The Journals of Gerontology Series A: Biological Sciences and Medical Sciences最新文献

{"title":"Predominant role of fat mass in the association between HMB and frailty","authors":"Begoña Molina-Baena, Jose Antonio Carnicero, Suzette L Pereira, Ricardo Rueda, Ángela Santos-Fandila, Alejandro Álvarez-Bustos, Francisco José García-García, Leocadio Rodríguez-Mañas","doi":"10.1093/gerona/glaf203","DOIUrl":"https://doi.org/10.1093/gerona/glaf203","url":null,"abstract":"Background β-hydroxy-β-methylbutyrate (HMB) is a bioactive metabolite formed from breakdown of leucine, which increases muscle protein synthesis and reduces muscle breakdown. Previous studies have shown an inverse association between HMB levels and frailty in older adults. This study aims to assess if body composition influences this association. Methods A cross-sectional analysis was conducted using data from a cohort of adults ≥65 years from the Toledo Study of Healthy Aging. Body composition [total lean (TBLM) and fat mass (TBFM)] was assessed using dual-energy X-ray absorptiometry. Frailty was assessed with the Frailty Trait Scale (FTS-12). Six regression models were employed to examine HMB/body composition ratios and frailty, adjusting by age, sex, comorbidity, waist-to-hip ratio, nutritional status and Mediterranean Diet adherence. Results Data from 1257 individuals (56.72% females, mean age 74.6 ± 5.95 years) were analyzed. Significantly higher values of HMB levels were observed in men compared to women. HMB/body composition ratios were significantly associated with frailty in both sexes. Increased HMB/TBFM ratios occurred due to both higher HMB levels (Q1: 0.155 ± 0.027 ng/ml vs. Q4: 0.280 ± 0.057 ng/ml) and lower fat mass (Q1: 19.11 ± 3.12 kg/m2 vs. Q4: 11.34 ± 2.44 kg/m2), while higher HMB/TBLM ratios were primarily driven by higher HMB levels (Q1: 0.149 ± 0.023 ng/ml vs. Q4: 0.292 ± 0.05 ng/ml), while lean mass remained constant (Q1: 25.11 ± 2.79 kg/m2 vs. Q4: 24.62 ± 2.91 kg/m2). The protective effect of the HMB/TBFM ratio was independent of the lean mass ratio. Conclusion The relationship between endogenous HMB and frailty is modified by body composition, with a stronger impact mediated by fat mass than lean mass. Future studies should explore the therapeutic implications of HMB supplementation in age-related changes in body composition and frailty.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Feasibility and Development of a Heart Rate-Based Mobility and Activity Scale for Hospitalized Older Adults (MAS).","authors":"Vincent Weng-Jy Cheung,Michaël Libotte,Patrick Viet-Quoc Nguyen,Thien-Tuong Minh Vu,Jean-Philippe Émond,Ariel Mundo Ortiz,Philippe Desmarais,Quoc Dinh Nguyen","doi":"10.1093/gerona/glaf212","DOIUrl":"https://doi.org/10.1093/gerona/glaf212","url":null,"abstract":"BACKGROUNDMobility is a critical component of health status in hospitalized older adults. Adoption of routine mobility tracking in acute and subacute settings is hampered by lack of automated and standardized measurements. Advances in smartwatch technology and machine learning provide the opportunity to use heart rate (HR) and HR variability data to quantify mobility and activity.METHODSIn this pilot study, we recruited 30 older adults aged 65 years and older in a tertiary care geriatric ward to develop (n = 8) and validate (n = 30) the automated Mobility and Activity Scale (MAS). Twelve features based on smartwatch HR data were used in a random forest model to predict 5 activity levels (0 = sleep to 4 = walking with at least a moderate effort or > 20 minutes). We examined concurrent validity with Hierarchical Assessment of Balance and Mobility (HABAM), gait speed, and functional status, as well as discriminant validity with frailty and multimorbidity. We assessed acceptability of watch wearing for patients and care staff.RESULTSParticipants' mean (SD) age was 86 years (8), 18 (60%) were female, and mean follow-up was 8.3 (5.2) days. Mean (SD) HABAM score was 36 (18) and gait speed was 0.53 (0.26) m/s. Across the cohort, mean (SD) MAS score was 1.2 (1.0) overall and 2.1 (0.7) for 10 most active hours of the day. MAS scores were moderately correlated with HABAM (r = 0.43 [95%CI = 0.07,0.69]) and functional status (r=-0.31 [95%CI=-0.60,0.06]), but not with gait speed (r = 0.02 [95%CI=-0.39,0.42]). MAS scores had no association with frailty or multimorbidity. Smartwatch wearing was acceptable.CONCLUSIONSSmartwatch-derived HR data may quantity hourly mobility and activity of hospitalized older adults and facilitate automated and real-time monitoring.