Gerontology最新文献

{"title":"Machine Learning for Establishing the Precision Prediction of Sarcopenia.","authors":"Chen-Cheng Yang, Po-Hung Chen, Cheng-Hong Yang, Hung-Yi Chuang","doi":"10.1159/000550283","DOIUrl":"10.1159/000550283","url":null,"abstract":"<p><strong>Introduction: </strong>As the global population ages, sarcopenia is increasingly recognized for its severe consequences, including disability, falls, injuries, hospitalization, and even death. Despite its significance, research on predicting sarcopenia using machine learning is limited. This study aims to develop an effective machine learning model for sarcopenia prediction.</p><p><strong>Methods: </strong>Data from 1,441 participants were retrospectively reviewed from Kaohsiung Medical University-affiliated hospitals between 2022 and 2024. The dataset included demographics, lifestyle habits, medical history, and other relevant factors, with sarcopenia assessment based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Six machine learning models were evaluated: CatBoost, k-nearest neighbor, naive Bayes, random forest, gradient boosting decision tree, and eXtreme Gradient Boosting. Model performance was assessed using accuracy, precision, recall, and F1 score. Feature importance and Shapley Additive Explanations were used for feature analysis.</p><p><strong>Results: </strong>CatBoost outperformed the other models, achieving an accuracy of 96.62%, with similarly high precision, recall, and F1 score. Feature importance analysis using SHAP revealed that age, gender, pulse rate, pulmonary disease, blood pressure, dizziness, and missing teeth were key predictors in the model for sarcopenia prediction.</p><p><strong>Conclusion: </strong>The findings suggest that the CatBoost model is a highly effective tool for predicting sarcopenia, offering potential for early detection and intervention.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"258-270"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948695","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":"Effects of Dual-Task Resistance Training and Detraining on Immunometabolic Markers in Institutionalized Older Adults.","authors":"Erivaldo Machado Araújo, Hélio José Coelho-Júnior, Lana Passos Milhomem, Filipe Moura Ribeiro, Emanuele Marzetti, Thiago Dos Santos Rosa, Octávio Luiz Franco, Samuel da Silva Aguiar","doi":"10.1159/000548386","DOIUrl":"10.1159/000548386","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the effects of a 12-week dual-task resistance training (RT) program on inflammatory and metabolic biomarkers in institutionalized older adults and assess the impact of detraining.</p><p><strong>Methods: </strong>The study followed a crossover experimental design. Participants were 11 older adults (mean age: 81.9 ± 3.0 years), who completed baseline (week 1), post-control (weeks 14-15), post-training (week 28), and post-detraining (week 42) assessments over 42 weeks. Immunometabolic markers, including interleukin (IL)-10, IL-18, IL-17, transforming growth factor-beta, sestrin-2, klotho, adiponectin, leptin, and irisin, were measured using enzyme-linked immunosorbent assay kits. A 12-week dual-task RT program (weeks 16-27) was carried out progressively, incorporating cognitive tasks during lower limb exercises. Cognitive complexity increased monthly, and detraining followed in weeks 29-41.</p><p><strong>Results: </strong>Results demonstrated a significant post-training increase in IL-10 (p = 0.011) and a decrease in IL-18 (p < 0.001), indicating improved inflammatory status. Metabolic markers such as sestrin-2 (p = 0.016), klotho (p < 0.001), adiponectin (p = 0.019), and irisin (p = 0.009) also increased post training. Notably, klotho and irisin levels remained elevated post detraining, suggesting sustained benefits.</p><p><strong>Conclusion: </strong>Dual-task RT enhanced inflammatory and metabolic profiles, partially retaining benefits after detraining. This intervention presents a viable strategy to mitigate aging-related systemic health decline in vulnerable populations.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"299-305"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124698","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":"Independent and Combined Effects of Type 2 Diabetes Mellitus and Inappropriate Medication Use on Fall Risk among the Older People.","authors":"Hatice Kübra Diker Çalış, Özlem Güç Suvak, Emin Gemcioğlu, Cenk Aypak","doi":"10.1159/000551011","DOIUrl":"10.1159/000551011","url":null,"abstract":"<p><strong>Introduction: </strong>Falls are a major cause of morbidity and mortality in older people, and type 2 diabetes mellitus (T2DM) has been identified as a key contributor. Another factor associated with increased fall risk is inappropriate medication use (IMU), which includes the use of inappropriate drugs or the omission of indicated ones. However, the independent and combined effects of T2DM and IMU on fall risk in older people remain unclear.