Clinical Interventions in Aging最新文献

{"title":"Association Between Premorbid Frailty Status and Functional Independence in Acute Ischemic Stroke Patients Following Endovascular Treatment in the Late Window.","authors":"Liping Huang, Chen Gong, Zhongming Qiu, Shuyu Jiang, Min Song, Zhiyuan Wang, Yankun Chen, Tao Xu, Pan Hu, Shengli Chen, Yangmei Chen, Thanh N Nguyen, Chang Liu","doi":"10.2147/CIA.S504456","DOIUrl":"https://doi.org/10.2147/CIA.S504456","url":null,"abstract":"<p><strong>Purpose: </strong>Although the predictive role of cerebral tissue impairment has been extensively investigated in acute ischemic stroke (AIS) patients undergoing endovascular treatment (EVT) in the late window, the impact of peripheral organs on clinical outcomes in these patients remains largely unknown. Therefore, we aimed to explore whether frailty, a reflection of the patient's physical status based on peripheral organ health at admission, could be associated with outcomes among AIS patients treated by EVT in the late window of 6-24 hours from stroke onset.</p><p><strong>Patients and methods: </strong>This was a post-hoc analysis of our RESCUE-BT trial, with findings validated in an external cohort. The 5-factor modified frailty index (mFI-5), a scale of five factors that could reflect premorbid physical conditions, was applied to estimate frailty status. The primary outcome was functional independence, defined as a 90-day modified Rankin Scale (mRS) score of 0-2.</p><p><strong>Results: </strong>There were 755 patients included in this study. After identifying the cut-off value of mFI-5 by the marginal effects approach, patients were divided into the frail group (mFI-5≥2) and the non-frail group (mFI-5<2). In multivariable analysis, frailty significantly reduced the likelihood of functional independence (aOR 0.37, 95% CI 0.21-0.65, P<0.001). Similar results were detected in the novel cohort constructed with propensity score matching (aOR 0.44, 95% CI 0.22-0.85, P=0.015) and in the external validation cohort (aOR 0.38, 95% CI 0.16-0.89, P=0.028). Moreover, frailty significantly improved the predictive performance of traditional predictors with an AUC of 0.77 (P=0.036 by DeLong's test).</p><p><strong>Conclusion: </strong>This study demonstrated that frailty according to the mFI-5 index was inversely associated with functional independence among AIS patients receiving EVT in the late window.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"523-535"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053534","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 a Neuroimmune Therapy Including Pineal Methoxyindoles, Angiotensin 1-7, and Endocannabinoids in Cancer, Autoimmune, and Neurodegenerative Diseases.","authors":"Paolo Lissoni, Franco Rovelli, Alejandra Monzon, Giusy Messina, Nicoletta Merli, Rosanna Tartarelli, Simonetta Tassoni, Francesca Zecchinato, Ana Cristina Simoes-E-Silva, Agnese Valentini, Giuseppe Di Fede, Daniel P Cardinali","doi":"10.2147/CIA.S513910","DOIUrl":"https://doi.org/10.2147/CIA.S513910","url":null,"abstract":"<p><strong>Purpose: </strong>Recent advancements in psycho-neuro-endocrine-immunology indicate that numerous noncommunicable diseases (NCDs) originate from disruptions in the cytokine immune network, resulting in chronic inflammatory responses. This persistent low-degree inflammation is attributed to deficiencies in crucial endogenous anti-inflammatory neuroendocrine systems, including the pineal gland, the endocannabinoid system, and the angiotensin-converting enzyme 2 / angiotensin 1-7 axis. The administration of pineal methoxyindoles (melatonin, 5-methoxytryptamine), cannabinoids, and angiotensin 1-7 may entail potential therapeutic benefits for NCDs, particularly for patients who do not respond to conventional treatments.</p><p><strong>Patients and methods: </strong>This study evaluates the safety and efficacy of a neuroimmune regimen comprising melatonin (100 mg/day at night), 5-methoxytryptamine (30 mg in the early afternoon), angiotensin 1-7 (0.5 mg twice daily), and cannabidiol (20 mg twice daily) in 306 patients with NCDs, including advanced cancer, autoimmune diseases, neurodegenerative disorders, depression, and cardiovascular disease.</p><p><strong>Results: </strong>The neuroimmune regimen successfully halted cancer progression in 68% of cancer patients, who also reported improvements in mood, sleep, and relief from anxiety, pain, and fatigue. In patients with autoimmune diseases, the treatment effectively controlled the disease process, remarkable in cases of multiple sclerosis. Additionally, positive outcomes were observed in patients with Parkinson's disease, Alzheimer's disease, and depression.</p><p><strong>Conclusion: </strong>Randomized controlled trials are required to assess this therapeutic approach for NCDs that includes endogenous neuroendocrine molecules regulating immune responses in an anti-inflammatory manner.