Drugs & Aging最新文献

{"title":"Vitamin D and Older Adults: To Supplement or Not to Supplement?","authors":"Niki G Mourelatou, Eleni Rebelos, Michael Hughes, Dimitris Kounatidis, Edward B Jude","doi":"10.1007/s40266-025-01277-3","DOIUrl":"10.1007/s40266-025-01277-3","url":null,"abstract":"<p><p>The aging population is steadily increasing, representing a significant portion of the global population. Vitamin D deficiency is highly prevalent, particularly among older adults and has been implicated in the pathogenesis of various chronic diseases. In June 2024, a clinical practice guideline was published by the Endocrine Society, recommending empiric vitamin D supplementation for those over 75 years old, suggesting that it could reduce mortality in this age group. Meanwhile, for the general population aged 50-74 years, not only was empiric supplementation not suggested but neither was routine testing of vitamin D levels. This review discusses the pathophysiological changes associated with aging, the conditions commonly affecting older adults that may be positively impacted by vitamin D, and the potential negative effects of such supplementation. By examining the current knowledge in the field, we aim to provide practical insights into the effects of vitamin D in individuals older than 75 years and to explore the potential benefits of expanding supplementation to include younger older adults, specifically those aged 65-74 years.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"111-121"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Sectional Study on Factors Associated with Hyperpolypharmacy and Medication Adherence in Older Adults with Multimorbidity and Polypharmacy.","authors":"Shanthi Beglinger, Lisa Bretagne, François Volery, Cinzia Del Giovane, Katharina T Jungo, Denis O'Mahony, Sophie Marien, Anne Spinewine, Wilma Knol, Ingeborg Wilting, Nicolas Rodondi, Christine Baumgartner","doi":"10.1007/s40266-025-01263-9","DOIUrl":"10.1007/s40266-025-01263-9","url":null,"abstract":"<p><strong>Background: </strong>Knowledge of multiple medication use and medication adherence is important to assess treatment effectiveness and prevent worsening of disease, re-hospitalization, and increased healthcare costs. Limited data exist on individuals with hyperpolypharmacy (ten or more concurrent medications) and their adherence.</p><p><strong>Objective: </strong>The objective of the study was to identify potential factors associated with hyperpolypharmacy, and medication adherence in participants with hyperpolypharmacy, as well as explore the relationship between hyperpolypharmacy and medication adherence.</p><p><strong>Methods: </strong>This is a cross-sectional analysis of baseline data from OPERAM, a multicenter study across four large European hospitals. Adults aged ≥ 70 years with multimorbidity and polypharmacy (five or more regular medications) were included. Demographic, clinical, and healthcare utilization data were assessed. Outcomes were hyperpolypharmacy and low/medium medication adherence (i.e., a score < 8 out of a maximum of 8) based on the Morisky Medication Adherence Scale-8 (MMAS-8^©). Multivariable logistic regression was used to identify factors associated with hyperpolypharmacy or low/medium adherence.</p><p><strong>Results: </strong>Of 2005 patients with multimorbidity and polypharmacy, 1029 (51%) exhibited hyperpolypharmacy. In multivariable analyses, the following factors were significantly associated with hyperpolypharmacy: increasing number of comorbidities (p for linear trend < 0.001), nursing home residency (odds ratio [OR] 2.20, 95% confidence interval [CI] 1.42-3.41), and visits to specialists/emergency department (OR 1.60, 95% CI 1.16-2.19) or any hospitalizations (OR 1.89, 95% CI 1.42-2.52) compared with visits to primary care physicians only. In the subgroup of 978 hyperpolypharmacy-only adults with available adherence data, 517 (53%) had low/medium medication adherence. In multivariable analyses, the odds of low/medium medication adherence increased with increasing number of comorbidities (p for linear trend 0.005) but decreased with older age (OR 0.69, 95% CI 0.52-0.92 for ≥ 80 versus < 80 years) and receipt of community nurse care (OR 0.59, 95% CI 0.44-0.81).</p><p><strong>Conclusions: </strong>More than half of older adults with hyperpolypharmacy had suboptimal medication adherence. Our findings suggest that primary care physicians may contribute to reducing hyperpolypharmacy, while introduction of community nurse visits could improve medication adherence.