Clinical Interventions in Aging最新文献

{"title":"Anticholinergic Burden and Its Association with Hospitalisation Risk and Causes of Admission in Older Adults with Mild Cognitive Impairment or Dementia.","authors":"Renuka Rahoo, Zhen Yi Liau, Min-Jie Low, Shahrul Bahyah Kamaruzzaman, Benedict Francis, Hui Min Khor","doi":"10.2147/CIA.S541108","DOIUrl":"10.2147/CIA.S541108","url":null,"abstract":"<p><strong>Background: </strong>Older adults with cognitive impairment are vulnerable to the adverse effects of cumulative use of medications with anticholinergic properties. However, existing research on hospitalisation risk in this population remains limited and often lacks focus on the specific causes of admission. This study aims to investigate the role of anticholinergic burden and its association with hospitalisation risk and reasons for admission among older adults with mild cognitive impairment or dementia.</p><p><strong>Methods: </strong>This retrospective study included older adults with mild cognitive impairment or dementia attending the memory clinic between January to December 2022. Collected data from the electronic medical records includes sociodemographic information, comorbidities, cognitive and functional assessment, neuropsychiatric symptoms, and medication history. Anticholinergic burden was assessed using the Anticholinergic Cognitive Burden (ACB) score. Cox proportional hazard analysis was performed to assess the association between ACB scores and hospitalisation risk. The underlying causes of hospital admissions were compared across the different ACB score groups.</p><p><strong>Results: </strong>A total of 657 older adults were included in the analysis, with a mean age of 80.66 (SD 7.39) years. Anticholinergic medication use was seen in 35.5%, with a mean ACB score of 0.8 (SD 1.3). Higher ACB scores were associated with nursing home residency, presence of neuropsychiatric symptom, poorer cognitive and physical function, and a greater number of prescribed medications compared to those with no anticholinergic burden. Older adults with ACB scores of 1-2 had an increased risk of hospitalisation (Hazard Ratio(HR)=1.84,95% CI:1.17-2.90) in univariate analysis, but this association was diminished after adjusting for confounders. The most common reasons for hospital admission were pneumonia (5.7%), acute kidney injury (3.8%), delirium (2.6%) and falls (2.6%). Notably, individuals hospitalised for serious adverse cardiovascular events or infected pressure ulcers had significantly higher ACB scores.</p><p><strong>Conclusion: </strong>One-third of older adults with mild cognitive impairment or dementia use anticholinergic medications, potentially worsening health outcomes. These findings underscore the importance of regular medication review and deprescribing strategies to minimise anticholinergic burden in this vulnerable population.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1661-1670"},"PeriodicalIF":3.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201921","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":"Smartphone App-Based Psychoeducation for Caregivers of People with Dementia in Vietnam: A Pilot Randomized Controlled Trial.","authors":"Tran To Tran Nguyen, Lan Duong Tuyet Vu, Khoa Tri Truong, Tuan Chau Nguyen, Truc Thanh Thai, Penelope Schofield, Tuan Anh Nguyen, The Ha Ngoc Than, Huan Thanh Nguyen","doi":"10.2147/CIA.S551994","DOIUrl":"10.2147/CIA.S551994","url":null,"abstract":"<p><strong>Purpose: </strong>Caring for people with dementia (PwD) is demanding, particularly for family caregivers in lower-middle-income countries like Vietnam, where support is limited. This study assessed the feasibility and preliminary impact of a smartphone-based psychoeducational program for caregivers of PwD.</p><p><strong>Participants and methods: </strong>In a pilot randomized controlled trial, 60 family caregivers were recruited from the Geriatrics Department of a public hospital and randomly assigned (1:1) to either an intervention or a usual care group. Eligible participants were aged 18 or older, primarily responsible for daily care, had at least a primary education, used a smartphone with internet access and Zalo, and reported moderate stress. The intervention group received a 7-week psychoeducational program via Zalo, featuring videos and interactive group chats. Feasibility was assessed through recruitment, retention, and data collection rates. Engagement and acceptability were measured through caregiver participation and feedback. Preliminary effects on depression, anxiety, stress, dementia knowledge, caregiver burden, social support, and health-related quality of life were explored.