Aging Medicine最新文献

{"title":"Chinese Expert Consensus on Immune Checkpoint Inhibitor Therapy for Elderly Patients with Advanced Non-small Cell Lung Cancer (2025 Edition)","authors":"National Center of Gerontology, Lung Cancer Committee of Beijing Oncology Association, Editorial Board of Chinese Journal of Geriatrics,&nbsp;Li Lin,&nbsp;Nie Xin,&nbsp;Wei Qian,&nbsp;Li Xu,&nbsp;Tian Yumeng,&nbsp;Wu Lin,&nbsp;Wang Jingyi,&nbsp;Wang Zhijie,&nbsp;Wang Mingzhao,&nbsp;Cao Baoshan,&nbsp;Gu Yangchun,&nbsp;Huang Meijuan,&nbsp;Yu Min,&nbsp;Yang Bo,&nbsp;Song Qi","doi":"10.1002/agm2.70067","DOIUrl":"https://doi.org/10.1002/agm2.70067","url":null,"abstract":"<p>Immune checkpoint inhibitors (ICIs) are an important treatment option for patients with advanced non-small cell lung cancer (NSCLC). There remains significant uncertainty regarding immunotherapy regimen selection and safety management for elderly lung cancer patients, due to the insufficient inclusion of geriatric patients in current clinical studies and the absence of specific management guidelines or consensus statements for immunotherapy in the elderly population. The consensus integrates the latest evidence-based medical evidence worldwide with clinical practice experience in China. It provides recommendations on key challenges in immunotherapy for elderly patients with advanced NSCLC, including geriatric assessment, treatment regimen selection, management of adverse reactions, and future research directions, aiming to provide a reference for clinical practice.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"9 1","pages":"5-19"},"PeriodicalIF":2.5,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147564892","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":"Promoting Medication Adherence in the Elderly: Factors and Insights From a Cross-Sectional Study.","authors":"Shokofeh Afkhami, Farkhondeh Asadi, Hassan Emami, Azam Sabahi","doi":"10.1002/agm2.70053","DOIUrl":"10.1002/agm2.70053","url":null,"abstract":"<p><strong>Objectives: </strong>This study reviewed the factors involved in medication adherence among the elderly. By understanding these factors, we can develop targeted strategies to promote better medication adherence, ultimately improving health outcomes for this population.</p><p><strong>Methods: </strong>This cross-sectional study was performed in 2023. In the first phase, five scientific databases were searched: PubMed, Science Direct, Springer, Wiley, and Wolters Kluwer. The review included articles published between 2001 and January 2022. The keywords used in the searches included \"drug adherence,\" \"medication adherence,\" \"elderly,\" and \"older adults.\" Two researchers independently evaluated the titles, abstracts, and texts of papers. Specific inclusion and exclusion criteria determined the selection of studies. Data were extracted using a data extraction form based on the study objectives. From all 116 articles retrieved, 68 studies were included. In the second phase, factors on medication adherence in the elderly were divided into categories and subcategories.</p><p><strong>Results: </strong>Factors involved in medication adherence among the elderly were divided into two categories: personal and external factors. Personal factors were classified into three subcategories: reducing, increasing, and other, while external factors included cultural, social, and economic factors as well as the influence of others. The most important factor associated with medication non-adherence among the elderly is polypharmacy. Other factors such as economic and social status, cognitive impairment, health literacy, age, and depression also significantly influence medication adherence among the elderly.</p><p><strong>Conclusions: </strong>The health system should focus on managing medications for older adults who use multiple drugs. Providing economic and social support, psychological training, and counseling can ameliorate medication adherence.