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"513-522"},"PeriodicalIF":3.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041442","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":"D-Dimer Levels and NIHSS as Prognostic Predictors in Elderly Patients with Cerebral Infarction.","authors":"Zhong Zheng","doi":"10.2147/CIA.S502994","DOIUrl":"https://doi.org/10.2147/CIA.S502994","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the relationship between D-dimer levels and NIHSS scores with prognosis in elderly patients with cerebral infarction.</p><p><strong>Methods: </strong>This study was a retrospective study that included 112 elderly patients with cerebral infarction admitted to our hospital from January 2022 to December 2023. The modified Rankin Scale (mRS) was used to assess the prognosis at six-month follow-up, and patients were divided into two groups: good prognosis (mRS 0-2) and poor prognosis (mRS 3-6). Detailed data collection and statistical analysis were conducted, including descriptive statistics of baseline data, correlation analysis between D-dimer and NIHSS scores, and multivariate logistic regression analysis to identify independent risk factors for poor prognosis.</p><p><strong>Results: </strong>Patients in the poor prognosis group had significantly higher age, BMI, proportions of smoking history, alcohol consumption history, transient ischemic attack (TIA) history, atrial fibrillation history, admission NIHSS scores, and D-dimer levels compared to the good prognosis group (P<0.05). In addition, there were significant differences in D-dimer levels among patients with mild (NIHSS 1-4), moderate (NIHSS 5-14), and severe (NIHSS≥15) strokes (P<0.001), and D-dimer levels were significantly positively correlated with NIHSS scores (r=0.58, P<0.001). Multivariate logistic regression analysis showed that D-dimer levels, admission NIHSS scores, age, atrial fibrillation, and TIA history were independent predictors of poor prognosis (P<0.05). ROC curve analysis showed that the AUC of D-dimer in predicting poor prognosis was 0.76 (95% CI: 0.67-0.85), with a sensitivity of 72% and specificity of 74%.</p><p><strong>Conclusion: </strong>D-dimer and NIHSS showed a significant positive correlation (r=0.58, P<0.001), with an AUC of 0.76 for predicting poor prognosis. Independent risk factors included age, atrial fibrillation, and a history of TIA. These findings support the use of D-dimer as a critical biomarker in risk stratification for elderly stroke patients.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"505-511"},"PeriodicalIF":3.5,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991436","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":"Serum sST2, IL-33, and Hcy Expression in Older Adults Patients with Myocardial Infarction and Their Predictive Value for MACE.","authors":"Liu-Chang Zheng, Fang Liu, Pei-Ming Zheng, Zheng Xiao, Fa-Cai Cui","doi":"10.2147/CIA.S519437","DOIUrl":"https://doi.org/10.2147/CIA.S519437","url":null,"abstract":"<p><strong>Objective: </strong>Acute myocardial infarction (AMI) in the elderly is associated with high morbidity and mortality, with major adverse cardiovascular events (MACE) remaining a major concern despite early revascularization. This study aimed to evaluate the association of soluble suppression of tumorigenicity 2 (sST2), interleukin-33 (IL-33), and homocysteine (Hcy) with coronary stenosis severity and their predictive value for MACE in elderly AMI patients.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 143 elderly AMI patients (≥65 years) admitted between June 2022 and June 2024. Patients were divided into two groups based on MACE occurrence: Group A (no MACE, n=56) and Group B (MACE, n=87). Serum sST2, IL-33, and Hcy levels were measured using ELISA, and coronary stenosis severity was assessed using the Gensini score. Statistical analyses included Spearman correlation, multivariate logistic regression, and receiver operating characteristic (ROC) curve analysis to evaluate predictive performance.</p><p><strong>Results: </strong>Serum sST2, IL-33, and Hcy levels were significantly higher in the MACE group compared to the non-MACE group (72.37±10.68 vs 38.76±11.15, p<0.05; 60.61±10.89 vs 33.74±11.23, p<0.05; 32.76±4.15 vs 15.38±4.62, p<0.05, respectively). Biomarker levels positively correlated with coronary stenosis severity (sST2: r=0.647, p<0.05; IL-33: r=0.659, p<0.05; Hcy: r=0.582, p<0.05). Multivariate logistic regression confirmed that sST2 (OR=1.056, 95% CI: 1.015-1.094, p=0.005), IL-33 (OR=1.069, 95% CI: 1.024-2.016, p=0.001), and Hcy (OR=1.037, 95% CI: 1.008-1.077, p=0.033) were independent risk factors for MACE. ROC analysis showed that sST2, IL-33, and Hcy had AUCs of 0.841 (95% CI: 0.762-0.915, p<0.001), 0.803 (95% CI: 0.724-0.878, p<0.001), and 0.729 (95% CI: 0.642-0.812, p<0.001), respectively. Combined detection of all three biomarkers significantly improved MACE prediction (AUC=0.910, 95% CI: 0.851-0.956, p<0.001).