Clinical Interventions in Aging最新文献

{"title":"Multimodal AI Model for Sarcopenia Detection: Integrating Chest CT and Clinical Parameters in Older Adults.","authors":"Yunfei Pan, Feimin Zhao, Xiaojun Chen, Jingjing Ren","doi":"10.2147/CIA.S590955","DOIUrl":"https://doi.org/10.2147/CIA.S590955","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia, an age-related syndrome marked by progressive loss of skeletal muscle mass and function, is associated with frailty, disability, falls, and increased mortality among older adults. However, existing diagnostic methods, such as dual-energy X-ray absorptiometry (DXA) and physical performance tests, are often inaccessible in routine clinical practice due to equipment and time constraints.</p><p><strong>Objective: </strong>This study aimed to develop and validated a multimodal, explainable AI model for identifying sarcopenia using routinely available chest CT scans and outpatient clinical data in older adults.</p><p><strong>Methods: </strong>A total of 290 participants (mean age 67.6 ± 5.8 years; 38.9% female) were included. A weakly supervised segmentation framework combining the Segment Anything Model (SAM) and Contrastive Language-Image Pretraining (CLIP) was employed to extract muscle features at the T12 level. Clinical variables, including anthropometric indices, lifestyle behaviors, and biochemical markers, were encoded and fused with imaging-derived features. A multi-layer perceptron (MLP) was trained to classify sarcopenia based on 2019 AWGS criteria. Model interpretability was assessed using SHAP (Shapley Additive Explanations) values.</p><p><strong>Results: </strong>The model achieved an AUC of 0.88 (95% CI: 0.83-0.92), accuracy of 0.85 (95% CI 0.82-0.89), sensitivity of 0.79 (95% CI: 0.70-0.987), and specificity of 0.88 (95% CI: 0.83-0.92). SHAP analysis revealed that gender, total triiodothyronine, creatine kinase, body mass index and creatinine were the most influential predictors. The fusion of weakly supervised learning and multimodal data enabled effective muscle region segmentation and improved diagnostic performance.</p><p><strong>Conclusion: </strong>In summary, we developed and internally validated an explainable multimodal AI model that integrates chest CT-derived muscle features with routine outpatient clinical variables for sarcopenia detection in older adults. The model demonstrated strong diagnostic performance and interpretability, highlighting its potential for opportunistic risk stratification in routine clinical workflows. Future multi-center validation and prospective studies are warranted to confirm its generalizability and long-term clinical utility.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"590955"},"PeriodicalIF":3.7,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786470","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":"Transcutaneous Auricular Vagus Nerve Stimulation and Pectoral-Intercostal Fascial Block for the Prevention of Chronic Postsurgical Pain in Elderly Patients Undergoing Off-Pump Coronary Artery Bypass Grafting: A 2×2 Factorial, Double-Blinded, Randomized Clinical Trial.","authors":"Sichen Cui, Luguang Yan, Peiying Huang, Haitao Yang, Weimin Liang, Lining Huang","doi":"10.2147/CIA.S583971","DOIUrl":"https://doi.org/10.2147/CIA.S583971","url":null,"abstract":"<p><strong>Background: </strong>Chronic postsurgical pain (CPSP) is common after off-pump coronary artery bypass grafting (OPCABG) in elderly patients. This trial investigated the efficacy of perioperative transcutaneous auricular vagus nerve stimulation (taVNS) and pectoral-intercostal fascial block (PIFB) for CPSP prevention.</p><p><strong>Methods: </strong>In this 2×2 factorial trial, 260 elderly patients (≥60 years) undergoing OPCABG were randomized to taVNS + ropivacaine PIFB, taVNS + placebo PIFB, sham taVNS + ropivacaine PIFB, or sham taVNS + placebo PIFB groups. The primary outcome was CPSP incidence at 3 months postoperatively. Several secondary outcomes were evaluated. Logistic regression was employed to analyze risk factors associated with CPSP. Lastly, mediation analyses were performed to explore the mediating factors between interventions and CPSP.