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"99-110"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12855351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145502697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Management of Glucocorticoid-Induced Osteoporosis with a Focus on Older Adults: A Narrative Review.","authors":"Elena Tsourdi, Ulrike Baschant, Martina Rauner, Hanna Taipaleenmäki, Elizabeth M Winter","doi":"10.1007/s40266-025-01269-3","DOIUrl":"10.1007/s40266-025-01269-3","url":null,"abstract":"<p><p>Glucocorticoid-induced osteoporosis is the most common cause of secondary osteoporosis and constitutes an important health problem, associated with an increased risk of fractures, significant morbidity and mortality, and long-term decreased quality of life. Aging is linked to extensive multimorbidity, polypharmacy, physical and mental disability, and an increased risk of falls, rendering management of glucocorticoid-induced osteoporosis in the older population particularly challenging. On a pathophysiological level, aging is associated with declining osteoblast activity, increased osteoclast activity, and increased bone marrow adiposity; effects that are all accentuated by glucocorticoids. In this narrative review, we discuss the pathophysiology of glucocorticoid-induced osteoporosis, and focus on the mechanism of action, pharmacokinetics, and pharmacodynamics of the various pharmaceutical agents used in the treatment of glucocorticoid-induced osteoporosis, as well as their efficacy, tolerability and safety, especially in older individuals.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"49-67"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Guideline Adherence in Gabapentinoid Use among Geriatric Outpatients: A Retrospective Cross-Sectional Study at a Falls Clinic.","authors":"Hussein Alkafaji, Jesper Schmidt, Johannes Riis, Dmitri Zintchouk, Stig Andersen","doi":"10.1007/s40266-025-01256-8","DOIUrl":"10.1007/s40266-025-01256-8","url":null,"abstract":"<p><strong>Purpose: </strong>With pain treatment shifting away from opioids, alternative analgesics-such as gabapentinoids-are increasingly being used. This study investigated the prevalence and indications for gabapentinoid use among geriatric outpatients, a population particularly vulnerable to central nervous system (CNS)-active drugs.</p><p><strong>Methods: </strong>A retrospective cross-sectional chart review was conducted among patients visiting the geriatric falls clinic at Aalborg University Hospital, Denmark, in 2013-14, 2018-19 and 2023. Demographic data, comorbidities, medication status, fall frequency, in-clinic measurements, reported pain and dizziness, frailty status, as well as indications for gabapentinoid prescriptions were extracted and classified according to guidelines.</p><p><strong>Results: </strong>A total of 773 patients were screened, and 635 included (2013/2018/2023, n = 144/265/226). The mean age was 81.2 years, 59% were female, and nearly half of the patients were frail (Clinical Frailty Scale (CFS) ≥ 5). Chronic pain was increasingly reported at the falls clinic (46/62/68%, p < 0.001). Gabapentinoid use increased with time (3.5/10.9/15%, p = 0.002), while opioid use decreased (29.2/19.2/11.9%, p < 0.001). A total of 65 patients took gabapentinoids for pain, of which 42 (62%) were not supported by guidelines; 18 (26%) were vaguely supported, while only five (7%) were clearly supported by guidelines. Most had been on gabapentinoids for > 1 year, and deprescription was initiated in approximately 40%.</p><p><strong>Conclusions: </strong>A marked increase in gabapentinoid use among patients assessed at the geriatric falls clinic was found, with a corresponding decrease in opioid use. The majority of gabapentinoid prescriptions were for indications not supported by guidelines.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"77-87"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12855225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial Real-World Evidence for Lecanemab in the United States.","authors":"Diana I Brixner, Chenyue Zhao, Hideki Toyosaki, Feride H Frech, Michael H Rosenbloom","doi":"10.1007/s40266-025-01261-x","DOIUrl":"10.1007/s40266-025-01261-x","url":null,"abstract":"<p><strong>Background: </strong>Lecanemab is the first anti-amyloid monoclonal antibody with full approval in the US for the treatment of early Alzheimer's disease (AD). This observational study aimed to provide information about patient demographics, clinical characteristics, provider specialty, and lecanemab utilization patterns.</p><p><strong>Methods: </strong>This observational study used open administrative claims from the PurpleLab, a database encompassing medical and pharmacy claims derived from diverse sources, such as clearinghouses and Pharmacies. We included patients receiving one or more lecanemab doses between January 6, 2023 and October 31, 2024, and having continuous clinical activity ≥ 6 months prior to the first lecanemab infusion. The observation period ran from the first lecanemab infusion to the latest clinical activity or data availability. Treatment gaps were calculated as the number of gap days in lecanemab supply between consecutive infusions.</p><p><strong>Results: </strong>Among the study population (n = 4261), mean age was 75.2 years, 77.8% were White, 98.4% lived in urban settings, 81.7% were treated by neurologists, 77.3% had AD, and 31.7% had mild cognitive impairment. Mean follow-up period was 171.1 days. Lecanemab infusions averaged 1.9 per patient per month (SD 1.0), 16.3 days apart (SD 11.0), and 2.8% of patients experienced a treatment interruption ≥90 days.