</p><p><strong>Conclusion: </strong>Serum sST2, IL-33, and Hcy levels are positively correlated with coronary stenosis severity and independently associated with MACE in elderly AMI patients. Their combined detection significantly enhances MACE prediction, providing a potential strategy for improved risk stratification and management in this high-risk population.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"495-504"},"PeriodicalIF":3.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047885","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":"Identification of Risk Group for Root Caries and Analysis of Associated Factors in Older Adults Using Unsupervised Machine Learning Clustering.","authors":"Linxin Jiang, Shaohong Huang, Daniel R Reissmann, Gerhard Schmalz, Jianbo Li","doi":"10.2147/CIA.S520229","DOIUrl":"https://doi.org/10.2147/CIA.S520229","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify the high-risk group for root caries using unsupervised machine learning and to explore the associated factors.</p><p><strong>Patients and methods: </strong>This cross-sectional study included 423 adults aged 65 to 74 years, surveyed in 2021. Clusters representing root caries risk were identified using k-prototypes clustering, with the optimal number of clusters determined by the maximum silhouette index. The confusion matrix and alluvial diagram were used to visualize the predictive accuracy and composition of the clustering results. Binary logistic regression models further analyzed the associated factors, while ROC (receiver operating characteristic) curves and the random forest model visualized the predictive performance and the most important associated factors.</p><p><strong>Results: </strong>Two clusters were identified: cluster 1, with low root caries risk (21.5% with and 78.5% without root caries), and cluster 2, with high root caries risk (83.7% with and 16.3% without root caries). The clustering results predicted root caries with an accuracy of 0.81, sensitivity of 0.79, and specificity of 0.83. Overlapping results from binary logistic regression and the random forest model indicated that older age, more periodontal pockets, more attachment loss, female, a history of systemic diseases, presence of xerostomia, and presence of unrestored tooth loss were positively associated with cluster 2. Brushing tooth ≥2 times per day and a high level of oral health knowledge were negatively associated with cluster 2. The ROC curve for the binary logistic regression model showed an AUC (area under the curve) of 0.84.</p><p><strong>Conclusion: </strong>Individuals who are older, female, with poorer oral and systemic health status, suboptimal oral hygiene behaviors, and lower oral health knowledge levels are more likely to be identified as high-risk group. The identified factors, revealed through unsupervised machine learning, can facilitate personalized prevention and management strategies for root caries in older adults.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"483-493"},"PeriodicalIF":3.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056314","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":"Intrinsic Capacity Deficits and 6-Month Outcomes in Older Adults with Acute LRTIs: A Multi-Center Study.","authors":"Bingxuan Weng, Jin Jin, Lixue Huang, Wenshu Jiao, Mengyuan Wang, Xinyue Zhang, Xunliang Tong, Yanming Li","doi":"10.2147/CIA.S501592","DOIUrl":"10.2147/CIA.S501592","url":null,"abstract":"<p><strong>Objective: </strong>Intrinsic capacity (IC), representing an individual's physical and mental abilities, is associated with adverse outcomes. Acute lower respiratory tract infections (LRTIs) contribute to poor long-term prognosis, yet effective assessment and intervention strategies remain limited. Given the critical role of IC in the aging population, understanding its prevalence and impact in older adults with LRTIs is crucial for improving management strategies. This study aims to characterize the domains and patterns of IC deficits and assess their influence on 6-month mortality and re-hospitalization in this population.</p><p><strong>Methods: </strong>This was a multi-center prospective cohort study conducted in China. Patients aged over 65 years hospitalized for acute LRTIs were consecutively enrolled and underwent IC evaluations upon admission between April 15, 2021, and January 15, 2023. Outcomes included 6-month mortality and re-hospitalization. Latent class analysis identified patterns of IC deficits, and multivariable logistic regression models assessed associations between IC deficit domains/patterns and adverse outcomes.