Clinical Interventions in Aging最新文献

{"title":"Post-Thrombectomy Pulse Pressure Trajectories and Outcomes in Middle-Aged and Older Stroke Patients.","authors":"Chen Xiao, Feng Gao, Bailong Xin, Yuzhen Wang, Xintian Xu, Xiaomei Ye, Jingping Sun, Xueli Cai","doi":"10.2147/CIA.S589196","DOIUrl":"10.2147/CIA.S589196","url":null,"abstract":"<p><strong>Background: </strong>Endovascular thrombectomy (EVT) is an established treatment for acute ischemic stroke in elderly patients. Nonetheless, age-specific vascular pathophysiology in this population presents distinct challenges for postprocedural blood pressure management. Pulse pressure has been linked to clinical outcomes, however, evidence regarding the impact of its dynamic patterns following EVT remains limited.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included patients aged over 45 years who had achieved successful reperfusion following thrombectomy. Group-based trajectory modeling was applied to characterize the patterns of pulse pressure over the first 24 hours post-procedure. The primary outcome was functional status at 90 days, assessed using the modified Rankin Scale. The association between pulse pressure trajectories and functional outcome was examined using ordinal logistic regression, with adjustment for potential confounders. Furthermore, subgroup analysis was performed to assess whether this association differed between patients aged <75 years and those ≥75 years.</p><p><strong>Results: </strong>Three distinct postoperative pulse pressure trajectories were identified: low-stable, moderate-increasing, and high-increasing. In the overall population, the moderate-increasing trajectory was associated with favorable 90-day functional outcomes after multivariate adjustment (adjusted OR, 0.52; 95% CI, 0.32-0.85), while no significant association was observed between the high-increasing and low-stable trajectories. Subgroup analysis revealed a significant interaction between age and trajectory group (<i>P</i> for interaction <0.05). The moderate-increasing trajectory was associated with better functional outcomes in patients aged ≥75 years (adjusted OR, 0.28; 95% CI, 0.13-0.62), whereas no statistically significant association was observed in the younger subgroup.</p><p><strong>Conclusion: </strong>Among patients aged >45 years undergoing EVT, the 24-hour pulse pressure trajectory is associated with 90-day functional outcome, and this association is modified by age. For patients aged 75 years or older, maintaining a moderate pulse pressure level may be associated with improved functional recovery.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"589196"},"PeriodicalIF":3.7,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595577","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 Machine Learning Model Integrating Systemic Immune-Inflammation Index for Predicting 28-Day Mortality in Geriatric Sepsis Secondary to Community-Acquired Bacterial Pneumonia.","authors":"Yifei Xu, Wei Chen","doi":"10.2147/CIA.S560732","DOIUrl":"10.2147/CIA.S560732","url":null,"abstract":"<p><strong>Purpose: </strong>Sepsis is a life-threatening clinical syndrome characterized by a dysregulated host response to infection. The systemic immune-inflammation index (SII) is a novel prognostic biomarker, However, its predictive value for early prognosis in elderly individuals suffering from sepsis secondary to community-acquired bacterial pneumonia (CABP) remains unclear. This study intends to apply machine learning techniques to develop an interpretable model for predicting prognosis.</p><p><strong>Patients and methods: </strong>This medical records review included elderly patients with sepsis secondary to CABP admitted to ICUs at Beijing Shijitan Hospital. Clinical outcomes based on 28-day survival status served as the basis for dividing participants into survivor and non-survivor groups. For prognostic prediction, five machine learning algorithms were developed, including Gradient Boosting Machine (GBM), Logistic Regression, Random Forest (RF), Light Gradient Boosting Machine (LightGBM), and Extreme Gradient Boosting (XGBoost). Model efficacy was quantified using the area under the receiver operating characteristic curve (AUROC) metric and assessed clinically through decision curve analysis (DCA). SHapley Additive exPlanations (SHAP) visualization provided insights into the models' decision-making processes.