Clinical Interventions in Aging最新文献

{"title":"Exploration of Pathogenesis and Cutting-Edge Treatment Strategies of Sarcopenia: A Narrative Review.","authors":"Yin Gao, Di Liu, Qixian Xiao, Shan Huang, Li Li, Baocheng Xie, Limin Zhou, Yi Qi, Yanzhi Liu","doi":"10.2147/CIA.S517833","DOIUrl":"10.2147/CIA.S517833","url":null,"abstract":"<p><p>Sarcopenia a progressive and multifactorial musculoskeletal syndrome characterized by loss of muscle mass and function, poses a significant global health challenge, particularly in aging populations. Epidemiological studies reveal that sarcopenia affects approximately 5-10% of the general population, with prevalence rates escalating dramatically after age 60 to reach 10-27% in older adults. This age-associated increase contributes significantly to healthcare burdens by elevating risks of disability, frailty, and mortality. Despite its profound impact, current clinical approaches to sarcopenia remain limited. While resistance exercise and protein supplementation form the cornerstone of management, their efficacy is often constrained by poor long-term adherence and variable individual responses, highlighting the urgent need for more comprehensive and personalized treatment strategies. The pathogenesis of sarcopenia is complex and influenced by various factors, including aging, inflammation, nutritional deficits, physical inactivity, and mitochondrial dysfunction. However, the precise molecular mechanisms underlying this condition are still not fully understood. Recent research has made significant strides in elucidating the intricate mechanisms contributing to sarcopenia, revealing novel insights into its molecular and cellular underpinnings. Notably, emerging evidence points to the pivotal role of mitochondrial dysfunction, altered myokine profiles, and neuromuscular junction degeneration in sarcopenia progression. Additionally, breakthroughs in stem cell therapy, exosome-based treatments, and precision nutrition offer promising avenues for clinical intervention. This review aims to synthesize the latest advancements in sarcopenia research, focusing on the novel contributions to its pathogenesis and treatment strategies. We explore emerging trends such as the role of cellular senescence, epigenetic regulation, and targeted therapeutic interventions that could reshape future approaches to managing sarcopenia. By highlighting recent breakthroughs and cutting-edge research, we hope to advance the understanding of sarcopenia and foster the translation of these findings into effective clinical therapies.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"659-684"},"PeriodicalIF":3.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175424","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 Prospective Nested Case-Control Study of Risk Factors for Postoperative Delirium in Elderly Patients with Colorectal Cancer.","authors":"Xinlong Cui, Naihan Cao, Shouyuan Tian, Yi Liu, Jie Xiang","doi":"10.2147/CIA.S507668","DOIUrl":"10.2147/CIA.S507668","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study is to investigate the risk factors associated with postoperative delirium (POD) in elderly patients diagnosed with colorectal cancer (CRC).</p><p><strong>Patients and methods: </strong>This prospective nested case-control study included elderly patients who underwent CRC surgery at Shanxi Provincial Cancer Hospital between May 2022 and September 2023. A propensity score matching (PSM) method was employed to match patients by age and sex. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for POD among elderly patients with CRC.</p><p><strong>Results: </strong>A total of 443 patients were enrolled, among them, 70 (15.8% of all patients, age: 69.5[64, 73], 55 [78.6%] males) developed POD and 373 did not develop POD (84.2% of all patients, age: 67[62, 71], 234 [62.7%] males). Following PSM at a 1:3 ratio, 70 POD patients and 210 age- and sex-matched non-POD patients were selected for further analysis. The POD group exhibited a significantly higher sleep quality score (9 [6, 15] vs 7.5 [3, 12], P = 0.004), greater intraoperative infusion volume (2041.43±724.37 vs 1814.05±653.83, P = 0.015), and elevated peak pain levels post-surgery (1 [0, 2] vs 1 [0, 1], P = 0.001). Univariate and multivariate logistic regression analyses identified higher education level (OR: 0.503 [0.259-0.977]) as an independent factor associated with lower POD risk, whereas higher sleep quality scores (OR: 1.103 [1.040-1.171]) and increased peak pain levels post-surgery (OR: 1.727 [1.295-2.304]) were identified as independent risk factors.</p><p><strong>Conclusion: </strong>Elevated peak postoperative pain levels, lower education levels, and sleep dysfunction or disturbance are independent risk factors for developing POD.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"639-648"},"PeriodicalIF":3.