Gerontology最新文献

{"title":"Identification of a Risk Allele at SLC41A3 and a Protective Allele HLA-DPB1*02:01 Associated with Sarcopenia in Japanese.","authors":"Motoki Furutani, Tetsuaki Kimura, Koya Fukunaga, Mutsumi Suganuma, Marie Takemura, Yasumoto Matsui, Shosuke Satake, Yukiko Nakano, Taisei Mushiroda, Shumpei Niida, Kouichi Ozaki, Tohru Hosoyama, Daichi Shigemizu","doi":"10.1159/000545298","DOIUrl":"10.1159/000545298","url":null,"abstract":"<p><strong>Introduction: </strong>Age-related alterations in muscle tissue morphology and function, as well as chronic pro-inflammatory conditions, contribute to the development of sarcopenia. To elucidate the multidimensional pathogenesis of sarcopenia, we performed a comprehensive genetic analysis, including common variants, rare variants, and human leukemia antigen (HLA).</p><p><strong>Methods: </strong>A total of 129 older adults were analyzed using whole-genome sequencing (WGS), including 67 sarcopenia patients and 62 normal controls. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 consensus. WGS data and associated clinical data were obtained from the National Center for Geriatrics and Gerontology Biobank in Japan. We performed logistic regression adjusted for age, sex, and body mass index for common variant (minor allele frequency [MAF] ≧0.01), rare variant (MAF <0.01), and HLA analyses. For the functional analysis, we performed RNA interference using human myoblasts and estimated gene expressions (MYOG, MYMK, MYMG) by quantitative PCR.</p><p><strong>Results: </strong>Rare variant analysis identified five rare coding variants of genes - SLC41A3, SYNRG, CLUAP1, CCHCR1, and ALDH2 - expressed in skeletal muscle. Of these, a deleterious frameshift deletion in SLC41A3 was associated with the pathogenesis of sarcopenia (p = 0.0012, odds ratio [OR] = 11.52, 95% confidence interval [CI] = 2.62-50.69). This deletion significantly reduced expression of myogenin (MYOG), a factor involved in myoblast differentiation (p = 0.0094), but did not affect the fusion of myogenic cells. We also discovered a new protective allele, HLA-DPB1*02:01 associated with sarcopenia (OR = 0.17, 95% CI = 0.060-0.51, p = 0.0015), which has a high occurrence rate in the Northeast Asian population.</p><p><strong>Conclusion: </strong>Rare variant analysis identified a deleterious frameshift deletion in SLC41A3 as a risk factor for sarcopenia. Our findings suggest that the suppression of MYOG could play a role in myogenesis or muscle maintenance, although this mutation did not impact the terminal differentiation of human myoblasts. Additionally, HLA analysis revealed that HLA-DPB1*02:01 has a protective effect, especially in Northeast Asian populations. Our study enhances the understanding of the etiology of sarcopenia and provides new insights into the mechanisms of its pathogenesis.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 5","pages":"376-387"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474934","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":"Development of Fall Risk Classification Models for Community-Dwelling Older Adults using Latent Class Analysis and Machine Learning.","authors":"Suyeong Bae, Mi Jung Lee, Daewoo Pak, Eun-Young Yoo, Jongbae Kim, Ickpyo Hong","doi":"10.1159/000544779","DOIUrl":"10.1159/000544779","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to identify fall-risk groups among community-dwelling older adults in South Korea and build a classification model to investigate risk-associated factors.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data of 9,231 older adults from the 2020 Korea Elderly Survey. We used latent class analysis to identify fall-risk groups based on fall indicators. Thereafter, classification models were developed with these identified groups as outcome variables.</p><p><strong>Results: </strong>Latent class analysis results indicated that a three-class model was more interpretable and fit the data better than other models. Among the models, the XGBoost algorithm displayed superior performance (accuracy = 0.70, precision = 0.69, recall = 0.70, F1-score = 0.68). Key variables associated with fall-risk groups included self-rated health, cognitive function, recent healthcare use, and assistance needed in instrumental activities of daily living.</p><p><strong>Conclusion: </strong>The study adopted a preventive approach by differentiating among low-, moderate-, and high-fall-risk groups, thus providing valuable insights for healthcare professionals. Identifying these risk factors can support the development of customized fall prevention programs for older adults.