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 6","pages":"523-555"},"PeriodicalIF":2.5,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965714","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":"Correlation Analysis of Serum Uric Acid and Uric Acid Creatinine Ratio With Sarcopenia in the Elderly.","authors":"Yi-Yang Liu, Qi-Fei Kuang, Shuang Li, Qun-Yan Xiang, Yu-Qing Ni, Chen Li, Le Liu, Jing Cai, Yi Wang, Yan-Jiao Wang, You-Shuo Liu","doi":"10.1002/agm2.70055","DOIUrl":"10.1002/agm2.70055","url":null,"abstract":"<p><strong>Objectives: </strong>Sarcopenia is a progressive and systemic skeletal muscle disease. Uric acid is a powerful endogenous antioxidant and an indicator reflecting the nutritional status in the human body. Serum uric acid creatinine ratio (UCR) is serum uric acid (SUA) corrected by renal function. The relationship between SUA, UCR, and sarcopenia remains underexplored. This study explored the correlation between SUA, UCR, and sarcopenia in elderly patients.</p><p><strong>Methods: </strong>This study included 214 elderly patients (aged > 65 years) who were hospitalized in Xiangya Second Hospital from March 2022 to July 2023. <i>T</i> test, <i>U</i> test, or chi-squared test was used to compare the differences between groups. Spearman correlation analysis was used to analyze the correlation between SUA, UCR, and skeletal muscle mass index (SMI) and handgrip strength. The relationship between SUA, UCR, and sarcopenia was estimated by a multivariate logistic regression model. ROC curve was drawn to test the diagnostic efficacy of SUA and UCR for sarcopenia.</p><p><strong>Results: </strong>The levels of SUA and UCR were significantly lower in participants with sarcopenia. Spearman correlation analysis showed that SUA and UCR were positively correlated with handgrip strength and skeletal muscle mass index. Multivariate logistic regression analysis showed that, after adjusting for relevant confounding factors, UCR remained significantly associated with sarcopenia, while SUA didn't. The AUC of SUA combined with UCR in diagnosing sarcopenia in males was 0.744. In females, the progressive significance of SUA was not statistically significant. The AUC of UCR was 0.658.</p><p><strong>Conclusion: </strong>In the elderly, SUA and UCR are related to sarcopenia, but there are certain gender differences.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 6","pages":"556-567"},"PeriodicalIF":2.5,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967245","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":"Prognostic Analysis of Lung Cancer With Brain Metastases in Elderly Patients: A Multicenter Retrospective Study.","authors":"Anqi Li, Daqin Feng, Chang Liu, Chaojue Huang, Tang Li, Donggui Wei, Fangyi Wei, Muling Shen, Congzhi Qin, Shufang Deng, Hui Liang, Panlin Mo, Minhai Dong, Yongjia Yu, Lun Liang","doi":"10.1002/agm2.70060","DOIUrl":"10.1002/agm2.70060","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the prognostic factors affecting overall survival (OS) in patients aged ≥ 65 years with lung cancer BMs.</p><p><strong>Methods: </strong>In this multicenter retrospective study, 293 patients aged ≥ 65 years diagnosed with lung cancer BMs between 2010 and 2023 were included. We analyzed the correlation between clinical information, treatment methods, molecular data, and OS. Univariate and multivariate Cox regression models were used to identify risk factors, and Kaplan-Meier survival curves were constructed for analysis.</p><p><strong>Results: </strong>A total of 293 patients aged ≥ 65 years with lung cancer BMs were included (age mean [SD], 69.40 [4.04] years). Univariate analysis of 293 lung cancer patients aged ≥ 65 years with BMs showed that risk prognostic factors included pathological type (SCLC, hazard ratio [HR] = 2.221, 95% confidence interval [CI] = 1.531-3.224, <i>p</i> < 0.001), location of BMs (HR = 1.428, 95% CI = 1.045-1.951, <i>p</i> = 0.025), diagnosis KPS (HR = 0.693, 95% CI = 0.528-0.909, <i>p</i> = 0.008), and targeted therapy (HR = 0.610, 95% CI = 0.465-0.798, <i>p</i> < 0.001). Multivariate analysis showed that pathological type (SCLC, HR = 1.814, 95% CI = 1.230-2.676, <i>p</i> = 0.003), diagnosis KPS (HR = 0.726, 95% CI = 0.550-0.959, <i>p</i> = 0.024), and targeted therapy (HR = 0.008, 95% CI = 0.506-0.902, <i>p</i> = 0.008) were independent factors of OS in such patients.