Clinical Interventions in Aging最新文献

{"title":"A Bidirectional Mendelian Randomization Study of Sarcopenia-Related Traits and Knee Osteoarthritis.","authors":"Longyao Zhang,&nbsp;Chao Zhang,&nbsp;Juntao Zhang,&nbsp;Aifeng Liu,&nbsp;Ping Wang,&nbsp;Jiankang Xu","doi":"10.2147/CIA.S424633","DOIUrl":"https://doi.org/10.2147/CIA.S424633","url":null,"abstract":"<p><strong>Background: </strong>With the development of population aging worldwide, sarcopenia and knee osteoarthritis (KOA), two age-related diseases, will continue to impose increasing medical and economic burdens on the society. Previous studies have discovered an association between the two, but the causality remains controversial, and it is difficult to eliminate confounding factors. Therefore, a Mendelian randomization (MR) study was conducted to overcome these confounding factors and investigate the causal relationship between sarcopenia and KOA.</p><p><strong>Objective: </strong>The present work focused on assessing the causality between KOA and sarcopenia, so as to provide new strategies to prevent and treat these two conditions in clinic.</p><p><strong>Methods: </strong>We registered the title with PROSPERO (ID: CRD42023421096). The two-sample bidirectional MR analysis was conducted in two steps, with sarcopenia being the exposure whereas KOA being the outcome in the first step, and vice versa in the second step. Genome-wide association studies (GWAS) data on low hand-grip strength (n=256,523), walking pace (n=459,915), appendicular lean mass (ALM, n=450,243), and KOA (n=403,124) were obtained from the UK Biobank. Methods such as the inverse variance weighted (IVW) and weighted median were utilized for assessing the causality of KOA with sarcopenia, and sensitivity analyses were also conducted.</p><p><strong>Results: </strong>In the main MR analysis using the IVW method, evidence suggested that low hand-grip strength, walking pace, and ALM had adverse effects on KOA (p-value 0.0001, odds ratio (OR) 1.4569, 95% confidence interval (CI) 1.2007-1.7677 for low hand-grip strength; p-value 0.0003, OR 1.1500, 95% CI 1.050-1.183 for ALM; p-value 5.29E-19, OR 0.0932, 95% CI 0.0553-0.1572 for walking pace). However, there was no causality of KOA with sarcopenia in the opposite direction.</p><p><strong>Conclusion: </strong>Our study suggests an obvious unidirectional causality of KOA with sarcopenia, and supports the notion that patients with sarcopenia are more susceptible to the development of KOA.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/7f/cia-18-1577.PMC10508245.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41144433","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":"Predictive Models of Muscle Strength in Older People with Type 2 Diabetes Mellitus.","authors":"Mateus Medeiros Leite,&nbsp;Ivo Vieira de Sousa Neto,&nbsp;Maurílio Tiradentes Dutra,&nbsp;Silvana Schwerz Funghetto,&nbsp;Alessandro de Oliveira Silva,&nbsp;Izabel Cristina Rodrigues da Silva,&nbsp;Luciano Ramos de Lima,&nbsp;Marina Morato Stival","doi":"10.2147/CIA.S414620","DOIUrl":"https://doi.org/10.2147/CIA.S414620","url":null,"abstract":"<p><strong>Purpose: </strong>To propose predictive models for absolute muscle strength (AMS) of elderly people with type 2 Diabetes Mellitus (DM2) in primary health care.</p><p><strong>Patients and methods: </strong>The cross-sectional study was conducted with 138 elderly diabetics. The AMS was measured by a JAMAR^® hydraulic handgrip dynamometer, determined by the sum of both hands. The following indices were evaluated: waist-to-height ratio (WHtR), body mass index (BMI), Lipid Accumulation Product (LAP), Triglyceride/High Density Lipoprotein (TG/HDL) ratio and platelet/lymphocyte ratio (PLR). Multiple linear regression was used in the statistical analysis.</p><p><strong>Results: </strong>The final regression model indicated 66.4% (R²=0.66) of the variation in AMS. WHtR decreased AMS by 41.1% (β = -0.19; t = -3.70; p < 0.001), while PLR by 11.3% (β = -0.12; t = -2.36; p = 0.020). Male sex increased AMS by 10.6% (β = 0.32; t = 4.16; p < 0.001), and lean mass (LM) by 0.89% (β = 0.46; t = 6.03; p < 0.001).</p><p><strong>Conclusion: </strong>WHtR and PLR predicted a decrease, while male sex and LM predicted an increase in AMS. It is suggested that these markers be used as screening measures for variation in AMS in older adults with DM2. These results have relevant practical application in primary health care since the markers are easy to use.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/21/98/cia-18-1535.PMC10506670.