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144078","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":"Resting-State Functional MRI Reveals Altered Seed-Based Connectivity in Diabetic Osteoporosis Patients.","authors":"Jiang Li, Min Liu, Jian Qin, Yuxiao An, Xiuzhu Zheng, Noor Shafini Mohamad, Izzad Ramli","doi":"10.2147/CIA.S521686","DOIUrl":"10.2147/CIA.S521686","url":null,"abstract":"<p><strong>Background: </strong>Diabetic osteoporosis (DOP) can cause abnormal brain neural activity, but its mechanism is still unclear. This study aims to further explore the abnormal functional connectivity between different brain regions based on the team's previous research.</p><p><strong>Methods: </strong>Resting-state functional magnetic resonance imaging (rs-fMRI) data were obtained from 14 participants diagnosed with type 2 diabetes mellitus (T2DM) and osteoporosis. For comparison, data from 13 T2DM patients without osteoporosis were analyzed. The seed regions for functional connectivity (FC) analysis were chosen according to brain areas previously reported to exhibit abnormal regional homogeneity (ReHo).</p><p><strong>Results: </strong>DOP patients exhibited significantly decreased BMD, T-scores, MoCA scores, and osteocalcin (OC) levels compared to controls (p<0.05). FC analysis revealed: 1) Reduced connectivity between the left middle temporal gyrus (increased ReHo) and middle occipital gyrus; 2) Enhanced connectivity between the right angular gyrus (increased ReHo) and left Rolandic operculum; 3) Weakened the left precuneus (increased ReHo) and right superior/left middle frontal gyri. These alterations correlated with deficits in visual processing, working memory, and executive function.</p><p><strong>Conclusion: </strong>Distinct FC reorganization in DOP patients reflects synergistic effects of metabolic and skeletal pathologies on neural networks, potentially mediating cognitive decline through visual pathway disruption and prefrontal-default mode network decoupling. The findings highlight neuroimaging biomarkers for metabolic bone disease-related cognitive disorders.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"649-658"},"PeriodicalIF":3.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152545","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":"Dietary Habits, Anthropometric Values, and Microvascular Reactivity in Older Persons of Both Sexes Living at Retirement Home in Osijek, Croatia.","authors":"Ines Drenjančević, Ivan Prošić, Lucija Firi, Ana Stupin, Ivana Jukić","doi":"10.2147/CIA.S514573","DOIUrl":"10.2147/CIA.S514573","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the correlation between dietary habits, anthropometric measurements, and microvascular reactivity with respect to sex in older adults (aged > 65 years) residing in organized accommodation within retirement homes.</p><p><strong>Patients and methods: </strong>Sixty-nine older persons who live in a retirement home in Osijek, Croatia volunteered to participate (34 men and 35 women) in this observational cross-sectional study. Study was performed in the period from May 1, 2024 to July 1, 2024. Subjects weight, height, waist circumference, hip circumference, blood pressure and heart rate were measured, and body mass index (BMI) and waist to hip ratio (WHR) were calculated. To assess microvascular endothelium-dependent vasodilation, skin microvascular post-occlusion reactive hyperemia (PORH) was assessed by Laser Doppler Flowmetry. Long-term dietary patterns and dietary habits were evaluated with validated EPIC-Norfolk food frequency questionnaire, in Croatian language. Study was approved by Ethical Committee of Faculty of Medicine Osijek (Class: 641-01/24-01/04, No: 2158-61-46-24-86).</p><p><strong>Results: </strong>Mean age (standard deviation, SD) of 34 older men was 83.8 (5.4) years, and of 34 older women 83.6 (5.5) years. The mean BMI of all subjects was 27.1 kg/m2 classifying them as overweight. Both men (WHR 0.99 (0.07)) and women (WHR 0.90 (0.06) had significantly higher than normal WHR (normal WHR, men <0.90, women <0.80), suggesting the visceral type of obesity. The mean intake of NaCl was higher (NaCl g/day men 6.91 (1.43), women 6.93 (2.51)), and intake of vitamin D lower (vitamin D µg/day men 3.64 (1.35), women 3.47 (2.61)) than recommended values (NaCl g/day <5 g/day, vitamin D 15 µg/day). Men consumed significantly more alcohol (alcohol g/day men 1.48 (3.36) vs women 0.17 (0.39), P = 0.03), while women had higher carotene intake (β-carotene, µg/day men 2603 (1020) vs women 3478 (1580), P = 0.009). Microvascular reactivity was similar in women and men (PORH, R-O% men 85.2 (30.6) vs women 76.2 (31.5), P > 0.05). However, women had a significant negative correlation of waist circumference (R = -0.350, P =0.04) and WHR (R = -0.406, P = 0.02) to PORH.</p><p><strong>Conclusion: </strong>Dietary habits were similar between older men and women, except for higher alcohol intake in men and higher carotene intake in women. In older women, microvascular reactivity was negatively associated with waist circumference and WHR, underscoring central obesity as a key cardiovascular risk factor in this population. Given the increased cardiometabolic vulnerability in postmenopausal women, measures of central adiposity should be routinely monitored in geriatric care.