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Heatwave Exposure and Multimorbidity with Depression Trajectories among Older Adults: Evidence from CHARLS.","authors":"Boye Fang,Youwei Wang,Xubao Li,Yanbi Hong","doi":"10.1093/gerona/glaf209","DOIUrl":"https://doi.org/10.1093/gerona/glaf209","url":null,"abstract":"BACKGROUNDDepression among older adults is a growing concern globally, influenced by both environmental stressors and individual health conditions. This study examines the impact of heatwave exposure and multimorbidity on depressive symptom trajectories among older Chinese adults.METHODSData from 3,819 adults aged 60 and above across five waves of the China Health and Retirement Longitudinal Study (CHARLS) were analyzed. Latent growth curve modeling (LGCM) identified depressive trajectories, and machine learning algorithms (Random Forest, Decision Tree, XGBoost, and SVM) were applied to predict trajectory categories. Multinomial logistic regression further explored the moderating effects of multimorbidity on the heatwave-depression relationship.RESULTSFive distinct depressive symptom trajectories were identified: consistently high, high but decreasing, consistently low, high and increasing, and low but increasing. Heatwave exposure was associated with a higher likelihood of persistent or worsening depressive symptoms, particularly among individuals with multimorbidity. Machine learning analysis highlighted maximum temperature as one of the most influential predictors, and further demonstrated that multimorbidity amplified the effect of heatwave exposure on depression trajectories. Multinomial logistic regression confirmed that individuals with multimorbidity were significantly more likely to exhibit worsening depressive symptoms when exposed to elevated temperatures.CONCLUSIONSThis study highlights the vulnerability of older adults with multimorbidity to worsened depression under heatwave exposure, emphasizing the need for tailored mental health interventions. Integrating climate adaptation and multimorbidity care is crucial for mitigating mental health impacts in this population. Policymakers should prioritize targeted interventions, incorporating climate adaptation and heatwave preparedness into mental health protocols to reduce adverse outcomes.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"115 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of the number of teeth on the cognitive function of older adults: an intermediary analysis based on dietary diversity","authors":"Shiyi Liao, Sailong Shi, Zhujun Chong, Chuiran Kong, Xuerui Chen, Peiyuan Qiu","doi":"10.1093/gerona/glaf213","DOIUrl":"https://doi.org/10.1093/gerona/glaf213","url":null,"abstract":"Background Tooth loss has been associated with cognitive function in older adults. We aimed to explore the mechanism between tooth loss and cognitive decline in these specific populations, which has been scarcely studied. Methods This study used the Longitudinal data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to build a linear mixed effects model to explore the impact of tooth loss on cognitive function in older adults. The effect of wearing dentures on the above effects was also evaluated. In addition, through mediation analysis, this study studied the mediating role of dietary diversity in the relationship between tooth loss and cognitive function. Results A total of 8283 older adults aged ≥65 years were included in this study. Maintaining ≥20 teeth was associated with better cognitive function (β = 0.338, 95% confidence interval [CI]: 0.229∼0.447), and so was denture wearing (β = 0.449, 95%CI: 0.351∼0.547). However, there was no significant difference in cognitive function between the older adults with < 20 teeth and dentures and those with ≥20 teeth (β = 0.084, 95%CI: -0.035∼0.203). The total effect and direct effect of tooth number on cognitive function were 0.201 (95%CI: 0.096-0.306) and 0.177 (95%CI: 0.072-0.282), respectively. The indirect effect of dietary diversity was 0.023 (95% CI: 0.010∼0.037), accounting for 11.65% of the total effect. Conclusions In Chinese older adults, more teeth were associated with better cognitive function. Denture wearing reduced the risk of cognitive decline caused by tooth loss to a certain extent. Dietary diversity mediated the relationship between tooth number and cognitive function.