Clinical Interventions in Aging最新文献

{"title":"Association Between Blood-Brain Barrier Disruption and Stroke-Associated Pneumonia in Acute Ischemic Stroke Patients After Endovascular Therapy: A Retrospective Cohort Study.","authors":"Haojun Ma, Rui Chen, Nannan Han, Hanming Ge, Shilin Li, Yanfei Wang, Xudong Yan, Chengxue Du, Yanjun Gao, Gejuan Zhang, Mingze Chang","doi":"10.2147/CIA.S475887","DOIUrl":"10.2147/CIA.S475887","url":null,"abstract":"<p><strong>Background: </strong>Stroke, particularly due to large vessel occlusion (LVO), is a major cause of mortality and disability globally. Endovascular therapy (ET) significantly improves outcomes for acute ischemic stroke (AIS) patients, but complications such as stroke-associated pneumonia (SAP) increase mortality and healthcare costs. This study investigates the association between blood-brain barrier (BBB) disruption and the increased risk of SAP and explores the relationship between BBB disruption and medium-term functional outcomes.</p><p><strong>Methods: </strong>The retrospective cohort study was performed on AIS patients enrolled between January 2019 to February 2023 who underwent ET. Patients were divided into two groups: BBB disruption and without BBB disruption. Multiple logistic regression model was conducted to measure the association between BBB disruption and SAP. Mediation analysis was used to estimate the potential mediation effects on the associations of BBB disruption with SAP. A restricted cubic spline (RCS) regression model was used to further outline the connection between the highest CT value of hyperattenuated lesions areas and the risk of SAP.</p><p><strong>Results: </strong>The study included 254 patients who underwent endovascular therapy, with 155 patients in the BBB disruption group (exposure) and 99 patients in the without BBB disruption group (control). Multiple logistic regression analysis revealed a significantly increased risk of SAP in patients with BBB disruption (OR = 2.337, 95% CI: 1.118-4.990, p = 0.025). Furthermore, mediation analysis suggested that this association may be partly due to malignant cerebral oedema and haemorrhagic transformation. The study found an inverse L-shaped dose-response relationship between the maximum CT values of BBB disruption areas and the incidence of SAP. SAP partially mediated the association between BBB disruption and 3-month poor functional outcome.</p><p><strong>Conclusion: </strong>BBB disruption are a potential risk factor for SAP. BBB disruption may affect short- and medium-term prognosis of patients after ET in part through SAP.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1611-1628"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11453164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382119","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 Indoor Air Pollutants on the Cardiovascular Health Outcomes of Older Adults: Systematic Review.","authors":"Nomagugu Ndlovu, Benedicta Ngwenchi Nkeh-Chungag","doi":"10.2147/CIA.S480054","DOIUrl":"10.2147/CIA.S480054","url":null,"abstract":"<p><p>Indoor air pollution accounts for approximately 3.8 million inopportune deaths annually at global level. Due to spending more time indoors, children and older adults are especially susceptible to the health risks of indoor air pollution. This review seeks to summarise existing knowledge on the cardiovascular health effects of three common indoor air pollutants, namely carbon monoxide (CO), particulate matter (PM_2.5 and PM₁₀), and Nitrogen dioxide (NO₂), focusing on older adults. We systematically reviewed the literature (PROSPERO CRD42024479220) on PubMed, Google Scholar, Scopus, Web of Science and Embase. The search yielded 20,914 records. Two independent reviewers screened the articles using titles, abstracts, and full-length articles written in English. Upon a detailed assessment of all the records, the review considered 38 full-length articles. Several studies reported mortality, myocardial infarction, stroke, increased hospitalisation and increased emergency room visits due to exposure to indoor air pollution. A few studies reported arrhythmias, hypertension and Ischaemic heart disease due to exposure to indoor air pollutants. The increased mortality, morbidity, hospitalization, and emergency rooms visits resulting from indoor air pollution associated CVDs makes indoor air pollution a health risk for older adults. There is, therefore, a need to synthesize information on studies relate d to how the selected indoor air pollutants affected the cardiovascular health of older adults.