{"title":"Effect of L-oxiracetam and oxiracetam on memory and cognitive impairment in mild-to-moderate traumatic brain injury patients: Study protocol for a randomized controlled trial","authors":"Tao Liu, Mingqi Liu, Meng Nie, Zhihao Zhao, Xuanhui Liu, Yu Qian, Yunhu Yu, Zhuang Sha, Chenrui Wu, Jiangyuan Yuan, Weiwei Jiang, Chuanxiang Lv, Liang Mi, Yu Tian, Jianning Zhang, Rongcai Jiang","doi":"10.1002/agm2.12335","DOIUrl":"10.1002/agm2.12335","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Patients with traumatic brain injury (TBI) often suffer memory and cognitive impairments, and oxiracetam-like drugs are considered to have a positive impact on these symptoms potentially. However, the efficacy and safety of <span>L</span>-oxiracetam and oxiracetam in TBI patients have not been sufficiently investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study adopts a multicenter, randomized, double-blind, parallel-group, phase 3 clinical trial design in 74 centers across 51 hospitals in China. A total of 590 TBI patients meeting criteria will be randomly allocated into three groups in a 2:2:1 ratio: <span>L</span>-oxiracetam group, oxiracetam group, and placebo group. The treatment period is 14 days, with a follow-up period of 90 days. The primary outcome measure is the change in the Loewenstein Occupational Therapy Cognitive Assessment score at 90 days after treatment. Secondary outcomes include changes in other cognitive assessments, neurological function, activities of daily living, and safety assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>There is no robust evidence to suggest that <span>L</span>-oxiracetam and oxiracetam can enhance memory and cognitive function in patients with mild to moderate TBI. This study has the potential to answer this crucial clinical question.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial registration</h3>\u0000 \u0000 <p>chinadrugtrials.org.cn, identifier CTR20192539; ClinicalTrials.gov, identifier NCT04205565.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 3","pages":"341-349"},"PeriodicalIF":2.2,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12335","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141343803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aging MedicinePub Date : 2024-06-14DOI: 10.1002/agm2.12336
Ivan David Lozada-Martinez, Luz Miryam Lozada-Martinez, Juan-Manuel Anaya
{"title":"Gut microbiota in centenarians: A potential metabolic and aging regulator in the study of extreme longevity","authors":"Ivan David Lozada-Martinez, Luz Miryam Lozada-Martinez, Juan-Manuel Anaya","doi":"10.1002/agm2.12336","DOIUrl":"10.1002/agm2.12336","url":null,"abstract":"<p>Centenarians, those aged 100 years or older, are considered the most successful biological aging model in humans. This population is commonly characterized by a low prevalence of chronic diseases, with favorable maintenance of functionality and independence, thus determining a health phenotype of successful aging. There are many factors usually associated with extreme longevity: genetics, lifestyles, diet, among others. However, it is most likely a multifactorial condition where protective factors contribute individually to some extent. The gut microbiota (GM) has emerged as a potential factor associated with the establishment of a favorable health phenotype that allows for extreme longevity, as seen in centenarians. To understand the possible impact generated by the GM, its changes, and the probable causes for successful aging, the aim of this review was to synthesize evidence on the role of the GM as a potential protective factor for achieving extreme longevity, using its relationship with centenarians.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 3","pages":"406-413"},"PeriodicalIF":2.2,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141339085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aging MedicinePub Date : 2024-06-14DOI: 10.1002/agm2.12328
Xin Nie, Chi Wang, He Zhang, Qianhui Liu, Lisha Hou, Yiping Deng, Wenbin Ye, Jirong Yue, Yong He
{"title":"The original scores of traditional Chinese medicine constitutions are risk and diagnostic factors in middle-aged and older adults with sarcopenia","authors":"Xin Nie, Chi Wang, He Zhang, Qianhui Liu, Lisha Hou, Yiping Deng, Wenbin Ye, Jirong Yue, Yong He","doi":"10.1002/agm2.12328","DOIUrl":"10.1002/agm2.12328","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Sarcopenia is a geriatric syndrome that occurs with age and is characterized by a gradual decline in muscle mass, power, and functionality. It serves as a prominent contributor to frailty, disability, and mortality among older individuals. Currently, no standardized global guidelines exist for the diagnosis of sarcopenia. This study aimed to establish the correlation between sarcopenia and the constitutions of traditional Chinese medicine (TCM), considering the connection between physical functioning and sarcopenia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 1441 participants in this study were diagnosed with sarcopenia. The Asian Working Group for Sarcopenia (AWGS) proposed a sarcopenia definition algorithm. To determine the constitution of each participant, classification and determination standards were used in traditional Chinese medicine. This study evaluated the demographics, lifestyles, and self-reported medical history of individuals diagnosed with sarcopenia through a self-administered questionnaire. The constitution of the participants was determined using TCM classification and determination standards. Subsequently, we analyzed the results of univariate analysis and multivariate regression and constructed a receiver operating characteristic (ROC) curve.