countries, where aging is progressing, the burden of disease was rather reduced. Therefore, if there is institutional support to receive appropriate treatment, it will be possible to reduce the national burden of disease.

Complement Heat Tolerance as a Marker of Protein Fragility and Its Clinical Significance.

This study aimed to establish a complement tolerance test (CTT) as a marker of protein fragility and discuss its clinical significance. Total complement activity (TCA) of serum was measured using a self-hemolysis colorimetric method. Human O-erythrocytes and rabbit anti-human O-erythrocyte antibodies were used to replace sheep erythrocytes and the corresponding hemolysin for the hemolysis test, respectively. The antigen-antibody specific binding activated the classical pathway of complement, generating a membrane attack complex, and the red blood cells rupture. A CTT was established to measure complement heat tolerance according to the sensitivity of complement proteins to temperature, which was calculated according to differences in TCA at different temperatures. The smaller the CTT the stronger the complement resistance to heat. The method was applied to the detection of diabetic patients and healthy controls. The mean value of CTT (mean) = 0.063 ± 0.003 with a coefficient of variation of 4.8% for the same specimen tested for complementary thermal resistance on 5 consecutive days, which is a good stability of the assay. Application of CTT on samples from patients with different ages revealed significantly higher mean CTT values for elderly patients (≥60-years old) relative to those for younger patients (20-40-years old) (p < 0.05). In addition, the mean CTT values for diabetic patients were significantly higher than those for healthy patients (p < 0.001). We successfully established a method that uses complement thermal resistance as a marker of protein fragility, with the results demonstrating the ability of the CTT identify age- and disease-related variations in patient samples and its potential efficacy for clinical application.

To and Fro Between Eros and Thanatos: What Where and the Death Drive.

This paper tries to read What Where as Beckett's realistic and pessimistic presentation of the ontological conditions of the human history, which the play defines as investigation, exploitation and quest for the ultimate truth. Its analysis finds that this presentation has important threads in common with the criticism of civilization in the later Freud's metapsychology, which formulated "an all-embracing, grand theory of the psyche" in terms of the development of the individual as well as the evolution of the entire species on the basis of the maxim that "ontogeny recapitulates phylogeny" What Where enacts this Freudian vision in theatrical terms as its theater version foregrounds the phylogenetic scale with the physical subjections happening among the characters and its television version the interior depth of the mind with the maneuvering of the television images. Another important commonality is that the character Bam is presented as a figure pertaining to Freud's concept of the death drive. The resulting theatrical picture is a sobering and realistic testimony to the individual and collective human existence that has always survived on questionings about, exploitation of and quest for a different object. This strikes a chord with how Beckett's characters embody his poetics of 'senility,' and leads to the political implications of freedom without hope or meaning, which is the infinite task of Beckett's senile characters.

Current state of cause of death determinations in Japan and the need to list the precise underlying cause of death.

When death is caused by a disease, the precise cause of the death must be determined to promote health and contribute to prevention efforts. The circumstances of death should also be clarified so that measures can be taken to prevent the recurrence. Statistics regarding the cause of death must be accurate, and such statistics are shaped by the determination of the cause of death. We examined the annual cause of death rankings and the mortality rate in Japan during the 25-year period 1993-2017. We identified improvements that are needed to provide more precision in the cause of death statistics, with a focus on variations in the rankings, and we describe the peculiar and vulnerable aspects of the Vital Statistics system in Japan; for example, at one time the national government advised physicians to not list "heart failure" as the terminal stage of a condition on a death certificate, and the "heart disease" mortality rate thus tended to decline in that period. The ranking of "heart disease" as a cause of death decreased, but its mortality rate subsequently increased again. In addition, the "pneumonia" mortality rate has remained high over the past few years, but it abruptly decreased in 2017, when "aspiration pneumonia" was separated as a cause from other pneumonias. The "senility" mortality rate has increased annually, and it is a leading cause of death. It is important that physicians understand the underlying causes of death and provide that without being influenced by the reporting customs of the times.

Regenerative capacity of bone marrow stem cells on aged albino rat's parotid excretory duct.

OBJECTIVE: To appraise structural features of parotid excretory duct during senility and probable effect of bone marrow-mesenchymal stem cells (BM-MSCs). DESIGN: A total of 14 healthy male albino rats were used. Seven adult rats (24-34-week-old) represented the control group (Group I). Seven senile rats (72-80-week-old) were utilized in which the left parotid gland served as "Old" (Group II) and were injected by 0.2 ml phosphate buffered saline; the right side represented "Old treated" (Group III) and got local injection of 1-1.5 million allogeneic BM-MSCs. One month later, glands were dissected and assessed structurally, ultra-structurally and statistically. RESULT: Histologically, Group I showed normal duct histology. In Group II duct lining lost its pseudostratification which was recovered in Group III. PCNA immunolocalization showed moderate reactivity in Group I, negative to mild reaction in Group II, and strong reaction in some of Group III cells. Ultra-structural features of Group I were ordinary in which basal cell had a large flat nucleus, and dark and light cells showed electron-dense cytoplasm and electron-lucent cytoplasm respectively. Tuft cell displayed long microvilli. Mucous droplets filled goblet cell. Group II revealed an apparent reduction in cells size, organelles and absence of tuft cell. In Group III all cell types were detected and they recovered their organelles, cell and nucleus shape. The highest mean area% of PCNA immunoreactivity was in Group I followed by Group III then Group II. CONCLUSIONS: Aging has a deteriorating effect on structure and ultra-structure of parotid gland excretory duct that could be amended by BM-MSCs.

