Geriatrics & Gerontology International最新文献

{"title":"Multidimensional Vulnerability Profiles Among Older Adults in Chinese Integrative-Care Settings: A Cross-Sectional Assessment of Function, Cognition, Clinical Risk, and TCM Constitution","authors":"Yizhou Wu, Haohua Li, Yiming Zhou","doi":"10.1111/ggi.70856","DOIUrl":"10.1111/ggi.70856","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Older adults in real-world Chinese integrative-care settings often present with uneven patterns of functional limitation, cognitive impairment, and clinical vulnerability. Whether routinely collected geriatric and Traditional Chinese Medicine (TCM) constitution records can be organized into clinically interpretable profiles remains insufficiently described.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional analysis of 402 adults aged 60 years or older assessed during 2024–2025 in three Shanghai institutions: a hospital TCM department, a nursing home, and an elderly care center. Of 435 screened records, 33 (7.6%) were excluded due to missing data. Four routine continuous variables were analyzed: Barthel Index, education-adjusted Montreal Cognitive Assessment (MoCA), a study-specific tumor risk score, and a study-specific infection risk score. Standardized variables were summarized by principal component analysis (PCA; PC1 and PC2, cumulative variance 70.8%) and K-means clustering. TCM constitution and concurrent care disposition were examined as external descriptive variables and were not used to derive clusters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants had a mean age of 78.0 ± 9.6 years; 206 (51.2%) were women. Among candidate solutions (<i>k</i> = 2–6), the gap statistic and silhouette coefficient both favored <i>k</i> = 2 (gap = 0.152, SE = 0.016; silhouette = 0.287), but a three-profile solution (silhouette = 0.252; gap = 0.118, SE = 0.019) was retained as an exploratory descriptive summary based on prespecified clinical interpretability criteria. The three profiles were: <i>Functionally Preserved Profile</i> (<i>n</i> = 149, 37.1%; Barthel 76.9 ± 14.8, MoCA 18.2 ± 3.9, tumor risk 9.6 ± 4.5, infection risk 25.0 ± 11.8), <i>Cognitive-Functional Vulnerability with Low Tumor-Risk Profile</i> (<i>n</i> = 101, 25.1%; Barthel 47.0 ± 18.2, MoCA 12.0 ± 4.6, tumor risk 4.9 ± 3.1, infection risk 34.3 ± 13.5), and <i>Multidomain High-Risk Profile</i> (<i>n</i> = 152, 37.8%; Barthel 37.8 ± 19.8, MoCA 12.0 ± 5.1, tumor risk 15.2 ± 5.6, infection risk 46.8 ± 15.2). The Cognitive-Functional Vulnerability profile had the lowest tumor risk score among the three profiles while its MoCA score was identical to that of the Multidomain High-Risk Profile, confirming that the profiles represent distinct combinations of domain-specific vulnerabilities rather than a single ordinal gradient. A preserved-function/impaired-cognition subgroup was identified in 73 participants (18.2%). Among nine TCM constitution labels, Yang deficiency differed across profiles after Bonferroni correction (<i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 ","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease Name Recognition and Prognosis in Older Patients With Heart Failure","authors":"Tatsuro Tasaka,&nbsp;Makoto Saito,&nbsp;Megumi Hamada,&nbsp;Masaki Kinoshita,&nbsp;Kaori Fujimoto,&nbsp;Sumiko Sato,&nbsp;Takumi Sumimoto,&nbsp;Tomoki Fujisawa,&nbsp;Kazuhisa Nishimura","doi":"10.1111/ggi.70857","DOIUrl":"10.1111/ggi.70857","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Health literacy is considered a prognostic determinant for patients with heart failure (HF), and the recognition of disease names could be fundamental to this. This study examined the proportion of patients with HF who recognized their disease name and its association with prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From January 2021 to June 2023, 188 hospitalized patients with HF (Stage B–D, median age 81 years) were asked to recall their disease name before discharge. Recognition accuracy was evaluated using a standardized scoring system, and interobserver agreement was confirmed. In a subset, communicative and critical health literacy (CCHL) was assessed. Prognostic outcomes included all-cause mortality and all-cause hospitalization after discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The recognition score showed high interobserver reliability (<i>κ</i> = 0.85). Seventy-two patients (38%) failed to recognize their primary diagnosis. Those without recognition had significantly lower CCHL scores than those with recognition (<i>p</i> &lt; 0.01). During a median follow-up of 280 days, 76 patients (40%) experienced adverse events. In univariate analyses, lack of diagnosis recognition was associated with