</p><p><strong>Methods: </strong>This prospective observational study was conducted among inpatients aged 65 years and older in the internal medicine department of a tertiary hospital between November 2022 and February 2023. Sociodemographic data, Turkish Inappropriate Medication Use in the Elderly (TIME-to-START/STOP) Criteria, and the Itaki Fall Risk Scale were collected through face-to-face interviews conducted by the researcher. The study population was divided into two groups: group 1 (patients without T2DM, n = 50) and group 2 (patients with T2DM, n = 58). The effects of the independent variables on fall risk were analyzed using a multivariable logistic regression model (backward Wald method, Nagelkerke R square 62.0%) in IBM SPSS Statistics 26.0. A p value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>T2DM and age were significant predictors of fall risk ([B = 2.775, p = 0.047, OR = 16.035]; [B = 0.137, p = 0.010, OR = 1.147]). Among participants with T2DM, females had higher risk of falls compared with males (B = 2.573, OR = 13.158, p = 0.043). At least one IMU was present in 75.0% of the cases per TIME-to-START. Fall risk was significantly higher in group 2 and in male participants who did not meet \"2+\" TIME-to-START criteria ([B = 2.077, OR = 8,000, p = 0.014]; [B = 2.118, OR = 8.316, p = 0.006]). IMU was not a significant fall risk predictor in either group according to TIME-to-STOP. Both T2DM and IMU identified by TIME-to-START were significant predictors of high fall risk in older people. In addition to T2DM, age, and IMU, living arrangement and history of falls were significant predictors. However, the primary focus was on the independent and combined effects of T2DM and IMU.</p><p><strong>Conclusions: </strong>Our study demonstrated that both T2DM and IMU identified by TIME-to-START were significant predictors of increased fall risk in older people. This risk was especially pronounced in patients with T2DM who also had multiple instances of inappropriate medication. These findings suggest that careful medication management is particularly important for fall prevention in older T2DM patients.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"331-342"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275990","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":"What Changes First? Mapping the Temporal Ordering of Age-Related Functional Decline across Domains Using 30-Year Longitudinal Data.","authors":"Gabriela Lunansky, Marjolein Visser, Martijn Huisman, Erik J Giltay, Almar A L Kok","doi":"10.1159/000548990","DOIUrl":"10.1159/000548990","url":null,"abstract":"<p><p><p>Introduction: Age-related functional decline is assumed to be a complex process in which declines in one domain may trigger decline in others. Yet research empirically identifying the temporal ordering of age-related decline across emotional, cognitive, physical, and social functioning as well as health-behavioral factors is still scarce.</p><p><strong>Methods: </strong>We analyzed up to 10 waves of the Longitudinal Aging Study Amsterdam (LASA) cohort over 30 years (n = 1,560), covering fifteen indicators of physical, cognitive, emotional and social functioning, and health-behavioral factors. We used directed dynamic time warping to quantify the temporal ordering of within-person changes in these indicators. Average temporal relationships were visualized as a network graph and by rank-ordering indicators according to their tendency to precede (high out-strength) or follow (high in-strength) changes in other indicators.</p><p><strong>Results: </strong>Participants were on average 62.3 ± 5.50 years old at baseline, 53.8% female, with 14.8 ± 4.74 years of follow-up. Physical and cognitive declines (e.g., physical performance and episodic memory) tended to precede decline in other domains, while changes in social functioning (e.g., social participation) tended to follow. No clear temporal ordering was found between emotional functioning (e.g., depression and anxiety) and other domains.