</p><p><strong>Results: </strong>Of the 62 caregivers approached, 60 enrolled (96.7%), and 54 completed the study (90% retention). Assessment completion rates were 96.7% immediately after the intervention and 93.1% at the 3-month follow-up. Over 85% of participants were engaged weekly, and all participants rated the program content positively. Acceptability was high, with more than 89% expressing satisfaction with the content, format, and duration. Preliminary findings indicated improvements in psychological distress, dementia knowledge, caregiver burden, and quality of life.</p><p><strong>Conclusion: </strong>This is the first study in Vietnam to evaluate a smartphone-based psychoeducational intervention for caregivers of PwD. The program was feasible, well-accepted, and showed potential benefits. It offers a promising, scalable support model for caregivers in resource-limited settings and warrants further investigation in a larger trial.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1647-1660"},"PeriodicalIF":3.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151620","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":"Assessing Lumbar Spine Microstructure in Osteoporosis Using IVIM-DWI and IDEAL-IQ Sequences.","authors":"Zhaojuan Shi, Lingdong Hu, Datian Su, Zhe Yang, Weiwei Liu, Kemei Yuan, Tiantian Wang, Zhaoping Cui, Jian Qin, Yue Zhang","doi":"10.2147/CIA.S541103","DOIUrl":"10.2147/CIA.S541103","url":null,"abstract":"<p><strong>Background: </strong>Currently, dual-energy X-ray absorptiometry (DEXA) and quantitative CT (QCT) are commonly used in clinical practice to measure bone mineral density (BMD), offering diagnostic value but involving radiation and inability to visualize bone microstructure. This study aims to assess lumbar spine bone microstructure changes in normal, osteopenic, and osteoporotic groups using IVIM-DWI and IDEAL-IQ sequences to provide useful information for clinical practice.</p><p><strong>Methods: </strong>A total of 346 patients (50-87 years, 232 females, 114 males) underwent spinal DEXA and MRI. Based on the BMD obtained from DEXA, the patients were stratified into: normal (n=79), osteopenia (n=92), and OP (n=175) groups. Then to evaluated the results of IVIM-DWI and IDEAL-IQ and extracted quantitative parameters from regions of interest covering the L1 to L4 vertebrae. Group comparisons used One-way analysis of variance and the Kruskal‒Wallis <i>H</i>-test. Receiver operating characteristic (ROC) and Spearman's analyses evaluated diagnostic performance and correlations.</p><p><strong>Results: </strong>Significant differences existed in the ADCslow, f, FF and R2* between groups (P<0.05). BMD was weakly positively correlated with ADCslow, f, and R2* (r=0.494, 0.153, 0.182, 0.029, P<0.001) but a negative correlation with FF (r=-0.402, P<0.001). BMD and the ADCslow and R2* decreased but FF increased with age (P<0.05 for all), whereas no significant association existed between age and ADCfast or f value (P>0.05). FF had the highest areas under the curve (AUCs) (0.624, 0.831 and 0.747) and sensitivity (72.2%, 70.9% and 81.5%) in differentiating normal from osteopenia patients, normal from osteoporosis patients, and osteopenia from osteoporosis patients, respectively. ADCslow and f had the highest specificity (88%) in differentiating between normal and osteopenia patients, while ADCslow had the highest specificity (91.4%) in differentiating between normal and osteoporosis patients.</p><p><strong>Conclusion: </strong>Quantitative parameters extracted from IVIM-DWI and IDEAL-IQ have the potential to become good biomarkers for diagnosing OP.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1635-1646"},"PeriodicalIF":3.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151594","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":"Two Methods of Handgrip Strength Assessment in Sarcopenia Evaluation: Associations with in-Hospital Mortality in Older Adults.","authors":"Eliana Hanna Deschamps, François R Herrmann, David De Macedo Ferreira, Mauro Silva, Christophe E Graf, Aline Mendes","doi":"10.2147/CIA.S529761","DOIUrl":"10.2147/CIA.S529761","url":null,"abstract":"<p><strong>Background: </strong>Handgrip strength (HGS) is a key diagnostic tool for sarcopenia, yet the comparative prognostic value of the hydraulic dynamometer and pneumatic vigorimeter in hospitalized older adults remains unclear. This study is the first to examine the vigorimeter as a predictor of in-hospital mortality in this setting.</p><p><strong>Methods: </strong>This prospective cohort study included 376 hospitalized older adults (mean age: 82.7 years) across acute, rehabilitation, and long-term care wards. HGS was assessed using both the dynamometer and vigorimeter, applying two sets of cut-offs per instrument. Sarcopenia was confirmed using bioelectrical impedance analysis to calculate the fat-free mass index (FFMI), with four diagnostic criteria combining HGS and FFMI thresholds. Associations between HGS, sarcopenia, and mortality were evaluated using logistic regression and Cox proportional hazards models, with Kaplan-Meier curves illustrating survival differences.