Clinical Interventions in Aging最新文献

{"title":"Multimodal Brain Monitoring-Guided Anesthesia Management Improves Functional Connectivity, Enhances Recovery and Attenuates Postoperative Pain in Elderly Surgical Patients.","authors":"Shuyi Yang, Shuai Feng, Hao Wu, Chonglin Zhong, Shubin Zhan, Chunxiu Wang, Zan Chen, Yaxian Huang, Guanxu Zhao, Yue Zhang, Tianlong Wang, Wei Xiao","doi":"10.2147/CIA.S551727","DOIUrl":"10.2147/CIA.S551727","url":null,"abstract":"<p><strong>Purpose: </strong>Perioperative neurocognitive disorder (PND) is common in elderly surgical patients and severely affects postoperative recovery. However, effective prevention is still lacking. Potential perioperative cerebral stressors (including inappropriate sedative/analgesic depth and imbalanced cerebral oxygen supply/demand) may be important contributing factors. We developed an anesthesia management protocol based on multimodal brain monitoring to achieve standardized, individualized, and real-time regulation of sedative/analgesic depth and cerebral oxygen saturation and investigated whether it could reduce the incidence of PND and its underlying mechanisms.</p><p><strong>Patients and methods: </strong>Patients (aged ≥65 years) were randomized into Groups C (n=88) and E (n=93). Patients in Group E received multimodal brain monitoring-guided anesthesia management, and those in Group C received BIS-guided anesthesia management. The Montreal Cognitive Assessment (MoCA) was performed both before and seven days after surgery. The postoperative pain scores were recorded. Resting-state functional MRI data were analyzed to examine functional connectivity (FC).</p><p><strong>Results: </strong>Group E demonstrated a numerically lower incidence of PND (15.50% vs 21.59% in Group C), but this difference was not statistically significant. Patients in Group E had increased FC within the right pulvinar, right sub-gyral region, and right inferior parietal lobule (<i>P</i> < 0.05). Significantly lower pain scores were observed in Group E at rest (1h: <i>P</i>=0.04; 24h: <i>P</i>=0.04) and during movement (1h: <i>P</i>=0.03).</p><p><strong>Conclusion: </strong>These results suggest that multimodal brain monitoring-guided anesthesia management may protect neurocognition by enhancing FC within cognition-associated brain regions and attenuating postoperative acute pain. And multimodal brain monitoring-guided anesthesia management may confer a clinically relevant reduction in PND incidence compared to BIS-guided management in elderly surgical patients.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1757-1771"},"PeriodicalIF":3.7,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338007","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":"Multidimensional Analysis of Frailty and Its Influencing Factors in Hospitalized Elderly Stroke Patients.","authors":"Huimin Zhou, Yan Han, Dan Xie, Kai Zheng, Haohao Zhu, Zhenhe Zhou, Yingying Ji","doi":"10.2147/CIA.S546975","DOIUrl":"10.2147/CIA.S546975","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a common geriatric syndrome, and its occurrence in elderly stroke patients may further worsen clinical outcomes, yet the influencing factors and potential causal relationship remain unclear.</p><p><strong>Objective: </strong>This study aimed to identify the influencing factors of frailty in elderly hospitalized stroke patients and to analyze the potential causal relationship between stroke and frailty.</p><p><strong>Methods: </strong>A multicenter cross-sectional survey including 210 elderly stroke patients was conducted, and bidirectional Mendelian randomization analysis was applied to examine the causal relationship between stroke and frailty. Univariate and multivariate logistic regression analyses were used to explore the impact of physiological, psychological, and clinical symptom factors on frailty.</p><p><strong>Results: </strong>The frailty index was positively correlated with stroke, and Mendelian randomization confirmed a bidirectional causal relationship. Univariate analysis showed significant associations between frailty and diabetes, lesion site, lesion location, and brain atrophy. Multivariate logistic regression further identified Fugl-Meyer score, Berg score, and MoCA score as independent risk factors for frailty in elderly hospitalized stroke patients.</p><p><strong>Conclusion: </strong>Frailty is strongly associated with stroke, and elderly stroke patients face an increased risk of frailty during hospitalization. These findings provide a basis for early identification of high-risk patients and the development of targeted intervention strategies in clinical practice, with important implications for stroke rehabilitation and elderly care.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1741-1755"},"PeriodicalIF":3.