Clinical Interventions in Aging最新文献

{"title":"Antithrombotic Therapy Strategies and Clinical Outcomes in Chinese Patients Aged 65 and Older with High Ischemic Risk Coronary Artery Disease.","authors":"Xiahuan Chen, Wenwen Liu, Jiaqi Zhang, Meilin Liu, Yi Li, Xiaozeng Wang, Yaling Han","doi":"10.2147/CIA.S491580","DOIUrl":"10.2147/CIA.S491580","url":null,"abstract":"<p><strong>Background: </strong>Elderly patients with coronary artery disease (CAD) are at heightened risk for ischemic and bleeding complications. This study evaluates antithrombotic therapy use and its clinical outcomes in Chinese patients aged ≥65 years with CAD and elevated ischemic risk.</p><p><strong>Methods: </strong>This prospective cohort study enrolled patients aged ≥65 years with diagnosed CAD and ≥ 1 high ischemic risk factor from two centers. We recorded major adverse cardiovascular events (MACE)-death, nonfatal myocardial infarction, nonfatal ischemic stroke-and bleeding events over a 2-year follow-up.</p><p><strong>Results: </strong>Of 1005 patients (mean age 76.3 ± 7.2 years; 25.3% female), 49.0% were aged 65-75 and 51.0% were >75. Antithrombotic regimens included no therapy (1.8%), single antiplatelet therapy (SAPT, 23.0%), dual antiplatelet therapy (DAPT, 64.3%), and anticoagulation (10.9%), with 60.9% of the latter combining antiplatelet therapy. Older patients (>75 years) experienced higher MACE rates (11.5% vs 6.3%; RR: 1.825; 95% CI: 1.203-2.769; p = 0.004) and a trend towards increased bleeding (8.4% vs 6.5%; p = 0.257). Notably, all-cause and cardiovascular mortality were significantly higher in this group. Anticoagulation therapy was linked to a higher, yet non-significant, MACE rate and significantly increased bleeding risk compared to SAPT and DAPT. Multivariate analysis identified age >75, LVEF <50%, and eGFR <50 mL/min/1.73 m² as predictors of mortality and MACE, with anticoagulation therapy increasing bleeding risk.</p><p><strong>Conclusion: </strong>In elderly CAD patients, those aged >75 years exhibit higher mortality and MACE rates, with anticoagulation therapy associated with increased bleeding. Age, reduced LVEF, and renal function emerge as critical predictors of adverse outcomes.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"415-424"},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796673","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 Vascular Aging Phenotypes with Adverse Clinical Outcomes in the Chinese Population: A Multicentre Study.","authors":"Ting Xu, Yucong Zhang, Yi Zhou, Lixue Yin, Xinwen Min, Shouling Wu, Cuntai Zhang, Lei Ruan","doi":"10.2147/CIA.S485597","DOIUrl":"10.2147/CIA.S485597","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the clinical implications of vascular aging (VAg) phenotypes based on the difference between chronological age (CA) and vascular age (VA).</p><p><strong>Patients and methods: </strong>We defined VA as the predicted age in a multivariable linear regression model including structural and functional parameters of arteries and conventional risk factors, in a multicentric, cross-sectional cohort (n=15580). According to the 10^th and 90^th percentiles of Δ-age (CA minus VA), we then classified the status of VAg into 3 phenotypes: the early VAg (EVA), the Normal VAg and the supernormal VAg (SUPERNOVA). We used Cox survival analysis to investigate the association between VAg phenotypes and the risk for adverse clinical outcomes (including all-cause death and cardiovascular disease) in an independent, prospective cohort (n=5316).</p><p><strong>Results: </strong>In the prospective cohort (11.07 years, 927 events), when compared to the Normal VAg phenotype, EVA had an increased risk (HR: 2.43; 95% CI: 1.80-3.27) and SUPERNOVA had a decrease risk (HR: 0.75; 95% CI: 0.64-0.90) of adverse clinical outcomes, in particular stroke events. EVA also showed a higher risk of myocardial infarction (HR: 3.21, 95% CI: 1.56-6.62) and all-cause death (HR: 1.79, 95% CI: 1.12-2.85). The associations were independent of the atherosclerotic cardiovascular disease risk score. Further, the C-statistics increased 0.010 (<i>P</i> < 0.001), 0.013 (<i>P</i> < 0.001) and 0.016 (<i>P</i> < 0.001) separately when adding baPWV, adding the combination of baPWV and CIMT, and adding the VAg phenotypes to a model of conventional risk factors in predicting cardiovascular events.</p><p><strong>Conclusion: </strong>This is the first study to evaluate the clinical implications of VAg phenotypes using multicentric data and undergone external validation in China. Our results emphasized that the classification of VAg phenotypes may be a potential tool to identify individuals who were susceptible to or resilient to VAg.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"403-414"},"PeriodicalIF":3.