</p><p><strong>Results: </strong>Higher HGS measured by the vigorimeter was independently associated with reduced in-hospital mortality (OR 0.96, 95% CI 0.93-0.98, p = 0.001), whereas no significant association was found for dynamometer-measured HGS. Confirmed sarcopenia was significantly associated with mortality for two diagnostic criteria (criterion 2: vigorimeter with DO-HEALTH1 cut-offs: OR 1.77, 95% CI 1.01-3.10, p = 0.047; criterion 4: vigorimeter with DO-HEALTH2 cut-offs: OR 1.76, 95% CI 1.01-3.07, p = 0.048), although no significant association was observed with time-to-mortality. Kaplan-Meier curves demonstrated significant survival differences only for vigorimeter-based HGS cut-offs (p = 0.04). Male sex and falls during hospitalization were associated with increased mortality, while admission to rehabilitation or long-term care wards was associated with reduced mortality.</p><p><strong>Conclusion: </strong>Vigorimeter-based HGS, especially using DO-HEALTH1 cut-offs, demonstrated superior prognostic value for in-hospital mortality compared to the dynamometer. These findings support the clinical utility of the vigorimeter for risk stratification and care planning in hospitalized older adults, particularly in settings where subtle neuromuscular deficits may influence outcomes.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1619-1634"},"PeriodicalIF":3.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139111","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":"Prealbumin Adjusted Prognostic Nutritional Index May Predict the Postoperative Survival and Free Walking Abilities of Patients with Hip Fractures: A Multi-Center Follow-Up Study.","authors":"Yue Zhang, Daqian Yu, Xian Xu, Yanping Guo, Zhibang Zhao, Shengchao Ji","doi":"10.2147/CIA.S539573","DOIUrl":"10.2147/CIA.S539573","url":null,"abstract":"<p><strong>Background: </strong>This multi-center study aims to develop and validate the Prealbumin-adjusted Prognostic Nutritional Index (PAPNI), hypothesizing that it would enhance prognostic prediction for hip fracture patients compared to traditional indices.</p><p><strong>Methods: </strong>Data from 771 patients (Cohort 1) and 673 patients (Cohort 2) were retrospectively analyzed. The PAPNI was formulated by substituting albumin with prealbumin in the Prognostic Nutritional Index (PNI) formula, with its weight optimized using receiver operating characteristic (ROC) curves. All individuals were followed up for 1 year. The relationships between PAPNI and outcomes were explored.</p><p><strong>Results: </strong>In both cohorts, PAPNI demonstrated superior predictive accuracy for 1-year mortality and free walking ability compared to PNI, prealbumin, and lymphocyte count alone. Patients with low PAPNI exhibited significantly higher mortality rates and lower free walking rates. Multivariate analyses confirmed PAPNI as an independent predictor for outcomes of hip fracture.</p><p><strong>Conclusion: </strong>PAPNI, incorporating prealbumin, offers a more accurate and convenient method for predicting postoperative survival and functional recovery of hip fractures, providing a basis for early nutritional intervention.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1571-1582"},"PeriodicalIF":3.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114793","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":"Pathological Mechanisms and Molecular Imaging Advances in Alzheimer's Disease.","authors":"Chang Liu, Yuxuan Meng, Rongrong Liu, Zhicheng Wang, Hongguang Zhao","doi":"10.2147/CIA.S534015","DOIUrl":"10.2147/CIA.S534015","url":null,"abstract":"<p><p>Alzheimer's disease (AD) is one of the most prevalent neurodegenerative disorders globally, where early diagnosis plays a pivotal role in delaying disease progression and improving patient outcomes. In recent years, the rapid, multidisciplinary advances in molecular imaging and emerging technologies have significantly advanced our understanding of AD pathogenesis, early diagnosis, and intervention strategies. Imaging tools such as positron emission tomography (PET) and magnetic resonance imaging (MRI), alongside emerging technologies like retinal imaging, nanosensors, and quantum dots (QDs), are continuously enhancing AD diagnostic pathways. Studies on the gut microbiome and extracellular vesicles (EVs) offer novel insights into AD pathogenesis. Furthermore, AI-driven multimodal data fusion techniques hold great promise for improving diagnostic accuracy. Future research will increasingly focus on multi-target synergistic intervention strategies, standardization of multimodal imaging, and the integration of AI with molecular diagnostics and treatment to enable early detection and personalized precision therapy for AD.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1583-1603"},"PeriodicalIF":3.