</p><p><strong>Results: </strong>The overall incidence of CPSP was 34.6%. No interaction was found between taVNS and PIFB. Compared with sham taVNS, taVNS significantly reduced CPSP incidence (28.6% vs 40.9%, <i>P</i> = 0.036), alleviated acute pain and improved recovery quality. PIFB did not reduce overall CPSP incidence (30.2% vs 38.8%, <i>P</i> = 0.143), though it alleviated acute pain on postoperative day 1 and reduced moderate-to-severe CPSP. Risk factors for CPSP included preoperative anxiety, pain catastrophizing, acute postoperative pain, and high IL-6 levels. Mediation analysis indicated taVNS's benefits were partially mediated by reducing acute pain (19.3%) and IL-6 (20.4%).</p><p><strong>Conclusion: </strong>Perioperative taVNS significantly reduced CPSP incidence and enhanced postoperative recovery in elderly OPCABG patients, partly mediated by alleviating acute pain and inflammation. Single-shot PIFB showed limited preventive effect on overall CPSP.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"583971"},"PeriodicalIF":3.7,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786457","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":"Nutritional-Inflammatory Recovery After Metal versus Plastic Biliary Stenting in Elderly Cholangiocarcinoma: A Prospective Observational Cohort Study.","authors":"Chen Li, Nana Zhang, Huhu Ren","doi":"10.2147/CIA.S593418","DOIUrl":"10.2147/CIA.S593418","url":null,"abstract":"<p><strong>Background: </strong>Malignant biliary obstruction (MBO) in elderly cholangiocarcinoma is frequently accompanied by systemic inflammation and impaired immune-nutritional reserve. We compared stent durability and early nutrition-inflammation recovery after self-expandable metal stents (SEMS) versus plastic stents.</p><p><strong>Methods: </strong>We conducted a single‑center prospective observational cohort of consecutive patients aged ≥65 years undergoing first‑time biliary stenting (2019-2024; N=188; SEMS n=109; plastic stent n=79). The primary endpoint was time to recurrent biliary obstruction (TRBO; TOKYO criteria), with death treated as a competing event. Confounding was addressed using propensity score overlap weighting. Competing‑risk outcomes were analyzed with Fine-Gray regression overall survival (OS) with weighted Cox models, longitudinal GNRI, PNI, NLR, and log(SII) trajectories with mixed‑effects models. Prognostic associations were evaluated using a prespecified 30‑day landmark analysis.</p><p><strong>Results: </strong>At 6 months, the overlap‑weighted cumulative incidence of TRBO was 35.6% with SEMS versus 52.9% with plastic (sHR 0.64, 95% CI 0.44-0.93). SEMS was associated with fewer biliary reinterventions (any intervention 44.1% vs 68.2%; sHR 0.58, 95% CI 0.41-0.82). From baseline to day ~30, SEMS recipients had greater recovery in GNRI (mean difference +1.9; 95% CI 0.4-3.4) and PNI (+1.8; 95% CI 0.5-3.1) and a larger reduction in log(SII) (-0.10; 95% CI -0.19 to -0.01). In the landmark cohort (n=153), each 3‑point increase in ΔPNI was associated with lower mortality (HR 0.86, 95% CI 0.78-0.95), while higher day‑30 SII predicted higher mortality (per doubling HR 1.22, 95% CI 1.05-1.42). OS and 30‑day adverse events did not differ significantly.</p><p><strong>Conclusion: </strong>In elderly cholangiocarcinoma with MBO, SEMS was associated with lower TRBO and fewer reinterventions, and with more favorable early nutrition-inflammation recovery. Early PNI improvement and residual inflammatory burden at ~30 days provided prognostic information, supporting integrated post‑drainage nutrition-inflammation monitoring.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"593418"},"PeriodicalIF":3.7,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724391","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":"Cochlear Inflammatory Microenvironment in Age-Related Hearing Loss: Mechanisms and Recent Advances.","authors":"Xiang Li, Zhenhua Wu, Qiang Zhou, Sen Lin","doi":"10.2147/CIA.S590182","DOIUrl":"https://doi.org/10.2147/CIA.S590182","url":null,"abstract":"<p><p>Age-related hearing loss (ARHL) is a common sensory disorder in older adults and a major public health concern that reduces quality of life and social functioning. Traditionally, ARHL has been associated with hair cell apoptosis, strial degeneration, spiral ganglion neuron loss, oxidative stress, and mitochondrial dysfunction. Recent studies suggest that dysregulation of the cochlear inflammatory microenvironment also contributes to its onset and progression. During aging, impaired immune regulation, weakened antioxidant defenses, blood-labyrinth barrier dysfunction, and persistent pro-inflammatory signaling disturb cochlear homeostasis and promote pathological remodeling, leading to injury of hair cells, synapses, and auditory neurons. In addition, systemic chronic low-grade inflammation, metabolic disturbances, and vascular dysfunction may further worsen cochlear inflammation. This review summarizes the structural basis, maladaptive remodeling, functional consequences, and potential therapeutic strategies of the cochlear inflammatory microenvironment in ARHL.