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between ultra-short heart rate variability and risk of Parkinson's disease: A prospective cohort study","authors":"Ruihan Wang, Kai Zhou, Nannan Li, Yingying Tang, Hui Gao, Linyuan Qin, Hanlin Cai, Feng Yang, Caimei Luo, Shiyu Feng, Mengyao Guo, Yongping Chen, Qing Gao, Qin Chen","doi":"10.1093/gerona/glaf204","DOIUrl":"https://doi.org/10.1093/gerona/glaf204","url":null,"abstract":"Background Cross-sectional studies have suggested that patients with Parkinson’s disease (PD) have significantly lower heart rate variability (HRV) than healthy controls. However, the role of ultra-short HRV (usHRV) as an early biomarker for PD remains unclear. The objective of this study was to investigate the association between usHRV and PD risk and its underlying mechanisms. Methods In a prospective cohort study based on the UK Biobank, participants without PD and dementia at baseline who had available 15-second resting electrocardiogram data (n = 48,202) were included. The participants were followed up for an average of 12.24 years and some were diagnosed with PD (n = 307). Cox proportional hazards models were used to examine the association between usHRV parameters and PD risk. A nested case-control study was conducted within the cohort to further investigate temporal trends in HRV. Mediation analysis was used to explore the underlying mechanisms driven by brain structure, peripheral inflammation and proteomic biomarkers. Results We found that lower usHRV parameters were significantly associated with an increased PD risk. Notably, an L-shaped association was observed between corrected root mean square of successive differences and PD risk. Temporal trend analysis suggested usHRV levels of patients with PD started to decline approximately 10 years before diagnosis. Mediation analysis revealed that thalamus-related fiber tracts, plasma inflammatory and neuroendocrine markers mediated the association between usHRV and PD risk. Conclusions Our findings provide evidence supporting that usHRV may serve as an early, convenient, and noninvasive biomarker of PD risk up to a decade before diagnosis.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective associations between accelerometer-measured physical activity, sedentary behavior, and healthy longevity: the Women's Health Accelerometry Collaboration.","authors":"Eric T Hyde,Gretchen E Bandoli,Jingjing Zou,Noe C Crespo,Humberto Parada,Kelly R Evenson,Annie Green Howard,Michael J LaMonte,Marcia L Stefanick,Lesley F Tinker,Bernhard Haring,JoAnn E Manson,I-Min Lee,Andrea Z LaCroix","doi":"10.1093/gerona/glaf206","DOIUrl":"https://doi.org/10.1093/gerona/glaf206","url":null,"abstract":"BACKGROUNDThe influence of physical activity (PA) and sedentary behavior (SB) on survival to late age with intact mobility is unclear. This study investigated associations between accelerometer-measured daily PA, SB, and survival to age 90 birthyear with and without intact mobility in the Women's Health Accelerometry Collaboration (WHAC).METHODSPostmenopausal U.S. women aged 78-89 years without mobility disability were followed for an average of 6.1 years. At age 90 birthyear, participants were categorized as: (1) surviving with intact mobility, (2) surviving with mobility disability, or (3) deceased. Participants wore an accelerometer on the hip for up to 7 days at baseline from 2011-2015. Covariate-adjusted multinomial logistic regression models estimated odds ratios (ORs) of PA (light, moderate-to-vigorous [MVPA], total, steps) and SB (sitting time, mean sitting bout duration) with survival outcomes relative to dying.RESULTSAmong 2,656 women (mean baseline age 83.1 years), 62.8% survived with intact mobility, 22.3% with mobility disability, and 15.0% died. Compared to dying before age 90, the OR (95% confidence intervals [CI]) for every 1-SD increment in accelerometer variables and survival with intact mobility were 1.36 (1.20, 1.54) for light PA, 1.69 (1.47, 1.96) for MVPA, 1.51 (1.33, 1.71) for total PA, 1.75 (1.51, 2.03) for steps, 0.70 (0.61, 0.80) for sitting time, and 0.79 (0.70, 0.89) for sitting bouts. Similar, weaker trends were present for mobility disability.CONCLUSIONSThese findings corroborate the potential role of increasing physical activity in preserving physical functioning as an important element of healthy longevity.