</p><p><strong>Results: </strong>In this investigation, clinical information from 364 geriatric participants suffering from sepsis secondary to CABP was examined. For developing prediction models, twelve predictors were chosen. During an extensive evaluation of multiple computational frameworks, the XGBoost algorithm exhibited superior prognostic capability regarding 28-day mortality (AUROC = 0.901, 95% CI: 0.853-0.949,). The SHAP summary plot generated from the optimal XGBoost model ranked the importance of predictive features. The SII, APACHE II score, age, Pneumonia Severity Index (PSI), gender was identified as the top five most influential factors.</p><p><strong>Conclusion: </strong>Elevated SII concentrations correlated significantly with this mortality rate. The interpretable XGBoost model accurately detected the precise link between admission SII measurements and subsequent 28-day all-cause mortality in the target patient population.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"560732"},"PeriodicalIF":3.7,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13032731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576003","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":"Percutaneous Endoscopic Decompression versus Non-Operative Care for Radicular Pain in the Oldest-Old with Lumbar Stenosis: A Target Trial Emulation Focusing on Pain Relief and Deprescribing.","authors":"Miao Wang, Qiong Wang, Guang-Zhou Li, Fan-Dong Wang, Long Tang, Hao Zhang","doi":"10.2147/CIA.S590476","DOIUrl":"10.2147/CIA.S590476","url":null,"abstract":"<p><strong>Objective: </strong>To emulate a target trial comparing percutaneous transforaminal endoscopic decompression (PTED) versus non-operative care for older patients with unilateral radicular pain due to lumbar spinal stenosis (LSS), focusing on comprehensive treatment failure and deprescribing.</p><p><strong>Design: </strong>Retrospective cohort study using a Target Trial Emulation Framework.</p><p><strong>Setting: </strong>Single academic spine center.</p><p><strong>Participants: </strong>143 consecutive patients aged ≥80 years with unilateral radicular symptoms and imaging-confirmed LSS (February 2022-October 2024). All underwent confirmatory diagnostic nerve root block.</p><p><strong>Interventions: </strong>PTED under local anesthesia (n=75) versus structured non-operative care (n=68).</p><p><strong>Main outcome measures: </strong>Primary outcome was 90-day comprehensive treatment failure (unplanned rehospitalization or treatment escalation due to uncontrolled pain or serious complication). Secondary outcomes were Oswestry Disability Index (ODI) and polypharmacy at 12 months.</p><p><strong>Results: </strong>PTED group had significantly lower primary outcome incidence (16.0% vs 44.1%). After multivariable adjustment and inverse probability weighting, PTED was associated with markedly lower odds of comprehensive treatment failure (adjusted odds ratio [aOR] 0.18, 95% CI 0.07-0.47), primarily driven by pain-related failure (aOR 0.06; number needed to treat = 3.7). Complication-related failure did not differ significantly between groups, yielding a favorable benefit-risk ratio of 6.6:1. Subgroup analyses confirmed treatment effect consistency across key patient characteristics. At 12 months, PTED patients demonstrated greater ODI improvement (adjusted difference -8.92 points) and significantly lower polypharmacy prevalence (aOR 0.14), indicating sustained \"deprescribing\" benefit.</p><p><strong>Conclusion: </strong>In this emulated target trial, PTED was associated with reduced 90-day treatment failure and benefits at 12 months in pain relief and polypharmacy reduction among carefully selected oldest-old patients with LSS. These findings support PTED's potential in this population and justify the need for a prospective randomized trial.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"590476"},"PeriodicalIF":3.7,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13024358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575980","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":"Bidirectional Relationship Between Systemic Immune-Inflammation Index and Postoperative Pneumonia in Elderly Patients Undergoing Colorectal Cancer Surgery: A Retrospective Cohort Study.","authors":"Yanmin Wu, Bing Ye, Tiantian Zhao, Peihua Lu","doi":"10.2147/CIA.S576360","DOIUrl":"10.2147/CIA.S576360","url":null,"abstract":"<p><strong>Objective: </strong>To explore the bidirectional relationship between the systemic immune-inflammation index (SII) and postoperative pneumonia (POP) in elderly patients with colorectal cancer (CRC), as well as its impact on clinical prognosis, in order to provide evidence for perioperative evidence-based management.