Gerontology最新文献

{"title":"Osteoporosis in the Oldest Old - From Diagnosis to Treatment: A Narrative Review.","authors":"Hans Peter Dimai, Barbara Obermayer-Pietsch","doi":"10.1159/ger/acxag010","DOIUrl":"https://doi.org/10.1159/ger/acxag010","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis and fragility fractures are major causes of disability, loss of independence, institutionalization, and mortality in the oldest old. Despite their exceptionally high fracture risk, adults aged ≥80 years remain underrepresented in randomized controlled trials. Diagnosis and treatment are complicated by the interaction of skeletal fragility with falls, sarcopenia, frailty, multimorbidity, cognitive and functional impairment, and competing mortality.</p><p><strong>Summary: </strong>This narrative review discusses the diagnosis, fracture-risk assessment, non-pharmacological management, and pharmacological treatment of osteoporosis in the oldest old. Bone mineral density (BMD) remains central to osteoporosis diagnosis but incompletely characterizes fracture risk at advanced age. Previous and particularly recent fractures, prevalent vertebral fractures, falls, physical performance, nutritional status, and frailty provide complementary information. Interpretation of the Fracture Risk Assessment Tool FRAX® requires particular consideration in the oldest old because competing mortality may cause 10-year fracture probabilities to plateau or decline despite increasing age-specific fracture incidence; FRAXplus® incorporates additional risk modifiers, including falls and the number and recency of previous fractures. Non-pharmacological interventions addressing nutrition, muscle function, balance, and falls complement bone-directed pharmacotherapy. Available evidence does not indicate that chronological age itself attenuates the efficacy of osteoporosis pharmacotherapy, although direct randomized fracture-endpoint evidence in adults aged ≥80 years remains limited. Risedronate and, historically, strontium ranelate provide some of the clearest fracture data specifically in this age group, whereas evidence for most other therapies derives from older-subgroup analyses, skeletal efficacy studies, observational data, or extrapolation from pivotal trials. At advanced age, renal function, cognition, mobility, adherence, caregiver support, and continuity of care increasingly influence the translation of efficacy into clinical effectiveness.</p><p><strong>Key messages: </strong>Fracture risk in the oldest old reflects the interaction of skeletal fragility with falls, frailty, sarcopenia, and functional reserve. Available evidence supports preservation of pharmacological antifracture efficacy with advancing age, but direct evidence in octogenarians and particularly nonagenarians remains scarce. Treatment feasibility and continuity of care become increasingly relevant at advanced age. Greater representation of the oldest old in clinical trials is needed, with particular attention to fracture outcomes, treatment sequencing, time to benefit, and outcomes relevant to independence and quality of life.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206752","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":"Local RAGE Inhibition Attenuates Early Diabetic Retinal Pathology in Streptozotocin-Induced Rats.","authors":"Anna Vakhrusheva, Nickolay A Kryuchkov, Andrey A Nedorubov, Yang Xi, Zulfiia G Guvatova, Ivan Morgunov, Alexey Moskalev","doi":"10.1159/ger/acxag008","DOIUrl":"https://doi.org/10.1159/ger/acxag008","url":null,"abstract":"<p><p>Introduction Diabetic retinopathy, which occurs during extended periods of chronic hyperglycemia, is one of the main causes of vision loss. The receptor for advanced glycation end products (RAGE) plays a central role in inflammatory and angiogenic signaling, both of which contribute to the pathogenesis of diabetic retinopathy, but its therapeutic targeting in ocular disease has been insufficiently explored. Methods We evaluated topical RAGE229, a small-molecule RAGE inhibitor, and an intravitreally administered anti-RAGE antibody in a streptozotocin-induced diabetic rat model. At day 84, treatment effects were assessed using masked fundoscopic scoring, RT-qPCR, immunohistochemistry, and histological morphometry. Treated eyes were evaluated against both route-matched diabetic vehicle-control groups and paired contralateral vehicle-treated eyes. Results Both interventions reduced fundoscopic pathology and retinal Vegfa and Nfkb1 expression, whereas Ager showed only a non-significant downward trend. NF-κB p65 immunoreactivity was reduced by both treatments, while a significant reduction in VEGF-A immunoreactivity was detected only in the paired anti-RAGE antibody analysis. Morphometric analysis indicated attenuation of diabetes-associated retinal thinning with both interventions. Neither intervention altered systemic glycemic control. Although both interventions demonstrated similar overall anatomical protection, anti-RAGE antibody treatment showed more consistent effects across protein-level and structural endpoints. Conclusion These findings provide proof-of-concept evidence that local RAGE-targeted treatment may attenuate vascular, molecular, and structural manifestations of early experimental diabetic retinopathy without detectable changes in systemic glycemia. Further preclinical studies should evaluate ocular exposure, direct target engagement, functional visual outcomes, and reproducibility in larger cohorts.