Clinical Interventions in Aging最新文献

{"title":"Advancements in the Optimization of Surgical Timing in Elderly Patients with Hip Fractures: A Narrative Review and Future Perspectives.","authors":"Xin Xu, Hui Yu, Junxiang Wang, Junfei Guo","doi":"10.2147/CIA.S526209","DOIUrl":"https://doi.org/10.2147/CIA.S526209","url":null,"abstract":"<p><p>The optimal timing for hip fracture surgery in elderly patients remains a topic of intense debate and complexity, with many factors influencing the decision-making process. This review examines the current evidence, exploring the advantages and challenges of early versus delayed intervention. It considers medical stability, preoperative medical stabilization, and patient comorbidities, and logistical challenges such as operating room availability and specialized physician access. While multiple studies have examined early versus delayed surgery, a universally agreed definition of \"unacceptable delay\" is absent. Some evidence indicates that postponing surgery beyond 24 hours may not significantly impact mortality and complication rates, especially in individuals with complex medical conditions. Conversely, early intervention within 48 hours is often recommended for stable patients. Several contributing factors, such as preoperative medical stabilization, hospital resources, and organizational structures, further complicate the issue. This review highlights the need for a nuanced, individualized, and patient-centered approach, taking into account the unique needs of each patient and the specific circumstances of the healthcare setting. It also emphasizes the importance of further research to provide a more comprehensive understanding of what constitutes an optimal delay, rather than adhering to rigid time frames. By offering a multifaceted examination of this critical subject, the review contributes valuable insights that may guide future clinical practice and policy in orthopedic care.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"881-894"},"PeriodicalIF":3.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530571","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":"Predicting Preoperative Deep Vein Thrombosis Using d-Dimer-to-Albumin Ratio Combined with Neutrophil-to-Lymphocyte Ratio in Older Patients with Hip Fracture.","authors":"Wenbin Lu, Fan Jia, Miaomiao Rao, Wubin Chen, Yi Liu, Jinjun Bian","doi":"10.2147/CIA.S523443","DOIUrl":"https://doi.org/10.2147/CIA.S523443","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the potential value of the d-dimer to albumin ratio (DAR) combined with the neutrophil-to-lymphocyte ratio (NLR) for predicting preoperative lower extremity deep vein thrombosis (DVT) in older patients with hip fracture.</p><p><strong>Methods: </strong>Demographic characteristics, comorbidities, medication history, and preoperative laboratory test results were collected from older patients with hip fracture between 2018 and 2023. Binary logistic regression analysis was used to assess the association between the DAR, NLR, and DVT. Receiver operating characteristic (ROC) curve analysis was performed to calculate the potential value of DAR combined with NLR in predicting preoperative DVT.</p><p><strong>Results: </strong>A total of 1177 patients were included, of whom 23 (2%) developed lower extremity DVT before surgery. Multivariate logistic regression analysis indicated that age (OR = 1.08, 95% CI = 1.01~1.15, <i>P</i> = 0.015), DAR (OR = 1.53, 95% CI = 1.21~1.92, <i>P</i> < 0.001), and NLR (OR = 1.24, 95% CI = 1.10~1.39, <i>P</i> < 0.001) were independently associated with preoperative DVT in older patients with hip fractures. Furthermore, the ROC curve analysis indicated that DAR combined with NLR has a significant predictive value for DVT, with an area under the curve of 78.72% (95% CI = 68.24-89.20%).</p><p><strong>Conclusion: </strong>The preoperative DAR and NLR were independently associated with preoperative DVT in older patients with hip fractures. DAR combined with NLR can be considered as a predictive indicator of DVT.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"873-879"},"PeriodicalIF":3.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530572","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":"Falls, Sleep Disorders and Cognitive Frailty in Hospitalized Older Adults with Hypertension:A Cross-Sectional Study.","authors":"Xiaoyan Li, Huizhen Li, Shibao Gan, Youran Zhang, Dianhe Yin, Baihui Zhu, Shiyi Wang, Yuru Liu","doi":"10.2147/CIA.S510228","DOIUrl":"10.2147/CIA.S510228","url":null,"abstract":"<p><strong>Purpose: </strong>Falls and fall-related injuries are highly prevalent among older adults. Falls negatively impact functional independence and quality of life, and are associated with increased morbidity, mortality, and healthcare costs. Sleep disorders in the older adults are a common phenomenon, with sleep quality gradually deteriorating as age increases. Cognitive frailty(CF) refers to the presence of both physical frailty(PF) and mild cognitive impairment(MCI) without simultaneous diagnosis of Alzheimer's disease(AD) or other dementia. Epidemiological studies have confirmed the association between falls and sleep disorders, as well as CF. However, no studies have yet investigated the relationship between falls, sleep disorders and CF in hospitalized older adults with hypertension. Our study is to explore the relationship between falls and both sleep disorders and CF in hospitalized older adults with hypertension, providing a basis for fall prevention.