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants who were diagnosed with sarcopenia had substantially lower original Neutral constitution scores (<i>P</i> < 0.050). In comparison to those without sarcopenia, individuals with sarcopenia exhibited notably elevated original Qi-deficiency, Yang-deficiency, Yin-deficiency, Blood-stagnation, and Qi-stagnation scores in contrast to those in the healthy group (<i>P</i> < 0.050). The identified risk factors associated with sarcopenia included the following: Neutral (OR = 0.903), Qi-deficiency (in males, OR = 1.126), Yang-deficiency (OR = 1.062), Phlegm-dampness (in males, OR = 0.833), and Blood-stagnation (in females, OR = 1.089). The highest area under the curve (AUC) was observed for the original neutral constitution score, followed by the Yang-deficiency and blood-stagnation scores (0.644, 0.613, and 0.611, respectively). Additionally, the AUC for the combined original scores of all nine constitutions among males reached 0.778.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this cross-sectional study of older people with higher original Qi-deficiency, Yin deficiency, Yang-deficiency, Blood-stagnation, and Qi-stagnation were associated with sarcopenia. Notably, various TC","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 3","pages":"334-340"},"PeriodicalIF":2.2,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12328","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141344667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Body composition characteristics and influencing factors of different parts of sarcopenia in elderly people: A community-based cross-sectional survey","authors":"Xinying Dong, Bingqing Bi, Yifei Hu, Li Wang, Xinying Liu, Wentao Li, Mingyue Li, Tong Xiang, Shugang Li, Hao Wu","doi":"10.1002/agm2.12327","DOIUrl":"10.1002/agm2.12327","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to describe the differences in body composition among different body parts of the elderly in the community and its relationship with sarcopenia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Elderly people aged ≥65 underwent bioelectric impedance analysis testing and were categorized into a sarcopenia group, possible sarcopenia group, and control group. The characteristics of body composition indicators in different parts and their relationship with different stages of sarcopenia were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sarcopenia group illustrated the lowest values of FFM, FFM%, BFM, BFM%, ICW, and limb PhA, along with higher ECW/TBW in the trunk and left leg compared to the control group. The possible sarcopenia group showed lower FFM% in limbs and trunk, and higher BFM% compared to the control group. Gender differences in elderly body composition were observed, with an increase in BFM% in various body parts posing a risk factor for possible sarcopenia in elderly males, whereas an increase in BFM% except in the left arm was a protective factor for sarcopenia in elderly females.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The body composition of the elderly in the community varied significantly in different stages of sarcopenia and genders, which correlated with sarcopenia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 3","pages":"384-392"},"PeriodicalIF":2.2,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12327","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141340819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aging MedicinePub Date : 2024-06-12DOI: 10.1002/agm2.12333
Jean-Pierre Michel
{"title":"How can precision health care contribute to healthy aging?","authors":"Jean-Pierre Michel","doi":"10.1002/agm2.12333","DOIUrl":"10.1002/agm2.12333","url":null,"abstract":"<p>The future of medicine will be closely linked to technological progress, to the great benefit of aging adults. Increasing knowledge in fields encompassing biology, physiology and functioning of the aging process, combined with the early detection of non-clinically apparent but significant changes will make it possible to promote healthy aging.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 3","pages":"269-271"},"PeriodicalIF":2.2,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12333","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141354306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aging MedicinePub Date : 2024-05-28DOI: 10.1002/agm2.12311
Xin Nie, Yu-meng Tian, Yue Yuan, Lin Li
{"title":"Delta-like ligand 3: A promising target against small cell lung cancer","authors":"Xin Nie, Yu-meng Tian, Yue Yuan, Lin Li","doi":"10.1002/agm2.12311","DOIUrl":"https://doi.org/10.1002/agm2.12311","url":null,"abstract":"<p>This commentary highlighted the current knowledge about novel DLL3-targeting agents for refractory small cell lung cancer.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 3","pages":"283-286"},"PeriodicalIF":2.2,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aging MedicinePub Date : 2024-05-18DOI: 10.1002/agm2.12300
Qi Pan, Sijia Fei, Ting Xie, Lixin Guo