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1629-1639"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11453128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382120","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 Clinical Frailty Scale is the Significant Predictor for in-Hospital Mortality of Older Patients in the Emergency Department [Response to Letter].","authors":"Jin-Wei Lin, Hsien-Hao Huang","doi":"10.2147/CIA.S495762","DOIUrl":"10.2147/CIA.S495762","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1609-1610"},"PeriodicalIF":3.5,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373311","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":"Understanding the Support Needs and Challenges Faced by Family Caregivers in the Care of Their Older Adults at Home [Letter].","authors":"Zhanshuo Xiao, Yilin Jiang, Narina A Samah","doi":"10.2147/CIA.S495160","DOIUrl":"10.2147/CIA.S495160","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1607-1608"},"PeriodicalIF":3.5,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367111","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":"Untargeted Metabolomic Study of Patients with Wet Age-Related Macular Degeneration in Aqueous Humor.","authors":"Qingquan Wei, Xianghong Tu, Qinghua Qiu, Li Wang","doi":"10.2147/CIA.S475920","DOIUrl":"10.2147/CIA.S475920","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to ascertain metabolic biomarkers and investigate the metabolic alterations associated with aqueous humor (AH) in wet age-related macular degeneration (AMD).</p><p><strong>Methods: </strong>AH samples were collected from a total of 20 participants, including 10 individuals diagnosed with wet AMD and 10 individuals undergoing cataract surgery, serving as the control group. Metabolomics analysis was performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify and quantify metabolites.</p><p><strong>Results: </strong>A total of 155 metabolites were identified in the AH samples. Among them, 10 metabolites emerged as potential biomarkers capable of differentiating patients with wet AMD from the control group. In the AH of wet AMD patients, there was increased expression of Cardiolipin (CL) (72:5), Diglyceride (DG) (18:3_18:2), DG (36:5e) and Triglyceride (TG) (24:7), while the expression of Ceramides (Cer) (d32:0), Cer (d34:0), Cer (d36:0), Monogalactosyldiacylglycerol (MGDG) (16:1_18:3), Sphingosine (SPH) (d18:0) and TG (16:0_10:4_16:0) was down regulated.</p><p><strong>Conclusion: </strong>Through metabolomics analysis of AH, this study successfully uncovered valuable metabolic biomarkers linked to wet AMD. These findings contribute to a more comprehensive understanding of the pathogenesis of wet AMD and offer potential avenues for the development of innovative treatment strategies for this condition.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1571-1580"},"PeriodicalIF":3.5,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Scale System Based on the Frailty Index and Laboratory Indicators for the Short-Term Prognosis of Patients with Acute Myocardial Infarction: A Retrospective Cohort Study.","authors":"Tianqing Cao, Fei Liu, Yan Yao, Danghong Sun, Rong Wang, Junxia Cao, Jie Meng, Ling Zhang, Weiming Li","doi":"10.2147/CIA.S469480","DOIUrl":"10.2147/CIA.S469480","url":null,"abstract":"<p><strong>Objective: </strong>Current scoring systems for short-term prognosis in patients with acute myocardial infarction (AMI) lack coverage of risk factors and have limitations in risk stratification. The aim of this study was to develop a novel assessment system based on laboratory indicators and frailty quantification to better infer short-term prognosis and risk indication in patients with AMI.</p><p><strong>Methods: </strong>A total of 365 patients with MI from January 2022 to June 2023 in Northern Jiangsu Province Hospital were included. The primary endpoint was all-cause mortality and major adverse cardiac events (MACE) during follow-up. A novel scoring model ranging from 0 to 12 was constructed, and the predictive ability of this scoring system was evaluated using the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>During follow-up, 68 patients experienced MACE. Five scoring indicators were selected through multivariate logistic regression analysis, resulting in a composite score with an AUC of 0.925, demonstrating good prognostic accuracy.