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181022","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":"Toward Standardization of Intrinsic Capacity Assessment: A Methodological Comparison of the Responsiveness of Composite Scoring Methods.","authors":"Salit Bar Shalom, Oron Levin, Vida J Cesnaitiene, Lina Mickeviciene, Nerijus Masiulis, Yael Netz","doi":"10.1159/ger/acxag007","DOIUrl":"https://doi.org/10.1159/ger/acxag007","url":null,"abstract":"<p><p>Intrinsic capacity (IC) is increasingly used as an intervention outcome; however, IC composites lack a standardized scoring method, hindering comparisons across trials. To determine whether the scoring method influenced the detection of intervention effects, we applied multiple composite scoring approaches to the same data and compared their responsiveness to a 12-week exercise intervention in older adults at risk of mild cognitive impairment.</p><p><strong>Methods: </strong>Pre- and post-intervention IC data were obtained from 59 community-dwelling older adults assigned to resistance training (n=34) or stretching and flexibility (n=25). The five-domain IC composite was computed repeatedly using alternative scoring approaches: z-score (concurrent and baseline-anchored variants), percentage of maximum possible (POMP), binary classification (0/1), and a three-category ordinal scale. Responsiveness was quantified using the standardized response mean (SRM).</p><p><strong>Results: </strong>Responsiveness ranged from negligible to large for identical data, indicating that the intervention effect depended on the scoring method. The ordinal and POMP composites were the most responsive (SRM 0.74-0.88 and 0.50-0.76). Within the z-score composite, responsiveness depended entirely on the standardization anchor: the concurrent specification was insensitive (SRM ≈ 0), whereas baseline-anchoring showed moderate responsiveness (0.62-0.71). The binary scoring was the least sensitive, showing a ceiling effect.</p><p><strong>Conclusions: </strong>Ordinal three-category scoring was the most responsive, suggesting that approaches combining a fixed reference with a category-based structure are well suited for detecting change in IC. This finding requires confirmation against external criteria for IC, such as its predictive validity for adverse health outcomes, along with domain weighting and instrument selection.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181067","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":"Socioeconomic Differences in the Association Between the Big Five Personality Traits and Episodic Memory Trajectories in Midlife and Old Age.","authors":"Laura Buchinger, Lucie Kalousova, Markus Wettstein, Josefine Atzendorf, David Richter, Denis Gerstorf","doi":"10.1159/ger/acxag004","DOIUrl":"https://doi.org/10.1159/ger/acxag004","url":null,"abstract":"<p><strong>Objectives: </strong>Episodic memory trajectories vary substantially between individuals in the second half of life: some maintain high levels of performance into their 80s, whereas others experience marked declines as early as their 50s. Identifying factors that help explain this heterogeneity is critical for understanding cognitive aging. Drawing on the resource substitution hypothesis and the Openness-Fluid-Crystallized-Intelligence (OFCI) model, this preregistered study examined whether the Big Five personality traits and their interactions with socioeconomic status (SES) predict individual differences in episodic memory trajectories, testing also potential non-linear associations. We expected higher openness and lower neuroticism to be associated with better memory levels and slower decline, with stronger effects at lower levels of SES.</p><p><strong>Methods: </strong>We analyzed data from 57,947 individuals aged 50 and older (M = 67.78, SD = 9.03) who participated in at least two waves (7, 8, or 9) of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Multilevel growth models were used to estimate associations between personality and episodic memory levels and 5-year change, and whether SES (i.e., education, income, and wealth) moderated these associations.</p><p><strong>Results: </strong>Consistent with the OFCI model and the resource substitution hypothesis, higher openness was associated with better episodic memory levels, particularly among individuals with lower wealth. Higher neuroticism and lower conscientiousness were linked to poorer episodic memory levels, but only among less wealthy individuals. Higher extraversion was associated with better memory levels overall, and individuals at the extremes of extraversion exhibited somewhat flatter declines compared to those with moderate levels. Except for extraversion, there was little evidence for non-linear associations or for associations with 5-year change in episodic memory.