Geriatrics & Gerontology International最新文献

{"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}

{"title":"Antiplatelet Therapy by Inertia: Heterogeneous Indications and Absent Re-Evaluation in a Geriatric Care Facility","authors":"Akira Tsuda,&nbsp;Takeshi Kato,&nbsp;Yasushi Suzuki,&nbsp;Kaori Shibuya","doi":"10.1111/ggi.70852","DOIUrl":"https://doi.org/10.1111/ggi.70852","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":"149029108","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":"Simple Bedside Muscle-Related Indicators Improve the Identification of Reduced Kidney Function in Hospitalized Older Adults: A Multicenter Cross-Sectional Study","authors":"Shigemi Morishita,&nbsp;Ken-ei Sada,&nbsp;Masataka Kudo,&nbsp;Naofumi Dobashi,&nbsp;Kiichiro Fujisaki,&nbsp;Sho Sasaki","doi":"10.1111/ggi.70851","DOIUrl":"https://doi.org/10.1111/ggi.70851","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Creatinine-based estimated glomerular filtration rate (eGFRcr) may overestimate kidney function in older adults with reduced muscle mass. Although current guidelines recommend cystatin C when creatinine-based estimates are unreliable, its routine use remains limited. We evaluated whether incorporating simple bedside muscle-related indicators into eGFRcr improves the identification of reduced kidney function defined by cystatin C-based estimated glomerular filtration rate (eGFRcys).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a multicenter cross-sectional study of hospitalized adults aged ≥ 60 years at four Japanese community hospitals. Three models were evaluated: eGFRcr only (Basic model), eGFRcr plus calf circumference (Model 1), and eGFRcr plus the finger-ring test (Model 2). The primary outcome was continuous eGFRcys, and eGFRcys &lt; 45 mL/min/1.73 m².</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 98 participants (median age 79 years), adding muscle-related indicators modestly improved model performance. Adjusted <i>R</i>² increased from 0.641 (Basic model) to 0.668 (Model 1) and 0.680 (Model 2). The proportion of participants correctly classified with eGFRcys &lt; 45 mL/min/1.73 m² increased from 56.1% with the eGFRcr alone to 80.5% with both extended models. Discrimination also improved (area under the curve: 0.882 vs. 0.921 and 0.918, respectively), although the differences were not statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Incorporating simple bedside muscle-related indicators to creatinine-based assessment improved the identification of reduced kidney function defined by eGFRcys in hospitalized older adults. These measures may complement eGFRcr interpretation when cystatin C measurement is unavailable or delayed. External validation is required before clinical implementation.</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.70851","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029070","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 of Computer and Smartphone Use, Health Literacy, and Frailty Among Community-Dwelling Older Adults: The Higashiura Study","authors":"Noriko Hori,&nbsp;Yosuke Osuka,&nbsp;Yoshiko Lily Ishioka,&nbsp;Kaori Kinoshita,&nbsp;von Fingerhut Georg,&nbsp;Kazuhiro Yoshiura,&nbsp;Shosuke Satake","doi":"10.1111/ggi.70836","DOIUrl":"10.1111/ggi.70836","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Frailty is an age-related condition involving physical, psychological, and social functional decline, and global efforts to prevent frailty using information and communication technology have recently expanded. This study aimed to examine whether computer and smartphone use among community-dwelling older adults is associated with frailty mediated by health literacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were community-dwelling adults aged ≥ 65 years without long-term care certification participating in the 2024 Higashiura Study. The primary outcome was frailty assessed using the revised Japanese Cardiovascular Health Study criteria. In this cross-sectional study, the independent variable was computer and smartphone use for health information acquisition and health management. The mediating variable was health literacy measured using the Communicative and Critical Health Literacy Scale. Mediation analysis was conducted, adjusting for age, gender, educational attainment, and household income, with 95% confidence intervals (CIs) estimated via bootstrapping.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 451 participants, 423 were analyzed. Frailty prevalence was 15 participants (3.5%), and 143 (33.8%) of participants reported computer and smartphone use. In the main outcome analysis (frailty vs. non-frailty), mediation analysis showed a non-significant direct effect (<i>β</i> = −0.818, 95% CI: −2.127 to 0.490) and a significant indirect effect through health literacy (<i>β</i> = 0.323, 95% CI: 0.084–0.698). No significant indirect effect was observed for the sub-outcome analysis (robust vs. non-robust).