</p><p><strong>Patients and methods: </strong>Demographic characteristics were collected from hypertensive patients aged 65 and above who were hospitalized in the Department of Geriatrics at Huaihe Hospital of Henan University, from July 2022 to June 2024. These patients were assessed for history of falls, sleep quality, CF, depression and nutritional status. Logistic regression analysis was used to examine the correlation between falls and both sleep disorders and CF.</p><p><strong>Results: </strong>A total of 266 older adults with hypertension were surveyed in this study, of whom 108 reported having fallen once or more in the past year. Both sleep disorders and CF were significantly associated with an increased risk of falls (sleep disorders: OR=2.625, 95% CI 1.214-5.678, P=0.014; CF: OR=5.920, 95% CI 2.632-13.314, P<0.001). Other significant risk factors included: Age (OR=1.119, 95% CI 1.055-1.188, P<0.001), Comorbidities (OR=2.855, 95% CI 1.353-6.024, P=0.006), Polypharmacy (OR=4.126, 95% CI 1.937-8.793, P<0.001), Compared to hospitalized older adults with hypertension with good nutritional status, those with malnutrition had a 4.698-fold higher risk of falls (95% CI 1.724-12.800, P=0.002).</p><p><strong>Conclusion: </strong>The incidence of falls was higher among hospitalized older adults with hypertension. Both sleep disorders and CF were strongly associated with falls in this patient population.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"859-872"},"PeriodicalIF":3.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477520","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":"The Impact of Power Training on Muscle Power, Physical Performance, and Physical Functioning in Older Adults: A Descriptive Case Series.","authors":"Mohamed El Hadouchi, Henri Kiers, Cindy Veenhof, Jaap Van Dieën","doi":"10.2147/CIA.S511954","DOIUrl":"10.2147/CIA.S511954","url":null,"abstract":"<p><strong>Purpose: </strong>Powerful Ageing is a power training intervention offered by Dutch municipalities to improve the physical functioning of its older residents, thereby reducing their reliance on assistive living devices and social support services. This study aimed to investigate the effects of Powerful Ageing on muscle power, physical performance, and physical functioning in older adults immediately following the intervention and at 1-year follow-up.</p><p><strong>Patients and methods: </strong>The study design was a prospective longitudinal case series. Eligible older adults requesting social support services from their municipality participated in a 14-week power training intervention. Primary outcomes were categorized according to ICF health domains: within the function domain, muscle power was measured with a Power Squat Test and a Lifting Test; within the activities domain, physical performance was assessed using the Star Agility Run and Timed Up-and-Go Test; and within the participation domain, physical functioning was assessed using a patient-specific complaints questionnaire. Participant motivation, a secondary outcome, was assessed using a short questionnaire.</p><p><strong>Results: </strong>Participants showed statistically significant improvements performing the Power Squat Test (p<0.001; effect sizes: 0.52-1.00), the Lifting Test (p<0.001; effect sizes: 0.64-0.82), the Star Agility Run (p<0.001; effect size: 0.61), and the Timed Up-and-Go Test (p<0.001; effect size: 0.74) immediately following Powerful Ageing. Additionally, activities of daily life became significantly less difficult to perform (p-value <0.001, effect sizes: 0.60-0.78). Among participants who continued power training following the intervention, these improvements were even greater at 1-year follow up. Participant motivation was high throughout the duration of the study.</p><p><strong>Conclusion: </strong>Powerful Ageing led to significant improvements in muscle power, physical performance, and physical functioning in older adults. Among participants who continued power training in the year following the intervention, improvements progressed even further, suggesting long-term benefits. Further research is needed to confirm the sustainability of the effects of power training in older adults.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"849-857"},"PeriodicalIF":3.