</p><p><strong>Conclusion: </strong>The study offers insights into early detection and prevention strategies for healthy aging. Assuming that physical and cognitive domains are primarily driven by age-related biological changes, our findings support theories proposing that biological changes precede functional decline and theories emphasizing the importance of psychosocial resilience. Moreover, this study highlights the potential of adopting a complex systems approach and innovative within-person analytical methods in gerontology. </p>.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"154-170"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12726857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354504","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":"Peripheral Artery Disease, Aging, and Falls: Forecasting a Looming Challenge for Older Adults.","authors":"Min Wang, Bijan Najafi, Min He","doi":"10.1159/000552232","DOIUrl":"10.1159/000552232","url":null,"abstract":"","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"553-556"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836981","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":"Age-Related Associations between Reactive-Balance Stepping Responses, Self-Induced Stepping, and Gray-Matter Volume.","authors":"Inbal Paran, Moti Salti, Hadas Nachmani, Yuliya Berdichevsky, Ilan Shelef, Itshak Melzer","doi":"10.1159/000551973","DOIUrl":"10.1159/000551973","url":null,"abstract":"<p><p><p>Introduction: The distinction between reactive and proactive balance control mechanisms in terms of age-related structural neural correlates is still scarce. From a biomechanical perspective, reactive stepping is a rapid response to sudden loss of stability, whereas proactive self-induced stepping requires anticipatory postural adjustments and longer duration. This study aims to explore how cortical and subcortical gray-matter volume correlates with variables of reactive and proactive stepping responses among older and young adults; and whether these stepping responses can be distinguished from one another in terms of their structural neural correlates (i.e., cortical and subcortical gray-matter volume).</p><p><strong>Methods: </strong>Twenty-six older adults and nine young adults underwent structural MRI brain scanning. Self-induced stepping variables were derived from ground reaction force data, while kinematic parameters of reactive stepping, including step thresholds, were obtained using a three-dimensional motion capture system. Age-related differences in ground reaction force measures, stepping kinematics, and gray-matter volume in ten regions of interest were examined, followed by partial correlation analyses.</p><p><strong>Results: </strong>Age-related impairments in reactive and proactive stepping performance were accompanied by significantly smaller gray-matter volume among older adults across all regions of interest (p ≤ 0.003), except for the brainstem (p = 0.026; post-correction significance level: p < 0.005). Partial correlation analyses including both older and young adults revealed significant associations whereby longer balance recovery durations and lower stepping thresholds were associated with lower gray-matter volume in prefrontal and cortical regions, and in the putamen and amygdala (r = -0.41 to -0.60, p ≤ 0.037; and r = 0.38 to 0.43, p ≤ 0.048, respectively). In self-induced stepping performance, longer preparation and step durations were significantly associated with lower precentral, cerebellar and amygdala gray-matter volume (r = -0.51 to -0.56, p ≤ 0.006).</p><p><strong>Conclusion: </strong>Age-related differences in reactive stepping deficits were primarily associated with lower gray-matter volume in prefrontal, cortical, putamen, and amygdala regions, whereas self-induced stepping impairments were associated with precentral, cerebellar, and amygdala gray-matter volumes. These findings suggest distinct neural substrates underlying reactive versus self-initiated balance control. Further investigation needs to explore whether intervention programs in older adults may change gray-matter volume in these regions. </p>.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"528-540"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653963","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":"Associations between Cardiovascular Risk Factors and Cognitive Function: A Cross-Sectional Study of Twins in the UK.","authors":"Swarna Vishwanath, Ellen J Thompson, Rose S Penfold, Ruth C E Bowyer, Cristina Menni, Ingrid Hopper, Joanne Ryan, Claire J Steves","doi":"10.1159/000551944","DOIUrl":"10.1159/000551944","url":null,"abstract":"<p><p><p>Introduction: Cardiovascular risk factors (CVRFs) have been associated with cognitive impairment; however, the underlying mechanisms remain unclear. This study used twins modeling, to investigate whether shared twin factors contribute to the associations between CVRFs and cognitive function.