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"625-638"},"PeriodicalIF":3.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144093","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":"Comprehensive Machine Learning-Based Prediction Model for Delirium Risk in Older Patients with Dementia: Risk Factors Identification.","authors":"Qifan Xiao, Shirui Zhou, Bin Tang, Yuqing Zhu","doi":"10.2147/CIA.S519366","DOIUrl":"10.2147/CIA.S519366","url":null,"abstract":"<p><strong>Background: </strong>Delirium superimposed on dementia (DSD) is a severe complication in older adults with dementia, marked by fluctuating cognition, inattention, and altered consciousness. Detection is challenging due to symptom overlap, yet it contributes to cognitive decline, prolonged hospitalization, and increased mortality. Identifying key risk factors and developing an accurate prediction model is crucial for timely intervention. This study aimed to establish a machine learning-based model to predict delirium risk, focusing on significant predictors to aid clinical decision-making.</p><p><strong>Methods: </strong>We prospectively collected clinical data from 636 older dementia patients. Five machine learning algorithms-Extreme Gradient Boosting (XGB), Random Forest (RF), Multilayer Perceptron (MLP), Categorical Boosting (CB), and Logistic Regression (LR)-were used to construct prediction models. Feature importance was analyzed using SHapley Additive exPlanations (SHAP) to identify key risk factors. Data included demographic information, biochemical parameters, comorbidities, medication history, and Visual Analogue Scale (VAS) scores.</p><p><strong>Results: </strong>The final analysis included 636 older dementia patients, with a mean age of 78.2 ± 6.3 years, of whom 187 (29.4%) developed delirium during hospitalization. The XGB model demonstrated the best performance, achieving the highest area under the receiver operating characteristic curve (0.930), accuracy (0.870), F1 score (0.892), and area under the precision-recall curve (0.989). The Brier score for the XGB model was 0.08. The SHAP method identified cerebrovascular disease, sedative drug use, hemoglobin levels, VAS score ≥4, superoxide dismutase, diabetes, hsCRP, hypertension, family presence, and hyperlipidemia as the most significant risk factors for delirium. The top 10 variables were used to construct a compact XGB model, which also exhibited good predictive performance.</p><p><strong>Conclusion: </strong>This study developed a machine learning-based prediction model for delirium risk in older dementia patients, with the XGB model demonstrating the best performance. The identified key risk factors provide insights for early intervention, potentially improving delirium management in clinical practice.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"613-623"},"PeriodicalIF":3.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112415","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 Impact of Anesthetic Management Under Bispectral Index Monitoring on the Early Recovery Quality of Elderly Patients Undergoing Laparoscopic Surgery: A Blinded Randomized Controlled Trial.","authors":"Min Shi, Yufang Long, Zhihu Zhou, Liqiao Huang, Danping Wu, Xu Zhang","doi":"10.2147/CIA.S507758","DOIUrl":"10.2147/CIA.S507758","url":null,"abstract":"<p><strong>Purpose: </strong>To comprehensively evaluate the impact of bispectral index (BIS) monitoring-guided anesthesia depth on the early recovery quality in elderly patients undergoing laparoscopic surgery.</p><p><strong>Methods: </strong>Ninety patients aged ≥60 years scheduled for laparoscopic surgery under general anesthesia were randomized into three groups: Group C (empirically guided anesthesia), Group B1 (BIS-guided, target range 40-60), and Group B2 (BIS-guided, target range 50-60). Blinded researchers evaluated recovery quality (QoR-15), pain (VAS), and sleep (RCSQ) preoperatively and on postoperative days 1, 2, 3, and 7 (POD_1,2,3,7). Postoperative delirium was assessed with CAM (POD₁-POD₃), and cognitive function (MMSE) was measured preoperatively, POD₃, and POD₇. Intraoperative data included vital signs, BIS values, anesthetic dosage, emergence/extubation times, PACU stay, and adverse events within three days post-surgery. Time to first ambulation and hospital stay were also recorded.