{"title":"First study with positive cardiovascular outcome in obesity: Reflections on SELECT","authors":"Qi Pan, Sijia Fei, Ting Xie, Lixin Guo","doi":"10.1002/agm2.12300","DOIUrl":"10.1002/agm2.12300","url":null,"abstract":"<p>At present, medications of the GLP-1RA class, such as liraglutide 3.0 mg,<span><sup>27</sup></span> semaglutide 2.4 mg,<span><sup>28</sup></span> and tirzepatide (GLP-1/GIP [glucose-dependent insulinotropic polypeptide] agonist)<span><sup>29</sup></span> have been approved for weight management for adult patients with obesity or overweight with obesity-related complications. The previous study of semaglutide 2.4 mg in obese patients with heart failure, the STEP-HFpEF study,<span><sup>22</sup></span> confirmed its significant improvement in clinical functional endpoints such as KCCQ-CSS score (Kansas City Cardiomyopathy Questionnaire clinical summary score) and 6MWD (6-Minute Walk Distance) for patients with heart failure and preserved/mildly reduced ejection fraction (HFpEF/HFmrEF), demonstrating the cardiovascular benefit of semaglutide 2.4 mg in patients with obesity. SELECT further confirmed that semaglutide 2.4 mg significantly reduced the risk of major cardiovascular events. As the first weight management drug with cardiovascular benefit confirmed by rigorous RCT globally, semaglutide 2.4 mg is of landmark significance and provides strong clinical evidence for the treatment of patients with CVD and overweight or obesity.</p><p>GLP-1RAs with proven cardiovascular benefits have been recommended by the guidelines as a first-line treatment for cardiovascular risk reduction in patients with T2DM and CVD or at high cardiovascular risk.<span><sup>30</sup></span> The SELECT further provided evidence for the use of high-dose GLP-1RA in a broader population of patients with overweight or obesity and CVD without T2DM.</p><p>CVD remains the principal cause of mortality both in China and globally. Overweight and obesity are not only significant risk factors for CVD but also as an independent chronic disease. With societal economic progress and lifestyle alterations, overweight and obesity have increasingly emerged as major societal concerns. Effective weight management necessitates a multidisciplinary, multilevel, and long-term comprehensive strategy that incorporates political, economic, environmental, social, and personal factors. Presently, the availability of new management options for obesity and CVD is expanding, and it is expected that these evidence-based treatments will overcome current clinical challenges, thereby better fulfilling the demands of clinical care.</p><p>QP made substantial contributions to the design of the study and drafted the manuscript. SF and TX calibrated the format and language of the article, while LG critically reviewed the manuscript. All authors have read and approved the final version to be published.</p><p>The study was supported by National High Level Hospital Clinical Research Funding (BJ-2022-195).</p><p>The authors declare that they have no competing interests.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 3","pages":"272-275"},"PeriodicalIF":2.2,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141125837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Trends in gynecological cancer incidence, mortality, and survival among elderly women: A SEER study","authors":"Subhadra Priyadarshini, Prafulla Kumar Swain, Khushi Agarwal, Diptismita Jena, Sourav Padhee","doi":"10.1002/agm2.12297","DOIUrl":"https://doi.org/10.1002/agm2.12297","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This paper aims to comprehensively analyze trends in gynecological cancers among elderly women in the United States from 1975 to 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Surveillance, Epidemiology, and End Results (SEER) population data were utilized for the analysis. Annual Percentage Change (APC) and Average APC were estimated using join-point regression to assess trends in mortality rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study reveals an increasing pattern of incidence and mortality in all gynaecological cancer sites except cervical cancer among elderly. The incidence of cervical cancer decreased from 1975 to 2007 and then increased, whereas cancer-specific mortality decreased from 1977 to 2020, indicating positive advancements in detection and treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite progress in managing certain gynecological cancers, challenges persist, particularly evidenced by increasing mortality rates for cancers in other female genital organs. This underscores the necessity for sustained research efforts and targeted interventions to address these ongoing challenges effectively.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 2","pages":"179-188"},"PeriodicalIF":0.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140880921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aging MedicinePub Date : 2024-04-25DOI: 10.1002/agm2.12309
Lin Li, Feilong Chen, Xiaoyan Li, Yiyuan Gao, Ning Wang, Tao Xu