</p><p><strong>Methods: </strong>This study used a cross-sectional design, and participants were from the UK adult twin registry. Clinically validated cognitive tests were administered during routine clinical research visits between 2013 and 2016, measuring overall global cognition, recall, verbal fluency, processing speed, and episodic memory and learning. CVRFs were total cholesterol (TC), high-density lipoprotein (HDL), systolic blood pressure (SBP), type 2 diabetes, and smoking status.</p><p><strong>Results: </strong>Participants were between 1,300 and 2,300 twins (depending on the cognitive test), and the mean age of twins was approximately 56 years. Cholesterol levels (both TC and HDL) were significantly associated (p < 0.05) with overall global cognition, recall, and verbal fluency with effect sizes (standardized) ranging from 0.5 to 0.11. In the twins modeling, after adjusting for genetic and shared environmental factors, the associations disappeared. Similarly, higher SBP levels were associated with poorer verbal fluency performance (-0.05 [-0.10 to 0.00]), and while between-pair effects were found to be significant (-0.09 [-0.15 to -0.03]), within-pair effects (after adjusting of shared environmental factors) were not.</p><p><strong>Conclusion: </strong>Higher TC and HDL and lower SBP were all associated with better performance on a range of validated cognitive tests. However, findings suggest that the association between CVRFs and cognitive function is predominantly explained by shared twin-pair factors which may be genetic or shared environment. </p>.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"491-499"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698554","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":"Probiotic, Prebiotic, or Synbiotic Supplementation in Parkinson's Disease: A Systematic Review and Meta-Analysis with Trial Sequential Analysis.","authors":"Miguel Cabanillas-Lazo, Milagros Pascual-Guevara, Fabian A Chavez-Ecos, Carlos Alva-Diaz, Victor Velasquez-Rimachi, Nicanor Mori, Federico Micheli","doi":"10.1159/000547665","DOIUrl":"10.1159/000547665","url":null,"abstract":"<p><strong>Introduction: </strong>Alterations in gut microbiota have been linked to various neurological diseases, including Parkinson's disease (PD). Modifying the microbiota through probiotics, prebiotics, or synbiotics may help improve symptoms in PD patients. This study aimed to evaluate the efficacy and safety of these supplements in treating PD.</p><p><strong>Methods: </strong>A systematic search was conducted in several databases, including PubMed, EMBASE, Scopus, Cochrane Library, Web of Science, and Google Scholar, until September 2023. No restrictions were placed on language or publication date. Study quality was assessed, and data were analyzed using meta-analysis techniques and narrative synthesis tables. The certainty of evidence was evaluated using GRADE, and trial sequential analysis was performed for primary outcomes.</p><p><strong>Results: </strong>Out of 3,608 studies identified, 69 were selected for review, with 16 analyzed qualitatively. Among these, 12 were randomized controlled trials, and 9 were included in the meta-analysis. Compared with the placebo group, the intervention group would improve non-motor symptoms related to constipation (weekly stools [MD]: 1.04; 95% CI: 0.83, 1.25; Bristol scale [MD]: 0.54; 95% CI: 0.38, 0.70; frequency of laxative use [MD]: -0.63; 95% CI: -0.94, -0.33) and could improve motor symptoms (UPDRS-III [MD]: -2.23; 95% CI: -5.00; 0.53), with very low certainty both due to indirectness and significant risk of bias.</p><p><strong>Conclusion: </strong>With very low to moderate certainty, probiotics, prebiotics, and synbiotics may improve constipation and motor symptoms in PD compared to placebo. These findings suggest a potential benefit, but more high-quality research is needed to confirm these effects and establish stronger evidence.