</p><p><strong>Conclusions: </strong>Pathological type, KPS, and targeted therapy significantly impact OS in elderly lung cancer BM patients. Targeted therapy may be a promising option for improving prognosis in this patient population.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05609162.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 6","pages":"585-591"},"PeriodicalIF":2.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967310","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":"A Retrospective Study of First-Line Immunotherapy for Advanced Non-Small Cell Lung Cancer in the Elderly.","authors":"Sheng Yang, Yalin Zhu, Sitong Liu, Kui Xiao","doi":"10.1002/agm2.70052","DOIUrl":"10.1002/agm2.70052","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;In this study, we compared the efficacy and safety of first-line IO among different age subgroups of elderly patients, as well as in comparison to non-elderly patients with advanced NSCLC. Additionally, we investigated hematological biomarkers associated with overall survival (OS) and compared the efficacy and safety of pembrolizumab plus chemotherapy (CT) versus tislelizumab plus CT in the treatment of advanced NSCLC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective analysis of clinical data from 298 patients with stage IIIB-IVB NSCLC without driver mutations who received first-line IO at The Second Xiangya Hospital of Central South University between June 1, 2019, and June 30, 2023. Differences between elderly and non-elderly patients, as well as among different elderly age subgroups, were analyzed using the chi-squared test and the Kruskal-Wallis &lt;i&gt;H&lt;/i&gt; test. Receiver operating characteristic (ROC) curves were used to determine the optimal cut-off values for hematological biomarkers. Patients were categorized into two groups based on treatment regimens: pembrolizumab plus CT and tislelizumab plus CT. To minimize baseline differences between the groups, 1:1 propensity score matching (PSM) was applied. A two-sided &lt;i&gt;p&lt;/i&gt;-value of &lt; 0.05 was considered statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study population was divided into two groups: elderly group (≥ 65 years old, &lt;i&gt;n&lt;/i&gt; = 145 cases) and non-elderly group (&lt; 65 years old, &lt;i&gt;n&lt;/i&gt; = 153 cases). The elderly group was further divided into three subgroups: 65-69 years old group (&lt;i&gt;n&lt;/i&gt; = 78 cases), 70-74 years old group (&lt;i&gt;n&lt;/i&gt; = 48 cases), and ≥ 75 years old group (&lt;i&gt;n&lt;/i&gt; = 19 cases). Kaplan-Meier survival analysis using the log-rank test revealed no statistically significant difference in OS among the age groups (&lt;i&gt;p&lt;/i&gt; = 0.100). Multivariate COX regression analysis indicated that smoking history, bone metastasis, PD-L1 tumor proportion score (TPS), and prognostic nutritional index (PNI) are independent prognostic factors for OS. Monocyte count (M), NLR, PLR, MLR, PIV, and SII were negatively correlated with OS, while PNI was positively associated with OS in patients with advanced NSCLC. Before PSM, the median OS (mOS) for patients receiving pembrolizumab plus CT and tislelizumab plus CT was 39.180 months (95% CI: 25.440-NA) and not reached (95% CI: 42.110-NA), respectively, with no statistically significant difference (&lt;i&gt;p&lt;/i&gt; = 0.287). After PSM, the mOS was 46.150 months (95% CI: 17.550-NA) in the pembrolizumab plus CT group, while it remained not reached (95% CI: 20.550-NA) in the tislelizumab plus CT group, again show no statistically significant difference (&lt;i&gt;p&lt;/i&gt; = 0.346).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Age may not be the main prognostic factor for the effectiveness of first-line immunotherapy in patients with advanced NSCLC. Longer mOS was observed in patients who were non-smokers, had no bone metast","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 6","pages":"592-611"},"PeriodicalIF":2.5,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967293","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":"Taste Propensity in Obese and Nonobese Older Adults.","authors":"Maedeh Akbari, Ladan Alizadeh Lemani, Nasim Abedimanesh, Jalal Hejazi","doi":"10.1002/agm2.70056","DOIUrl":"10.1002/agm2.70056","url":null,"abstract":"<p><strong>Objectives: </strong>To examine associations between taste propensity and body mass index (BMI) in elderly individuals (≥ 60 years), compare taste propensity between obese and nonobese groups, and explore gender-related differences to inform dietary interventions.