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114788","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":"Impact of Combined Cognitive and Physical Impairments on Long-Term Prognosis in Elderly Cardiovascular Disease Patients: A Prospective Cohort Study.","authors":"Yujia Liu, Ke Chai, Ting Wang, Zhikai Yang, Liwei Ji, Di Guo, Lingling Cui, Yao Luo, Ning Sun, Hua Wang","doi":"10.2147/CIA.S535038","DOIUrl":"10.2147/CIA.S535038","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the association between physical and cognitive function and long-term outcomes in elderly cardiovascular disease (CVD) patients, using the Short Physical Performance Battery (SPPB) and the Mini-Mental State Examination (MMSE).</p><p><strong>Patients and methods: </strong>In this prospective cohort study, 524 patients aged ≥65 years hospitalized in the Department of Cardiology at Beijing Hospital from September 2018 to April 2019 were evaluated. Baseline demographic, clinical, laboratory, and functional data were collected, and physical and cognitive function were assessed using SPPB and MMSE scores. Patients were followed for all-cause mortality over a 5-year period. Kaplan-Meier survival analysis and Cox proportional hazards models were used to examine the mortality risk associated with impairments.</p><p><strong>Results: </strong>Physical impairment was identified in 28.2% and cognitive impairment in 12.4% of patients. The combination of both impairments was associated with a 5.47-fold increased mortality risk (HR: 5.47; 95% CI: 2.78-10.78; p<0.001). Each 1-point increase in SPPB and MMSE scores correlated with a 16.3% and 8.7% reduction in mortality risk, respectively. Cognitive function, particularly attention and calculation ability, has emerged as a significant predictor of survival.</p><p><strong>Conclusion: </strong>Combined physical and cognitive impairments are prevalent in elderly CVD patients and strongly predict poor long-term prognosis. Routine assessment of cognitive function alongside physical performance can improve clinical decision-making, intervention strategies, and patient management, offering the potential to enhance outcomes in this high-risk population.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1605-1617"},"PeriodicalIF":3.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114809","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":"Unsupervised Clustering of Vertebral Hounsfield Units in Opportunistic Chest CT for Stratifying Bone Mass Subtypes in a 2 Years' Period.","authors":"Hui Yang, Jiang Li, Xiuzhu Zheng, Datian Su, Cheng Jia, Jian Qin, Quan Zhang","doi":"10.2147/CIA.S538123","DOIUrl":"10.2147/CIA.S538123","url":null,"abstract":"<p><strong>Background: </strong>There is an urgent need for a convenient and incidental method to assess the bone health status of the population, especially in primary-level hospitals lacking specialized bone density testing equipment. This study aims to investigate the association between multiple vertebral Hounsfield Unit (HU) value clusters and bone mass subtypes using an unsupervised learning approach, providing a practical tool for incidental osteoporosis screening in clinical settings.</p><p><strong>Materials and methods: </strong>This retrospective study included subjects who underwent chest CT and quantitative CT (QCT) from January 2023 to December 2024. Vertebral HU values (T7-T12) were measured on chest CT images. Intergroup comparisons (normal, osteopenia, and osteoporosis) in clinical findings and CT values were performed using Pearson χ² test and one-way analysis of variance. An unsupervised <i>k</i>-means clustering was applied to vertebral CT values across the cohort.</p><p><strong>Results: </strong>The study comprised 455 participants (260 males, 195 females) with a median age of 60 years (interquartile range, 51-67 years), who were classified into three groups: normal bone mass, 253 cases; osteopenia, 152 cases; osteoporosis, 50 cases. Among 455 participants, age inversely correlated with bone mass. Vertebrae HU values (T7-T12) exhibited significant stepwise declines from normal to osteopenia to osteoporosis (OP) groups. The clustering analysis revealed five distinct subtypes: cluster 1 strongly correlated with OP (45 of 72 cases), cluster 4 with osteopenia (107 of 146 cases), and clusters 2, 3, and 5 with normal bone mass (31 of 31 cases; 90 of 107 cases; 97 of 99 cases).</p><p><strong>Conclusion: </strong>Unsupervised clustering of T7-T12 vertebral HU values effectively stratifies bone mass subtypes, offering an efficient, CT-based screening method for skeletal health assessment, especially valuable in resource-limited primary-level hospitals lacking dedicated bone densitometry.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1561-1569"},"PeriodicalIF":3.