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"590182"},"PeriodicalIF":3.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724375","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":"Geriatric Focused ERAS Nursing Practices in Open and Hybrid Aortic Vascular Surgery.","authors":"Jingjing Ye, Yuanyuan Zhang","doi":"10.2147/CIA.S593842","DOIUrl":"https://doi.org/10.2147/CIA.S593842","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Enhanced Recovery After Surgery (ERAS) pathways have been adapted for open and lower extremity vascular surgery and increasingly guide perioperative care for older adults. However, little is known about how perioperative nurses implement ERAS-consistent and geriatric-focused practices for older patients undergoing open and hybrid aortic procedures, particularly in hybrid operating room settings and in Chinese hospitals, where pathway maturity and geriatric integration may vary across centres.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To describe perioperative nurses' implementation of ERAS-consistent and geriatric-focused nursing practices for older adults undergoing open and hybrid aortic vascular surgery in China, and to identify nurse- and organisation-level factors associated with higher implementation, with attention to modifiable determinants (training, ERAS pathways, staffing).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Registered nurses working in operating theatres/hybrid operating rooms, post-anaesthesia care units, intensive care/high-dependency units, vascular surgical wards and pre-assessment clinics in eight tertiary general hospitals in Shanxi Province, China, were surveyed between March and July 2024. The Geriatric-Focused Vascular ERAS Nursing Practices Questionnaire, developed from ERAS/SVS guidelines and geriatric surgery literature, measured nurse-reported implementation across perioperative domains, geriatric-focused elements, attitudes and perceived barriers. The instrument underwent expert review, pilot testing and internal consistency assessment, while more advanced psychometric testing was beyond the scope of this initial multicentre study. Data were analysed using descriptive statistics, group comparisons and multivariable linear regression; free-text responses were examined using inductive qualitative content analysis. The study was conceptually informed by a Donabedian structure-process-outcome framework and a capability-opportunity-motivation perspective on behaviour change.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 640 eligible nurses, 428 provided analysable responses (usable response rate 66.9%). The global ERAS implementation score (1-5) was 3.41 (SD 0.49). Implementation was highest for intraoperative/post-anaesthesia practices (3.82, SD 0.61) and preoperative education/optimisation (3.63, SD 0.72), and lowest for frailty and cognitive/delirium assessment (2.71, SD 0.81). Routine frailty assessment was reported by 23.4% and routine use of structured delirium screening tools by 30.8%. Higher implementation was independently associated with ERAS-specific training (B = 0.28, p &lt; 0.001), geriatric/frailty training (B = 0.12, p = 0.008), working in hospitals with a formal ERAS pathway (B = 0.24, p &lt; 0.001), higher perceived staffing adequacy (B = 0.09, p = 0.004), and greater experience (B = 0.04 per 5 years, p = 0.012) (adjusted R&lt;sup&gt;2&lt;/sup&gt; = 0.38). Qualitative findings highlighted ERAS as an \"ideal rather than","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"593842"},"PeriodicalIF":3.