Gerontology最新文献

{"title":"The Impact of Moderate Altitude on Manifestations of Coronary Artery Disease.","authors":"Natalie Van Ochten, Katarina Leyba, Benjamin J Kopecky, Emmett Suckow, Katie Nathe, Stephanie Laing, Justin S Lawley, Lydia Simpson, Benjamin D Levine, Lindsay M Forbes, William K Cornwell Iii","doi":"10.1159/000545848","DOIUrl":"10.1159/000545848","url":null,"abstract":"<p><strong>Background: </strong>Reductions in oxygen availability at altitude reduce oxygen supply to the myocardium. This reduction in oxygen supply may be problematic for patients with cardiovascular disease and/or associated comorbidities such as hypertension, diabetes, or heart failure.</p><p><strong>Summary: </strong>The risk of adverse cardiovascular events may be increased at altitude as a result of the interaction between hypoxia and exercise, which further increases myocardial demand for oxygen. When an acute coronary syndrome occurs, outcomes may be suboptimal given limited access to medical centers with cardiac catheterization laboratories and sudden cardiac death may occur. Pretravel planning should prioritize optimizing cardiovascular health and mitigating associated risk factors to reduce risk.</p><p><strong>Key messages: </strong>Patients should have a realistic expectation of the types of activities that can be undertaken at altitude based on their underlying cardiovascular risk profile. Travel itineraries should include a period of acclimatization to hypoxia before initiating planned activities. In this review, we provide an overview of the relevant physiology related to hypoxia, its impact on cardiovascular function and clinical considerations and management strategies for patients and providers to reduce risk of adverse events from occurring in austere environments.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-13"},"PeriodicalIF":3.1,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998905","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":"Experiences of Care Providers Working in Long-Term Care during the COVID-19 Pandemic.","authors":"David B Nicholas, Rosslynn Zulla, Jennifer Hewson, Navjot Virk, Jenna Naylor","doi":"10.1159/000545782","DOIUrl":"10.1159/000545782","url":null,"abstract":"<p><strong>Introduction: </strong>In this qualitative study, care providers from long-term care homes were interviewed to explore how they experienced, coped with, and adapted to care shifts during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Thirteen multidisciplinary care providers and 24 supervisory and administrative staff participated in either a focus group or individual interview between July 2021 and February 2022. Participants were front-line care providers in 5 urban long-term care homes in western Canada.</p><p><strong>Results: </strong>Care providers described negative impacts on residents and family members related to service delivery, restricted visiting, and quarantining protocols. They also identified negative impacts they experienced as care providers including fear and uncertainty, exhaustion, concerns about care provision, lower morale, and job self-efficacy. Buffers to stress comprised working as an integrated team and organizational support. Opportunities for growth and development and being adaptive were also described. Recommendations focused on organizational pandemic readiness and the importance of holistic care.</p><p><strong>Conclusion: </strong>These findings highlight the need to proactively ensure a supportive infrastructure, wellness-promoting work culture, and a sustainable resource plan to help care providers pivot and adapt in a pandemic.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"503-512"},"PeriodicalIF":3.1,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983785","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":"Dynamic Prediction of Cardiovascular Death among Old People with Mildly Reduced Kidney Function Using Deep Learning Models Based on a Prospective Cohort Study.","authors":"Chun Wang, Desheng Song, Jingran Dong, Yicheng Zhao, Yin Liu, Jing Gao, Zhuang Cui, Changping Li","doi":"10.1159/000545679","DOIUrl":"10.1159/000545679","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease (CVD) is more likely to occur in old people with mildly reduced kidney function. We aimed to identify target features in this cohort to reduce cardiovascular death using deep learning models.</p><p><strong>Methods: </strong>A total of 12,650 older people (age ≥60) with mildly reduced kidney function from Tianjin Community Health Promotion Prospective Study were recruited from 2014 to 2020. Cardiovascular death was verified by the death certificates from the provincial vital statistics offices. Mildly reduced kidney function was defined when estimated glomerular filtration rate (eGFR) between 45 mL/min/1.73 m2 ≤ and 90 mL/min/1.73 m2. Data were analyzed using Cox regression, random survival forest (RSF), DeepHit (DH), and Dynamic DH (DDH). Concordance Index (C-index) and Brier Score (B-S) were used to compare the models' performances.