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diurnal Regulation of Urinary Behavior and Gene Expression in Aged Mice","authors":"Danielle S Taylor, Albert A Allotey, Rachel E Fanelli, Sushumna B Satyanarayana, Sharanya S Bettadapura, Cole R Wyatt, Jason G Landen, Adam C Nelson, Emily E Schmitt, Danielle R Bruns, Nicole L Bedford","doi":"10.1093/gerona/glaf208","DOIUrl":"https://doi.org/10.1093/gerona/glaf208","url":null,"abstract":"Nocturia, defined as waking one or more times per night to urinate, is a prevalent and burdensome condition with few effective treatments. While the primary risk factor for nocturia is advanced age, few preclinical studies have addressed the pathophysiological mechanisms of nocturia in older subjects. Here, we develop a translational model of nocturia using aging mice and a behavioral paradigm that enables circadian assessment of voluntary urination in group-housed animals. We discovered dampened diurnal regulation of urinary behavior in aged mice compared to adult controls. Molecular analyses revealed disrupted diurnal expression of canonical circadian genes in aged mouse kidney and bladder tissues. Notably, we identified age-related loss of diurnal regulation of the bladder mechanosensory ion channel, Piezo1, suggesting a potential mechanism linking circadian disruption to altered bladder sensitivity. Our results reveal a role for circadian dysfunction in age-related nocturia and identify Piezo1 as a promising therapeutic target for chronobiological intervention.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term effects of Progressive High-Speed Resistance Exercise in Older Women with Low Muscle Strength. A Randomized Clinical Trial","authors":"Luis Polo-Ferrero, Alfonso J Cruz-Jentoft, Javier Vallejo-Martín, Ana Silvia Puente-González, María Carmen Sánchez-Sánchez, Fausto J Barbero-Iglesias, Roberto Méndez-Sánchez","doi":"10.1093/gerona/glaf211","DOIUrl":"https://doi.org/10.1093/gerona/glaf211","url":null,"abstract":"Background Low muscle strength and sarcopenia are strong predictors of disability. Although multicomponent training (MT) is commonly recommended, its long-term effects remain unclear, and evidence on High-Speed Resistance Training (H-RT) in older women is limited. Methods This double-blind randomized trial evaluated the effects of a 32-week intervention, with RT (weeks 1–11) progressing to H-RT (weeks 12–32) vs MT, on muscle strength, body composition, and functional performance. A total of 120 women aged ≥65 years (mean age: 77.0 ± 6.8 years) with low muscle strength (diagnosed with probable sarcopenia according to EWGSOP2) were randomized into H-RT, MT, or a non-exercise control group (CG). Results Both exercise modalities improved lower-limb physical performance, as assessed by the Five Times Sit-to-Stand Test, compared to women who did not exercise (p < 0.001), with no significant differences between H-RT and MT (p = 0.127) (H-RT: -3.2 ± 2.5 s; MT: -2.6 ± 2.5 s vs CG: -0.8 ± 2.1 s). Functional and body composition improvements were seen in both groups. H-RT led to greater improvements in the Timed Up & Go Test (-0.9 ± 1.9 s; p = 0.007) and waist circumference (-4.5 ± 5.1 cm; p = 0.010), while MT showed better results in aerobic capacity (Two-minute step test: +19.9 ± 17.2 steps; p = 0.044). Conclusions H-RT is an effective alternative to MT for improving strength, performance, and body composition in older women, with specific benefits. Further studies should confirm its role in preserving intrinsic capacity and preventing sarcopenic obesity.