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477521","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":"A Nomogram for Predicting Pulmonary Complications Following Laparoscopic Surgery in Elderly Patients After the COVID-19 Pandemic.","authors":"Di Liu, Dan Liu, Fei Jiang, Yue Zhang, Hui Huang, Lei Zou, Yong Yang","doi":"10.2147/CIA.S515849","DOIUrl":"10.2147/CIA.S515849","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pulmonary complications (PPCs) are common and serious after laparoscopic surgery, better than cardiac complications in predicting long-term mortality after non-cardiac surgery. In the post-epidemic era, the specific incidence of PPCs and their risk factors remain unclear.</p><p><strong>Methods: </strong>This two-center retrospective study used the eligible patients' demographics and clinical characteristics to develop a prediction model. These patients who had undergone laparoscopic surgery from January 2023 to April 2024 were randomized into the training set and validation set. The main outcome was the incidence of PPCs. The multi-input processing method was used for missing data imputation. The variables with a <i>P</i>-value ≤0.05 and the covariates considered meaningful in clinical practice in univariate logistic regression analysis were subjected to multivariate logistic regression analysis to determine the independent risk factors of PPCs. The ROC, AUC, calibration curve, and clinical decision curve analysis of both sets were used to evaluate the model's predictive accuracy.</p><p><strong>Results: </strong>278 patients (21.21%) developed PPCs. Surgical site and the comorbidities (except pulmonary diseases), pulmonary abnormalities, 24-h white blood cell count, and 24-h neutrophil percentage before surgery were independent risk factors for PPCs and used for the establishment of a nomogram prediction model for PPC risk in elderly patients. The AUC value, sensitivity, and specificity were 0.88, 75.4%, and 87.6% respectively in the model's ROC curve. Internal verification (AUC: 0.86) confirmed the model's good calibration and discrimination abilities. Clinical decision curve analysis showed that the model had a positive clinical net benefit within the risk threshold range of 0%~30%.</p><p><strong>Conclusion: </strong>This study identified the high-risk individuals of PPCs in elderly patients. PPC risk in elderly patients after laparoscopic surgery could be effectively reduced by optimizing surgical site selection, controlling preoperative comorbidities, adjusting preoperative lung conditions, and monitoring preoperative 24-h white blood cell count and neutrophil percentage.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"837-848"},"PeriodicalIF":3.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327468","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":"Predicting Short-Term Risk of Cardiovascular Events in the Elderly Population: A Retrospective Study in Shanghai, China.","authors":"Wenqing Zhu, Shuoyuan Tan, Zhitong Zhou, Miaomiao Zhao, Yingquan Wang, Qi Li, Yang Zheng, Jianwei Shi","doi":"10.2147/CIA.S519546","DOIUrl":"10.2147/CIA.S519546","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular diseases (CVD) represents a leading cause of morbidity and mortality worldwide, including China. Accurate prediction of CVD risk and implementation of preventive measures are critical. This study aimed to develop a short-term risk prediction model for CVD events among individuals aged ≥60 years in Shanghai, China.</p><p><strong>Methods: </strong>Stratified random sampling recruited elderly individuals. Retrospective data (2016-2022) were analyzed using Lasso-Cox regression, followed by a multivariable Cox regression model. The risk scoring was visualized through a nomogram, and the model performance was assessed using calibration plots and receiver operating characteristic curves.</p><p><strong>Results: </strong>A total of 9,636 individuals aged ≥60 years were included. The Lasso-Cox regression analysis showed male gender (HR=1.482), older age (HR=1.035), higher body mass index (HR=1.015), lower high-density lipoprotein cholesterol (HR=0.992), higher systolic blood pressure (HR=1.009), lower diastolic blood pressure (HR=0.982), higher fasting plasma glucose (HR=1.068), hypertension (HR=1.904), diabetes (HR=1.128), and lipid-lowering medication (HR=1.384) were related to higher CVD risk. The C-index in the training and validation data was 0.642 and 0.623, respectively. Calibration plots indicated good agreement between predicted and actual probabilities.</p><p><strong>Conclusion: </strong>This short-term predictive model for CVD events among the elderly population exhibits good accuracy but moderate discriminative ability. More studies are warranted to investigate predictors (gender, high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, hypertension, and lipid-lowering medication) of CVD incidence for the development of preventive measures.