</p><p><strong>Results: </strong>During the follow-up of 7 years, 838 people died of CVD (6.62%). Age, gender, hypertension, diabetes, and eGFR were closely related to cardiovascular death. Both accuracy and precision of models, predictive performance gets better as the number of follow-up visits increases. In predicting cardiovascular death, the C-index and B-S value of COX were only 0.711 and 0.001 at the first follow-up, and values were 0.767 and 0.073 at last time, respectively. This trend is similar in the other three models, with the DDH model standing, which showed the individual survival prediction with more accuracy at different time points (for the 6-year survival prediction, the C-index = 0.797 and B-S = 0.022 for the average of all time points) than the Cox, RSF, and DH.</p><p><strong>Conclusion: </strong>A novel deep learning algorithm used in our study has shown its superior performance in the prediction of individual dynamics in longitudinal studies, which improves predictive power with increasing data input over time.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-14"},"PeriodicalIF":3.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007910","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":"Clinical Characteristics and Outcomes of Elderly COVID-19 Patients Admitted to ICU during Chinese Mainland's Omicron Wave: A Multicenter Retrospective Cohort Study.","authors":"Ziying Chen, Linna Huang, Qi Zhang, Yuqiong Wang, Guohui Fan, Xu Huang, Min Li, Sichao Gu, Yi Zhang, Yingying Feng, Ye Tian, Xiaoyang Cui, Ying Cai, Tianshu Zhai, Xianxia Zhuo, Xiaojing Wu, Bin Cao, Qingyuan Zhan","doi":"10.1159/000545536","DOIUrl":"10.1159/000545536","url":null,"abstract":"<p><strong>Introduction: </strong>There is limited information on elderly patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infections. We aimed to describe the characteristics and outcomes of elderly patients with Omicron variant infections admitted to the intensive care unit (ICU) on the Chinese mainland and to evaluate the risk factors associated with mortality in these patients.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective study including elderly patients with SARS-CoV-2 infection who were admitted to the ICU from November 1, 2022, to February 11, 2023, on the Chinese mainland. The primary objective of the study was to describe the characteristics and outcomes of elderly ICU patients with Omicron variant infections. The secondary objective was to evaluate the risk factors for mortality of these patients.</p><p><strong>Results: </strong>We included 1,605 patients aged 65 years or older diagnosed with severe or critical COVID-19 and admitted to ICUs in 59 hospitals across different areas of the Chinese mainland. The median age was 78 years (P25-P75, 72-84), with male patients accounting for 1,164/1,605 (72.5%) and 1,459/1,605 (90.9%) of patients having at least one comorbidity. The median APACHE II scores and SOFA scores were 16 (P25-P75, 11-23) and 5 (P25-P75, 3-8), respectively. Among these patients, 553 (34.5%) were recovery discharged, 557 (34.7%) died in the ICUs, and 495 (30.8%) discharged voluntarily during therapy and were later confirmed dead after discharge. Multivariable logistics analysis indicated that older age, coinfection, high levels of white blood cell count, blood urea nitrogen, D-dimer, and lactate at admission were against for recovery discharged.</p><p><strong>Conclusions: </strong>Elderly patients infected with the Omicron variant of SARS-CoV-2 and admitted to the ICU had a considerable mortality rate. Better understanding of risk factors for mortality may improve clinical management and more rational allocation of limited medical resources during a COVID-19 surge.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003963","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":"Effect of Surface Perturbation Treadmill Training Program on Strategies and Kinematics of Reactive Stepping during Standing in Older Adults: A Single-Blinded Randomized Controlled Trial.","authors":"Shani Batcir, Yoav Gimmon, Ilan Kurz, Shmuilk Edelman, Noa Levitsky Gil, Rafi Adar, Elena Rabaev, Ronen Debi, Guy Shani, Amir Shapiro, Itshak Melzer","doi":"10.1159/000545480","DOIUrl":"10.1159/000545480","url":null,"abstract":"<p><strong>Introduction: </strong>Perturbation-based balance training reduces fall rates dramatically by triggering and improving balance recovery skills. We aimed to investigate whether multidirectional surface perturbation treadmill training, which explicitly challenges age-related impairments in reactive responses, can improve balance recovery responses in standing and reduce annual falls.</p><p><strong>Methods: </strong>This was a two-arm parallel-group randomized controlled trial with concealed allocation, blinded assessors, data analyzers, and intention-to-treat analysis. Fifty-three older adults aged 80.1 ± 5.2 years, living in retirement housing, were randomized into two groups: (1) surface perturbation-based hands-free treadmill training (SPTT, n = 27) and (2) control group, hands-free treadmill walking training without perturbations (TT, n = 26). Both received a 12-week, 24-session training program. For primary outcomes, we evaluated balance recovery, pre- and post-intervention, by stepping thresholds, percentage of stepping responses, total probability of stepping, and kinematics of reactive stepping to lateral-surface perturbations in standing. Fall incidents were monitored prospectively 1 year after training for a secondary outcome.