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41155390","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":"Potential Mobile Health Applications for Improving the Mental Health of the Elderly: A Systematic Review.","authors":"Ya-Hsin Chou,&nbsp;Chemin Lin,&nbsp;Shwu-Hua Lee,&nbsp;Ya-Wen Chang Chien,&nbsp;Li-Chen Cheng","doi":"10.2147/CIA.S410396","DOIUrl":"https://doi.org/10.2147/CIA.S410396","url":null,"abstract":"<p><p>The rapid aging of the global population presents challenges in providing mental health care resources for older adults aged 65 and above. The COVID-19 pandemic has further exacerbated the global population's psychological distress due to social isolation and distancing. Thus, there is an urgent need to update scholarly knowledge on the effectiveness of mHealth applications to improve older people's mental health. This systematic review summarizes recent literature on chatbots aimed at enhancing mental health and well-being. Sixteen papers describing six apps or prototypes were reviewed, indicating the practicality, feasibility, and acceptance of chatbots for promoting mental health in older adults. Engaging with chatbots led to improvements in well-being and stress reduction, as well as a decrement in depressive symptoms. Mobile health applications addressing these studies are categorized for reference.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/52/e1/cia-18-1523.PMC10506600.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41167531","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 a Brief Cognitive Screening Tool for Predicting Postoperative Delirium in Patients with Parkinson's Disease: A Secondary Analysis.","authors":"Yongde Zhou,&nbsp;Xiaoxiao Wang,&nbsp;Zhengqian Li,&nbsp;Yu Ma,&nbsp;Cuiping Yu,&nbsp;Yao Chen,&nbsp;Jian Ding,&nbsp;Jianfeng Yu,&nbsp;Rongsong Zhou,&nbsp;Ning Yang,&nbsp;Taotao Liu,&nbsp;Xiangyang Guo,&nbsp;Ting Fan,&nbsp;Chengmei Shi","doi":"10.2147/CIA.S410687","DOIUrl":"https://doi.org/10.2147/CIA.S410687","url":null,"abstract":"<p><strong>Background: </strong>A simple, rapid, and effective cognitive screening test appropriate for fast-paced settings with limited resources and staff is essential, especially preoperatively. This study aimed to develop and validate the short versions of Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) for predicting postoperative delirium (POD) in patients with Parkinson's disease (PD) who were scheduled for surgery.</p><p><strong>Methods: </strong>The current study was a secondary analysis of data collected from 128 inpatients scheduled for deep brain stimulation of the subthalamic nuclei (STN-DBS) lasting >60 min, at Tsinghua University Yuquan Hospital, China. Preoperative cognitive screening was performed during the preoperative visit using the MMSE and MoCA. The optimal MMSE and MoCA cut-off scores for detecting PD-MCI was 27 and 23 respectively. The POD was assessed twice a day on the first postoperative day until discharge by the confusion assessment method. The backward conditional logistic regression analysis was used to organize the reduced versions of the MMSE or MoCA. Also, the areas under the receiver operating characteristic curves (AUCs) were examined using the DeLong test.</p><p><strong>Results: </strong>125/128 PD patients were included in the analysis, and 27 (21.6%) developed POD. The MMSE reduced version (orientation to time, attention and calculation, and comprehension) demonstrated performance similar to the original MMSE in predicting POD (<i>z</i>=0.820, <i>p</i>=0.412). The AUC of the original MoCA and the short MoCA (visuospatial and executive attention and orientation) were 0.808 and 0.826, respectively. There was no significantly difference in the AUC values between the tests (<i>z</i>=0.561, <i>p</i>=0.575).</p><p><strong>Conclusion: </strong>Our simplified MMSE and MoCA could be efficiently used to identify patients at risk for POD. Also, short cognitive tests could be considered while predicting POD in fast-paced preoperative settings with limited resources and staff.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/31/cia-18-1555.PMC10506594.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41177290","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":"C-Reactive Protein and Albumin Levels as Useful Tools for Predicting In-Hospital Outcomes in Polish Nonagenarians.","authors":"Michal Mazurkiewicz,&nbsp;Wojciech Lizurej,&nbsp;Lukasz Mazurkiewicz,&nbsp;Arkadiusz Majewski,&nbsp;Slawomir Tobis,&nbsp;Maciej Cymerys","doi":"10.2147/CIA.S422895","DOIUrl":"https://doi.org/10.2147/CIA.S422895","url":null,"abstract":"<p><strong>Purpose: </strong>The admissions of nonagenarians to internal medicine wards are rising. The aim of this study was to analyse the causes of ward admission and blood and renal parameters as potential mortality predictors in this age group.</p><p><strong>Patients and methods: </strong>Out of 1140 patients, 111 nonagenarians aged 90+ admitted to the Internal Medicine Ward in one general hospital in Poznan in 2019 were studied. Medical records of these patients were analysed to find factors attributable to the hospitalisation.