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774802","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":"Development of an Online Nomogram for Predicting Postoperative Hypoalbuminemia in Older Adults Following Femoral Neck Fractures.","authors":"Han Gong, Haixiang Miao, Weishi Hong, Wenlong Yu, Yu Sun","doi":"10.2147/CIA.S497811","DOIUrl":"10.2147/CIA.S497811","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative hypoalbuminemia after total hip arthroplasty (THA) in older adults with femoral neck fractures can increase the risk of postoperative infection and lengthen hospital stays. The purpose of this study was to construct an online nomogram that can be used for the clinical preoperative assessment of older adults to reduce the incidence of postoperative complications.</p><p><strong>Methods: </strong>This study included older adults who underwent THA for femoral neck fracture at Northern Jiangsu People's Hospital between December 2018 and April 2022. Univariate and multivariate logistic regression analyses were performed for the training cohort to identify independent risk factors. The area under the ROC curve (AUC), calibration curve, and decision curve analysis (DCA) of the training group (n=306) and the validation group (n=131) were plotted to assess the model performance.</p><p><strong>Results: </strong>Multivariate logistic regression analysis revealed 5 independent risk factors, including Age, body mass index (BMI), surgery time, preoperative blood calcium level, and preoperative erythrocyte sedimentation rate (ESR). We constructed a nomogram, and the area under the curve (AUC) of the nomogram was 0.763 (95% CI 0.705-0.820) for the training group and 0.750 (95% CI 0.665-0.835) for the validation group. The calibration curve showed good consistency between the predicted and actual probabilities. Decision curve analysis (DCA) showed that using the nomogram had a high net benefit.</p><p><strong>Conclusion: </strong>Old age, lower BMI, longer surgery time, preoperative blood calcium level and preoperative ESR are independent risk factors for postoperative hypoalbuminemia after THA in older adults with femoral neck fractures. The online nomogram had high predictive values for to predict clinical postoperative hypoalbuminemia older adults with femoral neck fracture.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"369-380"},"PeriodicalIF":3.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755410","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":"Preoperative Cognitive Optimization and Postoperative Cognitive Outcomes: A Narrative Review.","authors":"Yumiko Ishizawa","doi":"10.2147/CIA.S505388","DOIUrl":"10.2147/CIA.S505388","url":null,"abstract":"<p><strong>Background: </strong>Perioperative neurocognitive disorder (PND) is a growing concern and affects millions of older adult surgical patients each year in the United States. However, the effective prevention of PND has yet to be established. Recently, preoperative brain exercise has been suggested to decrease postoperative delirium incidence in older patients. This review aims to interpret existing preoperative cognitive optimization research, determine if the research supports preoperative cognitive optimization, and identify gaps in the knowledge of the older surgical population.</p><p><strong>Methods: </strong>A literature search was performed in Pub Med (1995-2024) using the keywords (Older Surgical Patients, Presurgical Assessment, Cognitive Optimization, Neurocognitive Disorder, Postoperative Cognitive Impairment, Postoperative Delirium, Dementia, Frailty Syndrome, Prehabilitation, and Brain Plasticity). The type of literature included clinical trials, case series, cohort studies, and reviews. Among these articles, I included the one in which full text is available in Pub Med and is identified that specifically investigates cognitive function in older adults.</p><p><strong>Results and conclusion: </strong>Evidence of the effect of preoperative cognitive optimization on postoperative cognitive functions in older adult surgical patients is still limited. Postoperative delirium was reduced by preoperative cognitive training. A limited number of clinical studies suggest the beneficial effect of preoperative cognitive training, but others show no effects. Further studies are needed on the cognitive training dosage, duration, and platform type. Studies are also required in presurgical patients with preexisting cognitive impairment or dementia.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"395-402"},"PeriodicalIF":3.