</p><p><strong>Methods: </strong>Clinical data of 2500 patients aged ≥60 years who underwent CRC resection at two hospitals from August 2017 to August 2023 were retrospectively analyzed. Demographic characteristics, preoperative/postoperative SII ((platelet × neutrophil)/lymphocyte counts), laboratory indicators, intraoperative variables, and prognosis were collected. Univariate and multivariate logistic regression analyses were used to determine the bidirectional association between SII and POP. Propensity score matching (PSM) with a 1:3 ratio was performed to balance confounding factors and verify result robustness, and the variance inflation factor (VIF) was used to assess multicollinearity.</p><p><strong>Results: </strong>The incidence of POP was 6.8% (171/2500), and 25.0% (625/2500) of patients had a postoperative SII increase of ≥30%. Multivariate analysis showed that the highest quartile of preoperative SII (SII_Q4) was an independent risk factor for POP (OR=6.017, 95% CI: 3.377-10.72, P<0.001), and POP was independently associated with a postoperative SII increase of ≥30% (OR=9.063, 95% CI: 4.933-18.696, P<0.001). After PSM, the risks of complications such as respiratory failure, septic shock, and anastomotic leakage, as well as the 2-year mortality rate (76.6% vs 26.5%; OR=9.078), were significantly higher in the POP group than in the non-POP group (all P<0.05). The maximum VIF was 1.30, indicating no significant multicollinearity.</p><p><strong>Conclusion: </strong>Elevated preoperative SII has a bidirectional association with POP in elderly CRC patients-high preoperative SII increases POP risk, while POP exacerbates postoperative SII elevation, both leading to poor prognosis. Integrating routine perioperative SII screening and dynamic monitoring into clinical practice can facilitate early risk stratification and targeted interventions, thereby optimizing perioperative care quality and improving patient outcomes.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"576360"},"PeriodicalIF":3.7,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13011849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516064","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":"Healthcare Providers' Perception of Implementing the Bedside Exercises for Hospital Fitness (BE-FIT) Patient-Led Rehabilitation Program for Older Patients: A Qualitative Descriptive Study.","authors":"Sadaf Murad-Kassam, Beate C Sydora, Rachel G Khadaroo, Jude A Spiers","doi":"10.2147/CIA.S566353","DOIUrl":"10.2147/CIA.S566353","url":null,"abstract":"<p><strong>Background: </strong>Delayed mobilization in older surgery patients is a major risk factor for postoperative complications, including functional decline, prolonged hospital stays, and a higher risk of hospital readmission. Although postoperative mobilization is a foundational nursing intervention, it is not consistently performed due to competing demands such as staffing shortages and high patient acuity. The Bedside Exercises for hospital FITness (BE-FIT) program is a patient-led rehabilitation initiative that shifts the traditional model of care by positioning patients as active participants in performing exercises after surgery, rather than relying on healthcare providers to carry out the exercises with them.</p><p><strong>Objective: </strong>This study aims to explore healthcare providers' experiences and perceptions of the delivery of the BE-FIT program to older postoperative patients in acute care surgical units and to identify strategies to improve program acceptance and sustainability.</p><p><strong>Methods: </strong>A qualitative descriptive design was implemented. Semi-structured in-person interviews were conducted with 14 healthcare providers who participated in BE-FIT implementation across four surgical units. Interviews were audio-recorded and data were analyzed using an inductive content analysis approach.