an increased risk of adverse outcomes, but this association disappeared after adjustment for age, cognitive function, and HF severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A substantial number of older patients with HF did not recognize their primary diagnosis, but disease recognition was not an independent determinant of prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Kidney Function and Risk of Cognitive Impairment Among Chinese Older Adults","authors":"Xin Wang,&nbsp;Yue Zhang,&nbsp;Zhigang Wang,&nbsp;Xiaolei Liu","doi":"10.1111/ggi.70859","DOIUrl":"10.1111/ggi.70859","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The association between kidney function and dementia remains inconsistent across studies, and its relationship in older adults is unclear. This study aimed to investigate the longitudinal associations between kidney dysfunction, assessed by estimated glomerular filtration rate (eGFR) and albuminuria, and cognitive impairment (CI) in a national cohort of Chinese older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included individuals aged ≥ 65 years from the 2011 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE). Kidney function was evaluated by eGFR (CKD-EPI equation) and the urinary albumin-to-creatinine ratio (ACR), classified by KDIGO categories and quartiles. Multivariable logistic regression models were used to assess cross-sectional (<i>n</i> = 3364) and prospective (<i>n</i> = 1195) associations, controlling for sociodemographic and clinical confounders. The false discovery rate was controlled for multiple comparisons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In cross-sectional analysis, both lower eGFR and higher ACR were independently associated with higher odds of prevalent CI. Prospectively, over a 3-year follow-up, 143 of 1195 cognitively normal participants developed CI. Compared to those with normal kidney function, participants with impaired (eGFR &lt; 60 mL/min/1.73 m²) kidney function had a significantly higher risk of incident CI (OR = 1.744, 95% CI: 1.162–2.616). Similarly, elevated ACR (categories A2 and A3) was associated with increased incident CI risk (A2: OR = 1.801, 95% CI: 1.111–2.920; A3: OR = 2.650, 95% CI: 1.541–4.557).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Impaired kidney function, indicated by reduced eGFR and elevated ACR, is independently associated with an increased risk of cognitive impairment in older adults. These findings support integrating cognitive screening into the clinical management of elderly patients with chronic kidney disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"White Blood Cell to HDL-C Ratio and Sarcopenia: A Dual-Cohort Analysis Including Exploratory Insights on Hepatitis B History","authors":"Wenshuo Cheng,&nbsp;Huiling Xiang","doi":"10.1111/ggi.70858","DOIUrl":"10.1111/ggi.70858","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sarcopenia, driven by inflammation and lipid dysregulation, lacks inexpensive screening tools. The white blood cell to HDL-C ratio (WHR) integrates these pathways, but its utility for sarcopenia screening remains unvalidated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study evaluated the WHR-sarcopenia association in dual cohorts, validated it using machine learning, and explored potential effect modification of hepatitis B virus (HBV) status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 10 131 NHANES (2011–2018) and 7872 KNHANES (2010–2011) adults. Sarcopenia was defined via DXA using FNIH/AWGS criteria. Weighted logistic regression, restricted cubic splines, and machine learning (LASSO, XGBoost) were applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher ln(WHR) was independently associated with sarcopenia in NHANES (adjusted OR = 2.50; 95% CI: 2.01–3.10) and consistently validated in KNHANES (OR = 1.85; 95% CI: 1.49–2.29). WHR ranked among the top predictive features across machine learning models. Exploratory stratified analysis suggests that the association between ln(WHR) and sarcopenia appears to be stronger in the HBV-exposed subgroup. However, although the formal interaction test was not significant (<i>p</i> = 0.270), these findings are hypothesis-generating results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>WHR, a cost-free routine metric, is robustly linked to sarcopenia. Integrating it into geriatric assessments could facilitate early high-risk identification for timely interventions, while exploratory findings suggesting a possible modifying role of HBV history require prospective validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Surgical Treatment of Insulinoma in a 91-Year-Old Woman","authors":"Takeshi Yagihashi,&nbsp;Naoki Ohtake,&nbsp;Toshitaka