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"126-141"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145943200","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":"Hemoglobin-to-Red Cell Distribution Width Ratio at Admission as an Anemia-Independent Predictor of Mortality after Fragility Hip Fracture Surgery in Older Adults.","authors":"Soon-Phil Yoon, Hyuck Min Kwon, Jun Young Park, Kwan Kyu Park, Woo-Suk Lee, Hyeokjoo Jang, Byung-Woo Cho","doi":"10.1159/000550890","DOIUrl":"10.1159/000550890","url":null,"abstract":"<p><strong>Introduction: </strong>The hemoglobin-to-red cell distribution width ratio (HRR), which has demonstrated better predictive ability than the red blood cell distribution width (RDW) and hemoglobin level, has not been used to predict orthopaedic surgical outcomes and may be a novel prognostic parameter for mortality.</p><p><strong>Methods: </strong>This is a retrospective cohort study, providing a Level of Evidence III. In this single-center cohort study, data of 363 patients (aged ≥60 years) who underwent surgery for fragility hip fracture at our institution between January 2016 and December 2018 were retrospectively analyzed. Multivariable Cox proportional hazards and Kaplan-Meier survival curve analyses were performed to compare the high and low HRR and RDW groups, divided based on cutoff values. The power of mortality prediction over time was assessed by comparing Harrell's concordance index using the bootstrapping method.</p><p><strong>Results: </strong>Among the 363 patients, the overall mortality was 48.48% (176/363), with a mean ± standard deviation of 4.31 ± 2.09 (0.02-7.44) years. The HRR was significantly associated with all-cause mortality after hip fracture surgery (hazard ratio: 0.989; 95% confidence interval: 0.978-0.999; p = 0.044). Moreover, during the follow-up period after 1 year, the HRR demonstrated the second-highest predictive ability for mortality among all laboratory parameters and indicators reflecting the general condition, and it remained unaffected by anemia status for up to 4 years.</p><p><strong>Conclusion: </strong>The HRR is proposed as a novel prognostic indicator for mid- to long-term survival after hip fracture surgery in older patients.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"289-298"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149567","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 of Pain with Self-Reported Hearing Difficulty among Adults Aged 50 Years or Older in Six Prospective Cohorts.","authors":"Xueyuan Xu, Deyi Luo, Erjie Xie","doi":"10.1159/000551972","DOIUrl":"10.1159/000551972","url":null,"abstract":"<p><strong>Introduction: </strong>Pain is highly prevalent in older adults and is linked to hyperacusis, yet evidence on its relationship with self-reported hearing difficulty (HD) remains limited. The aim of this study was to investigate the associations of pain with incident HD.</p><p><strong>Methods: </strong>Adults aged ≥50 from six nationally representative aging cohorts were included: the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), the Mexican Health and Ageing Study (MHAS), the China Health and Retirement Longitudinal Study (CHARLS), and the Korean Longitudinal Study of Aging (KLoSA). Pain trajectories were derived from four consecutive biennial assessments of pain severity. Logistic regression was applied to examine cross-sectional associations between pain and HD. Cox proportional hazard models assessed longitudinal associations of pain with HD. Primary analyses adjusted for age, sex, education, marital status, smoking, alcohol consumption, hypertension, and diabetes; sensitivity analyses additionally included depressive symptoms as a covariate.</p><p><strong>Results: </strong>Cross-sectional and longitudinal analyses included 130,521 participants (mean age 62.8 years; range 50-106) and 11,067 participants (mean age 60.9 years; range 50-87), respectively. Frequent pain was associated with higher odds of HD, with dose-response gradients for severity (p for trend<0.001). Five distinct pain trajectories were defined. Participants in the persistent moderate-severe pain trajectory group had the highest risk of HD (pooled HR = 1.62, 1.38-1.90), followed by the increasing group (pooled HR = 1.31, 1.07-1.59) and the fluctuating group (pooled HR = 1.25, 1.14-1.38), while decreasing pain trajectories showed no significant associations. The persistent no-mild pain group served as the reference group. In sensitivity analyses, group-based trajectory modeling further identified three distinct pain trajectories.</p><p><strong>Conclusion: </strong>Pain status and dynamic trajectories significantly impact HD risk. Standardized pain management should be integrated into future HD prevention strategies.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"571-581"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837023","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}