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 231 elderly participants (aged ≥ 60 years) in Zanjan city, categorized into obese (<i>n</i> = 80) and nonobese (<i>n</i> = 151) groups. Taste propensity was assessed using a validated food frequency questionnaire (FFQ) evaluating six taste groups: sweet, salty, sour, bitter, umami, and fat. Pearson's correlation and independent samples <i>t</i>-tests were used to examine relationships between BMI and taste propensity.</p><p><strong>Results: </strong>Inverse correlations were observed between BMI and sweet (<i>r</i> = -0.172, <i>p</i> = 0.009), bitter (<i>r</i> = -0.139, <i>p</i> = 0.035), and umami (<i>r</i> = -0.168, <i>p</i> = 0.010) taste propensities; whereas there were positive correlations between BMI and salty (<i>r</i> = 0.204, <i>p</i> = 0.002) and fat (<i>r</i> = 0.167, <i>p</i> = 0.011) taste scores. Moreover, obese participants showed a lower propensity for sweet and umami tastes (<i>p</i> = 0.049; <i>p</i> < 0.001), but a higher propensity for salty and fat tastes (<i>p</i> = 0.029; <i>p</i> = 0.024) compared to nonobese individuals. A gender difference was observed in umami propensity among obese participants, with women showing a stronger propensity (<i>p</i> = 0.033).</p><p><strong>Conclusions: </strong>Obesity in the elderly is associated with altered taste perception, particularly an increased propensity for salty and fatty foods and a decreased propensity for sweet and umami tastes. These findings may inform tailored dietary interventions in older adults.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 6","pages":"577-584"},"PeriodicalIF":2.5,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966680","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":"Hospitalized Older Patients' Readiness to Use mHealth Mobility Apps.","authors":"Trevor Denton, Shuo Tian, Sachita Shrestha, Liana Marquis, Anupama Goyal, Stephanie Parks Taylor, David Paje","doi":"10.1002/agm2.70061","DOIUrl":"10.1002/agm2.70061","url":null,"abstract":"<p><strong>Objectives: </strong>Hospitalization-associated disability (HAD) is prevalent among older adults, impacting their recovery and independence post-discharge. Assessing the readiness and willingness of older adults to use mobile health (mHealth) apps can provide new opportunities to mitigate HAD by promoting physical activity during hospitalization.</p><p><strong>Methods: </strong>We performed a cross-sectional study of patients aged 65 years and older, admitted to the general medical unit of a large academic hospital. In-person surveys assessed participants' perceptions of physical activity, mobile device familiarity, and willingness to use a hypothetical mHealth mobility app that would provide reminders to be active during hospitalization. Participants also completed a practical digital literacy assessment by setting an alarm on their personal mobile device. Demographic and clinical data were abstracted from electronic medical records.</p><p><strong>Results: </strong>Of 80 eligible patients invited, 69 (86%) were enrolled. The median age of participants was 74 years (interquartile range, 69-77 years). The majority of participants preferred to stay physically active during hospitalization (81%), owned a mobile device (83%), and expressed willingness (55%) to use an mHealth app that provides notifications to perform physical activities. Participants willing to use such an app had a higher median Charlson comorbidity score (8 vs. 6, <i>p</i> = 0.005), more likely completed education beyond high school (84% vs. 57%, <i>p</i> = 0.016), and reported greater comfort using mobile devices in general (90% vs. 67%, <i>p</i> = 0.033) compared to those unwilling. Willing participants were more successful in the alarm-setting task compared to those unwilling (63% vs. 13%, <i>p</i> = 0.001).