</p><p><strong>Findings: </strong>Three themes emerged: (A) barriers and (B) facilitators for the implementation of the BE-FIT program, and (C) recommendations to enhance BE-FIT exercise uptake. Participants recognized the program's value in promoting early postoperative mobilization for older patients and appreciated the program's flexibility, simplicity, and patient-centred approach. However, operational barriers and patient resistance to mobilization affected implementation in clinical practice. Recommendations emphasized interdisciplinary engagement, integration into routine clinical workflows, family involvement, and leveraging technology.</p><p><strong>Conclusion: </strong>Healthcare providers perceive BE-FIT as a useful and adaptable tool to support early mobilization in older surgical patients. Insights gathered from frontline healthcare providers will inform strategies to improve the program's implementation, enhance adherence and support long-term sustainability.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"566353"},"PeriodicalIF":3.7,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515980","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 Association Between Short-Term Bone Loss and Future Osteoporotic Vertebral Fractures.","authors":"Ludan Chen, Jinsheng Yi, Weijia Xi, Long Liu, Feiyu Niu, Wei Zhang, Jiexiong Xu, Jinhui Cai, Qingyu Liu","doi":"10.2147/CIA.S589861","DOIUrl":"10.2147/CIA.S589861","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between longitudinal change in Hounsfield Units (HU) value and future osteoporotic vertebral fracture (OVF).</p><p><strong>Methods: </strong>This longitudinal case-control study involved 52 cases with future OVF and 104 age- and sex-matched controls. Each participant underwent two chest computed tomography (CT) scans. The baseline regional (anterior, middle, posterior, superior, inferior) and integral HU value from T4, T7, T10, and L1 vertebrae were measured. The coefficient of variation (CV) indicated heterogeneity in HU. Bone loss was quantified by the annual rate of HU value loss. Conditional logistic regression was employed to evaluate the independent risk factors (baseline CT characteristics and annual HU value loss) for each vertebra in predicting future OVF.</p><p><strong>Results: </strong>The baseline regional and integral HU value of T4, T7, T10 and L1 significantly decreased in OVF patients compared to the controls (<i>p</i> ≤ 0.001), with the integral HU value negatively related to future OVF. A decreased superior/inferior HU rate for T7 vertebra (OR=0.397, <i>p</i>=0.003) and an increase in CV for L1 vertebra (OR=1.110, <i>p</i>=0.034) were independently correlated with future OVF. With a follow-up interval of 22.40 ± 12.28 months for the OVF group and 35.15 ± 12.42 months for the control group, a higher annual rate of HU value loss (per 1% increased) was independently positively connected to the risk of future OVF (OR = 1.074, 1.088, and 1.099, for T4, T7, and T10 vertebrae, respectively, all <i>p</i>≤ 0.006).</p><p><strong>Conclusion: </strong>Reduced baseline vertebral HU value and increased annual HU value loss calculated by chest CT may be crucial for predicting OVF, providing valuable guidance for future short-term (approximately 1-3 years) OVF risk evaluation.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"589861"},"PeriodicalIF":3.7,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516036","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":"Efficacy of Percutaneous Vertebroplasty Assisted by a Curved Cement Delivery Guide for Osteoporotic Vertebral Compression Fractures in the Elderly.","authors":"Mi Li, Min Liang, Yang Xiang, Ao Yan, Weidong Yang, Renxin Xu, Tao Zhang","doi":"10.2147/CIA.S593025","DOIUrl":"10.2147/CIA.S593025","url":null,"abstract":"<p><strong>Objective: </strong>To explore the clinical efficacy of percutaneous vertebroplasty (PVP) assisted by a curved bone cement delivery guide for osteoporotic vertebral compression fractures (OVCFs) in the elderly.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled 96 elderly patients with OVCFs who underwent PVP. Patients were divided into three groups based on the surgical approach: the Curved Guide group (n=34), the Unilateral group (n=30), and the Bilateral group (n=32). Baseline characteristics were compared among the three groups. Surgical parameters assessed included operative time, intraoperative blood loss, and fluoroscopy frequency. Bone cement-related outcomes encompassed injection volume, distribution pattern, and leakage rate. Treatment efficacy was evaluated using VAS and ODI scores. Radiographic outcomes included vertebral height restoration and kyphotic angle correction.