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"825-836"},"PeriodicalIF":3.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318420","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":"Targeting Senescence, Oxidative Stress, and Inflammation: Quercetin-Based Strategies for Ocular Diseases in Older Adults.","authors":"Alessandro Medoro, Sergio Davinelli, Luca Scuderi, Gianluca Scuderi, Giovanni Scapagnini, Serena Fragiotta","doi":"10.2147/CIA.S516946","DOIUrl":"10.2147/CIA.S516946","url":null,"abstract":"<p><p>Quercetin, a flavonol abundant in fruits and vegetables, has attracted significant attention for its senotherapeutic effects, which involve the selective elimination of senescent cells and the modulation of pro-inflammatory phenotypes that contribute to age-related dysfunctions. These actions, together with its antioxidant, anti-inflammatory, neuroprotective, and anti-angiogenic properties, make quercetin a promising strategy for ocular diseases associated with visual impairment in older adults such as age-related macular degeneration, cataract, diabetic retinopathy, and glaucoma. This review emphasizes the mechanisms by which quercetin exerts its protective effects, with particular attention to its ability to target cellular senescence, reduce oxidative stress, and modulate inflammation. Despite extensive preclinical evidence, the clinical application of quercetin remains limited due to challenges related to poor bioavailability, rapid degradation, and the absence of standardized ocular formulations. Progress in drug delivery systems, including nanoparticles, nanoemulsions, and solid lipid carriers, provides promising strategies to overcome these barriers. In addition, combining quercetin with established treatments, such as anti-vascular endothelial growth factor (VEGF) agents and neuroprotective drugs, may enhance its therapeutic potential in managing and possibly reversing age-related ophthalmic disorders.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"791-813"},"PeriodicalIF":3.5,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12155388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276383","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":"Effects of HALP Score, C-Reactive Protein/Albumin Ratio, and Platelet/Lymphocyte Ratio on Predicting Mortality in Geriatric Patients in the Respiratory Intensive Care Unit.","authors":"Kamuran Uluç, Esra Akkütük Öngel, Şükran Merve Çolakoğlu, Nazan Köylü İlkaya, Özkan Devran, Ahmet Oğuzhan Küçük, Hatice Kutbay Özçelik","doi":"10.2147/CIA.S482214","DOIUrl":"10.2147/CIA.S482214","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to evaluate the effects of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score, C-reactive protein/albumin ratio (CAR), and platelet/lymphocyte ratio (PLR) on predicting mortality in geriatric patients admitted to the respiratory intensive care unit (ICU).</p><p><strong>Materials and methods: </strong>In this retrospective observational cohort study, data of patients followed up in the respiratory ICU between 01.07.2021 and 31.12.2023 were evaluated. Age, gender, HALP score, hemoglobin, albumin, lymphocyte, platelet, and C-reactive protein (CRP) levels, along with PLR, CAR, and patient prognosis (exitus/discharge), were recorded from patient files and the hospital data processing system.</p><p><strong>Results: </strong>The study included 405 patients (140 women and 265 men) over 65 years of age. In multivariate analysis, higher PLR and CAR values were associated with a higher mortality rate, whereas patients with a higher HALP score had a lower mortality rate (p<0.001). In the ROC analysis, a statistically significant cut-off value was found for the HALP score in predicting mortality (p<0.001). HALP score ≤ 9.94 indicates mortality, with a sensitivity of 67.25%, specificity of 53%, PPV (positive predictive value) of 64.98%, and NPV (negative predictive value) of 55%. CAR value ≥ 30.13 indicates mortality, with a sensitivity of 69.87%, specificity of 61.36%, PPV of 70.18% and NPV of 61.02%. There was no statistically significant cut-off value for PLR in predicting mortality (p=0.076).</p><p><strong>Conclusion: </strong>We found that the HALP score, PLR value, and CAR value are important scores that may be useful in determining mortality and treatment modality in geriatric patients treated in the ICU.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"815-823"},"PeriodicalIF":3.5,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276382","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":"Association Between Pain and Frailty in Middle-Aged and Older Patients: The Mediating Roles of Sleep and Mood.","authors":"Hua-Peng Wang, Tao Wang, Hao-Tian Ye, Yong-Yan Dong, Shi-Jie Zhao, Qing-Ren Liu, Xiao-Yi Hu, Mu-Huo Ji, Jian-Jun Yang","doi":"10.2147/CIA.S515294","DOIUrl":"10.2147/CIA.S515294","url":null,"abstract":"<p><strong>Purpose: </strong>Pain and frailty are significantly social concerns negatively affecting physical and mental health in middle-aged and older population. This study aimed to investigate the association between pain and frailty, with a particular focus on the mediating roles of sleep and mood.