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755411","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":"Relationship Between Peripheral Serum Adiponectin and Cerebrospinal Fluid TNF-α, IL-1β, Lactic Acid, Pyruvic Acid and Perioperative Neurocognitive Dysfunction in Elderly Patients Undergoing Hip Arthroplasty.","authors":"Lideng Guo, Di Wang, Xiawei Lai, Yuqing Chi, Shuxian Liu, Xiaoqun Su, Huiqun Chen, Baiqin Su, Haihui Xie","doi":"10.2147/CIA.S496820","DOIUrl":"10.2147/CIA.S496820","url":null,"abstract":"<p><strong>Background: </strong>Postoperative neurocognitive dysfunction (PND) represents a form of cognitive impairment related to surgery and anesthesia, which may manifest hours or even weeks after the surgical procedure, persist, and potentially progress into Alzheimer's disease. The etiology of PND is intricate, with central nervous inflammation playing a crucial role. The clinical manifestations of PND are not distinctive, no obvious image alterations are observable, and the diagnosis rate is relatively low, thereby influencing prognosis and augmenting postoperative complications and mortality. The optimal treatment approach for PND lies in timely identification and management of the high-risk factors causing PND and implementing early prevention. We hypothesize that the level of peripheral blood adiponectin (APN) is correlated with PND, potentially through inhibiting the central inflammatory response and regulating brain energy metabolism.</p><p><strong>Methods: </strong>Fifty elderly patients undergoing elective hip arthroplasty under continuous epidural spinal anesthesia (CESA) were included. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) preoperatively and postoperatively at 1, 2, 3, and 7 days. Serum APN and CSF levels of TNF-α, IL-1β, lactic acid, and pyruvic acid were measured. The occurrence of PND was recorded, and the patients were divided into a PND group and a non-PND group.</p><p><strong>Results: </strong>PND occurred in 16 patients (34.04%). The PND group had lower serum APN levels and higher cerebrospinal fluid (CSF) concentrations of TNF-α, IL-1β, and lactic acid compared to the non-PND group. CSF TNF-α and IL-1β levels were negatively correlated with serum APN concentration. These biomarkers are associated with PND occurrence and have high diagnostic value.</p><p><strong>Conclusion: </strong>Decreases in serum APN and increases in TNF-α, IL-1β, and lactic acid in CSF may be involved in the pathophysiological process of PND in elderly patients after surgery.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"381-393"},"PeriodicalIF":3.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755412","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":"Determinants of Transitional Care Utilization Among Older Adults with Chronic Diseases: An Analysis Based on Andersen's Behavioral Model.","authors":"Yuan-Yuan Ma, Ting-Ting Wu, Li Wang, Yu-Fei Qian, Jing Wu, Gui-Ling Geng","doi":"10.2147/CIA.S490166","DOIUrl":"10.2147/CIA.S490166","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the current utilization status of transitional care service among older adults with chronic diseases and identify factors influencing their use.</p><p><strong>Methods: </strong>Utilizing Andersen's Behavioral Model, a cross-sectional survey was conducted in a specific region from October 2023 to December 2023 using convenience sampling. The survey aimed to analyze the impact of predisposing factors, enabling factors, and need factors on the utilization of transitional care services by older adults with chronic diseases.</p><p><strong>Results: </strong>Disease guidance had the highest utilization rate at 61.92% among various types of professional guidance on transitional care, while other professional guidance and services had utilization rates below 50%. Regarding predisposing factors, older adults with chronic diseases who were unmarried, employed part-time or full-time, or previously unemployed indicated lower utilization of transitional care services. In terms of enabling factors, those with a primary caregiver, high monthly family income, and medical insurance were more likely to use transitional care. With respect to need factors, older adults with a higher number of chronic diseases and impaired activities of daily living were less likely to use transitional care services.</p><p><strong>Conclusion: </strong>Older adults with chronic diseases tend to underutilize transitional care services. Based on Andersen's Behavioral Model, factors influencing the utilization of these services include marital status, employment status, previous occupation, primary caregiver presence, monthly family income, method of medical expense payment, number of chronic diseases, and Activities of Daily Living score.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"349-367"},"PeriodicalIF":3.