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among community-dwelling older adults, not engaging in health-related computer and smartphone use was associated with frailty, and lower health literacy may be involved in this association. Further longitudinal studies are needed to clarify temporal relationships between these factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 9","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148989221","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":"Network Analysis of Health-Related Quality of Life by Frailty Status Among Korean Older Adults: Korea National Health and Nutrition Examination Survey (KNHANES) 2019–2021","authors":"SoYoung Kim,&nbsp;BeLong Cho","doi":"10.1111/ggi.70773","DOIUrl":"10.1111/ggi.70773","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Frailty in older adults is a multidimensional syndrome associated with adverse outcomes and reduced health-related quality of life (HRQoL). However, differences in HRQoL structure by frailty status are not well understood, and this study aimed to compare HRQoL network structures between frail and non-frail older adults and identify the most influential components in each group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from 1311 adults aged ≥ 65 years in the 2019–2021 Korea National Health and Nutrition Examination Survey. Frailty was defined using a modified Fried phenotype, and HRQoL was measured with the Health-Related Quality of Life Instrument with Eight Items. Regularized partial correlation networks were estimated, and centrality, accuracy, and stability were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Frail group was older, more often female, socioeconomically disadvantaged, and had higher comorbidity burdens than non-frail group. In the frail group, depression–happiness was the strongest link, with working, depression, happiness, and sleep showing high centrality (strength); in non-frail group, climbing stairs–pain was strongest, with working, depression, climbing stairs, and pain central. Across groups, HRQoL was positively associated with better self-rated health, absence of unmet medical needs, and better oral health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HRQoL is organized differently according to frailty status: mental–emotional domains dominate the frail network, whereas physical-social domains dominate the non-frail network. The consistently high centrality of Work across groups highlights perceived role participation as a key lever for improving HRQoL in older adults. These findings support frailty-specific, network-informed strategies—emphasizing emotional support in frail older adults and physical resilience in non-frail older adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 9","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ggi.70773","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919346","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":"Nationwide Descriptive Analysis of Older Inpatients Eligible for Japan's Dementia-Care Financial Incentive in Acute-Care Hospitals","authors":"Jinyan Wu,&nbsp;Kojiro Morita,&nbsp;Ayumi Igarashi,&nbsp;Hideo Yasunaga,&nbsp;Taro Kojima,&nbsp;Taisuke Yasaka,&nbsp;Yuya Kimura,&nbsp;Hiroki Matsui,&nbsp;Kiyohide Fushimi,&nbsp;Noriko Yamamoto-Mitani","doi":"10.1111/ggi.70824","DOIUrl":"10.1111/ggi.70824","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>In 2016, Japan introduced a dementia care add-on (DCA; levels 1 and 2) to incentivize hospital-based dementia care. However, nationwide characteristics of eligible patients, including care processes and outcomes, remain unclear. We conducted a descriptive national analysis of DCA-eligible inpatients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed a national inpatient database in Japan, including patients aged ≥ 65 years admitted between fiscal years 2016 and 2019 who met DCA eligibility criteria—moderate-to-severe dementia without severe consciousness disturbance. Patient characteristics, DCA uptake, care utilization indicators, and outcomes were summarized by year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1 046 652 hospitalizations, patients were predominantly of advanced age (mean 85.4 years) and functionally dependent, with &gt; 70% requiring full assistance with activities of daily living at admission and discharge. Patient characteristics remained stable over time; approximately 20% were admitted for pneumonia or aspiration pneumonia. From 2016 to 2019, DCA1 and DCA2 billings increased from 6.4% to 20.8% and from 13.2% to 32.8%, respectively. Mean length of stay declined from 33.7 to 27.8 days, and in-hospital mortality from 13.9% to 12.9%. Potentially inappropriate medication use at discharge decreased from 16.2% to 14.0%. In-hospital fractures remained stable at 0.9%–1.0%. About half of patients admitted from home were discharged home.