</p><p><strong>Conclusions: </strong>In this single-center study, most older adults prefer to stay physically active, and a majority are willing and capable of using an mHealth app to receive mobility reminders during hospitalization. These findings support the development of targeted mHealth interventions to decrease HAD in geriatric acute care settings.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 6","pages":"503-510"},"PeriodicalIF":2.5,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967222","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":"Mechanism of RNA Oxidation and Its Inhibitor Involved in Ang II-Induced Cardiomyocyte Hypertrophy.","authors":"Tong Liu, Jin Bian","doi":"10.1002/agm2.70057","DOIUrl":"10.1002/agm2.70057","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the mechanism of RNA oxidation and its inhibitor MTHI involved in cardiomyocyte hypertrophy.</p><p><strong>Methods: </strong>The hypertrophic H9c2 cardiomyocytes were stimulated with different concentrations and times of Ang II (Ang II) to construct a model of hypertensive heart failure in vitro. Transfection of H9c2 cells with the MTH1 overexpression plasmid was performed. The mRNA expression of ANP, BNP, and β-MHC in each experimental group was detected by PCR. The expression of 8-oxoG in H9c2 cells was determined by immunofluorescence and enzyme-linked immunosorbent assay (ELISA). The activation of the ERK-MAPK pathway and the amount of MTH1 protein were detected by WB semi-quantitative method.</p><p><strong>Results: </strong>Notably, RNA oxidation is a critical event in cellular senescence, and its accumulation is strongly linked to the aging process and the development of age-related diseases. In our model of cardiomyocyte hypertrophy, the oxidative damage of RNA was aggravated, and the expression of MTH1 was increased. At the same time, the sequence of ERK-MAPK pathway proteins was activated. It can be seen that the oxidative damage of RNA is related to the process of cardiomyocyte hypertrophy. After transfection of the MTH1 overexpression plasmid into the cardiomyocyte hypertrophy model, we found that the amount of 8-oxoG decreased, and the activation of ERK-MAPK signaling pathway proteins decreased, and H9c2 cell hypertrophy decreased. Therefore, we concluded that 8-oxoG may aggravate the hypertrophy of the cardiomyocyte hypertrophy model by activating the ERK-MAPK pathway.</p><p><strong>Conclusion: </strong>The oxidative damage of RNA is involved in the process of cardiomyocyte hypertrophy. The mechanism may be that 8-oxoG, a product of RNA oxidation, activates the downstream ERK-MAPK signaling pathway. These findings provide new perspectives for further exploration into the role of RNA oxidation in the pathogenesis of age-related diseases, particularly heart failure.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 6","pages":"612-623"},"PeriodicalIF":2.5,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967313","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":"Transcranial Direct Current Stimulation Neuromodulation in Elderly Individuals and Its Impact on Anxiety and Depression Symptoms.","authors":"Guilherme Augusto Santos Bueno, Arthur Dutra do Bomfim, Ruth Losada de Menezes, Renato Canevari Dutra da Silva, Elton Brás Camargo Júnior, Henrique Salmazo da Silva","doi":"10.1002/agm2.70059","DOIUrl":"10.1002/agm2.70059","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effects of anodal transcranial direct current stimulation (tDCS) over the left prefrontal cortex, combined with computerized cognitive training, on cognitive performance, anxiety, depression, motor reaction time, and neurophysiological markers in elderly women with subjective cognitive decline or preserved cognition.</p><p><strong>Methods: </strong>This was a randomized double-blind clinical trial involving 30 elderly women allocated to three groups: active tDCS, sham tDCS, and controls. The intervention consisted of nine sessions of tDCS combined with cognitive training. Cognitive aspects (Addenbrooke's Cognitive Examination-Revised), depressive symptoms (CES-D), anxiety symptoms (GAI), motor reaction times, and neurophysiological aspects (EEG) were assessed. Statistical analyses included ANOVA and paired <i>t</i>-tests for between-group comparisons.