</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted involving 244 middle-aged and older participants in local hospital. Their pain, frailty, sleep and mental health conditions were assessed through face-to-face interviews. Linear regression analysis was used to examine the association between pain and frailty. Simple and serial mediation models were employed to investigate the complex mediation effects of sleep and mood on pain and frailty.</p><p><strong>Results: </strong>Significant effects were observed in both the pain-frailty nexus and the frailty-pain nexus. For simple mediation models, we identified significant mediation effects of sleep (<i>β_Sleep</i> =0.049, 95% CI: 0.011, 0.094), anxiety (<i>β_Anxiety</i> =0.054, 95% CI: 0.023, 0.094), and depression (<i>β_Depression</i> =0.093, 95% CI: 0.049, 0.150) in the pain-frailty nexus. Similarly, in the frailty-pain nexus, sleep (<i>β_Sleep</i> =0.096, 95% CI: 0.043, 0.162), anxiety (<i>β_Anxiety</i> =0.085, 95% CI: 0.029, 0.156), and depression (<i>β_Depression</i> =0.126, 95% CI: 0.056, 0.208) continued to be significant mediators, while sleep and depression had more significant mediating effects than anxiety. Serial mediation models revealed that sleep and depression jointly played a sequential mediation role in the frailty-pain nexus ( <i>β_a</i> =0.020, 95% CI: 0.002, 0.044; <i>β_b</i> =0.043, 95% CI: 0.014, 0.081).</p><p><strong>Conclusion: </strong>Our research provided evidence supporting the robust association between pain and frailty and offered new sights into potential strategies by enhancing sleep quality and mental health for preventing and managing both pain and frailty.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"777-789"},"PeriodicalIF":3.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276381","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":"Risk Factors and Prediction Model for Postoperative Pneumonia Following Hip Arthroplasty in Older Adults.","authors":"Bingbing Xiang, Jingyuan Zhang, Chaoyi Deng, Han Yang, Liu Qian, Wensheng Zhang","doi":"10.2147/CIA.S521087","DOIUrl":"10.2147/CIA.S521087","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pneumonia is one of the most common complications following hip arthroplasty in older adults. It often results in delayed recovery, prolonged hospital stays, and increased perioperative mortality rates.</p><p><strong>Objective: </strong>To analyze the risk factors for postoperative pneumonia in older adults undergoing hip arthroplasty and develop a nomogram-based prediction model using perioperative variables.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 308 older adults who underwent hip arthroplasty. Relevant clinical data were collected and recorded. Univariate and multivariate logistic stepwise regression analyses were conducted to identify the risk factors for postoperative pneumonia in this population. A risk prediction model for postoperative pneumonia was then developed and visualized using a nomogram.</p><p><strong>Results: </strong>Among the 308 older adults, 46 developed postoperative pneumonia, with an incidence rate of approximately 14.94%. Multivariate logistic regression analysis revealed that American Society of Anesthesiologists (ASA) classification, intensive care unit (ICU) admission, preoperative anemia, creatine kinase-MB (CKMB), brain natriuretic peptide (BNP), and postoperative aspartate aminotransferase (AST) were independent risk factors for postoperative pneumonia in elderly patients (P<0.05). The final prediction model for postoperative pneumonia was: P = 1 / [1 + e^(-3.690 + 0.982×ASA + 0.982×ICU + 0.806×Preoperative Anemia + 1.494×CKMB + 0.843×BNP + 0.917×Postoperative AST)], with Hosmer-Lemeshow χ² = 5.989 (P = 0.541). Receiver operating characteristic curve analysis showed an area under the curve of 0.792 (95% CI: 0.761-0.823). The Brier score of the calibration curve was 0.103 (close to 0), and decision curve analysis indicated that the threshold probability of the model ranged from 0.01 to 0.8, with net benefits greater than 0 across all probabilities, suggesting the model has good accuracy and clinical utility.</p><p><strong>Conclusion: </strong>We identified six important predictors-ASA grade, ICU admission, preoperative anemia, CKMB, BNP, and postoperative AST levels-and developed a risk prediction model for postoperative pneumonia following hip arthroplasty in older adults, providing a valuable reference for its prevention in this population.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"763-775"},"PeriodicalIF":3.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235693","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}