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DCA-eligible inpatients are highly vulnerable. Despite increased uptake, coverage remained incomplete. This study provides baseline data to inform dementia care policy and future evaluations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 9","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ggi.70824","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911519","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":"Comment on: “Effectiveness of High-Intensity Versus Low-To-Moderate-Intensity Resistance Training in Improving Muscle Strength and Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials”","authors":"Songxiahe Zhao,&nbsp;Jinrui Lin,&nbsp;Yibin Du","doi":"10.1111/ggi.70776","DOIUrl":"10.1111/ggi.70776","url":null,"abstract":"","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 9","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900249","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":"Correction to “Early Acute-Phase Energy Intake Is Independently Associated With Swallowing Decline in Older Patients With Aspiration Pneumonia: A Retrospective Cohort Study”","authors":"","doi":"10.1111/ggi.70833","DOIUrl":"10.1111/ggi.70833","url":null,"abstract":"<p>\u0000 <span>M. Shigemasa</span>, <span>Y. Yatomi</span>, <span>J. Kayashita</span>, <span>Y. Hattori</span>, and <span>S. Tanimoto</span>, “ <span>Early Acute-Phase Energy Intake Is Independently Associated With Swallowing Decline in Older Patients With Aspiration Pneumonia: A Retrospective Cohort Study</span>,” <i>Geriatrics and Gerontology International</i> <span>26</span>, no. <span>7</span> (<span>2026</span>): e70660, https://doi.org/10.1111/ggi.70660.\u0000 </p><p>In the above-cited article, the authors identified errors in reported descriptive figures. The corrections are set out below. Tables 1 and 2 and Figures 1–3 are correct as published.</p><p>The number and proportion of patients with swallowing decline were reported incorrectly in the Results section of the Abstract. The first sentence currently reads:</p><p>“Of 200 patients, 109 (54.5%) experienced swallowing decline at discharge.”</p><p>This should have read:</p><p>“Of 200 patients, 108 (54.0%) experienced swallowing decline at discharge.”</p><p>The quartile-specific counts in Table 1 (34, 33, 23, and 18 patients in Q1–Q4) sum to 108 and are correct as published.</p><p>Because the Youden Index is the sum of sensitivity and specificity minus one, the identified cutoff value of 15.3 kcal/kg/day is unchanged, as are the area under the curve (0.648, 95% CI: 0.571–0.724) and the unadjusted odds ratio for intake below the cutoff (2.97, 95% CI: 1.65–5.32).</p><p>These errors are confined to reported descriptive figures. The adjusted odds ratios, the ROC-derived cutoff value and its area under the curve, the test for trend, the sensitivity analyses, and the test for interaction are unchanged, as are Tables 1 and 2 and Figures 1–3. The conclusions of the article are unaffected.</p><p>We apologize for these errors.</p>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 9","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900268","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":"Continence Impairment and Depressive Symptoms Jointly Identify Older Adults at Increased Risk of Mortality: Parallel Analyses From NHANES and CHARLS","authors":"Xin Jin,&nbsp;Xinming Chen,&nbsp;Qian Ye,&nbsp;Feng Sun","doi":"10.1111/ggi.70831","DOIUrl":"10.1111/ggi.70831","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Continence impairment and depressive symptoms frequently coexist in older adults, but whether their co-occurrence identifies a subgroup at elevated mortality risk across populations remains uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted parallel analyses among adults aged ≥ 60 years in the 2005–2010 National Health and Nutrition Examination Survey (NHANES) linked mortality files and the 2011–2018 China Health and Retirement Longitudinal Study (CHARLS). Continence impairment was defined as urinary or fecal incontinence in NHANES and by a combined functional item on difficulty controlling urination and defecation in CHARLS; these measures were harmonized at the conceptual rather than item level. Participants were classified as having neither exposure, depressive symptoms only, continence impairment only, or both. NHANES used survey-weighted Cox models, whereas CHARLS used ordinary unweighted Cox models in a unified fixed 7-year cohort. Missing covariates were addressed by multiple imputation with 20 datasets. Additive interaction measures were estimated from fixed-horizon risk ratios, not hazard ratios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analyses included 4851 NHANES participants (1052 deaths) and 4690 CHARLS participants (1044 deaths). Compared with neither exposure, the co-occurring group had higher mortality in NHANES (HR 1.60, 95% CI 1.20–2.13; <i>p</i> = 0.001) and CHARLS (HR 1.50, 95% CI 1.19–1.87; <i>p</i> &lt; 0.001). Fixed-horizon risk-ratio analyses provided no statistical evidence of additive interaction. The CHARLS midpoint death-time analysis produced a similar co-occurring-group estimate (HR 1.54, 95% CI 1.23–1.93).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Co-occurring continence impairment and depressive symptoms identified a higher-risk subgroup relative to participants with neither exposure in both cohorts, highlighting the value of considering these conditions together in mortality risk assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"26 9","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905783","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}