</p><p><strong>Results: </strong>Baseline data were comparable among the three groups (<i>P</i> > 0.05). The operation time, intraoperative blood loss, and fluoroscopy frequency in the Curved group were significantly lower than those in the Bilateral group (<i>P</i> < 0.001) and comparable to those in the Unilateral group (<i>P</i> > 0.05). The excellent and good rate of bone cement distribution, vertebral height restoration rate, and Cobb angle correction rate in the Curved group were significantly higher than those in the Unilateral group (<i>P</i> < 0.001) and did not differ significantly from those in the Bilateral group (<i>P</i> > 0.05). Postoperative improvements in VAS and ODI cores were significantly greater in the Curved group than in the Unilateral group (<i>P</i> < 0.05). The incidence of complications was comparable among the three groups (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Curved guide-assisted PVP combines the benefits of a minimally invasive unilateral puncture with effective fracture reduction and optimal bone cement distribution. This technique achieves definitive clinical efficacy in elderly patients with OVCFs and merits broader clinical application.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"593025"},"PeriodicalIF":3.7,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505421","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 Between Preoperative Activities of Daily Living and Postoperative Delirium in Elderly Patients Undergoing Non-Cardiac Surgery: A Prospective Cohort Study.","authors":"Yuting Liu, Zhuan Zhu, Xuzhou Dang, Tingwei Qu, Wenjie Zhang, Xuesen Su","doi":"10.2147/CIA.S578062","DOIUrl":"https://doi.org/10.2147/CIA.S578062","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium (POD) is a common complication in elderly surgical patients associated with adverse outcomes. However, the relationship between low preoperative Barthel Index (BI) and POD remains unclear.</p><p><strong>Purpose: </strong>This study investigated the correlation between preoperative BI and POD incidence in elderly patients undergoing non-cardiac surgery.</p><p><strong>Patients and methods: </strong>This prospective cohort study enrolled 298 patients (≥65 years) undergoing elective non-cardiac surgery under general anesthesia. Preoperative BI assessed activities of daily living (ADL) within 24 hours before surgery. POD was screened twice daily until postoperative day 7 or discharge using the 3-Minute Diagnostic Interview for Confusion Assessment Method-defined Delirium (3D-CAM). Univariate and multivariate logistic regression analyzed associations between BI and POD. Restricted cubic spline (RCS) and two-piecewise linear regression explored non-linearity and identified inflection points. Findings were validated using inverse probability of treatment weighting (IPTW), and BI's incremental predictive value was evaluated by receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>POD incidence was 25.8% (77/298). Multivariate analysis showed lower preoperative BI (OR=0.956, 95% CI: 0.940-0.973, p<0.001), lower BMI (OR=0.860, 95% CI: 0.757-0.977, p=0.020), and advanced age (OR=1.174, 95% CI: 1.102-1.250, p<0.001) independently associated with POD. RCS revealed a nonlinear relationship with inflection at BI=75. Patients with BI<75 had significantly higher POD risk than those with BI≥75 (OR=4.615, 95% CI: 2.377-8.963, p<0.001), robust after IPTW adjustment (42.9% vs 14.5%; adjusted OR=4.445, 95% CI: 2.564-7.707, p<0.001). This association was pronounced in patients with fewer comorbidities, shorter anesthesia duration, and shorter preoperative stays. Incorporating the BI score significantly improved the discrimination of the predictive model for POD.</p><p><strong>Conclusion: </strong>Preoperative ADL impairment (BI<75) independently predicts POD in elderly non-cardiac surgery patients. Preoperative BI assessment is recommended for perioperative risk stratification, identifying low-BI patients as targets for preventive interventions.