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 5","pages":"337-350"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474932","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 Temporal Relation of Physical Function with Cognition and the Influence of Brain Health in the Oldest-Old.","authors":"Nienke Legdeur, Maryam Badissi, Vikram Venkatraghavan, Davis C Woodworth, Fanny Orlhac, Jean-Sébastien Vidal, Frederik Barkhof, Claudia H Kawas, Pieter Jelle Visser, María M Corrada, Majon Muller, Hanneke F M Rhodius-Meester","doi":"10.1159/000542395","DOIUrl":"10.1159/000542395","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Physical function and cognition seem to be interrelated, especially in the oldest-old. However, the temporal order in which they are related and the role of brain health remain uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We included 338 participants (mean age 93.1 years) from two longitudinal cohorts: the UCI 90+ Study and EMIF-AD 90+ Study. We tested the association between physical function (Short Physical Performance Battery, gait speed, and handgrip strength) at baseline with cognitive decline (MMSE, memory tests, animal fluency, Trail Making Test (TMT-) A, and digit span backward) and the association between cognition at baseline with physical decline (mean follow-up 3.3 years). We also tested whether measures for brain health (hippocampal, white matter lesion, and gray matter volume) were related to physical function and cognition and whether brain health was a common driver of the association between physical function and cognition by adding it as confounder (if applicable).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Better performance on all physical tests at baseline was associated with less decline on MMSE, memory, and TMT-A. Conversely, fewer associations were significant, but better scores on memory, TMT-A, and digit span backward were associated with less physical decline. When adding measures for brain health as confounder, all associations stayed significant except for memory with gait speed decline.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In the oldest-old, physical function and cognition are strongly related, independently of brain health. Also, the association between physical function and cognitive decline is more pronounced than the other way around, suggesting a potential for slowing cognitive decline by optimizing physical function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Physical function and cognition seem to be interrelated, especially in the oldest-old. However, the temporal order in which they are related and the role of brain health remain uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We included 338 participants (mean age 93.1 years) from two longitudinal cohorts: the UCI 90+ Study and EMIF-AD 90+ Study. We tested the association between physical function (Short Physical Performance Battery, gait speed, and handgrip strength) at baseline with cognitive decline (MMSE, memory tests, animal fluency, Trail Making Test (TMT-) A, and digit span backward) and the association between cognition at baseline with physical decline (mean follow-up 3.3 years). We also tested whether measures for brain health (hippocampal, white matter lesion, and gray matter volume) were related to physical function and cognition and whether brain health was a common driver of the association between physical function and cognition by adding it as confounder (if applicable).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Better performance on all physical tests at baseline was associated with less decline on MMSE, memory, and TMT-A. Conversely, fewer a","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"13-27"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589914","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":"Exercise in the Prevention of Age-Related Fragility Fractures (Narrative Review).","authors":"Katharina Kerschan-Schindl, Timothy Hasenoehrl","doi":"10.1159/000543377","DOIUrl":"10.1159/000543377","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Loss of bone integrity and the age-associated decrease of the neuromuscular function make elderly subjects prone to fragility fractures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary: &lt;/strong&gt;Exercise is a strategy to counteract these age-associated changes and impairments. Because of the tight relationship between muscle and bone - anatomically, functionally, and biochemically - physical activities and targeted exercises, which induce muscle contraction and sufficient mechanical stress, influence bone metabolism. Exercise proved to have a positive effect on bone mineral density. The young skeleton is especially susceptible to impact and strenuous stimuli. This also applies to the neuromuscular system in the case of balance training. Therefore, the best time to start preventing fragility fractures is at young age. Despite the lower responsiveness in older age, targeted training is also very important at an advanced age. Lowering the modeling threshold, osteoanabolic treatment seems to increase the responsiveness to mechanical loading. In case of antiresorptive treatment, a more intensive training may be necessary.