</p><p><strong>Results: </strong>Compared with Group C, Group B1 and B2 had lower propofol consumption, shorter emergence/extubation times, and higher BIS values (T₂-T₅ and overall mean) (<i>P</i><0.05). QoR-15 scores improved on POD₂ in Group B1 and on both POD₁ and POD₂ in Group B2 (<i>P</i><0.05). The RCSQ scores increased on POD₁ and POD₃ in Group B1 (<i>P</i><0.05) and on POD₁, POD₂ and POD₃ in Group B2 (<i>P</i><0.05). In addition, Group B2 had a shorter PACU stay and time to first postoperative ambulation (<i>P</i><0.05). No differences were found in the incidence of postoperative delirium, POCD, or MMSE scores among the three groups. Compared to Group B1, Group B2 exhibited shorter emergence and extubation times, elevated BIS values at T3 and T5, a higher mean BIS value throughout surgery, and enhanced QoR-15 scores on POD₁ and POD₂ (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>BIS monitoring-guided anesthesia management can enhance early recovery from laparoscopic surgery in elderly patients with BIS values within a safe range, which may be particularly advantageous for this demographic during laparoscopic procedures.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"597-612"},"PeriodicalIF":3.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103073","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 Vegetable and Fruit Consumption Patterns with Cognitive Function in Older People with Different BMI Ranges: Findings from China.","authors":"Liang Huang, Zixuan Hong, Ying Guo, Wenjin Song, Jiawei Huang, Wenwen Cao, Chenglin Cao, Ren Chen, Zhongliang Bai","doi":"10.2147/CIA.S515094","DOIUrl":"https://doi.org/10.2147/CIA.S515094","url":null,"abstract":"<p><strong>Purpose: </strong>There is a lack of research on how vegetable and fruit consumption patterns affect cognitive function in older adults with varying BMIs. Therefore, this study aims to explore their relationship, with a special focus on gender differences.</p><p><strong>Patients and methods: </strong>A cross-sectional survey was conducted in Anhui Province, China, between July and September 2019, and information was collected from 6211 participants regarding socio-demographics, the frequency of vegetable and fruit consumption per week, and cognitive function. The study utilized descriptive analysis and binary logistic regression to determine the association between cognitive function and consumption patterns of vegetable and fruit.</p><p><strong>Results: </strong>There were no statistically significant associations between vegetable and fruit consumption patterns and cognitive function in underweight and obese older adults. Among normal weight men, older adults in the V+/F- (AOR=1.65; 95% CI: 1.16-2.35) and V-/F- (AOR=3.95; 95% CI: 1.86-8.42) groups were more likely to have cognitive impairment compared with the V+/F+ group. However, no associations were observed between the two in women of normal weight. For the overweight women, a higher risk of cognitive impairment was found in the V+/F- group (AOR=1.54; 95% CI: 1.12-2.11), while older men did not.</p><p><strong>Conclusion: </strong>The correlation between vegetable and fruit consumption patterns and cognitive function varies among older adults with different BMIs. Findings suggest the need for targeted nutritional interventions for these communities to maintain cognitive function in older adults.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"587-596"},"PeriodicalIF":3.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080669","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":"Impacts of Prior Anti-Osteoporosis Treatments on Sequential Denosumab Responses in BMD Changes Among Postmenopausal Osteoporosis Women in East China: Real-World Data Analysis.","authors":"Guoyu Guan, Yanping Du, Wenjing Tang, Minmin Chen, Weijia Yu, Huilin Li, Qun Cheng","doi":"10.2147/CIA.S511622","DOIUrl":"https://doi.org/10.2147/CIA.S511622","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the impacts of prior anti-osteoporosis treatments on bone mineral density (BMD) changes in Chinese postmenopausal women with osteoporosis following 1-year Denosumab (Dmab) therapy.</p><p><strong>Patients and methods: </strong>This retrospective cohort study enrolled 381 postmenopausal women, all receiving a 1-year Dmab treatment. Participants were stratified into five groups based on prior anti-osteoporosis treatments: no treatment (NT), alendronate (ALN), zoledronic acid (ZOL), teriparatide (TPT), and raloxifene (RAL). Potential factors influencing BMD changes were screened using least absolute shrinkage and selection operator (LASSO). The selected variables were then incorporated into a multivariate regression model to identify independent risk factors. Finally, after adjusting for confounders, the impacts of prior anti-osteoporosis treatment on sequential Dmab responses were evaluated.</p><p><strong>Results: </strong>1) Further BMD increases were observed after sequential 1-year Dmab with prior use of other anti-osteoporosis drugs; 2) Compared to the NT group, ZOL significantly reduced BMD changes at the lumbar spine (LS), femoral neck (FN), and total hip (TH) (LS: β = -0.01, P = 0.016; FN: β = -0.01, <i>P</i> = 0.010; TH: β = -0.01, <i>P</i> = 0.011); Significant negative associations with FN BMD changes were observed for the ALN group (β = -0.01, <i>P</i>< 0.001), and the RAL group (β = -0.01, <i>P</i> = 0.010) compared to the NT group; TPT showed no significant differences with the NT group at all sites; 3) Multiple analysis revealed baseline BMD were independently associated with changes in BMD (LS: β = -0.04, <i>P</i> = 0.009; FN: β = -0.19, <i>P</i> <0.001; TH: β = -0.14, <i>P</i> <0.001).