Sugawara,&nbsp;Takuya Minagawa,&nbsp;Takahide Hashimoto,&nbsp;Masaya Yamaga,&nbsp;Tomohiko Yoshida,&nbsp;Amika Kajiyama,&nbsp;Rikako Furukawa,&nbsp;Masahiro Shinoda,&nbsp;Osamu Itano,&nbsp;Minoru Takemoto","doi":"10.1111/ggi.70843","DOIUrl":"10.1111/ggi.70843","url":null,"abstract":"","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Dosage Drive Durability? A Longitudinal Study on Digital Cognitive Training for Sustained Functional Independence","authors":"Bruno Costa Poltronieri,&nbsp;Cíntia Monteiro Carvalho,&nbsp;Karin Reuwsaat,&nbsp;Maria Eduarda Alves Reis,&nbsp;Ana Carolina Madeira,&nbsp;Thayná de Carvalho Freire,&nbsp;Rogerio Panizzutti","doi":"10.1111/ggi.70848","DOIUrl":"https://doi.org/10.1111/ggi.70848","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to investigate whether a higher cumulative dose of digital cognitive training leads to greater and more sustained improvements in cognition and functionality among older adults with Mild Neurocognitive Disorder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We recruited participants aged 60 or older with mild neurocognitive disorder to a double-blinded, randomized, stepped wedge clinical trial of digital cognitive training (DCT) compared to an active control group of commercial computer games. Participants were evaluated for functionality and cognition before, after 10 h and 20 h of intervention and in the follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-seven participants completed DCT and were evaluated. The group that received 20 h of DCT showed significant improvements in functionality and satisfaction, as well as gains in processing speed, verbal fluency, and inhibitory control. The 10 h group also showed improvements in specific areas such as processing speed and recognition. In the 20 h group, the benefits were maintained at 3- and 6-month follow-ups, especially in functionality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study suggests that a higher cumulative dose of DCT may lead to more sustained improvements in functionality performance among older adults with mild neurocognitive disorder. Findings highlight the need for further research to determine optimal training dosage for long-term improvements in cognition and functionality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>The studies reported in the manuscript were pre-registered at ClinicalTrials.gov under the identifier NCT03911765</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ggi.70848","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Absorbent Product Use and Quality of Life in Community-Dwelling Older Adults","authors":"Hiroaki Nakagawa,&nbsp;Hajime Yamazaki,&nbsp;Akihiro Ozaka,&nbsp;Ryohei Yamamoto,&nbsp;Sho Sasaki,&nbsp;Sugihiro Hamaguchi,&nbsp;Shunichi Fukuhara","doi":"10.1111/ggi.70853","DOIUrl":"10.1111/ggi.70853","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Absorbent products are widely used to manage incontinence. However, the circumstances under which they are used and whether burden differs by product type remain unclear. We conducted a population-based study to evaluate the association between incontinence-related quality of life (QOL) and absorbent product use and to compare burden across product types.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study included independent, community-dwelling older adults aged ≥ 75 years in Japan. Incontinence status and absorbent product use were assessed using a self-reported questionnaire. Incontinence-related QOL and the burden of absorbent product use were evaluated using the one-item Quality of Life Disease Impact Scale. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between incontinence-related QOL and absorbent product use. Linear regression models were used to evaluate the burden across product types.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 3120 participants (median age, 79 years; interquartile range, 76–83), 43.1% reported any incontinence, including urinary incontinence (40.8%) and fecal incontinence (12.6%). Absorbent products were used by 14.7% of participants. Reduced incontinence-related QOL was associated with absorbent product use (OR: 2.02, 95% CI: 1.65–2.47; <i>p</i> &lt; 0.001), independent of incontinence frequency. Compared with pants-type products, flat-type products tended to be associated with greater burden (<i>β</i> = 1.56, 95% CI: −0.089 to 3.21; <i>p</i> = 0.064), and a similar tendency was observed among participants with fecal incontinence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinicians need to understand that absorbent product use reflects not only symptom frequency but also the impact of incontinence on QOL. Appropriate product selection based on individual incontinence characteristics may help reduce burden.