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724361","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":"Targeted Decompression Under Local Anesthesia versus Extensive Decompression Under General Anesthesia for Octogenarians with Lumbar Degenerative Diseases: A Real-World Propensity Score-Matched Analysis.","authors":"Hang Zhang, Huili Cai, Yunzhong Cheng, Xuelin Li, Yang Liu, Fengping Liu, Jingchuan Sun, Haidan Chen","doi":"10.2147/CIA.S589760","DOIUrl":"https://doi.org/10.2147/CIA.S589760","url":null,"abstract":"<p><strong>Background: </strong>Surgical management of lumbar degenerative diseases (LDD) in octogenarians requires balancing effective neural decompression against diminishing physiological reserves. While general anesthesia (GA)-based endoscopic techniques (ENDO-GA) are highly effective, they often impose excessive systemic stress on frail patients. Conversely, percutaneous endoscopic lumbar discectomy under local anesthesia (PELD-LA) provides targeted decompression while mitigating these GA-associated risks. Given the scarcity of direct comparisons in this fragile population, this study evaluates the safety and efficacy of PELD-LA versus ENDO-GA.</p><p><strong>Methods: </strong>We retrospectively analyzed 100 consecutive octogenarians treated for LDD between January 2021 and December 2024. Patients were stratified into two specific surgical strategy groups: targeted decompression via PELD-LA (n=54) and extensive decompression via ENDO-GA (utilizing UBE or Delta techniques, n=46). To minimize selection bias, a 1:1 Propensity Score Matching (PSM) was conducted using specific covariates (age, sex, comorbidities, and ASA classification), yielding 39 matched pairs (n=78). Primary outcomes assessed perioperative safety and recovery efficiency (complications, PONV, ambulation time, and length of hospital stay).Secondary outcomes evaluated postoperative clinical efficacy (VAS and ODI at 3 months, and modified MacNab criteria at 12 months postoperatively).</p><p><strong>Results: </strong>After propensity score matching, baseline characteristics were well-balanced between the two groups. Perioperatively, the PELD-LA group exhibited significantly shorter operative times (97 vs 150 min, P<0.001), earlier ambulation (48 vs 72 h, P<0.001), and reduced length of hospital stay (9 vs 14 days, P<0.001) compared to the ENDO-GA group. Clinically, despite a smaller \"targeted\" decompression range, PELD-LA achieved long-term efficacy (MacNab criteria: 94.9% vs 94.9%, P=1.000) comparable to extensive decompression, while demonstrating superior early pain relief and functional improvement (VAS and ODI) at 3 months postoperatively (P<0.01). Crucially, the overall complication rate was significantly lower in the PELD-LA group (30.8% vs 82.1%, P<0.001), primarily driven by a marked reduction in postoperative nausea and vomiting (PONV) (23.1% vs 66.7%, P<0.001).</p><p><strong>Conclusion: </strong>Within our short-to-medium-term observation period, PELD-LA delivered clinical efficacy comparable to GA-based endoscopic procedures for octogenarians, while significantly reducing perioperative complications and accelerating recovery. Crucially, we do not assert that PELD-LA is universally superior; rather, we emphasize the importance of tailored patient selection. For frail patients with limited physiological reserve, PELD-LA serves as a physiologically rational strategy, balancing targeted decompression with the preservation of systemic stability.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"589760"},"PeriodicalIF":3.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724410","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 Body-Driven Mind: Effects of Conventional and Non-Immersive Virtual Reality-Based Physiotherapy on Cognitive Function in Older Orthopedic Patients.","authors":"Małgorzata Dębska-Janus, Jacek Polechoński, Paweł Dębski, Anna Zwierzchowska","doi":"10.2147/CIA.S576150","DOIUrl":"https://doi.org/10.2147/CIA.S576150","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the effects of exercise-based rehabilitation on cognitive functions in orthopedic patients and compared conventional rehabilitation with a protocol supplemented by physical activity (PA) performed in a non-immersive virtual reality (nIVR) environment.</p><p><strong>Materials and methods: </strong>A three-week exercise-based intervention was conducted among 48 orthopedic patients with lower limb joint dysfunctions (mean age 69.9 ± 4.8 years) hospitalized at the AccessMedica Rehabilitation Center. Participants were randomly assigned to two groups: the control group (CG; n = 24), which completed a standard kinesiotherapy and physical therapy program, and the experimental group (EG; n = 24), which, in addition to standard therapy, participated in three 30-minute nIVR-based PA sessions per week using interactive applications. Cognitive functions were assessed using the Addenbrooke's Cognitive Examination III (ACE-III)-version A before and version B after the intervention. The intensity of nIVR-based PA was monitored by heart rate telemetry, and participants' perceived enjoyment was assessed using the Physical Activity Enjoyment Scale (PACES).