</p><p><strong>Results: </strong>The leading causes of admission were infections and cardiovascular diseases, and the main causes of death were cardiovascular diseases. Elevated C-reactive protein (CRP) level was a statistically significant death predictor. Equally, decreased albumin level was found to be a mortality predictor. No such relationships were obtained for haematological or renal parameters.</p><p><strong>Conclusion: </strong>Our study uniquely analysed a relatively large group of hospitalised nonagenarians and identified those who need particular attention in the ward by identifying those with the highest risk of death. CRP and albumin levels may serve as useful indicators of in-hospital mortality in this age group.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/28/cia-18-1547.PMC10506667.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41170931","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":"Effect of Dexmedetomidine on Postoperative Plasma Neurofilament Light Chain in Elderly Patients Undergoing Thoracoscopic Surgery: A Prospective, Randomized Controlled Trial.","authors":"Yue-Ru Hou,&nbsp;Cheng-Yun Xu,&nbsp;Ming-Zi An,&nbsp;Zhen-Ping Li,&nbsp;Hua-Dong Ni,&nbsp;Tao Chen,&nbsp;Qing-He Zhou","doi":"10.2147/CIA.S422560","DOIUrl":"https://doi.org/10.2147/CIA.S422560","url":null,"abstract":"<p><strong>Purpose: </strong>Dexmedetomidine exerts a neuroprotective effect, however, the mechanism underlying this effect remains unclear. This study aimed to explore whether dexmedetomidine can reduce the increase in neurofilament light chain (NfL) protein concentration to play a neuroprotective role during thoracoscopic surgery.</p><p><strong>Patients and methods: </strong>Patients aged ≥60 years undergoing general anesthesia for thoracoscopic surgery were randomly assigned to receive dexmedetomidine (group D) or not receive dexmedetomidine (group C). Patients in group D received a loading dose of dexmedetomidine 0.5 µg/kg before anesthesia induction and a continuous infusion at 0.5 μg·kg^-1·h^-1 until the end of the surgery. Dexmedetomidine was not administered in group C. The primary outcome was the NfL concentration on postoperative day 1. The concentrations of procalcitonin (PCT), serum amyloid A (SAA), and high-sensitivity C-reactive protein (hs-CRP) were detected preoperatively and on postoperative day 1. In addition, the numerical rating scale (NRS) and quality of recovery-40 (QoR-40) scores were evaluated.</p><p><strong>Results: </strong>A total of 38 patients in group D and 37 in group C were included in the analysis. No differences were observed between the groups in terms of the plasma concentration of NfL preoperatively and on postoperative day 1 (11.17 [8.86, 13.93] vs 13.15 [10.76, 15.56] pg/mL, <i>P</i> > 0.05; 16.70 [12.23, 21.15] vs 19.48 [15.25, 22.85] pg/mL, <i>P</i> > 0.05, respectively). However, the postoperative plasma NfL concentration was significantly higher than the preoperative value in both groups (both <i>P</i> < 0.001). The groups exhibited no differences in PCT, SAA, hs-CRP, NRS, and QoR-40 (all <i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Intraoperative administration of dexmedetomidine at a conventional dose does not appear to significantly reduce the increase in postoperative plasma NfL concentration in elderly patients undergoing thoracoscopic surgery. This finding suggests that the neuroprotective effect of dexmedetomidine at a conventional dose was not obvious during general anesthesia.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/de/65/cia-18-1565.PMC10506605.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41164844","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":"An Easy-to-Implement Clinical-Trial Frailty Index Based on Accumulation of Deficits: Validation in Zoster Vaccine Clinical Trials.","authors":"Melissa K Andrew,&nbsp;Sean Matthews,&nbsp;Joon Hyung Kim,&nbsp;Megan E Riley,&nbsp;Desmond Curran","doi":"10.2147/CIA.S364997","DOIUrl":"https://doi.org/10.2147/CIA.S364997","url":null,"abstract":"<p><strong>Purpose: </strong>Despite being among those most in need of protection, frail older adults are often not well represented in clinical trials. Although frailty likely influences responses to treatments and vaccines, frailty may not be explicitly considered in trials even when frail participants are enrolled due to the perception that frailty is difficult to measure effectively and efficiently without adding to participant or data collection burden. We developed an easy-to-implement frailty index, the Clinical Trial-Frailty Index (CT-FI), based on baseline medical history and standard patient-reported outcomes using data from clinical trials of recombinant Zoster vaccine (the ZOE-50 and ZOE-70 studies). Our objective was to demonstrate that the CT-FI is a robust measure that may be used retrospectively or prospectively in clinical trials where sufficient patient data have been collected.