</p><p><strong>Conclusion: </strong>Our findings underscore the relevance of wealth as an important socioeconomic resource for cognitive health beyond income and education, particularly in old age, when income is typically reduced. Overall, the results support modest concurrent associations between personality, SES, and episodic memory levels, but provide hardly any evidence for longitudinal effects. More frequent and longer-term longitudinal assessments are needed to clarify potential effects on cognitive aging.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127369","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":"Impact of a Geriatric Co-management Service on Surgical Cancer Care for Older Adults.","authors":"Eli Wolfgang, Carla Williams, Joao Filipe G Monteiro, Dean Batteson, Lynn McNicoll, Stefan Gravenstein, Mitchell Wice","doi":"10.1159/ger/acxag006","DOIUrl":"https://doi.org/10.1159/ger/acxag006","url":null,"abstract":"<p><p>In 2011, Brown University Health's Division of Geriatrics started its inaugural geriatric co-management service to improve older adult (OA) care for patients with hip fractures. Its success in care and cost reduction prompted the health system to expand geriatric co-management. Meanwhile, oncology surgeons treat increasingly older and frailer patients due to improved therapies and survival. The literature established what we saw here: increased mortality and complications in frail OA and failure of strategies like Enhanced Recovery After Surgery and Prehabilitation. In 2021, the division launched an oncologic surgery co-management program. Explicit to its launch, hospital sponsors required a 2-year study for benchmarks and quality metrics with a primary outcome of reducing mortality and delirium. QI metrics were developed through PowerBI dashboards using hospital and EMR data, analyzing 4,359 cases, which measured length of stay (LOS), readmissions, mortality, and disposition, from July 2018 to August 2024. We compared outcomes between the pilot (Geri) and those with no geriatric involvement (UC) using 1:1 propensity score matching. Bivariate analyses used chi-square and Student's t-tests for descriptive comparisons and multivariate linear or logistic regression analyses for outcome rates and adjusted when appropriate. The matched sample consisted of 309 cases in each group. 14% were underrepresented minorities. The Geri group had a lower odds ratio (OR) for hospice or in-hospital mortality (OR 0.27, 95% CI 0.12-0.61, p = 0.0016), as well as significantly lower odds of delirium, measured by a positive CAM (OR 0.29, 95% CI 0.11-0.73, p = 0.0086). ICU admission was lower in the geri group, although not statistically significant (18 vs 25, p = 0.0690). Overall hospital length of stay was longer in the geri group (8.2 ± 15.4 vs. 6.2 ± 5.6 days, p = 0.0350). Geri patients were less likely to be discharged home (OR 0.51, 95% CI 0.33-0.77) but were more likely to be discharged to a skilled nursing facility (OR 2.25, 95% CI 1.43-3.53) or inpatient rehabilitation facility (OR 8.52, 95% CI 1.04-69.6). Conclusion: Geriatric co-management in surgical oncology significantly reduced mortality and delirium as measured by CAM among OA, demonstrating meaningful improvements in patient outcomes. Although LOS increased and home discharges decreased, these results may indicate more appropriate discharge planning for this patient population. Geriatric co-management represents a critical, evidence-based component of surgical oncology care for OA. This study adds to the growing evidence supporting the role of Geriatric Medicine in improving the quality of care for OA.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108330","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":"Speech-Derived Digital Biomarkers from a Brief Video-Recorded Dual-Task Test Differentiate Mild Cognitive Impairment: A Multisite Cohort Study.","authors":"Mohammad Dehghan Rouzi, Aminreza Khandan, Alireza Rahimi, Aria Rabet, Pegah Tajvidi, Melina Eftekhari, Linda Ercoli, Bonnie J LaFleur, Bijan Najafi","doi":"10.1159/ger/acxag003","DOIUrl":"https://doi.org/10.1159/ger/acxag003","url":null,"abstract":"<p><strong>Introduction: </strong>Dual-task testing, which combines a motor task with a simultaneous memory task, is commonly used to detect early cognitive decline because it challenges attention and executive function. However, most dual-task assessments emphasize motor performance while overlooking speech during the memory component. Speech reflects the integrity of multiple cognitive systems and has emerged as a promising digital biomarker of brain health. Yet, existing speech-based protocols typically rely on single-task, clinic-based recordings, limiting scalability and real-world applicability. Integrating speech analysis into brief, functional dual tasks may provide a practical solution for remote cognitive assessment.</p><p><strong>Objective: </strong>To determine whether speech captured during a 20-second upper extremity frailty (UEF) dual-task test can distinguish individuals with mild cognitive impairment (MCI) from cognitively healthy adults in a fully remote environment.