Gerontology最新文献

{"title":"The Diagnosis of Osteoporosis, Including Opportunistic Computed Tomography: A Narrative Review.","authors":"Ling Wang, Daniele Diacinti, Davide Diacinti, Salvatore Minisola, Liu Yajun","doi":"10.1159/000545961","DOIUrl":"10.1159/000545961","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis is the most common metabolic bone disease with a high prevalence in the elderly population. The diagnosis is straightforward when a fragility fracture at major skeletal sites (hip, vertebrae, humerus, distal radius) occurs. However, the diagnosis may be challenging in the absence of fractures or when, even with a fracture (morphometric vertebral), no symptoms are reported by the patient.</p><p><strong>Summary: </strong>In recent years, there has been a huge advancement in diagnostic imaging modalities with particular interest in measuring skeletal resistance. Each technique has inherent advantages and disadvantages. In this narrative review, we discuss all diagnostic modalities from bone mineral density to more sophisticated techniques.</p><p><strong>Key messages: </strong>It is hoped that a greater utilization of opportunistic CT will increase patient screening with consequent advantages for patient care and future fraction prevention.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"453-460"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007913","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":"No Consistent Evidence that Ageism Is Linked to Biological Aging Status in the US Health and Retirement Study.","authors":"Mingxin Liu, Alan A Cohen, Véronique Legault, Sewanou Hermann Honfo, Kamaryn Tanner, Tamas Fulop, Mélanie Levasseur","doi":"10.1159/000543253","DOIUrl":"10.1159/000543253","url":null,"abstract":"<p><strong>Introduction: </strong>Ageism, defined as stereotype, prejudice, and discrimination against people based on their age, has been shown to have unfavorable impacts on health. While discrimination has often been shown to negatively impact health, whether ageism might accelerate biological aging itself is unclear.</p><p><strong>Methods: </strong>We conducted secondary analyses of the Health and Retirement Study (HRS, 2008, 2012, and 2016 waves). Ageism was estimated using self-perception of aging (SPA) and perceived age discrimination (PAD). Other types of discrimination (e.g., racism, sexism) were also considered. The Everyday Discrimination Scale was used to assess PAD and other types of discrimination. Biological aging was measured through homeostatic dysregulation (HD, n = 3,443, 2016 wave, six measures), epigenetic age (n = 1,484, 2016 wave, five measures), and telomere length (n = 1,981, 2008 wave). Biological aging measures were modeled as a function of ageism within and across waves.</p><p><strong>Results: </strong>Within waves, SPA score was associated with some elevated HD (e.g., β = 0.11, p < 0.001, quantified by 44 biomarkers) and epigenetic age indices (e.g., β = 0.61, p < 0.001, Hannum Epi Age). After controlling for comorbidities and social participation, these variables were no longer associated. Effects were similar but weaker in predicting 2016 biological aging from SPA in 2008 and 2012. PAD was not associated with biological aging measures, in contrast to other types of discrimination, which were.</p><p><strong>Conclusions: </strong>We found no consistent evidence linking ageism to biological aging status. Further research should investigate why; potentially, ageism has less time to become biologically embedded, compared to racism and sexism, which might be experienced throughout one's life, but measurement challenges could also be present.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 3","pages":"185-202"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474929","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":"2025-01-01","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":"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":"425-438"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","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":"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":"461-473"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","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":"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":"439-452"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","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":"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}

{"title":"Erratum.","authors":"","doi":"10.1159/000543486","DOIUrl":"10.1159/000543486","url":null,"abstract":"","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"252"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448827","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":"Real-Life Physical Activity in Community-Dwelling Older Adults over a Year with Changes in COVID-19 Restrictions in Norway.","authors":"Arnhild Jenssen Nygård, Kristin Taraldsen, Maren Lie, Dawn A Skelton, Øyvind O Salvesen, Jorunn L Helbostad","doi":"10.1159/000541490","DOIUrl":"10.1159/000541490","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic lockdowns have reduced physical activity (PA) among home-dwelling older adults. The main aim of this study was to investigate how real-life PA in home-dwelling older adults changed over a year with gradual eases in COVID-19 restrictions.</p><p><strong>Methods: </strong>Community-dwelling older adults (≥65 years) were recruited from local exercise groups aimed at preventing functional decline and falls. All participants had been involved in the exercise groups before the pandemic but had been without the offer for 6 months prior to inclusion because of COVID-19 restrictions. Sensor-based PA was measured using Axivity accelerometers worn on the lower back and right thigh for seven consecutive days at baseline (autumn 2020), 6 (spring 2021) and 12 (autumn 2021) months. PA activities were classified using the HAR70+ machine learning model, validated on older adults.</p><p><strong>Results: </strong>Ninety-one older adults (78 ± 6.4 years, 88% female) were included. At baseline, 9% used walking aids and 26.5% reported a fall in the previous year. Daily time spent upright did not change, while time spent walking decreased by 8.19 min from baseline to 12 months (p < 0.048). Walking bouts of >10 min decreased with 0.5 bouts per day (p < 0.001), and the longest walking bout showed a nonsignificant decrease of 17.7 min (p = 0.056). This shows a change toward a more sedentary activity pattern over the year despite a gradual ease of the restrictions.</p><p><strong>Conclusion: </strong>In a relatively well functioning group of older adults, PA did not increase with gradual ease in COVID-19 restrictions.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 2","pages":"131-142"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474861","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":"Research Progress of Senolytic Drugs in the Treatment of Orthopedic Diseases.","authors":"Minjie Zhang, Pengqiang Lou, Dan Shou, Peijian Tong, Yang Zhang","doi":"10.1159/000543386","DOIUrl":"10.1159/000543386","url":null,"abstract":"<p><strong>Background: </strong>Orthopedic diseases, including osteoarthritis, osteoporosis, and age-related musculoskeletal disorders, significantly impact quality of life and are becoming increasingly prevalent with aging populations. A growing body of evidence highlights the role of cellular senescence in the pathogenesis of these conditions. Senescent cells (SCs), characterized by irreversible cell cycle arrest, accumulate in tissues over time, contributing to inflammation, tissue degeneration, and impaired regeneration. The emerging field of senolytics, which aims to selectively eliminate these SCs, has garnered attention as a novel therapeutic strategy in orthopedics.</p><p><strong>Summary: </strong>Senolytic drugs, including small molecules, peptides, and natural compounds, have shown promise in preclinical models and early clinical trials for the treatment of various age-related diseases. In orthopedics, senolytics have been investigated for their potential to ameliorate cartilage degradation, bone fragility, and other degenerative changes associated with aging. Recent studies have demonstrated that targeting SCs in musculoskeletal tissues can improve tissue function, reduce inflammation, and promote regeneration. Although the majority of research is still in the preclinical phase, the positive outcomes from animal studies and early clinical trials suggest that senolytic drugs may offer new therapeutic avenues for orthopedic diseases.</p><p><strong>Key messages: </strong>Senolytic therapies hold significant potential for treating orthopedic diseases by targeting the underlying cellular senescence that contributes to tissue degeneration and inflammation. Preclinical and clinical studies indicate that senolytic drugs may enhance tissue repair, alleviate symptoms, and slow disease progression in musculoskeletal disorders. Further research is needed to optimize drug efficacy, ensure safety, and identify patient populations that may benefit the most from these treatments. The development of senolytic drugs could revolutionize the management of aging-related orthopedic diseases, providing a more targeted and effective approach than current treatments.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 3","pages":"221-238"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474930","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}