</p><p><strong>Methods: </strong>The CT-FI was based on baseline medical history and Quality of Life questionnaires (SF-36 and EQ-5D). Items meeting criteria for inclusion were scored from 0 to 1, then summed for each participant and divided by the total number of deficits considered. Validation analyses included descriptive verification of distribution and age- and sex-associations in relation to usual patterns of the frailty index, regressions in relation to outcomes hypothesized to be related to frailty, and resampling methods within the index.</p><p><strong>Results: </strong>The CT-FI distribution was well represented by a gamma distribution with a range of 0-0.70. Deficit accumulation increased with chronological age and was higher for females. Multivariate Cox regression survival analysis showed that the CT-FI, age, and sex were significant predictors of mortality. Jackknife and Bootstrap resampling methods highlighted the robustness of the CT-FI, which was not sensitive to inclusion/exclusion of specific individual or groups of variables.</p><p><strong>Conclusion: </strong>We have developed a reliable, robust and easy-to-implement CT-FI with potential retrospective or prospective application in other clinical trials.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8e/c0/cia-17-1261.PMC9397533.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33437975","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 development of the Promoting Independence in Dementia (PRIDE) intervention to enhance independence in dementia.","authors":"Lauren Yates,&nbsp;Emese Csipke,&nbsp;Esme Moniz-Cook,&nbsp;Phuong Leung,&nbsp;Holly Walton,&nbsp;Georgina Charlesworth,&nbsp;Aimee Spector,&nbsp;Eef Hogervorst,&nbsp;Gail Mountain,&nbsp;Martin Orrell","doi":"10.2147/CIA.S214367","DOIUrl":"https://doi.org/10.2147/CIA.S214367","url":null,"abstract":"<p><strong>Objective: </strong>Support after a diagnosis of dementia may facilitate better adjustment and ongoing management of symptoms. The aim of the Promoting Independence in Dementia (PRIDE) study was to develop a postdiagnostic social intervention to help people live as well and as independently as possible. The intervention facilitates engagement in evidence-based stimulating cognitive, physical and social activities.</p><p><strong>Methods: </strong>Theories to promote adjustment to a dementia diagnosis, including theories of social learning and self-efficacy, were reviewed alongside self-management and the selective optimization model, to form the basis of the intervention. Analyses of two longitudinal databases of older adults, and qualitative analyses of interviews of older people, people with dementia, and their carers about their experiences of dementia, informed the content and focus of the intervention. Consensus expert review involving stakeholders was conducted to synthesize key components. Participants were sourced from the British NHS, voluntary services, and patient and public involvement groups. A tailored manual-based intervention was developed with the aim for this to be delivered by an intervention provider.</p><p><strong>Results: </strong>Evidence-based stimulating cognitive, physical, and social activities that have been shown to benefit people were key components of the proposed PRIDE intervention. Thirty-two participants including people with dementia (n=4), carers (n=11), dementia advisers (n=14), and older people (n=3) provided feedback on the drafts of the intervention and manual. Seven topics for activities were included (eg, \"making decisions\" and \"getting your message across\"). The manual outlines delivery of the intervention over three sessions where personalized profiles and plans for up to three activities are developed, implemented, and reviewed.</p><p><strong>Conclusion: </strong>A manualized intervention was constructed based on robust methodology and found to be acceptable to participants. Consultations with stakeholders played a key role in shaping the manualized PRIDE intervention and its delivery. Unlike most social interventions for dementia, the target audience for our intervention is the people with dementia themselves.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/CIA.S214367","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41216904","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":"Utilization, effect, and benefit of the individualized Meeting Centers Support Program for people with dementia and caregivers.","authors":"Rose-Marie Dröes, Annelies van Rijn, Eline Rus, Seghoslène Dacier, Franka Meiland","doi":"10.2147/CIA.S212852","DOIUrl":"10.2147/CIA.S212852","url":null,"abstract":"<p><strong>Purpose: </strong>There are few interventions on an individual basis to support community-dwelling people with dementia to continue to fulfill their potential in society and to support their informal caregivers via e-Health. This study explored the effectiveness of the individualized Meeting Centers Support Program (iMCSP) consisting of DemenTalent (people with dementia work as volunteers in a society based on their talents), Dementelcoach (telephone coaching), and STAR e-Learning for caregivers, compared to regular MCSP and No day care support.