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755408","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":"Using the 5Ms Framework to Advance Aging-Responsive Care for Heart Failure with Reduced Ejection Fraction.","authors":"Abigail Latimer, Debra K Moser, Jia-Rong Wu, Kim K Birtcher, Malachy J Clancy, Jennifer D Portz, Joanna Paladino, Daniel D Matlock, Christopher E Knoepke","doi":"10.2147/CIA.S493243","DOIUrl":"10.2147/CIA.S493243","url":null,"abstract":"<p><p>Complexity of care is the inevitable consequence of an aging population and is particularly true in instances where patients are managing chronic conditions such as heart failure with reduced ejection fraction (HFrEF). HFrEF itself is complex, with an undulating course of illness, increased risk of sudden cardiac death, and myriad accompanying treatment considerations. Generalist management of HFrEF among older patients is further complicated by competing comorbidities, potential for financial toxicity, potential for mental health symptoms, and risk of care with does not align with goals and preferences. The 5Ms (multicomplexity, mind, mobility, medications, and matters most) is a holistic conceptualization of care that has been applied to the care of older adults, including in gastroenterology, ICU care, oncology, and dentistry. In this narrative review, we present 5Ms Model of care for older adults with HFrEF.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"325-333"},"PeriodicalIF":3.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701924","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":"Multimodal Factors Affect Longitudinal Changes in Dynamic Balance in Community-Dwelling Older Adults.","authors":"Chitra Banarjee, Jethro Raphael M Suarez, Kworweinski Lafontant, Hwan Choi, Chen Chen, Rui Xie, Ladda Thiamwong","doi":"10.2147/CIA.S495112","DOIUrl":"10.2147/CIA.S495112","url":null,"abstract":"<p><strong>Purpose: </strong>Dynamic balance, an important contributor to fall risk in older adults, involves maintaining the center of pressure while in locomotive states and is. Fall risk appraisal (FRA) is defined as assessing an older adult's awareness of their physiological and perceived fall risk. This longitudinal study aimed to evaluate how multimodal factors predict fluctuations in dynamic balance in community-dwelling low-income older adults, utilizing fear of falling (FoF), static balance, fall history, and moderate-to-vigorous physical activity (MVPA).</p><p><strong>Patients and methods: </strong>The longitudinal study included 140 community-dwelling, low-income older adults, with 124 women and 16 men. FoF was assessed using the Short Falls Efficacy Scale International (Short FES-I) and static balance using BTracks Balance Test (BBT). Both were utilized to define FRA Distance, an integrated quantification of physiological and perceived balance deficits. MVPA was assessed using accelerometers, fall history using self-report, and dynamic balance using the Timed Up and Go (TUG) test. The study was conducted at 4 timepoints at T1 (baseline), T2 (2 months), T3 (4 months), and T4 (6 months).</p><p><strong>Results: </strong>Using mixed effects multilevel models, TUG scores were predicted by time, %MVPA, and FRA distance ratio. The effect of FRA distance ratio was primarily driven by FoF, and the effect of %MVPA varied by age. Additionally, while fall history did not show a predictive relationship with TUG scores, it did predict FRA distance.</p><p><strong>Conclusion: </strong>Dynamic balance fluctuated over time and was influenced by multimodal factors, namely MVPA and FRA, which captured the interplay between static balance and FoF. Fall history did not directly predict dynamic balance but played a role in FRA, implicating the subjective effects of fall history. These findings demonstrate how physical activity, FRA, and their interactions can predict changes in dynamic balance. Future work can utilize the results to evaluate low-cost interventions for community-dwelling older adults.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"335-348"},"PeriodicalIF":3.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701917","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":"Validity of the Updated Rx-Risk Index as a Disease Identification and Risk-Adjustment Tool for Use in Observational Health Studies.","authors":"Imaina Widagdo, Mhairi Kerr, Lisa Kalisch Ellett, Clement Schlegel, Elham Sadeqzadeh, Alvin Wang, Allison Louise Clarke, Nicole Pratt","doi":"10.2147/CIA.S494145","DOIUrl":"10.2147/CIA.S494145","url":null,"abstract":"<p><strong>Purpose: </strong>Identifying patient health conditions in observational studies is essential for accurately measuring healthcare practices and planning effective health policy interventions. This analysis evaluates the validity of the Rx-Risk Index, a tool that uses medication dispensing data to identify patient comorbidities and measure overall health. We examined an updated version of the Rx-Risk Index, reflecting changes in treatment practices, to assess its validity as a tool for identifying specific health conditions and as a measure of overall health to aid in risk adjustment in observational studies.