</p><p><strong>Methods: </strong>In a multisite U.S. cohort, community-dwelling adults aged 50-79 years completed the Montreal Cognitive Assessment (MoCA) and a 20-second UEF dual task involving repeated elbow flexion-extension while counting backward aloud. Elbow motion and speech were recorded using the built-in webcam and microphone of a smartphone, tablet, or laptop during a Zoom session. Audio was extracted and transcribed into time-stamped text using an automated pipeline powered by OpenAI's Whisper large automatic speech recognition model. Custom-developed algorithms extracted nine speech-derived features reflecting timing, pausing behavior, and counting performance. Logistic regression models incorporating demographics, patient-reported outcomes, and speech features were constructed to classify cognitive status.</p><p><strong>Results: </strong>Among 319 recordings meeting predefined audio-quality criteria (110 MCI; 209 controls), multiple speech features differed significantly between groups (p<0.05) and showed modest correlations with MoCA scores (Spearman's ρ=0.26-0.32, p<0.05). Models including speech features significantly improved discrimination of MCI compared to demographics alone. The combined model achieved an area under the receiver operating characteristic curve of 0.79, compared with 0.56 for demographics-only models.</p><p><strong>Conclusions: </strong>Speech captured during a brief, video-recorded dual-task test provides meaningful digital biomarkers of cognitive impairment. This device-agnostic protocol enables scalable, low-burden cognitive screening and supports longitudinal brain health monitoring outside traditional clinical settings.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864415","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":"Hypertensive Crisis in the Elderly: Epidemiological, Clinical, and Outcome - EDEN-47 Study.","authors":"Òscar Miró, Ana García-Martínez, Sira Aguiló, John Parissis, Effie Polyzogopoulou, Pere Llorens, Juan González Del Castillo","doi":"10.1159/000553140","DOIUrl":"10.1159/000553140","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to define the frequency and annual rate of hypertensive crisis in older patients attending emergency department (ED), the sociodemographic and baseline patient profile, and clinical characteristics and long-term outcome of the hypertensive crisis episode. We also looked for differences between men and women.</p><p><strong>Methods: </strong>This was a retrospective analysis of the multipurpose EDEN cohort, which recruited during 1-week period all patients aged ≥65 years who visited the ED of 52 Spanish public hospitals covering 19.3% of Spanish population. Demographic, social, baseline, and clinical data of the episode of hypertensive crisis were recorded. Estimations of annual incidence were made, in general and through patient age. Outcome consisted of 1-year post-discharge combined adverse event (revisit to ED, hospitalization, or death). Comparison between men and women was performed in unadjusted and adjusted models.</p><p><strong>Results: </strong>There were 186 cases of hypertensive crises among the 25,557 patients included in the EDEN cohort. The relative frequency of hypertensive crisis was 0.73% of ED visits (95% CI: 0.63-0.84), with 0.56% (0.44-0.72) in men and 0.87% (0.73-1.04) in women (OR for men 0.64, 0.47-0.87), and annual rate of hypertensive crisis in Spanish older population was 429 cases per 100,000 inhabitants (95% CI: 371-493), with 341 (267-436) in men and 493 (413-590) in women (OR for men 0.69, 0.51-0.94). Patients with hypertensive crisis had better baseline health status than the rest of the older patients attending the ED, with cardiovascular comorbidity being frequent (previously known hypertension in 88.2%) and with 22% having additional acute diagnoses on top of the hypertensive crisis. Hospitalization was needed in 7.5% of cases (0.5% in intensive care unit) and in-hospital mortality was observed in 2 cases (1.1%). Combined adverse events 1 year after discharge accounted for 57.9% of patients, with 65.6% in men and 52.5% in women (adjusted HR 1.61, 1.01-2.57).</p><p><strong>Conclusions: </strong>Hypertensive crises are more frequent in older women than men and they present a worse profile at baseline and higher severity than men. Nonetheless, men with hypertensive crisis may have a worse long-term prognosis compared to women, highlighting the need for targeted post-discharge monitoring strategies in this subgroup.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-15"},"PeriodicalIF":3.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850505","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":"Melding Geriatrics and Physical Medicine and Rehabilitation to Help Older Adults.","authors":"Jordan Helfand, Benjamin K Helfand, Sunpil Hwang, Martin Wice, Mitchell Wice","doi":"10.1159/ger/acxag002","DOIUrl":"10.1159/ger/acxag002","url":null,"abstract":"<p><strong>Background: </strong>Older adults are living longer with a rising number of comorbidities, medical complexity, and disability. The number of older adults in the USA is growing with a dramatic surge expected in the next decade as the baby boomers come of age. With increasing age and comorbidities comes frailty, a phrase used to describe a person's physical decline in function and vulnerability to poor health outcomes. Geriatrics is a field of medicine that focuses specifically on older adults who are frail or at risk of being frail. In contrast, physical medicine and rehabilitation (PM&R), also known as physiatry, is a field that focuses on maximizing independence and quality of life for those with physical disabilities or injuries.