</p><p><strong>Results: </strong>A significant improvement in overall cognitive performance was observed only in the EG following the intervention (p < 0.004, d = -0.643). Significant enhancements were found in attention (p = 0.004) and verbal fluency (p = 0.039). In contrast, patients undergoing conventional rehabilitation demonstrated no statistically significant pro-cognitive effects. The intensity of nIVR-based PA corresponded to a moderate level or close to its upper limit, and participants reported high enjoyment of this form of exercise.</p><p><strong>Conclusion: </strong>Supplementing conventional exercise-based rehabilitation with VR-supported physical activity sessions yields superior outcomes in attention and verbal fluency as well as higher overall cognitive results compared to standard rehabilitation programs. Moreover, VR-assisted exercise therapy is perceived by orthopedic patients as highly engaging, while its exercise intensity remains within the range recommended for health benefits in both physical and psychological domains.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"576150"},"PeriodicalIF":3.7,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640371","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 Preoperative Frailty on Postoperative Complications and Cognitive Impairment in Liver Cancer Patients: An Observational Cohort Study.","authors":"Ziyuan Li, Tangchen Yin, Yifan Sun, Zhunzhun Liu, Shaozheng Song, Xiaoyan Zhang","doi":"10.2147/CIA.S589717","DOIUrl":"https://doi.org/10.2147/CIA.S589717","url":null,"abstract":"<p><strong>Background: </strong>Frailty is characterized by an age-related decline in physiological reserve and is closely linked to postoperative outcomes. Early identification of preoperative frailty is therefore essential. This study aims to examine the associations between preoperative frailty and postoperative complications and cognitive impairment in patients with liver cancer, and to identify potential contributing factors.</p><p><strong>Methods: </strong>This observational cohort study was conducted at the Affiliated Hospital of Jiangnan University from February to June 2025 and included 115 patients with liver cancer who underwent surgery. Frailty status was assessed using the Fried Phenotype criteria on 1 day before surgery, and cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) on postoperative day 3. Postoperative complications occurring before discharge were also recorded.</p><p><strong>Results: </strong>A total of 43 patients (37.4%) developed postoperative complications, which may have been associated with preoperative frailty and its components, including exhaustion, grip strength, and low physical activity. Moreover, significantly higher prevalences of postoperative hypoproteinemia and liver function impairment, as well as markedly lower MoCA scores in unadjusted comparisons on postoperative day 3 (continuous outcome) were observed in patients with preoperative frailty. Receiver operating characteristic (ROC) analysis indicated that the frailty score may serve as a predictor of postoperative complications.</p><p><strong>Conclusion: </strong>Preoperative frailty in patients with liver cancer may be associated with postoperative complications, and the frailty score may potentially serve as a predictor of these complications.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"589717"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635036","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":"Correlation Analysis of the New Inflammatory Composite Index with the Degree of Coronary Artery Lesions in Elderly Patients.","authors":"Yan Cui, Jiao Chen, Peng Lu, Lijun Yang, Zheng Xie, Xiaofen Weng, Yonghua Wu, Xiang Lu, Liya Mo","doi":"10.2147/CIA.S591819","DOIUrl":"https://doi.org/10.2147/CIA.S591819","url":null,"abstract":"<p><strong>Background: </strong>Systemic inflammation plays a key role in the development and progression of coronary artery disease (CAD). However, the clinical relevance of hematologic inflammatory indices in elderly patients has not been fully clarified.</p><p><strong>Objective: </strong>To investigate the association of five hematologic inflammatory indices-neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI)-with the presence and severity of CAD in an elderly population.