</p><p><strong>Patients and methods: </strong>We conducted a validation study using two Australian linked health datasets, the Person-Level Integrated Data Asset (PLIDA) and the National Health Data Hub (NHDH), from 2010 to 2018, focusing on individuals aged 65 years or older. The sensitivity, specificity, PPV/NPV, Cohen's kappa, and F1 scores were used to assess agreement between Rx-Risk Index conditions and two reference standards: patient self-reported conditions and hospital diagnosis. The Rx-Risk Index's predictive validity for one-year mortality was also evaluated using logistic regression, with model fit assessed by AIC and c-statistic.</p><p><strong>Results: </strong>Data were analysed from 3,959 individuals in PLIDA and 157,709 individuals in NHDH. The Rx-Risk Index showed high sensitivity (≥75%) for diabetes, chronic airways disease, hyperlipidemia, and epilepsy against both self-reported conditions and hospital diagnoses. However, hyperlipidemia and hypertension showed lower specificity (<70%). High PPVs (≥78%) were observed for diabetes and renal failure. The agreement between the Rx-Risk Index and self-reported conditions was stronger (Cohen's kappa: 0.41-0.81 for 7 conditions) than between Rx-Risk Index and ICD10-AM diagnoses (kappa: 0.73 for one condition). The Rx-Risk Index was a strong predictor of one-year mortality, with c-statistic of 0.820 (95% CI: 0.817-0.825).</p><p><strong>Conclusion: </strong>Selected Rx-Risk Index conditions are reasonable proxies for identifying specific conditions, particularly those requiring pharmacological management. The Rx-Risk Index was a strong predictor of one-year mortality, suggesting it is a valid measure of overall health. This study demonstrates the Rx-Risk Index's potential to enhance disease classification and risk adjustment in observational studies, supporting informed decision-making in health policy planning.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"309-323"},"PeriodicalIF":3.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694201","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":"Evaluation of Waist-Calf Circumference Ratio to Assess Sarcopenia in Older Patients with Chronic Low Back Pain: A Retrospective Observational Study.","authors":"Hee Jung Kim, Ji Young Kim, Shin Hyung Kim","doi":"10.2147/CIA.S503349","DOIUrl":"10.2147/CIA.S503349","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic low back pain is prevalent among older adults, who are at a higher risk for sarcopenia. The waist-to-calf circumference ratio has emerged as a health indicator, reflecting the balance between central adiposity and muscle mass. This study examined the association between waist-to-calf circumference ratio and sarcopenia, as well as factors like muscle mass, strength, and physical performance in older patients with chronic low back pain.</p><p><strong>Patients and methods: </strong>Ambulatory patients aged 65 years and older with chronic low back pain were included. Sarcopenia was assessed using the 2019 diagnostic criteria from the Asian Working Group for Sarcopenia. We compared demographic data, pain-related factors, comorbidities, and measurements related to sarcopenia and obesity across quartiles of the waist-to-calf circumference ratio. The prevalence of sarcopenia and severe sarcopenia was investigated, and multivariable analysis was conducted to identify independent factors associated with sarcopenia.</p><p><strong>Results: </strong>Among 592 patients, 85 had sarcopenia (14.3%), and 71 had severe sarcopenia (11.9%). Patients with a high waist-calf circumference ratio had more comorbidities and longer pain duration. The prevalence of severe sarcopenia increased with higher quartile of waist-calf circumference ratio (Q1=7.9%, Q2=8.6%, Q3=14.8%, Q4=16.9%, P=0.006). When recommended cut-off values for the parameters used to diagnose sarcopenia were applied, the numbers of patients with low grip strength and low physical performance but not low muscle mass were greater among patients with a high waist-calf circumference ratio. Also, a high waist-calf circumference ratio was significantly associated with severe sarcopenia.</p><p><strong>Conclusion: </strong>In older patients with chronic low back pain, a high waist-calf circumference ratio was associated with severe sarcopenia, characterized by reduced muscle strength and impaired physical performance. The waist-calf circumference ratio might serve as a useful tool for assessing sarcopenia in this population.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"299-308"},"PeriodicalIF":3.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694199","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}