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key message: &lt;/strong&gt;A multiple component exercise intervention reduces the risk of age-associated fragility fractures. Depending on the mode of exercise, it mainly affects bone integrity or the neuromuscular system. The effect of exercising also depends on age and bone-specific medications influencing the sensitivity of these structures. However, despite a lower sensitivity to exercise at higher age, targeted training is especially important when getting older to decrease the risk of fragility fractures. In case of prevalent fragility fractures, patients should exercise as well; the training stimulus simply needs to be adapted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Loss of bone integrity and the age-associated decrease of the neuromuscular function make elderly subjects prone to fragility fractures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary: &lt;/strong&gt;Exercise is a strategy to counteract these age-associated changes and impairments. Because of the tight relationship between muscle and bone - anatomically, functionally, and biochemically - physical activities and targeted exercises, which induce muscle contraction and sufficient mechanical stress, influence bone metabolism. Exercise proved to have a positive effect on bone mineral density. The young skeleton is especially susceptible to impact and strenuous stimuli. This also applies to the neuromuscular system in the case of balance training. Therefore, the best time to start preventing fragility fractures is at young age. Despite the lower responsiveness in older age, targeted training is also very important at an advanced age. Lowering the modeling threshold, osteoanabolic treatment seems to increase the responsiveness to mechanical loading. In case of antiresorptive treatment, a more intensive training may be necessary.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key message: &lt;/strong&gt;A multiple component exerci","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 3","pages":"173-184"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474928","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":"Enhancing Frailty Status and Health-Related Quality of Life in Community-Dwelling Frail Older Adults.","authors":"Pei-Shan Li, Chia Jung Hsieh, Nae-Fang Miao, Chuan-Hsiu Tsai, Chieh-Yu Liu, Hung-Ru Lin, Shu-Fang Vivienne Wu, Jordan Koh","doi":"10.1159/000543909","DOIUrl":"10.1159/000543909","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Frailty poses a significant concern among older adults residing in the community, impacting their health and quality of life. This study investigated the effectiveness of the Fitness and Nutrition Program for Seniors (FANS) in addressing frailty and enhancing health-related quality of life. The study aimed to evaluate the effects of a 6-month FANS on frailty status and health-related quality of life in community-dwelling frail older adults, and to compare the effects on fall efficacy, pain intensity, daily activities, stages of physical activity and nutrition behavior change, and satisfaction following the intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A quasi-experimental design was used to assess the FANS among frail older adults (ClinicalTrials.gov Identifier NCT05242549). The intervention, based on the Transtheoretical Model, was conducted in a mixed setting, combining in-person sessions held at a community care center and remote group care delivered through the LINE app. The experimental group (43 individuals) received the FANS intervention, while the control group (38 individuals) continued with standard health promotion activities provided at the same community care center. Intention-to-treat analysis evaluated the intervention's impact. Measurements were taken before the intervention and at the 3-month and 6-month marks to assess changes in frailty status (using Cardiovascular Health Study criteria), health-related quality of life (Short Form-12), fall efficacy (Short Falls Efficacy Scale International), pain intensity (Pain Visual Analogue Scale), and daily activities (Instrumental Activities of Daily Living scale). Behavior change stages and satisfaction were monitored using the Fitness and Nutrition for Seniors Behavior Change Stages and Satisfaction Scale.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Within the experimental group, significant improvements were observed over time across multiple measures, indicating intragroup effects, including frailty, overall health-related quality of life, fall efficacy, pain intensity, and daily activities. Between-group effects demonstrated statistically significant differences in daily activities. Time and group effects showed statistically significant improvements in frailty at 3 months and 6 months post-intervention. Following the intervention, a substantial percentage of participants in the experimental group progressed in behavior change stages related to physical activity and diet, with 83.72% in the action and maintenance stages for physical activity behavior change and 81.40% in those for dietary behavior change. The overall satisfaction rating for the program was 9.25 out of 10 (mean ± SD: 9.25 ± 0.24).