</p><p><strong>Results: </strong>Both groups showed a significant decrease in the percentage of multiple-step responses (p = 0.013) and a shorter total recovery time to recover balance (p = 0.006). Compared with the TT, the SPTT led to a more significant reduction in single-step and multiple-step thresholds (p = 0.003 and p = 0.002, respectively), total probability of stepping (p = 0.008), shorter first-step length (p = 0.003), total steps path length (p = 0.007), and decreased total center-of-mass (CoM) displacement (p = 0.040) during recovery stepping. One-year prospective fall monitoring revealed nine fall events in the SPTT group compared to 17 in the TT group. Although these numbers are insignificant, they imply a potential generalization that SPTT can reduce annual falls.</p><p><strong>Conclusion: </strong>A 12-week SPTT reduces the risk of falls by improving reactive balance responses in retirement-housing older adults. Findings suggest that the primary benefit of SPTT was better control in the CoM following perturbations. This study addressed the generalizability of PBT benefits from walking to standing and the personalization of perturbation training to enhance effectiveness and real-life applicability.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-14"},"PeriodicalIF":3.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016309","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":"Identifying New Risk Factors for Comorbidities in the Elderly.","authors":"Yuge Jiang, Ping Liu, Yi Liu, Zhuyun Gong, Longhe Xu","doi":"10.1159/000545175","DOIUrl":"10.1159/000545175","url":null,"abstract":"<p><strong>Introduction: </strong>This is a cross-sectional design to evaluate high-density lipoprotein cholesterol (HDL-C) and fasting blood glucose (FBG) as novel biomarkers for assessing the risk of geriatric comorbidities. Based on data from 316 patients with geriatric comorbidities, participants were selected through hospital records according to predefined inclusion and exclusion criteria. The primary outcome measures include the impact of HDL-C and FBG levels on the severity of comorbidities and the calibration and decision utility of the nomogram prediction model. The study also explores the clinical value of the nomogram model in managing the risk of geriatric comorbidities amidst the aging population.</p><p><strong>Methods: </strong>Multiple statistical methods, including logistic regression, Lasso regression, and calibration analysis, were used to assess the associations of the above factors and evaluate the performance of the nomogram prediction model. The model demonstrated high predictive accuracy in internal and external validation, with nearly perfect calibration performance observed in the external validation. Decision curve analysis further confirmed the model's high clinical utility and benefit.</p><p><strong>Results: </strong>HDL-C was significantly negatively associated with the risk of geriatric comorbidities (odds ratio [OR] = 0.387, 95% confidence interval [CI]: 0.286-0.547, p < 0.05), while FBG was positively associated with comorbidity risk (OR = 1.050, 95% CI: 1.129-2.136, p < 0.05). The nomogram model demonstrated high predictive accuracy in internal and external validation, with nearly perfect calibration performance observed in the external validation. Decision curve analysis further confirmed the model's high clinical utility and benefit.</p><p><strong>Conclusion: </strong>This study underscores the importance of HDL-C and FBG as critical biomarkers for assessing comorbidity risk in the elderly and reveals the potential application of the nomogram prediction model in the risk prediction and management of elderly comorbidities. These findings support using these indicators in predicting and intervening comorbidities in the elderly, providing substantial evidence for further research and clinical practice.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-15"},"PeriodicalIF":3.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962559","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":"Aging Alters the Sense of Force but Not the Sense of Position in the Wrist and Ankle Joints.","authors":"Mélanie Henry, Stéphane Baudry","doi":"10.1159/000542869","DOIUrl":"10.1159/000542869","url":null,"abstract":"<p><strong>Introduction: </strong>The impact of aging on proprioceptive senses remains an open question. As the senses of position and force may rely on different neural substrates, we investigated the effect of aging on both senses to provide original and more comprehensive data on age-related changes in proprioception.</p><p><strong>Methods: </strong>The senses of position and force were assessed in several conditions using position- and force-reproduction tasks in young (20-40 years) and older (60-90 years) adults in the wrist (experiment 1, n = 41, 20 older adults) and ankle joints (experiment 2, n = 46, 24 older adults).</p><p><strong>Results: </strong>In both experiments, older adults exhibited larger force-reproduction errors than young adults at low (5% maximal force, p < 0.001) but not moderate forces (20% maximal force, p > 0.056). No age-related decline was observed for position-reproduction errors (p > 0.30), regardless of movement amplitude. Rare weak-to-moderate correlations were observed between position- and force-reproduction errors (r ≤ 0.53, p ≥ 0.009).