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"578062"},"PeriodicalIF":3.7,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445738","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":"Hypertension as a Major Risk Factor in Alzheimer's Disease: Mechanisms, Interactions and Therapeutic Perspectives.","authors":"Enshe Jiang, Sami Ullah, Irum Waheed, Jinqian Han, Xiaoguang Zhang","doi":"10.2147/CIA.S585864","DOIUrl":"https://doi.org/10.2147/CIA.S585864","url":null,"abstract":"<p><p>Alzheimer's disease (AD) and hypertension (HTN) are closely related pathophysiological pathways that have a major impact on cognitive impairment in later life. Chronic high blood pressure exacerbates neurodegenerative processes by accelerating cerebrovascular dysfunction, impairing the clearance of amyloid-β (Aβ), promoting tau pathology and causing microvascular damage. Through mechanisms such as endothelial dysfunction, blood-brain barrier (BBB) disruption, white matter hyperintensities, cerebral microbleeds, and decreased cerebral perfusion, midlife HTN is consistently a strong predictor of late-life dementia. Neuropathological and biomarker analyses demonstrate that HTN is strongly linked to tau burden, neuronal death, and regional brain atrophy, even in the presence of continuous amyloid deposition. Experimental evidence showing that HTN enhances Aβ deposition, neuroinflammation, and small vessel disease, all of which contribute to cognitive decline, thereby supporting the vascular theory of AD. Antihypertensive medications, particularly those that target the renin-angiotensin system, have promising neuroprotective benefits and somewhat lower the prevalence of dementia. This review suggests that controlling blood pressure throughout life could significantly reduce the global incidence of dementia. In addition to being a major vascular risk factor, HTN also acts as a separate accelerator of neurodegeneration linked to AD. This highlights the need for early detection and continuous blood pressure medication as practical, scalable preventive measures.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"585864"},"PeriodicalIF":3.7,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445684","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 Shifting Prognostic Value of Performance Status in Aging Glioblastoma Patients: A Retrospective Cohort Study.","authors":"Qiushi Zhang, Lei Zhang, Haiying Liu, Lize Chen, Shiduo Li, Xiaoyan Gao, Jason H Huang, Erxi Wu, Jing Tong","doi":"10.2147/CIA.S574787","DOIUrl":"https://doi.org/10.2147/CIA.S574787","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate how advancing age affects the prognostic value of preoperative versus postoperative Karnofsky Performance Status (KPS) for guiding clinical interventions in glioblastoma (GBM) patients aged 60 and older.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included 89 patients (≥60 years) with newly diagnosed GBM treated between 2017 and 2021. We analyzed demographic, clinical, and treatment data, identifying prognostic factors for overall survival (OS) via Cox proportional hazards models. The utility of preoperative and postoperative KPS was assessed in age-stratified subgroups (60-64, 65-69, and ≥70 years) using Kaplan-Meier analysis.</p><p><strong>Results: </strong>Multivariable analysis confirmed greater extent of resection (P<0.001), higher postoperative KPS (HR: 0.981, P=0.006), and chemoradiation (P<0.001) as independent predictors of improved OS. Age-stratified analysis revealed that preoperative KPS was prognostic only in the \"young-elderly\" group (60-64 years, P=0.003), losing its predictive power in patients aged ≥65. In contrast, postoperative KPS remained a robust and consistent prognostic indicator across all elderly age groups (P≤0.001 for all).</p><p><strong>Conclusion: </strong>The prognostic utility of preoperative KPS diminishes significantly after age 65, suggesting its use as a standalone determinant for aggressive interventions should be reconsidered in the older-elderly. Postoperative KPS, however, is a powerful predictor across the aging spectrum. These clinical-only findings underscore that interventions preserving functional status are critical to improving outcomes in this aging population.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"21 ","pages":"574787"},"PeriodicalIF":3.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12970025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436741","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}