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The FANS is a feasible and innovative community health promotion initiative tailored specifically for frail older adults residing in the community, particularly during a pandemic. This program has demonstrated significant improvements","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 4","pages":"273-291"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474865","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":"Depressive Symptoms in Older People: Exploring Associations with Other Diseases, Functional Capacity and the Home Environment.","authors":"Abda Alicia Calheiros da Silva, João Araújo Barros-Neto, Laryssa Cristiane da Silva, Larissa de Lima Soares, Thaynara Maria Pontes Bulhões, Müller Ribeiro-Andrade, Andrey Ferreira da Silva, Ana Paula Grotti Clemente, Giovana Longo-Silva, Risia Cristina Egito de Menezes","doi":"10.1159/000545809","DOIUrl":"10.1159/000545809","url":null,"abstract":"<p><strong>Introduction: </strong>The presence of depressive symptoms in older people has become increasingly relevant in the context of global population aging. Although not a natural consequence of aging, such symptoms may be influenced by chronic conditions, functional limitations, and environmental factors. This study sought to assess the occurrence of depressive symptoms in older people from a region of Brazil and to investigate the related factors using a multilevel perspective.</p><p><strong>Methods: </strong>This is a cross-sectional, population-based study among individuals aged ≥60 years. Depressive symptoms (outcome) were measured using the GDS-15, with a score of five points or higher indicating the presence of depressive symptoms. Diseases were assessed through self-reports. Functional capacity was evaluated using (i) the Katz index; (ii) handgrip strength; and (iii) walking speed. The surrounding environment for physical activity was assessed based on participants' perceptions. Multilevel logistic regression models examined the odds of having depressive symptoms according to the variables analyzed.</p><p><strong>Results: </strong>The prevalence of depressive symptoms among older people was 36.6%, with a higher proportion among women (41.2%). Individuals diagnosed with diabetes mellitus (OR = 1.63; CI: 1.06-2.49), cataracts (OR = 1.76; CI: 1.17-2.66), those considered dependent for performing basic activities of daily living (OR = 6.70; CI: 1.21-37.14), with low handgrip strength (OR = 2.44; CI: 1.50-3.97), and those who reported heavy vehicle traffic as a barrier to physical activity (OR = 1.71; CI: 1.14-2.56) had higher chances of presenting depressive symptoms.</p><p><strong>Conclusion: </strong>Regardless of individual and municipal characteristics, the presence of depressive symptoms in older people was associated with chronic/degenerative diseases, functional capacity impairment, and the perception of the environment (heavy vehicle traffic) as a hindrance to physical activity around the home.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"524-534"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093494","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":"Antiresorptive Therapy for Osteoporosis in Older Subjects.","authors":"Anne Sophie Sølling, Natasha Amran Laursen, Torben Harsløf, Bente Lomholt Langdahl","doi":"10.1159/000544781","DOIUrl":"10.1159/000544781","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis increases the risk of fractures and mortality, particularly in the elderly population. However, prescribing antiresorptive medication to elderly patients with osteoporosis is complex. The benefit-risk ratio should be considered for all patients but can be particularly challenging in older individuals due to factors like comorbidities, polypharmacy, fall risk, and potential rare side effects of long-term treatment.</p><p><strong>Summary: </strong>We reviewed the efficacy and safety of antiresorptive treatments, including calcium and vitamin D supplementation, in elderly patients by evaluating published trials, reviews, and meta-analyses. Our findings confirm that antiresorptive treatment for osteoporosis is both effective and safe in the elderly population.</p><p><strong>Key messages: </strong>One key challenge is ensuring compliance, which can be difficult for some elderly patients. In such cases, intravenously or subcutaneously administered antiresorptive treatment should be considered to improve adherence and overall treatment compliance.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 4","pages":"297-307"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474863","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":"AI and Machine Learning for Detection and Management of Delirium in Care Home Residents.","authors":"Jay Banerjee, Fabian Hoger, Adam Lee Gordon","doi":"10.1159/000543561","DOIUrl":"10.1159/000543561","url":null,"abstract":"<p><strong>Background: </strong>Presently, diagnosing delirium in older people is a challenge. Diagnostic support tools such as the Confusion Assessment Method and 4AT provide structure but require specialist training, resources, and implementation support, while some subjectivity persists in diagnosis. This is particularly the case in people who live with dementia who often experience rapid fluctuation in cognitive abilities and behaviours. This leads to variation in diagnosis between settings and care providers, with consequent harmful impact on those experiencing delirium. These challenges become greater in care homes where dementia is prevalent, daily fluctuation is the norm, and the majority of staff are not trained healthcare professionals.