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12526399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309662","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 Ambiguous Role of HMGB1 Across the Hallmarks of Aging: A Narrative Review.","authors":"Manru Ning, Yihuai Liang, Liu Zhang, Feifei Wang, Li He","doi":"10.2147/CIA.S550572","DOIUrl":"10.2147/CIA.S550572","url":null,"abstract":"<p><p>Aging is a complex, multifactorial process driven by interconnected biological mechanisms collectively known as the hallmarks of aging, which contribute to functional decline and the onset of age-related diseases. High-mobility group box 1 (HMGB1), a nuclear DNA chaperone and damage-associated molecular pattern (DAMP), plays a pivotal role in regulating these hallmarks through its dual functions: preserving genomic stability within the nucleus and promoting inflammatory responses when released extracellularly. This review examines the multifaceted involvement of HMGB1 in key aging hallmarks, such as genomic instability, telomere attrition, mitochondrial dysfunction, and chronic inflammation among others. Preclinical studies demonstrate that nuclear HMGB1 supports chromatin integrity and DNA repair, whereas its extracellular release triggers TLR4/RAGE signaling pathways, thereby intensifying inflammaging and senescence-associated secretory phenotypes (SASP). Emerging therapeutic approaches-such as HMGB1 inhibitors, neutralizing antibodies, and epigenetic modulators-show potential in restoring genomic homeostasis and mitigating age-related pathologies. Nevertheless, significant challenges remain, including elucidating HMGB1's roles in nutrient sensing and psychosocial stress, fine-tuning interventions to preserve its nuclear functions while minimizing extracellular toxicity, and establishing efficacy in human clinical settings. Addressing these gaps may position HMGB1 as a promising multifunctional target for delaying aging and translating preclinical findings into clinical applications.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1729-1740"},"PeriodicalIF":3.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304054","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":"Clinical Manifestations and Neural Basis of Semantic Dementia: Converging Evidences From Brain Imaging Studies.","authors":"Xuanyu Chen, Yi Chen, Guoping Peng, Xiaoyan Liu","doi":"10.2147/CIA.S520351","DOIUrl":"10.2147/CIA.S520351","url":null,"abstract":"<p><p>Semantic dementia (SD) is a progressive neurodegenerative disorder primarily characterized by core linguistic deficits, notably impaired confrontation naming and single-word comprehension. Associated features include surface dyslexia, prosopagnosia, relatively preserved speech production, and emotional or behavioral abnormalities. Neuroimaging reveals initial asymmetrical atrophy of the anterior temporal pole, with subsequent progression posteriorly and contralaterally. Early detection is challenging due to initial presentation often manifesting as mild word-finding difficulties, furthermore, comorbid behavioral-emotional symptoms and distinct clinical profiles associated with right- versus left-sided atrophy complicate diagnosis. Therefore, this paper comprehensively delineates the principal clinical features of SD, encompassing language deficits, emotional impairment, behavioral disturbances, and other domains. It also reviews structural and functional imaging findings and investigates the relationship between clinical manifestations and patterns of brain injury. To advance understanding of SD's clinical manifestation, the paper introduces the controlled semantic and social-semantic frameworks.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1715-1728"},"PeriodicalIF":3.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294026","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":"Beyond Hormone Replacement: Multifaceted Effects of Phytoestrogens for Optimizing Kinesiological and Physiological Adaptations in Postmenopausal Women.","authors":"Yingjia Hu, Yi Hu, Tao Li, Rengfei Shi","doi":"10.2147/CIA.S539923","DOIUrl":"10.2147/CIA.S539923","url":null,"abstract":"<p><p>Phytoestrogens (PEs), a class of naturally occurring plant compounds primarily categorized into isoflavones, lignans, flavonoids, coumarins, and stilbenes, exhibit structural similarity to endogenous estrogens and exert regulatory effects through estrogen receptors. This comprehensive review examines the multifaceted roles of PEs in enhancing exercise performance and promoting health among postmenopausal women. Current evidence demonstrates that PEs not only ameliorate characteristic menopausal symptoms but, more significantly, improve physical function through multiple mechanisms: (1) augmenting muscle protein synthesis while mitigating inflammation and oxidative stress to optimize muscular performance; (2) modulating glucolipid metabolism and cardiovascular function to establish physiological foundations for exercise; and (3) preserving bone mineral density and regulating neurotransmitter activity to maintain motor coordination. Although combined PE-exercise interventions demonstrate synergistic benefits, their efficacy is influenced by dosage variations and interindividual metabolic differences. Future investigations should prioritize the development of precision PE applications to optimize kinesiological outcomes and health parameters in postmenopausal populations.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1695-1711"},"PeriodicalIF":3.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287232","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":"Individualising Post-ERCP Management in the Geriatric Patients with Comorbidities [Response to Letter].","authors":"Thana Boonsinsukh","doi":"10.2147/CIA.S571559","DOIUrl":"10.2147/CIA.S571559","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1713-1714"},"PeriodicalIF":3.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287329","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":"Individualising Post-ERCP Management in the Geriatric Patients with Comorbidities [Letter].","authors":"Kosar Hashemzadeh, Majid Hashemzadeh","doi":"10.2147/CIA.S569241","DOIUrl":"10.2147/CIA.S569241","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1693-1694"},"PeriodicalIF":3.