{"title":"Association between low handgrip strength and incontinence among Chinese middle-aged and older people: A cross-sectional study","authors":"Lin Li, Feilong Chen, Xiaoyan Li, Yiyuan Gao, Ning Wang, Tao Xu","doi":"10.1002/agm2.12309","DOIUrl":"10.1002/agm2.12309","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Incontinence seriously affects the lives of middle-aged and older people. Pelvic floor muscle assessment is very important for incontinence, and handgrip strength can be used as an auxiliary diagnostic tool. Our study aims to find new cutoff points of handgrip strength as early indicators of incontinence and analyze the association between low handgrip strength and incontinence among Chinese middle-aged and older people.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were recruited from the 2015 China Health and Retirement Longevity Study. Receiver operating characteristic (ROC) curves were used to find the handgrip strength cutoff point. Logistic regression analysis was performed to explore other incontinence-related risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 10,229 middle-aged and older people. Compared with normal handgrip strength participants, medium strength participants had 1.510 [men, 95% confidence interval (CI) = 1.017–2.243] and 1.792 (women, 95% CI = 1.294–2.480) times greater risk of incontinence, and low strength participants had 2.420 (men, 95% CI = 1.787–3.277) and 1.516 (women, 95% CI = 1.130–2.032) times greater risk of incontinence. Trend test results showed that the risk of incontinence increased with decreasing handgrip strength in middle-aged and older people.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study suggests that handgrip strength < 31 kg in men and < 20.5 kg in women is significantly associated with higher risk of incontinence in Chinese middle-aged and older people. The risk of incontinence increases with decreasing handgrip strength. Handgrip strength should be measured in routine physical examinations in middle-aged and older people for timely assessment and intervention in incontinence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 3","pages":"360-367"},"PeriodicalIF":2.2,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140656240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aging MedicinePub Date : 2024-04-18DOI: 10.1002/agm2.12303
Liming Zhang, Zhenyu Sun, Xueqing Jia, Ciyun Zhao, Jiening Yu, Xinwei Lyu, Joseph Tak Fai Lau, Na Li, Dongfu Qian, Zhihui Wang, Xi Chen, Zuyun Liu
{"title":"Confronting health disparities: Lessons from the USA","authors":"Liming Zhang, Zhenyu Sun, Xueqing Jia, Ciyun Zhao, Jiening Yu, Xinwei Lyu, Joseph Tak Fai Lau, Na Li, Dongfu Qian, Zhihui Wang, Xi Chen, Zuyun Liu","doi":"10.1002/agm2.12303","DOIUrl":"10.1002/agm2.12303","url":null,"abstract":"<p>Reducing health disparities, generically referring to any measurable aspect of health that varies across individuals or social groups, has been positioned as a cornerstone of health care improvement and a priority for safety. Disparities in mortality, a fundamental manifestation of health inequality, pose complex challenges to the USA and China,<span><sup>1-3</sup></span> two of the largest health systems worldwide. In the USA, mortality disparities substantially exist across races, locations, and causes of death. Similarly, in China, these disparities are critical and vary remarkably across different sociodemographic contexts. The observed health disparities could be attributed to multiple determinants,<span><sup>4</sup></span> such as health care access, socioeconomic status, and environmental exposure. Identifying disparities through a sophisticated surveillance system for incident diseases and mortality and deciphering potential causes are indispensable prerequisites for promoting health equity.</p><p>In a recent issue of the <i>Lancet</i>, the GBD US Health Disparities Collaborators conducted a county-level time-series analysis of racial-ethnic disparities in mortality in the USA.<span><sup>5</sup></span> Utilizing the unique data acquired from the US National Vital Statistics death certificates and the US National Center for Health Statistics, the authors estimated age-standardized mortality from 2000 to 2019 by racial-ethnic group and county, describing the intersections between racial-ethnic and location-based disparities in mortality. The findings offer insights for future actions. First, they elucidated the temporal dynamic transitions of all-cause and cause-specific mortality in about two decades, providing a holistic insight into the evolving landscape of the mortality spectrum. This facilitates policymakers in navigating transitions in the primary goals of economic and health care policies with greater precision. Second, the non-Latino and non-Hispanic American Indian or Alaska Native (AIAN) and Black populations manifested higher mortality than the White populations across most causes of morbidity, which was attributable to the role of systemic racism on health and an increased risk of premature death. This racial disparity is evident in the socioeconomic status of minoritized individuals and populations. It is also reflected through various pathways, such as residential segregation, high rate of incarceration, chronic stress, and discrimination in health care, among other factors. In contrast, the Asian and Latino populations had lower mortality rates across most causes than the other racial-ethnic groups. It is well known that the USA stands as a prominent destination for immigrants, solidifying its position as one of the world's largest immigrant nations. With a staggering population of over 45 million foreign-born individuals, immigrants constitute a significant 13.6% of the country's total population. Undeniably, the Asian i","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 2","pages":"158-161"},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140689119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}