</p><p><strong>Summary: </strong>This review will focus on key topics where the field of geriatrics and PM&R converge with the ultimate goal to improve the overall function and quality of life of older individuals. In particular, this review will look at gait and balance, vertigo, fall prevention, hip fractures, neurologic changes, and exercise.</p><p><strong>Key messages: </strong>The management of many conditions that impact the care and independence of older adults lies at the convergence of PM&R and geriatrics. Incorporating expertise and individualized approaches in parallel, from both fields, can help improve outcomes for this patient population, as much of the care for these conditions requires multimodal, collaborative solutions with emphasis on things like activity of daily lives, gait, mobility, nutrition, exercise, general health, well-being, and fall prevention; to name a few.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827483","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":"construction and evaluation of sarcopenia risk prediction model for non-obese older adults.","authors":"Xin Liu, Shichen Wang, Yanan Wei, Qian Xue, Jingtong Wang","doi":"10.1159/000553306","DOIUrl":"https://doi.org/10.1159/000553306","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopenia is common in older adults, with distinct features in non-obese individuals. This study developed and validated a nomogram to predict sarcopenia risk specifically in non-obese older adults.</p><p><strong>Methods: </strong>Data from 1,654 CHARLS participants were used for model development and internal validation, and 263 NHANES participants for external validation. LASSO regression selected predictors. A nomogram was constructed and assessed using AUC (discrimination), calibration curves (accuracy), and decision curve analysis (clinical utility).</p><p><strong>Results: </strong>Seven variables were included in the final nomogram: age, sex, BMI, hemoglobin (Hb), difficulty rising from a chair, history of falls, and basic living ability. The model demonstrated excellent discrimination, with an AUC of 0.88 (95% CI: 0.86-0.90) in the training set. Performance remained robust in the internal (AUC 0.89, 95% CI: 0.85-0.92) and external (AUC 0.94, 95% CI: 0.91-0.97) validation sets. In the sex-stratified analysis, age, BMI, BUN, liver diseases, and basic living ability were included in the male model (AUC: 0.95, 95% CI: 0.93-0.97). For females, age, BMI, creatinine (Cr), difficulty running 1 km, and basic living ability were included (AUC: 0.83, 95% CI: 0.79-0.87). All models demonstrated good calibration and clinical utility.</p><p><strong>Conclusion: </strong>This study established an effective and simple prediction model for sarcopenia in non-obese older adults. This nomogram can serve as a valuable clinical tool for the early identification and proactive management of sarcopenia in this specific population.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-18"},"PeriodicalIF":3.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792057","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":"Mitochondrial Dysfunction as a Central Hub of Aging: From Molecular Cascades to Inter-Organ Communication Networks.","authors":"Chaodong Han, Zilian Zhang, Yafeng Song","doi":"10.1159/000553430","DOIUrl":"10.1159/000553430","url":null,"abstract":"<p><strong>Background: </strong>Mitochondrial dysfunction serves as a fundamental driver of the aging process, precipitating progressive functional decline through complex molecular cascades.</p><p><strong>Summary: </strong>This review elucidates the core mechanisms underpinning this dysfunction, including reactive oxygen species-induced redox imbalance, mitochondrial DNA damage accumulation, impaired mitophagy, and metabolic reprogramming. Crucially, we examine how mitochondria act as signaling hubs for inter-organ crosstalk. Through the secretion of mitokines (e.g., FGF21 and GDF15) and the release of damage-associated molecular patterns, dysfunctional mitochondria trigger chronic inflammation via the cyclic GMP-AMP synthase-stimulator of interferon genes and NLRP3 inflammasome (NLRP3) pathways, actively driving systemic aging within the skeletal muscle-brain and adipose/liver-cardiovascular axes. Additionally, this paper synthesizes current therapeutic interventions, ranging from lifestyle modifications and nicotinamide adenine dinucleotide (NAD+) precursors to frontier technologies like mitochondrial transplantation and gene editing.</p><p><strong>Key messages: </strong>While promising in animal models, clinical translation of these interventions is currently hindered by limited long-term safety data and evidence gaps. Therefore, mitochondria-targeted studies incorporating integrated multi-organ phenotyping are urgently required to establish robust strategies for extending human healthspan.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-14"},"PeriodicalIF":3.1,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792055","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}