</p><p><strong>Conclusion: </strong>The novel prognostic assessment system, which integrates age, Stress Hyperglycemia Ratio (SHR), Neutrophil to Lymphocyte Ratio (NLR), lactate, and frailty score, exhibits good predictive value for short-term MACE in patients with acute myocardial infarction and may enable more accurate risk classification for future use in MI patient risk management.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1597-1606"},"PeriodicalIF":3.5,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362347","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":"Graded Progressive Home-Based Resistance Combined with Aerobic Exercise in Community-Dwelling Older Adults with Sarcopenia: A Randomized Controlled Trial.","authors":"Minjing Liu, Jiaojiao Li, Jing Xu, Ya Chen, Chiafu Chien, Hui Zhang, Qing Zhang, Li Wang","doi":"10.2147/CIA.S473081","DOIUrl":"10.2147/CIA.S473081","url":null,"abstract":"<p><strong>Purpose: </strong>This randomized parallel controlled trial aimed to determine the effectiveness of graded progressive home-based resistance combined with aerobic exercise in improving physical fitness in community-dwelling older adults with sarcopenia.</p><p><strong>Patients and methods: </strong>Community-dwelling older adults (≥60 years) with sarcopenia were randomly assigned to the intervention group (IG), receiving 12 weeks of graded progressive home-based resistance and aerobic exercise training, and the control group (CG), maintaining lifestyle unchanged. The primary outcomes were knee extensor muscle strength and the six-minute walk distance (6MWD). Intention-to-treat analysis was applied to the data from all participants in the CG and IG. Post-intervention differences between the intervention and control groups were determined using a generalized estimated equation model with pre-values adjusted.</p><p><strong>Results: </strong>Data from all the participants in the IG (n=41) and CG (n=45) were analyzed. After the intervention, knee extensor muscle strength (95% CI: 0.140-3.460, <i>P</i>=0.036), 6MWD (95% CI: 35.350-80.010, <i>P</i><0.001), flexor muscle strength and the results of 30s bicep curls, 30s chair stand, the chair sit and reach test and back stretch test in the IG were larger and value of the timed up-and-go test was smaller than those in the CG (<i>P</i><0.05). The body composition, quality of life and their changes showed no group differences. The attendance rates were 82.9% and 85.4% for resistance and aerobic exercise, respectively.</p><p><strong>Conclusion: </strong>The 12-week graded progressive home-based resistance and aerobic exercise intervention improved muscle strength, balance, flexibility, and cardiorespiratory fitness in community-dwelling older adults with sarcopenia, whereas body composition and quality of life remained unchanged. The research was approved by the Ethics Committee of Soochow University (ECSU-2019000161) and registered at the Chinese Clinical Trial Registry (ChiCTR1900027960, http://www.chictr.org.cn/showproj.aspx?proj=45968).</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1581-1595"},"PeriodicalIF":3.5,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Coronary-Friendly Device Mitigating Risk of Coronary Obstruction in Transcatheter Aortic Valve Replacement.","authors":"Yuntao Lu, Minyan Yin, Ye Yang, Wenshuo Wang, Lili Dong, Xue Yang, Chunsheng Wang, Xiaolin Wang, Jinmiao Chen, Lai Wei","doi":"10.2147/CIA.S467594","DOIUrl":"https://doi.org/10.2147/CIA.S467594","url":null,"abstract":"<p><strong>Purpose: </strong>Transcatheter aortic valve replacement (TAVR) induced coronary artery obstruction (CAO) is a rare but devastating complication. Current preventive strategies need additional procedures and may be associated with adverse events. This study aimed to evaluate the early safety and efficacy of stand-alone TAVR using the J-Valve (Jianshi JieCheng Medical Technology Co. Ltd, Shanghai, China) in patients at potential high risk for CAO.