</p><p><strong>Results: </strong>A total of 1,001 older patients were included, with a mean age of 76 years (IQR: 69-84). Most of (839, 83.8%) the patients had at least one IC domain deficit. The 6-month re-hospitalization and mortality rates were 20.7% (190/933) and 7.7% (70/914). More domains of IC deficits, particularly in cognition (OR 1.873) and vitality (OR 1.737) deficits were associated with increased 6-month re-hospitalization rates. Three distinct IC deficit patterns were identified: relatively robust (73.5%), limited vitality and locomotion (18.6%), and impaired cognition, vision, and hearing group (7.9%). Compared to the relatively robust group, the limited vitality and locomotion group had a significantly higher risk of re-hospitalization (OR 2.025, 95% CI 1.388-2.932).</p><p><strong>Conclusion: </strong>IC deficits were prevalent and associated with increased re-hospitalization in older adults with LRTIs. Early detection and targeted interventions may reduce re-hospitalization rates and improve patient outcomes.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"471-482"},"PeriodicalIF":3.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Cognitive Decline in Aging: Mechanisms and Mitigation Strategies - A Narrative Review.","authors":"Zbigniew Jost, Sylwester Kujach","doi":"10.2147/CIA.S510670","DOIUrl":"https://doi.org/10.2147/CIA.S510670","url":null,"abstract":"<p><p>Cognitive decline is a natural process that accompanies aging. In some cases, such as in sarcopenia-burdened or diseased older adults, the disease course may be more rapid. Declining cognitive function is associated with changes in the central nervous system per se or peripheral triggers that impair cognition. This review discusses issues related to central, central-peripheral, and peripheral factors that enhance cognitive deterioration, such as cortical thickness, cerebral white matter structure and function, blood-brain barrier (BBB) disruption, insulin resistance, inflammation, and vascular dysfunction. BBB permeability appears to be a critical point for factors associated with aging that may accelerate cognitive decline. Thus, we provide an in-depth analysis of the central-peripheral crosstalk. Additionally, we discuss high-intensity interval training (HIIT) as a promising strategy to counteract changes that accompany the aging process. Resistance (RHIIT) and aerobic (AHIIT) may be beneficial for cognitive health among the elderly, but their lack of empirical confirmation is a huge gap in the research.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"459-469"},"PeriodicalIF":3.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035445","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":"Evaluation of the Diagnosis Accuracy of the AWGS 2019 Criteria for \"Possible Sarcopenia\" in Thai Community-Dwelling Older Adults.","authors":"Nath Adulkasem, Ekasame Vanitcharoenkul, Pojchong Chotiyarnwong, Apichat Asavamongkolkul, Aasis Unnanuntana","doi":"10.2147/CIA.S513657","DOIUrl":"https://doi.org/10.2147/CIA.S513657","url":null,"abstract":"<p><strong>Background: </strong>The term \"possible sarcopenia\" was introduced in the Asian Working Group for Sarcopenia (AWGS) 2019 guidelines to characterize individuals at high risk for sarcopenia in primary care settings. However, studies that support the diagnostic accuracy of this criteria remain scarce. Accordingly, the primary aim of this study was to assess the diagnostic accuracy of the AWGS 2019 \"possible sarcopenia\" criteria for detecting sarcopenia in Thai community-dwelling older adults. Our secondary aim was to explore the use of adjunct variables to improve the diagnostic accuracy of the \"possible sarcopenia\" criteria for detecting sarcopenia.</p><p><strong>Methods: </strong>This study is a secondary analysis of an epidemiological investigation of the prevalence of sarcopenia among Thai older adults that was conducted during 2021-2022. We assessed the performance of the \"possible sarcopenia\" criteria against sarcopenia diagnoses based on the AWGS 2019 guidelines. In an attempt to improve the diagnostic performance of the AWGS 2019 criteria, we combined the AWGS 2019 criteria with age, sex, height, body weight, or BMI to create modified criteria. The variable that influenced the highest area under the receiver operating characteristic curve (AUC) was incorporated in the modified AWGS 2019 criteria.</p><p><strong>Results: </strong>A total of 2456 participants (mean age 69.0 ± 6.1 years, 63.6% female) were included. Of these, 445 (18.1%) patients were diagnosed with sarcopenia. The \"possible sarcopenia\" criteria showed a sensitivity of 94.6%, a specificity of 54.0%, and an AUC of 74% for detecting sarcopenia. Incorporating BMI improved the AUC by 17%. A BMI cutoff value <24 kg/m² was shown to increase specificity to 72.7%, while maintaining sensitivity at 89.9%.