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287292","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":"Sarcopenia as a Stronger Predictor for All-Cause Mortality Than Osteoporosis in a Medical Center in Central Taiwan.","authors":"Pei-Iun Hsieh, Shih-Yi Lin, Chiann-Yi Hsu, Shih-Ming Huang, Hsin-Ti Huang, Shuo-Chun Weng","doi":"10.2147/CIA.S548332","DOIUrl":"10.2147/CIA.S548332","url":null,"abstract":"<p><strong>Purpose: </strong>Sarcopenia (SP) and osteoporosis (OP) both pose higher risks for adverse health outcomes. This study explored the relationship among sarcopenia, osteoporosis and all-cause mortality.</p><p><strong>Patients and methods: </strong>This retrospective cohort utilized a tertiary-hospital-based cohort during the years from 2018 to 2024. Patients received dual-energy X-ray absorptiometry scans. Osteoporosis was diagnosed when T-scores of <-2.5 were determined at the L-spine or femoral neck. Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 criteria: low muscle strength, low physical performance, and a low appendicular skeletal mass index. We utilized the Cox proportional hazard model and Kaplan-Meier curves to depict observed time to mortality. Post-hoc analysis was applied for subgroup comparison and statistical power calculation. Interaction terms sensitivity analysis was used for analyzing mutually exclusive groups.</p><p><strong>Results: </strong>A total of 545 patients (median age [interquartile range] 68.7 [52.8-80.7] years; 72.3% women) were analyzed. At baseline, 15.6% had SP alone, 23.1% had OP alone, and 14.3% had both conditions. Over median 0.7 (interquartile range = 0.2-1.4) years of follow-up, 24 deaths occurred. Older age, multimorbidity, sarcopenia, and osteoporosis were significantly associated with higher mortality. In multivariable analysis adjusting for age and multimorbidity, sarcopenia alone was a stronger predictor of mortality compared to osteoporosis alone (hazard ratio [HR] 7.34 vs 3.99), and the mortality HR was 7.34 for sarcopenia with or without osteoporosis higher than 3.99 for osteoporosis with/without sarcopenia. Interaction analysis was not feasible in the four-group comparison, as the interaction term overlapped with the 'both sarcopenia and osteoporosis' group; in the other three groups, the SP×OP interaction was not significant. SP patients were more likely to be older, male, and have lower body mass index, total tissue, and lean mass.</p><p><strong>Conclusion: </strong>These findings suggest that sarcopenia may be a more important predictor of mortality than osteoporosis in patients, highlighting the need for muscle health assessment.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1681-1692"},"PeriodicalIF":3.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281559","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":"Classification of Elderly Patients with Comorbidities and Their Subtypes: A Data-Driven Cluster Analysis.","authors":"Xiuqi Qiao, Xinda Chen, Weihao Wang, Lixin Guo, Qi Pan","doi":"10.2147/CIA.S549148","DOIUrl":"10.2147/CIA.S549148","url":null,"abstract":"<p><strong>Background: </strong>To explore the precise classification of elderly patients with multimorbidity and identify subgroups with an increased prevalence of related diseases.</p><p><strong>Methods: </strong>A data-driven clustering analysis (K-means clustering) was conducted on individuals aged 60 years or older with comorbidities. The clustering was based on five essential and routinely measured variables: body mass index (BMI), intrinsic capacity (IC), low-density lipoprotein cholesterol (LDL-c), fasting plasma glucose (FPG), and systolic blood pressure (SBP). Logistic regression models were used to compare the prevalence of diabetes, coronary heart disease, hypertension, osteoporosis, sarcopenia, and frailty among the clusters.</p><p><strong>Results: </strong>A total of 350 elderly patients with a mean age of 78.74 ± 8.27 years were included. Four subtypes of elderly patients with multimorbidity were identified, with significant differences in disease prevalence observed among the groups. Specifically, cluster 1 included 70 participants who exhibited the highest levels of LDL-c and BMI, as well as relatively higher IC scores. Cluster 2 consisted of 117 participants, who had the highest IC scores among all clusters and similar BMI levels to cluster 1. Cluster 3 included 77 participants and was distinguished by the highest SBP levels. Cluster 4, comprising 86 participants, had the lowest IC and BMI levels. Compared with cluster 2, cluster 4 had significantly higher prevalence of hypertension and frailty. Cluster 3 and 4 had higher prevalence of coronary heart disease compared with cluster 1, and cluster 4 had the highest prevalence of osteoporosis and sarcopenia.</p><p><strong>Conclusion: </strong>There is significant pathophysiological heterogeneity among individuals with elderly multimorbidity. This classification method provides a crucial foundation for understanding disease complexity in this population. Future research, including intervention studies based on these classifications, is needed to evaluate their potential clinical utility.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1671-1680"},"PeriodicalIF":3.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253355","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":"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}