</p><p><strong>Results: </strong>The tDCS group exhibited significant improvements in global cognition, episodic memory, verbal fluency, and language. Additionally, there was a significant reduction in anxiety and depression scores compared to those in the sham and control groups. The motor reaction time was reduced in the tDCS group, indicating improved sensorimotor integration. The EEG data demonstrated increased cortical excitation and improved emotional valence in the tDCS group.</p><p><strong>Conclusion: </strong>Anodal tDCS associated with computerized cognitive training has proven to be an effective strategy for optimizing performance in memory tasks, verbal fluency, and decision-making as well as for reducing anxiety and depression symptoms in elderly individuals with or without subjective cognitive decline. Based on these findings, tDCS is a promising and safe tool for developing cognitive interventions for the elderly. Future studies should explore the long-term effects and impact of different stimulation protocols.</p><p><strong>Trial registration: </strong>This clinical trial is registered in the Brazilian Clinical Trials Registry (ReBEC) under the identification number RBR-16768.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 6","pages":"511-522"},"PeriodicalIF":2.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966694","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":"Predictive Value of Triglyceride/HDL-C Ratio for Unplanned Coronary Revascularization in Elderly Patients With Type 2 Diabetes and Coronary Artery Disease: A Retrospective Cohort Study.","authors":"Wei Zhu, Yin Zhang, Pan Gao","doi":"10.1002/agm2.70058","DOIUrl":"10.1002/agm2.70058","url":null,"abstract":"<p><strong>Objectives: </strong>The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio reflects atherogenic dyslipidemia and insulin resistance. Its predictive value for unplanned coronary revascularization in elderly patients with type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) is unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed 1796 patients aged ≥ 60 years with T2DM and angiographically confirmed CAD from January 2008 to November 2021. The primary endpoint was unplanned coronary revascularization, defined as revascularization performed because of angina symptoms, new ischemic changes on ECG, or signs of reversible myocardial ischemia on noninvasive imaging. TG/HDL-C ratio was evaluated by tertiles in Kaplan-Meier analysis and as a continuous variable in Cox models: Model 1 (unadjusted), Model 2 (age, gender, smoking), and Model 3 (further adjusted for lipid, metabolic, renal, and angiographic covariates). Restricted cubic spline (RCS) analysis and prespecified subgroup analyses were performed.</p><p><strong>Results: </strong>During a median follow-up of 1175 days (interquartile range, 597-1986), unplanned revascularization occurred in 309 patients (17.2%). In the fully adjusted model, TG/HDL-C ratio remained independently associated with increased risk (per 1-unit increase: hazard ratio [HR] 1.029, 95% confidence interval [CI] 1.007-1.051, <i>p</i> = 0.011; per standard deviation increase: HR 1.158, 95% CI 1.039-1.290, <i>p</i> = 0.008). Compared with the lowest tertile, the highest tertile showed a significantly higher risk of unplanned revascularization (HR = 1.646, 95% CI = 1.133-2.393, <i>p</i> < 0.010). The RCS analysis demonstrated a relatively flat risk below approximately 3.427, with a progressive increase thereafter (<i>p</i> for overall association = 0.006; <i>p</i> for nonlinearity = 0.045). Subgroup analyses showed no statistically significant interactions (all <i>p</i> for interaction > 0.05), and the direction of association was consistent across predefined clinical strata.</p><p><strong>Conclusion: </strong>Higher TG/HDL-C ratio independently predicted unplanned revascularization in elderly patients with T2DM and CAD. This simple, widely available lipid parameter may aid long-term risk stratification, but prospective multicenter studies are needed for validation.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 6","pages":"568-576"},"PeriodicalIF":2.5,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967299","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}