</p><p><strong>Methods: </strong>This retrospective single-center study included 582 consecutive patients aged ≥60 years who underwent coronary angiography between 2021 and 2023. Based on the extent of coronary artery involvement, patients were categorized into four groups: normal (n = 131), single-vessel disease (n = 133), two-vessel disease (n = 136), and three-vessel disease (n = 182). Inflammatory indices were calculated from routine blood counts. Group differences were assessed using the Kruskal-Wallis test. Multivariable logistic regression analysis was performed after adjustment for age, sex, body mass index, hypertension, and diabetes. Discriminatory performance was evaluated using receiver operating characteristic (ROC) curve analysis with comparisons conducted by the DeLong test.</p><p><strong>Results: </strong>All five inflammatory indices were significantly associated with increasing angiographic severity of CAD (all <i>P</i> < 0.05). Among them, SIRI demonstrated the strongest independent association (OR = 4.91, 95% CI: 2.11-11.44) and the highest area under the ROC curve (AUC = 0.766), followed by SII (AUC = 0.749). The addition of inflammatory indices to conventional risk factors modestly improved model discrimination.</p><p><strong>Conclusion: </strong>This study demonstrates that SIRI and SII are valuable inflammatory biomarkers for evaluating the severity of coronary artery disease in elderly patients, highlighting the role of systemic inflammation in the progression of age-related atherosclerosis. As the first systematic comparison of five hematologic composite indices in a geriatric cohort, our findings suggest that SII and SIRI-both cost-effective and readily available parameters-are closely associated with CAD severity, though prospective studies are needed to establish their clinical value.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"591819"},"PeriodicalIF":3.7,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595494","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":"Indobufen versus Aspirin After CABG in Septuagenarians: A Propensity Score-Matched Cohort Study.","authors":"Libin Yang, Ben Huang, Zhenhang Chen, Mieradilijiang Abudupataer, Ziang Zuo, Gao Liu, Yongxin Sun, Chunsheng Wang","doi":"10.2147/CIA.S589035","DOIUrl":"https://doi.org/10.2147/CIA.S589035","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the safety and efficacy of indobufen-based versus aspirin-based sequential antiplatelet therapy in septuagenarians undergoing coronary artery bypass grafting (CABG).</p><p><strong>Patients and methods: </strong>Patients aged 70-79 years who underwent CABG between 2020 and 2022 received either indobufen- or aspirin-based dual antiplatelet therapy (DAPT) (with clopidogrel) for 12 months, followed by monotherapy with their respective baseline agent (indobufen or aspirin) for an additional year. Propensity score matching (1:2, caliper 0.25 SD) balanced the baseline characteristics. The primary outcomes were 2-year major adverse cardiac and cerebrovascular events (MACCE) and Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding.</p><p><strong>Results: </strong>Among 296 patients (indobufen, 46; aspirin, 250), 104 (indobufen, 36; aspirin, 68) were well matched. Before matching, indobufen showed similar 2-year MACCE risk to aspirin (6.5% vs 6.8%; subdistribution hazard ratio [sHR] 0.96, 95% CI 0.28-3.28; p = 0.95) and lower BARC type 2, 3, or 5 bleeding (2.2% vs 6.8%; sHR 0.32, 95% CI 0.04-2.38; p = 0.23). After matching, results remained consistent (MACCE 8.3% vs 10.3%; sHR 0.81, 95% CI 0.21-3.10; p = 0.76; bleeding 2.8% vs 11.8%; sHR 0.24, 95% CI 0.03-1.87; p = 0.14). Indobufen reduced clinically relevant bleeding by 9.0% (number needed to treat [NNT] ≈ 11) without compromising ischemic outcomes.</p><p><strong>Conclusion: </strong>Indobufen-based sequential therapy provided ischemic protection similar to that of aspirin, while showing a favorable bleeding profile in septuagenarians undergoing CABG. For individuals with a high bleeding risk or aspirin intolerance, indobufen may represent a practical alternative. Larger prospective studies focusing on geriatric outcomes are warranted.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"589035"},"PeriodicalIF":3.7,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13039662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610316","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}