</p><p><strong>Conclusions: </strong>Lecanemab utilization followed US FDA-approved prescribing information. Disparities for minority and rural-based populations were observed suggesting opportunities to improve access for underserved populations.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"69-76"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12855276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145400204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriate Use of Proton Pump Inhibitors in Older Adults: Concerns and Solutions.","authors":"Jennifer Bolt, Wade Thompson, Colleen Inglis","doi":"10.1007/s40266-025-01266-6","DOIUrl":"10.1007/s40266-025-01266-6","url":null,"abstract":"<p><p>Proton pump inhibitors (PPIs) are amongst the most commonly prescribed medications worldwide. Clinical practice guidelines identify clear indications for short-term and long-term use; however, many older adults are prescribed potentially unnecessary PPIs. Multiple concerns exist with unnecessary PPI therapy, including the potential long-term risk of adverse effects. An association between PPI use and fractures, dementia, and respiratory and gastrointestinal infections has been suggested in observational data; however, there is a paucity of high-quality data supporting a causative relationship. Despite this, PPIs remain a target for medication optimization in older adults because of the high rate of unnecessary use, cost, and contribution to pill burden and polypharmacy. A multidimensional approach is required to reduce unnecessary PPI's, including the alignment of initial prescribing with evidence-based indications, reassessment of existing prescriptions, enhancement of knowledge and resources for patients and prescribers, and support for deprescribing. To increase deprescribing success, barriers to PPI deprescribing must be addressed, including the fear of symptom recurrence, insufficient time and education, and lack of concern regarding long-term use. Deprescribing strategies, such as tapering, can aid in success, as can the utilization of nonpharmacological and lower risk options for managing symptoms of gastric-acid-related disorders.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"1-8"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying the Bradford Hill Criteria to Assess the Independent Causal Roles of Aging and Medication in Frailty Progression: A Systematic Review.","authors":"Subindra Kazi Thapa, Jia Li, John Mach, Sarah N Hilmer, Carl M J Kirkpatrick","doi":"10.1007/s40266-025-01273-7","DOIUrl":"10.1007/s40266-025-01273-7","url":null,"abstract":"<p><strong>Background: </strong>The scientific literature, including systematic reviews and meta-analyses, has frequently described associations between aging, medication use, and frailty, without evaluation of their independent causation. The Bradford Hill Criteria, a framework consisting of nine principles for assessing epidemiological causation, is ideally suited to unconfound and assess the independent causal effect of aging versus medication use, in frailty progression.</p><p><strong>Methods: </strong>A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, searched MEDLINE, EMBASE, and CENTRAL with no restrictions on date or study design. Studies were selected based on predefined inclusion criteria and assessed for quality using the Joanna Briggs Institute critical appraisal tool. Where appropriate, meta-analyses of collated data were performed in RStudio, including effect sizes accounting for minimum age and polypharmacy to reduce confounding bias. Causal relationships between aging, medication use, and frailty were then evaluated independently using the nine principles of the Bradford Hill Criteria.</p><p><strong>Results: </strong>Data from 105 moderate-to-high quality studies based on the Joanna Briggs Institute assessment were extracted, formatted, and compiled to allow evaluation via the Bradford Hill Criteria. Evidence supported a strong independent causal relationship between aging, medication use, and frailty progression across eight of the nine principles. Strength of association, consistency, and a clear biological gradient were observed, with frailty increasing alongside age and medication count, respectively. Temporality was addressed as aging and medication exposure often preceded frailty, while interventions reducing medication supported the experiment criterion. Biological plausibility, biological coherence, and analogy were reinforced by clear biological mechanism, scientific reasoning, and epidemiological patterns. However, specificity could not be fully met, as frailty is influenced by multiple factors beyond aging and medication use, making the relationship inherently non-specific.</p><p><strong>Conclusions: </strong>An independent causal link between aging and frailty, as well as between medication use and frailty, is well supported by the framework of Bradford Hill Criteria. Given the limited availability of randomized controlled trials or interventional studies in older adults, these findings offer valuable insights where evidence has been lacking and serve as a strategic starting point for future investigations into factors driving frailty progression.