Composition and regulation of the immune microenvironment of salivary gland in Sjögren's syndrome.

Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease characterized by exocrine gland dysfunction and inflammation. Patients often have dry mouth and dry eye symptoms, which seriously affect their lives. Improving dry mouth and eye symptoms has become a common demand from patients. For this reason, researchers have conducted many studies on external secretory glands. In this paper, we summarize recent studies on the salivary glands of pSS patients from the perspective of the immune microenvironment. These studies showed that hypoxia, senescence, and chronic inflammation are the essential characteristics of the salivary gland immune microenvironment. In the SG of pSS, genes related to lymphocyte chemotaxis, antigen presentation, and lymphocyte activation are upregulated. Interferon (IFN)-related genes, DNA methylation, sRNA downregulation, and mitochondrial-related differentially expressed genes are also involved in forming the immune microenvironment of pSS, while multiple signaling pathways are involved in regulation. We further elucidated the regulation of the salivary gland immune microenvironment in pSS and relevant, targeted treatments.

Cumulative Incidence and Factors Associated With Subsequent Vertebral Compression Fractures: A Nationwide Population-based Study.

OBJECTIVE: Patients who experience vertebral compression fractures are vulnerable to subsequent vertebral compression fractures (SVCFs). The purpose of this nationwide population-based study was to determine the age-specific cumulative incidence and factors associated with SVCFs in South Korea. METHODS: Diagnostic codes, medical costs, and comorbid diseases in patients who had a vertebral compression fracture in 2011 and 2012 were collected from the National Health Insurance Service database of South Korea from 2007 to 2018. Demographic data, mortality rate, medical cost, and frequency of vertebroplasty or kyphoplasty were compared between patients with an initial fracture (IF) and those with a subsequent fracture (SF). RESULTS: The cumulative incidence of SVCFs over 4 years was 24.4% and increased rapidly within a few months after the IF. In 2011, SVCFs occurred in 17,004 patients, and the incidence rate per 100,000 people was 113.6 (84.9 in men vs. 138.5 in women). The odds ratio (OR) of SVCFs in units of 10 years was the highest in women in their 60s, at 2.89. However, in men in their 70s, the OR was the highest, at 2.51. The rates of vertebroplasty or kyphoplasty, medical expenses, and mortality rate were significantly higher in the SF group than in the IF group (P < 0.01). CONCLUSIONS: The age-specific cumulative incidence of SVCFs per 100,000 people was 113.6. SVCFs were more frequent among women, the elderly, and patients who underwent vertebroplasty or kyphoplasty. Women in their 60s or above and men in their 70s or above were at highest risk.

Mortality Predictive Value of the C2HEST Score in Elderly Subjects with COVID-19-A Subanalysis of the COLOS Study.

Senility has been identified among the strongest risk predictors for unfavorable COVID-19-outcome. However, even in the elderly population, the clinical course of infection in individual patients remains unpredictable. Hence, there is an urgent need for developing a simple tool predicting adverse COVID-19-outcomes. We assumed that the C2HEST-score could predict unfavorable clinical outcomes in the elderly subjects with COVID-19-subjects. METHODS: We retrospectively analyzed 1047 medical records of patients at age > 65 years, hospitalized at the medical university center due to COVID-19. Subsequently, patients were divided into three categories depending on their C2HEST-score result. RESULTS: We noticed significant differences in the in-hospital and 3-month and 6-month mortality-which was the highest in high-risk-C2HEST-stratum reaching 35.7%, 54.4%, and 65.9%, respectively. The medium-risk-stratum mortalities reached 24.1% 43.4%, and 57.6% and for low-risk-stratum 14.4%, 25.8%, and 39.2% respectively. In the C2HEST-score model, a change from the low to the medium category increased the probability of death intensity approximately two-times. Subsequently, transfer from the low-risk to the high-risk-stratum raised all-cause-death-intensity 2.7-times. Analysis of the secondary outcomes revealed that the C2HEST-score has predictive value for acute kidney injury, acute heart failure, and cardiogenic shock. CONCLUSIONS: C2HEST-score analysis on admission to the hospital may predict the mortality, acute kidney injury, and acute heart failure in elderly subjects with COVID-19.