</p><p><strong>Conclusion: </strong>In wrist and ankle joints, the age-related decline in proprioception is limited to the sense of force, especially for low forces. This nonuniform decline in proprioception across proprioceptive senses and testing conditions could reflect a decline in the central processing of proprioceptive information.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 2","pages":"100-111"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541181","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":"Association between Serum Albumin-to-Creatinine Ratio and Readmission in Elderly Heart Failure Patients: A Retrospective Cohort Study.","authors":"Leilei Guo, Li Liu, Tianwen Li, Lina Cai, Li Hu, Yueshan Zhou","doi":"10.1159/000542616","DOIUrl":"10.1159/000542616","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the relationship between the serum albumin-to-serum creatinine ratio (sACR) and readmission in elderly heart failure patients.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using data from the PhysioNet Restricted Health Data database. The exposure variable was sACR and the outcome variable readmission. Multivariate logistic regression and subgroup analyses were performed to assess the independent association between sACR and readmission. Smooth curve fits were applied to examine the nonlinear relationship. We employed multiple imputation and E-value sensitivity analyses to assess the robustness of our results.</p><p><strong>Results: </strong>Our study included 1,725 participants, of whom 40.6% were male, 59.2% were aged 60-79 years, and 40.8% were aged 80 years and older. After adjusting for potential confounders, we found that for each unit increase in sACR, the 28-day readmission rate decreased by 48% (odds ratio [OR] = 0.52, 95% CI: 0.29-0.95, p = 0.003). The 28-day readmission rate was significantly higher in the low sACR group (sACR <0.32) than in the high sACR group (sACR >0.51) (OR = 0.47, 95% CI: 0.3-0.76, p = 0.002). Similar results were observed for 3-month and 9-month readmission. Subgroup analysis showed no significant interactions. A nonlinear relationship was observed between the sACR and readmission. Sensitivity analyses have confirmed the robustness of our results.</p><p><strong>Conclusion: </strong>There is a negative association between sACR and readmission in Chinese heart failure patients. Our study may offer novel insights into the management of heart failure readmissions.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"28-38"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667146","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":"Foot and Footwear Considerations for Older People: A Special Article Collection for Gerontology.","authors":"Hylton B Menz, Yvonne M Golightly","doi":"10.1159/000542899","DOIUrl":"10.1159/000542899","url":null,"abstract":"","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"47-48"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881991","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":"Views of Aging and Subjective Cognition in Middle-Aged and Older Adults: A Systematic Review.","authors":"Nikki L Hill, Justin Do, Emily Bratlee-Whitaker, Jennifer Renee Turner, Andrea Sillner, Casey Fishman, Jacqueline Mogle","doi":"10.1159/000542507","DOIUrl":"10.1159/000542507","url":null,"abstract":"<p><strong>Introduction: </strong>Views of aging have been linked with many important outcomes in older adults. Subjective cognition, or one's perception of their cognitive functioning, may be a valuable indicator of cognitive changes as individuals age, but is known to be impacted by a variety of factors. The aim of this systematic review was to synthesize the evidence on relationships between views of aging and subjective cognition, including whether and how these relationships may differ based on age.</p><p><strong>Methods: </strong>Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, we conducted a comprehensive literature search in four databases: PubMed, CINAHL, PsycINFO, and ProQuest Dissertations and Theses. Critical appraisal utilized the Critical Appraisal Skills Programme (CASP) checklists. Twenty sources (including 21 studies) met inclusion and exclusion criteria, from which data were systematically extracted and results narratively synthesized.</p><p><strong>Results: </strong>Seventeen out of the 21 identified studies (81%) found a relationship between more positive views of aging and better subjective cognition; however, some studies reported mixed results based on the domain of aging views. Domains that were consistently associated with subjective cognition were subjective age, attitudes toward one's own aging, aging well, and essentialist beliefs about aging. Only three studies reported age group differences or changes in associations over time, precluding conclusions about differences across middle- and older ages.</p><p><strong>Conclusion: </strong>Most studies supported associations between views of aging and subjective cognition. More longitudinal as well as qualitative research is needed to advance understanding of factors that influence these relationships.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"49-70"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715917","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}