</p><p><strong>Method: </strong>An explorative randomized controlled trial with pre/post measurements (M0-M6) and two groups (iMCSP and regular MCSP). In addition, a comparison was made between iMCSP and a reference No day care control group. Standardized questionnaires were administered on self-esteem, neuropsychiatric symptoms, experienced autonomy and quality of life of the person with dementia, and on caregiver's sense of competence, quality of life, and happiness.</p><p><strong>Results: </strong>The iMCSP interventions resulted in a broader group of participants utilizing the Meeting Centers. Compared to regular MCSP, DemenTalent had a moderate positive effect on neuropsychiatric symptoms, which also proved less severe. Positive affect of participants improved within the DemenTalent and regular MCSP group after six months. Caregivers of DemenTalent participants experienced less emotional impact of neuropsychiatric symptoms. No differences were found in experienced burden, sense of competence, or quality of life in caregivers using iMCSP or regular MCSP. Compared to those receiving No day care support, caregivers of DemenTalent participants and caregivers using Dementelcoach or STAR e-Learning proved happier. Post-hoc analyses, accounting for potential between-group differences in outcome measures at baseline, generally showed results in the same direction. People with dementia and caregivers highly appreciated iMCSP and regular MCSP.</p><p><strong>Conclusion: </strong>iMCSP can be effectively applied as alternative or additional support via regular Meeting Centers for people with dementia and caregivers who prefer individualized activities/support. DemenTalent decreased the severity of neuropsychiatric symptoms of people with dementia and emotional burden of caregivers. All iMCSP interventions tended to result in caregivers being happier compared to those receiving no support. Larger-scale studies are needed to investigate the effect of iMCSP on other domains of quality of life of participants.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/ad/cia-14-1527.PMC6717152.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41216905","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":"Cognitive frailty among Malaysian older adults: baseline findings from the LRGS TUA cohort study.","authors":"Nurul Fatin Malek Rivan,&nbsp;Suzana Shahar,&nbsp;Nor Fadilah Rajab,&nbsp;Devinder Kaur Ajit Singh,&nbsp;Normah Che Din,&nbsp;Mahadzir Hazlina,&nbsp;Tengku Aizan Tengku Abdul Hamid","doi":"10.2147/CIA.S211027","DOIUrl":"https://doi.org/10.2147/CIA.S211027","url":null,"abstract":"<p><strong>Purpose: </strong>This study was aimed at determining the presence of cognitive frailty and its associated factors among community-dwelling older adults from the \"LRGS-Towards Useful Aging (TUA)\" longitudinal study.</p><p><strong>Patients and methods: </strong>The available data related to cognitive frailty among a sub-sample of older adults aged 60 years and above (n=815) from two states in Malaysia were analysed. In the LRGS-TUA study, a comprehensive interview-based questionnaire was administered to obtain the socio-demographic information of the participants, followed by assessments to examine the cognitive function, functional status, dietary intake, lifestyle, psychosocial status and biomarkers associated with cognitive frailty. The factors associated with cognitive frailty were assessed using a bivariate logistic regression (BLR).</p><p><strong>Results: </strong>The majority of the older adults were categorized as robust (68.4%), followed by cognitively pre-frail (37.4%) and cognitively frail (2.2%). The data on the cognitively frail and pre-frail groups were combined for comparison with the robust group. A hierarchical BLR indicated that advancing age (OR=1.04, 95% CI:1.01-1.08, <i>p</i><0.05) and depression (OR=1.49, 95% CI:1.34-1.65, <i>p</i><0.001) scored lower on the Activity of Daily Living (ADL) scale (OR=0.98, 95% CI:0.96-0.99, <i>p</i><0.05), while low social support (OR=0.98, 95% CI:0.97-0.99, <i>p</i><0.05) and low niacin intake (OR=0.94, 95% CI:0.89-0.99, <i>p</i><0.05) were found to be significant factors for cognitive frailty. Higher oxidative stress (MDA) and lower telomerase activity were also associated with cognitive frailty (<i>p</i><0.05).</p><p><strong>Conclusion: </strong>Older age, a lower niacin intake, lack of social support, depression and lower functional status were identified as significant factors associated with cognitive frailty among older Malaysian adults. MDA and telomerase activity can be used as potential biomarkers for the identification of cognitive frailty.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2019-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/CIA.S211027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41216902","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}