</p><p><strong>Conclusion: </strong>The AWGS 2019 criteria for \"possible sarcopenia\" showed excellent sensitivity in detecting sarcopenia but lacked sufficient specificity. The modified AWGS \"possible sarcopenia\" criteria, which includes a BMI cutoff of <24 kg/m², increased the specificity for detecting sarcopenia while preserving high sensitivity among Thai community-dwelling older adults.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"425-433"},"PeriodicalIF":3.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042354","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":"Molecular and Cellular Mechanisms Linking Chronic Kidney Disease and Sarcopenia in Aging: An Integrated Perspective.","authors":"Jing Chang, Yuer Liang, Pingping Sun, Xiangyang Fang, Qianmei Sun","doi":"10.2147/CIA.S516704","DOIUrl":"https://doi.org/10.2147/CIA.S516704","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) and sarcopenia are prevalent conditions among the aging population, contributing significantly to morbidity and mortality. CKD exacerbates sarcopenia through complex molecular and cellular mechanisms, including chronic inflammation, oxidative stress, uremic toxin accumulation, protein-energy wasting, and hormonal dysregulation. This review explores the interplay between CKD and sarcopenia, focusing on key pathways such as mTOR signaling, the AMPK-FOXO axis, and myostatin/activin pathways that regulate muscle protein metabolism. Additionally, mitochondrial dysfunction and impaired autophagy emerge as critical contributors to muscle wasting. Clinical implications include identifying biomarkers such as interleukin-6, tumor necrosis factor-alpha, myostatin, and Klotho for diagnosis and monitoring, while potential therapeutic strategies involve targeting the AMPK/mTOR pathway, enhancing mitochondrial function, and inhibiting myostatin activity. Emerging approaches, including multi-omics technologies and AI-driven personalized treatment models, offer innovative solutions for understanding and managing the CKD-sarcopenia axis. This review underscores the need for integrated therapeutic strategies and multidisciplinary collaboration to mitigate muscle wasting and improve outcomes in CKD patients. By bridging molecular insights with clinical applications, this work aims to inform future research and translational efforts in addressing this critical healthcare challenge.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"449-458"},"PeriodicalIF":3.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Inflammation Markers for Frailty in Older Patients with CVD.","authors":"Suiyuan Hu, Xuan Lai, Yanyan Shi, Haodi Chai, Zhijun Guo, Dongyang Liu, Cheng Cui","doi":"10.2147/CIA.S502617","DOIUrl":"https://doi.org/10.2147/CIA.S502617","url":null,"abstract":"<p><strong>Background: </strong>Chronic inflammation plays a pivotal role in the development of frailty in patients with cardiovascular diseases (CVD). Systemic inflammatory response index (SIRI) has been shown to reflect the overall inflammatory status. This study aimed to investigate the relationship between SIRI and frailty in older patients with CVD, and to develop a nomogram for predicting the risk of frailty in this population.</p><p><strong>Methods: </strong>A total of 234 older patients with CVD were included. Inflammation markers were derived from routine blood tests, and frailty status was assessed using the FRAIL scale. Clinical and laboratory characteristics were compared between patients with or without frailty. Multivariate logistic regression was employed to identify significant variables for inclusion in the nomogram. The performance of the nomogram, including its discrimination and calibration, was rigorously evaluated.</p><p><strong>Results: </strong>A total of 98 cases were assigned to the frailty group and 136 to the non-frailty group. Patients in the non-frailty group were generally younger, more likely to have normal kidney function, and better blood pressure control. Frail patients exhibited a higher degree of systemic inflammation compared to non-frail patients (P < 0.05). Age, LDL-C and SIRI were identified as three independent risk factors with significant potential for predicting frailty in CVD patients. Therefore, we constructed a clinical nomogram model for frailty based on age, LDL-C and SIRI. The nomogram for frailty had considerable discriminative and calibrating abilities.</p><p><strong>Conclusion: </strong>In summary, our study demonstrated a significant association between elevated levels of inflammation markers, particularly SIRI, and an increased risk of frailty. Furthermore, by integrating age, LDL-C and SIRI, we established a nomogram to predict the risk of frailty in older patients with CVD.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"435-447"},"PeriodicalIF":3.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991641","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}