</p><p><strong>Conclusion: </strong>These findings indicated that prior anti-osteoporosis treatments differentially influenced BMD responses to 1-year Dmab therapy. While patients who had previously been treated with ZOL had limited subsequent BMD improvement, patients who had previously used TPT and had lower baseline BMD benefited more.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"573-586"},"PeriodicalIF":3.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991528","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":"All-Cause Mortality Risk in Elderly Patients with Femoral Neck and Intertrochanteric Fractures: A Predictive Model Based on Machine Learning.","authors":"Aoying Min, Yan Liu, Mingming Fu, Zhiyong Hou, Zhiqian Wang","doi":"10.2147/CIA.S511935","DOIUrl":"https://doi.org/10.2147/CIA.S511935","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to identify the influencing factors for all-cause mortality in elderly patients with intertrochanteric and femoral neck fractures and to construct predictive models.</p><p><strong>Methods: </strong>This study retrospectively collected elderly patients with intertrochanteric fractures and femoral neck fractures who underwent hip fractures surgery in the Third Hospital of Hebei Medical University from January 2020 to December 2022. Cox proportional hazards regression is used to explore the association between fractures type and mortality. Boruta algorithm was used to screen the risk factors related to death. Multivariate logistic regression was used to determine the independent risk factors, and a nomogram prediction model was established. The ROC curve, calibration curve and DCA decision curve were drawn by R language, and the prediction model was established by machine learning algorithm.</p><p><strong>Results: </strong>Among the 1373 patients. There were 6 variables that remained in the model for intertrochanteric fractures: age (HR 1.048, 95% CI 1.014-1.083, p = 0.006), AMI (HR 4.631, 95% CI 2.190-9.795, P < 0.001), COPD (HR 3.818, 95% CI 1.516-9.614, P = 0.004), CHF (HR 2.743, 95% CI 1.510-4.981, P = 0.001), NOAF (HR 1.748, 95% CI 1.033-2.956, P = 0.037), FBG (HR 1.116, 95% CI 1.026-1.215, P = 0.011). There were 3 variables that remained in the model for femoral neck fractures: age (HR 1.145, 95% CI 1.097-1.196, P < 0.001), HbA1c (HR 1.264, 95% CI 1.088-1.468, P = 0.002), BNP (HR 1.001, 95% CI 1.000-1.002, P = 0.019). The experimental results showed that the model has good identification ability, calibration effect and clinical application value.</p><p><strong>Conclusion: </strong>Intertrochanteric fractures is an independent risk factor for all-cause mortality in elderly patients with hip fractures. By constructing a prognostic model based on machine learning, the risk factors of mortality in patients with intertrochanteric fractures and femoral neck fractures can be effectively identified, and personalized treatment strategies can be developed.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"559-571"},"PeriodicalIF":3.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054704","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":"T Cell Aging: An Important Target for Perioperative Immunomodulation.","authors":"Haoning Lan, Songchao Xu, Huili Li, Ruijuan Guo, Zhong Feng, Yun Wang","doi":"10.2147/CIA.S519438","DOIUrl":"https://doi.org/10.2147/CIA.S519438","url":null,"abstract":"<p><p>Although T cells are crucially involved in maintaining immune function, their roles change with age. Furthermore, T cell aging has a unique onset and progression mechanism and several clinical indicators have been developed to detect it. Moreover, perioperative pain and stressful stimuli could affect the body's immune status, influencing patients' recovery. This article examines how preoperative and intraoperative complications influence T cell aging. These factors include conditions such as hypertension, diabetes, acute respiratory distress syndrome, hypoxemia, depression, pain, obesity, neurologic diseases, tumors, autoimmune diseases, as well as aspects like anesthetic modalities, types of surgery, and medications. This analysis could help identify groups at a high risk of perioperative T cell aging. For example, elderly cancer patients with multiple chronic diseases may be the most affected by T cell aging. We also discuss the effects of T cell aging on postoperative phenomena such as neurological dysfunction and recovery quality. Based on insights from this discussion, we deduced that prehabilitation, pharmacological treatment, and adoptive neuro-immunotherapy could modulate T cell aging in the perioperative period, thus improving clinical prognosis.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"537-557"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042431","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}