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087954","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 of Decay Accelerating Factor (CD55) Positive Extracellular Vesicles with Advanced Age and Blood Glucose Levels in Elderly Individuals.","authors":"Xinyang Yue, Shuang Liang, Haiyue Zhang, Tenglong Dai, Jun Wu","doi":"10.2147/CIA.S536479","DOIUrl":"10.2147/CIA.S536479","url":null,"abstract":"<p><strong>Background: </strong>Extracellular vesicles (EVs) play a pivotal role in driving aging, serving as vehicles for the transmission of aging-related signals. Decay-accelerating factors (DAFs), also known as CD55, a crucial complement regulator, exhibits age-associated alterations, yet its expression on circulating EVs remains poorly characterized. This study aims to investigate differences in plasma EVs and CD55 positive EVs concentrations in younger and older adults, and explore their correlations with age and blood glucose levels.</p><p><strong>Methods: </strong>In this study, 40 older adults (≥65 years) undergoing routine physical examinations at Beijing Jishuitan Hospital and 40 gender-matched younger adults (<65 years) were enrolled prospectively. Blood glucose levels were measured using the standard glucose oxidase method. Circulating EVs concentrations were quantified by flow cytometry, including circulating total EVs, endothelial EVs (EEVs), platelet EVs (PEVs), red blood cell EVs (REVs), lymphocyte EVs (LEVs), monocyte EVs (MEVs), neutrophil EVs (NEVs), white blood cell EVs (WEVs), and CD55-positive EVs.</p><p><strong>Results: </strong>Compared to younger adults, older adults exhibited significantly lower concentrations of LEVs, MEVs, NEVs, and WEVs (<i>p</i> < 0.05). Concentrations of CD55 positive EVs, including CD55+EEVs, CD55+PEVs, CD55+LEVs, CD55+MEVs, CD55+NEVs, and CD55+WEVs, were markedly reduced in older adults (<i>p</i> < 0.05). Notably, CD55+PEVs showed the strongest negative correlation with age (r = - 0.6228, <i>p</i> < 0.001). Furthermore, significant inverse correlations were found between blood glucose levels and concentrations of CD55+EEVs (<i>p</i> = 0.001), CD55+PEVs (<i>p</i> = 0.006), CD55+LEVs (<i>p</i> < 0.001), CD55+MEVs (<i>p</i> = 0.001), and CD55+WEVs (<i>p</i> = 0.003).</p><p><strong>Conclusion: </strong>Our findings indicate significant differences in plasma EVs subtypes between older and younger adults and demonstrate robust negative correlations between CD55+ EVs subtypes and both aging and elevated glucose levels. Thus, these results suggest CD55+ EVs as a critical contributor to metabolic disorders in aging, offering potential risk assessment and monitoring strategies in older populations.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1549-1560"},"PeriodicalIF":3.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082232","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":"Machine Learning-Based Prediction of Post-PKP Frailty: A Retrospective Cohort Study.","authors":"Dingjun Xu, Ziwei Fan, Zhiyuan Li, Mengxian Jia, Xiang Fang, Yizhe Shen, Quan Zhou, Changnan Xie, Honglin Teng","doi":"10.2147/CIA.S537151","DOIUrl":"10.2147/CIA.S537151","url":null,"abstract":"<p><strong>Background: </strong>Frailty and osteoporotic vertebral compression fractures (OVCFs) exhibit bidirectional causality, yet the impact of percutaneous kyphoplasty (PKP) on frailty progression remains unclear. This study developed machine learning (ML) models to predict post-PKP frailty and identify key predictors.</p><p><strong>Methods: </strong>A retrospective cohort of 4599 PKP patients was categorized into frailty/non-frailty groups based on two-year follow-up. Variables included preoperative baseline data, imaging parameters (fracture number/segments, Genant classification, T2 hyperintensity), clinical characteristics (osteoporosis severity, Visual Analogue Scale scores, residual low back pain [LBP]), and surgical details. After data splitting (4:1 ratio), features were selected to train and optimize ML models, with performance evaluated via area under the curve (AUC). The ML model with the best performance was selected as our final model while using it for external validation. SHAP analysis determined predictor contributions.</p><p><strong>Results: </strong>Key features (residual LBP, Genant classification, etc) informed model development. Hyperparameter optimization enhanced performance, with Extreme Gradient Boost achieving superior prediction (AUC 0.950, 95% CI 0.934-0.965). The model still maintains a good performance in the external test set, with an AUC of 0.845 (95% CI 0.805-0.884). SHAP identified residual LBP, Genant classification, and postoperative recumbency duration as top predictors.</p><p><strong>Conclusion: </strong>ML models effectively predict post-PKP frailty, highlighting modifiable risk factors. Standardized anti-osteoporosis therapy, residual LBP prevention, and reduced postoperative recumbency may mitigate frailty risk.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1537-1548"},"PeriodicalIF":3.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076345","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}