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Delirium Detection through the Open Health Natural Language Processing Consortium and ENACT Network.","authors":"Sunyang Fu,Min Ji Kwak,Jaerong Ahn,Zhiyi Yue,Shreyas Ranganath,Joseph R Applegate,Andrew Wen,Liwei Wang,Chenyu Li,Michele Morris,Kelly M Toth,Timothy D Girard,John D Osborne,Richard E Kennedy,Nelly-Estefanie Garduno-Rapp,Phillip Reeder,Justin F Rousseau,Chao Yan,You Chen,Mayur B Patel,Tyler J Murphy,Bradley A Malin,Chan Mi Park,Jia Heling,Sandeep Pagali,Allyson K Palmer,Jennifer St Sauver,Sunghwan Sohn,Elmer V Bernstam,Shyam Visweswaran,Yanshan Wang,Hongfang Liu","doi":"10.1093/gerona/glaf207","DOIUrl":"https://doi.org/10.1093/gerona/glaf207","url":null,"abstract":"BACKGROUNDDelirium is often underdiagnosed in clinical practice and is not routinely coded for billing. While manual chart review can identify delirium, it is labor-intensive and impractical for large-scale studies. Natural language processing (NLP) can analyze unstructured text in electronic health records (EHRs) to extract meaningful clinical information.METHODSTo support national integration of NLP for EHR-based delirium identification across different institutions, we launched the Delirium Interest Group within the national Evolve to Next-Gen Accrual to Clinical Trials (ENACT) NLP Working Group. This paper outlines our initial efforts to standardize, evaluate, and translate an NLP-based delirium detection model into the i2b2/ENACT platform.RESULTSMultisite contextual inquiry identified several key challenges, including variations in local screening practices (e.g., tools used, documentation frequency, and quality control), the need for harmonized definitions in the context of EHRs, and the complexity of modeling temporal logic. Multisite NLP evaluation revealed variable performance degradation driven by differences in delirium screening practices, clinical documentation patterns and semantics, and note syntactic structures.CONCLUSIONOur work represents an important first step toward enabling scalable and standardized NLP-based delirium detection across institutions. By engaging diverse institutions through the ENACT NLP Working Group, we identified shared challenges and site-specific variations that impact model implementation and performance. Our collaborative approach enabled the development of a more robust framework for delirium identification across heterogeneous EHR systems. Future efforts will build on this foundation to enhance the validity, usability, and translational impact of delirium detection.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development, validity, and utility of a model-based intrinsic capacity composite score in community-dwelling older persons","authors":"Yong-Hao Pua, Laura Tay, Ross Allan Clark, Julian Thumboo, Ee-Ling Tay, Shi-Min Mah, Wang Min Xian, Lim Jin Jin, Gary Kwok Kum Hoe, Yee-Sien Ng","doi":"10.1093/gerona/glaf210","DOIUrl":"https://doi.org/10.1093/gerona/glaf210","url":null,"abstract":"BACKGROUND To address the lack of a composite intrinsic capacity (IC) score based on the World Health Organization (WHO) Integrated Care for Older People (ICOPE) Screening tool, we propose a model-based approach to computing the composite score by developing and validating a model that uses the ICOPE screening items to predict the presence of impaired IC in community-dwelling older adults. METHODS In this cross-sectional study, a sample of 1,235 participants (mean[SD], 68[7]years) completed a multi-domain geriatric and fitness assessment, from which we (i) operationalized the ICOPE Steps 1-2 screening/assessment and (ii) derived a 5-point count-based Step 1 composite IC score and an 8-point Step 2 composite IC score. Proportional-odds regression analysis, leveraging on ICOPE screening items, was used to predict, for a given person, the probability that the Step 2 score was ≤6points (impaired IC) and the corresponding mean score (model-based composite IC score). RESULTS The model c-statistic for impaired IC was 0.81 (95%CI, 0.79 to 0.86) and calibration was excellent. The model-based IC scores showed stronger discriminative validity than did the count-based scores for the prefrailty/frailty, sarcopenia, and restricted life-space-mobility outcomes (AUC differences, 0.05-0.12; P-values < 0.001). At a decision threshold of 20%, the model-based approach yielded greater net benefit (0.016), and it allowed a greater proportion of participants to potentially delay Step 2 assessment (n = 633 vs 317) without compromising positive and negative predictive values. CONCLUSIONS If externally validated, composite IC scores derived from the proposed model-based approach have the potential to facilitate more granular risk stratification and IC monitoring.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}