</p><p><strong>Summary: </strong>Here, we outline the potential for AI-based human activity recognition (HAR) approaches to identify and flag deviations from normal behaviour that may be precursors of a delirium state, enabling earlier detection and management, and better outcomes. We outline how statistical process control approaches could form the basis of diagnostic algorithms and the steps required to test the feasibility of this approach in the care home setting.</p><p><strong>Key messages: </strong>Delirium detection and diagnosis, difficult in any setting, are more difficult in care homes because of resident, staff, and organisational factors. Artificial intelligence, machine learning, and HAR have potential to make diagnosis more reliable because of their ability to recognise changes from normal patterns of behaviour at an individual level.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 3","pages":"214-220"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474869","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 Association between Tumor Necrosis Factor-Alpha Inhibitor Use and Dementia Risk in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.","authors":"DaRae Chung, Yoojin Noh, Yun Mi Yu, Young-Mi Ah","doi":"10.1159/000544123","DOIUrl":"10.1159/000544123","url":null,"abstract":"<p><strong>Introduction: </strong>Tumor necrosis factor-alpha inhibitors (TNFi), commonly prescribed for rheumatoid arthritis (RA), have been studied for their potential association with dementia risk. However, previous findings are inconclusive. This study aimed to evaluate the impact of TNFi use on dementia in patients with RA.</p><p><strong>Methods: </strong>A systematical search of MEDLINE, Embase, and CENTRAL databases from inception to October 1, 2023, was conducted. Longitudinal comparative studies investigating the association between TNFi use and risk of dementia in patients with RA were included. Pooled adjusted risks of dementia and meta-analysis were conducted to synthesize relative estimates with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Seven observational studies involving 633,089 patients with RA were included, of which 6 were included in the meta-analysis. The pooled meta-analysis comparing the risk of dementia (hazard ratio [HR] = 0.77, 95% CI: 0.64-0.93) and Alzheimer's disease (AD) (odds ratio = 0.31, 95% CI: 0.23-0.43) between TNFi users and non-users showed a significant association. However, the pooled HR for AD risk was inconsistent. Also, the subgroup analyses indicated that TNFi use was associated with a decreased dementia risk in older adult patients with a mean age of ≥65 years at enrollment (HR = 0.86, 95% CI: 0.80-0.92) and TNFi new users (HR = 0.86, 95% CI: 0.80-0.92).</p><p><strong>Conclusions: </strong>Systematic review and meta-analysis suggest that lowering the level of systemic TNF-alpha by using TNFi could lower the risk of dementia. However, given the retrospective nature of the included studies, further prospective studies are needed to evaluate the role of TNFi in dementia onset.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 4","pages":"308-318"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474868","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-Specific Predictors of Changes in Subjective Life Expectancy: A 10-Year Longitudinal Study.","authors":"Clara de Paula Couto, Anna E Kornadt, Klaus Rothermund","doi":"10.1159/000542868","DOIUrl":"10.1159/000542868","url":null,"abstract":"<p><strong>Introduction: </strong>Subjective life expectancy (SLE) is considered an indicator of future time perspective and has implications for developmental outcomes in different areas of life. Previous studies rarely took a lifespan approach, although it would allow for a better understanding of whether the factors affecting SLE vary with participants' chronological age. Therefore, in this study, we aimed to investigate the predictors of changes in SLE across the lifespan, focusing on views of aging and preparation for old age.</p><p><strong>Methods: </strong>SLE was assessed across a 10-year longitudinal interval in a sample of German adults participating in the Ageing-as-Future study (n = 514; age range at T1: 30-80 years). Personalized views of aging (future self-views) and preparations for old age assessed at T1 were used to predict changes in SLE across the longitudinal interval.</p><p><strong>Results: </strong>Positive future self-views predicted greater stability in SLE across the 10-year interval; this effect was only obtained for younger adults. High levels of preparation for old age predicted greater stability in SLE, but only for older participants.</p><p><strong>Conclusion: </strong>Psychological variables capturing beliefs and behaviors regarding old age and aging have been shown to play a pivotal role in development in old age. The current study demonstrates that these variables influence an important aspect of future time perspective, namely, the subjectively expected time left to live. Examining psychological and behavioral predictors of SLE is relevant, as it broadens the understanding of which factors play a role in expanding or shrinking the perceived remaining lifetime.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 2","pages":"125-130"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474917","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}