</p><p><strong>Clinical trial registration: </strong>PROSPERO Registration Number CRD42024614144.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"9-28"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12855283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Peripheral Neuropathy: New Diagnostics and Treatment Perspectives.","authors":"Michal Dubský, Dominika Sojáková, Vladimira Fejfarová, Edward B Jude","doi":"10.1007/s40266-025-01267-5","DOIUrl":"10.1007/s40266-025-01267-5","url":null,"abstract":"<p><p>Diabetic peripheral neuropathy (DPN) is one of the most significant chronic complications in people with diabetes. It is a highly heterogeneous condition that affects various parts of the nervous system and presents with a wide range of symptoms. Early diagnosis of diabetic neuropathy is possible if regular screening for this complication is conducted using modern diagnostic methods. Every diabetes clinic should perform annual screening for DPN to identify the risk of diabetic foot disease using a monofilament and tuning fork (or biothesiometer). The treatment of diabetic neuropathy remains limited, as studies on causal therapy have shown conflicting results. In most cases, treatment is restricted to achieving optimal glucose control, symptomatic therapy and the management of the painful form of diabetic neuropathy. Ultimately prevention of complications secondary to neuropathy is paramount and it can lead to foot ulcerations, deformities and amputations.Diabetic neuropathy represents a major health challenge for individuals with diabetes, necessitating ongoing research and public health initiatives aimed at improving screening, prevention and treatment strategies.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"29-48"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12855444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Sacubitril/Valsartan in Reducing Hospitalizations in Older Belgian Adults with Heart Failure and Reduced Ejection Fraction: An Age-Stratified Study.","authors":"Eléonore Maury, Lorenz Van der Linden, Kris Bogaerts, Ann Belmans, Mieke Jansen","doi":"10.1007/s40266-025-01265-7","DOIUrl":"10.1007/s40266-025-01265-7","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with reduced ejection fraction is increasingly prevalent in older adults, yet data on guideline-directed therapies in the oldest age groups remain limited.</p><p><strong>Objective: </strong>To assess outcomes of sacubitril/valsartan in adults aged ≥75 years, across age strata (≥75, ≥80, ≥85, ≥90 years; 75-79, 80-84, 85- 89 years), focusing on cardiovascular, heart failure, and all-cause hospitalizations, and mortality.</p><p><strong>Methods: </strong>This retrospective study evaluated all patients aged ≥ 75 years in Belgium with chronic heart failure with reduced ejection fraction who started sacubitril/valsartan between 1 November, 2016 and 31 December, 2018.</p><p><strong>Results: </strong>A total of 1705 patients were divided into the following age groups: 75-79, 80-84, 85-89, and ≥ 90 years. Cardiovascular hospitalization rates significantly decreased across all age groups after sacubitril/valsartan initiation. Patients aged 75-79 years showed a reduction from 0.74 events/year (95% confidence interval [CI] 0.68-0.81) prior to treatment to 0.54 (95% CI 0.47-0.62, p < 0.001) after initiation. Rates fell from 0.73 (95% CI 0.66-0.80) to 0.53 (95% CI 0.44-0.65, p < 0.001) in those aged 80-84 years, from 0.62 (95% CI 0.52-0.74) to 0.44 (95% CI 0.35-0.57, p < 0.01) in those aged 85-89 years, and from 0.78 (95% CI 0.59-1.03) to 0.42 (95% CI 0.22-0.83, p < 0.01) in patients aged ≥ 90 years. Heart failure-related hospitalization rates also showed consistent reductions: 0.34 (95% CI 0.30-0.39) prior to treatment to 0.28 (95% CI 0.22-0.34) after initiation in patients aged 75-79 years, and from 0.38 (95% CI 0.33-0.43) to 0.30 (95% CI 0.23-0.39) in those aged 80-84 years (all p < 0.05). The rates decreased from 0.35 (95% CI 0.28-0.44) to 0.27 (95% CI 0.20-0.38, p = 0.08) in those aged 85-89 years and from 0.52 (95% CI 0.36-0.76) to 0.29 (95% CI 0.12-0.75, p < 0.05) in the oldest patients aged ≥ 90 years.</p><p><strong>Conclusions: </strong>Broader application of guideline-directed medical therapy in geriatric heart failure with reduced ejection fraction care should be prioritized.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"89-98"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12855300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The FORTA (Fit for the Aged) List 2024: Fifth Version of a Validated Clinical Aid for Improved Pharmacotherapy in Older Adults.","authors":"Farhad Pazan, Christel Weiss, Martin Wehling","doi":"10.1007/s40266-025-01257-7","DOIUrl":"10.1007/s40266-025-01257-7","url":null,"abstract":"","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"1197-1199"},"PeriodicalIF":3.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}