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenic Obesity as a Key Determinant of Urinary Incontinence in Older Women","authors":"Neziha Özlem Deveci,&nbsp;Sibel Akın,&nbsp;Kamil Deveci","doi":"10.1111/ggi.70838","DOIUrl":"10.1111/ggi.70838","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Urinary incontinence (UI) is a common geriatric syndrome that adversely affects quality of life. Sarcopenia and sarcopenic obesity (SO) may increase vulnerability to UI through the interplay of muscle weakness and excess adiposity, yet their contribution in older women is not well established. This study examined the prevalence of UI across women with sarcopenia and SO and explored its associations with other geriatric syndromes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study, 535 community-dwelling women aged ≥ 60 years attending a geriatrics outpatient clinic underwent comprehensive geriatric assessment. Sarcopenia risk was screened using the SARC-F questionnaire, muscle strength measured by handgrip dynamometry, and muscle mass estimated via bioelectrical impedance analysis. Obesity was defined by BMI, waist circumference, or body fat percentage, and SO was defined as the coexistence of sarcopenia and obesity. Logistic regression was used to identify independent predictors of UI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>UI was reported by 49.9% of participants. Women with UI had higher BMI, more frequent falls, greater frailty, depressive symptoms, higher SARC-F scores, and a greater prevalence of SO. Among the three adjustment methods for SMMI, only BMI-adjusted values showed an association with UI. In multivariable logistic regresion models, fall history (aOR 2.05, 1.38–3.02), SARC-F score (aOR 1.12, 1.02–1.22) and BMI-defined SO (aOR 1.80, 1.09–2.96) independently predicted UI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SO, sarcopenia risk, and fall history are key determinants of UI in older women. Incorporating muscle and adiposity assessment into continence evaluation may support earlier interventions to maintain continence and independence in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Machine Learning–Derived Risk Scorecard for Pneumonia Hospitalization in Japanese Old-Old Adults","authors":"Akio Shimizu,&nbsp;Hajime Kamiya,&nbsp;Masaki Tanabe,&nbsp;Ryota Sakamoto,&nbsp;Hirokazu Matsui,&nbsp;Ryo Momosaki","doi":"10.1111/ggi.70850","DOIUrl":"https://doi.org/10.1111/ggi.70850","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To develop and internally validate a machine learning–based risk scorecard for 1-year pneumonia hospitalization among community-dwelling Japanese adults aged ≥ 75 years using routinely collected frailty screening and claims data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study of 1 098 404 community-dwelling adults aged ≥ 75 years who completed the Questionnaire for Medical Checkup of Old-Old (QMCOO) between April 2020 and March 2024, using the Late-Stage Medical Care System claims database. Data were split into training (70%) and test (30%) sets. A Super Learner ensemble of 20 base learners was developed to predict 1-year pneumonia hospitalization (ICD-10: J12–J18, J69). An independent 17-feature point-based scorecard (0–21 points) was derived from the training set with Platt calibration. Performance was evaluated by the area under the receiver operating characteristic curve (AUC), calibration slope, and calibration-in-the-large.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1 098 404 participants (mean age 80.6 [SD 5.0] years; 40.3% male), 4525 (0.41%) experienced pneumonia hospitalization. On the test set, the Super Learner achieved an AUC of 0.823 (95% CI, 0.812–0.834) and the scorecard 0.786 (0.774–0.798), which showed good calibration (slope 1.017; calibration-in-the-large −0.001). Stratification into low (0–6 points; 55.6%, 0.12% event rate), moderate (7–10; 35.4%, 0.49%), and high (≥ 11; 9.0%, 1.91%) groups yielded a 15.9-fold risk gradient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A QMCOO-based risk scorecard showed good discrimination and calibration for predicting 1-year pneumonia hospitalization in this population. If externally validated, this tool may help identify high-risk individuals during routine health checkups and support targeted preventive assessment in primary care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ggi.70850","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty, Functional Status, and Functional Decline Are Not Interchangeable Outcomes","authors":"Daniel Robson","doi":"10.1111/ggi.70845","DOIUrl":"https://doi.org/10.1111/ggi.70845","url":null,"abstract":"","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}