</p><p><strong>Patients and methods: </strong>CAO was defined as coronary ostia obstruction requiring intervention. Patients at potential high risk for CAO were identified retrospectively from 673 consecutive patients who underwent TAVR from January 2015 to July 2021 at Zhongshan Hospital, Fudan University. Procedural results and early outcomes were evaluated according to Valve Academic Research Consortium-3 definitions.</p><p><strong>Results: </strong>A total of 20 consecutive patients (age 72 ± 9 years; 85% female;) were included. The Society of Thoracic Surgeons-Predicted Risk of Mortality was 5% (interquartile range, 4 to 10%). All patients (100%) had at least 2 classical risk factors for CAO by pre-procedural computed tomography analysis, and 90% patients had native aortic valve diseases. TAVR was successful in 95% of cases, with only 1 patient requiring second device implantation. Early safety at 30 days was achieved in all cases without death. All patients were free from CAO, stroke or emergency reintervention. Post-procedural mean aortic valve gradient was 7 (interquartile range, 4, 12) mmHg, and none/trace or mild aortic regurgitation was present in all patients.</p><p><strong>Conclusion: </strong>Stand-alone TAVR using the J-Valve may mitigate the risk of TAVR-induced CAO.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1557-1570"},"PeriodicalIF":3.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330504","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 Admission Hyperglycemia with Clinical Outcomes in Patients with Symptomatic Intracranial Hemorrhage After Endovascular Treatment for Large Vessel Occlusive Stroke.","authors":"Jie Yan, Jiandi Huang, Tianqiang Pu, Jiaxing Song, Jie Yang, Linyu Li, Fengli Li, Wenjie Zi, Changwei Guo, Zhouzhou Peng","doi":"10.2147/CIA.S453389","DOIUrl":"10.2147/CIA.S453389","url":null,"abstract":"<p><strong>Background: </strong>Symptomatic intracranial hemorrhage (sICH) is a fatal complication after endovascular treatment (EVT) for acute large vessel occlusive (LVO) stroke. The aim of this study was to investigate the association between hyperglycemia and outcomes in patients with postprocedural sICH.</p><p><strong>Methods: </strong>Of the 2567 patients with AIS who underwent EVT from two large multicenter randomized trials and two prospective multicenter registry studies, 324 patients occurred sICH with documented admission glucose were included in this study. The primary outcome was functional independence (defined as a modified Rankin Scale score of 0 to 2) at 90 days. Secondary outcomes included mRS score of 0 to 3, 0 to 1, and mRS score at 90 days. Safety outcome was the mortality within 90 days. Admission hyperglycemia was defined as a plasma blood glucose ≥7.8 mmol/L (140 mg/dL) in our analysis.</p><p><strong>Results: </strong>Of 324 eligible participants included in this study, hyperglycemia was observed in 130 (40.1%) patients. The median age was 67 (IQR, 58-75) years, and median blood glucose level was 7.1 (IQR, 6.0-9.3) mmol/L. After adjusting for confounding variables, admission hyperglycemia was associated with decreased odds of functional independence (adjusted odds ratio[OR] 0.34; 95% CI 0.17-0.68; P= 0.003), decreased odds of favorable outcome (adjusted OR 0.31; 95% CI 0.16-0.58; P < 0.001) and increased odds of mortality (adjusted OR 2.56; 95% CI 1.47-4.45; P = 0.001) at 90 days. After 1:1 propensity score matching analysis, the results were consistent with multivariable logistic regression analysis.</p><p><strong>Conclusion: </strong>In patients who suffered sICH after EVT for acute large vessel occlusive stroke, hyperglycemia is a strong predictor of poor clinical outcome and mortality at 90 days.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1545-1556"},"PeriodicalIF":3.5,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11430306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330505","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 Clinical Frailty Scale is the Significant Predictor for in-Hospital Mortality of Older Patients in the Emergency Department [Letter].","authors":"Ji Wu, Xiping Shen","doi":"10.2147/CIA.S490961","DOIUrl":"10.2147/CIA.S490961","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1507-1508"},"PeriodicalIF":3.5,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156453","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}