Clinical Interventions in Aging最新文献

{"title":"Effects of Remimazolam on Intraoperative Frontal Alpha Band Power Spectrum Density and Postoperative Cognitive Function in Older Adults Undergoing Lower Extremity Fractures Surgeries: A Randomized Controlled Trial.","authors":"Hao Wu, Shunping Tian, Hongxia Ma, Wei Zhou, Shantian Feng, Lijun Meng, Jinlei Ou, Fei Xu, Zhuan Zhang","doi":"10.2147/CIA.S496437","DOIUrl":"https://doi.org/10.2147/CIA.S496437","url":null,"abstract":"<p><strong>Purpose: </strong>Low density of electroencephalogram alpha band power was reported to be associated with perioperative cognitive dysfunction. Few studies have conducted to explore the effects of remimazolam on intraoperative frontal alpha band power spectrum density in older adults. Here, we aimed to explore the impact of remimazolam on intraoperative frontal brain wave alpha band activity and postoperative cognitive function in older adults undergoing lower extremity fractures surgeries.</p><p><strong>Methods: </strong>Patients undergoing elective general anesthesia for lower extremity fracture surgery were randomly allocated to remimazolam group (Group R) and midazolam group (Group M). Group R was induced with remimazolam bolus 0.1 mg/kg followed by a maintenance dose of 0.1 mg·kg^-1·h^-1 for general anesthesia. Group M was induced with midazolam 0.05 mg/kg followed by normal saline maintenance of 0.1 mL·kg^-1·h^-1. The rest anesthesia protocol was the same for both groups. Electroencephalogram data was recorded before anesthesia induction till the end of surgery. Cognitive function was assessed preoperatively, and at the first, third, fifth, and seventh day postoperatively.</p><p><strong>Results: </strong>Compared with Group M, Group R had significantly higher intraoperative power spectral density of the frontal alpha band (<i>P</i> < 0.001), and significantly lower incidence of postoperative cognitive dysfunction at T₈ and T₉ (P = 0.031 and P = 0.017, respectively).</p><p><strong>Conclusion: </strong>Remimazolam can increase frontal brain wave alpha band power spectrum density and improve postoperative cognitive function in older adults undergoing lower extremity fractures surgeries.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"2195-2205"},"PeriodicalIF":3.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957246","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":"Sensitivity and Specificity of Three Measures of Intrinsic Capacity in Older People Aged 80 and Over in Nursing Homes.","authors":"Linlin Ma, Enjie Zheng, Yi Fang, Huixian Chen, Chuncong Zhou, Shuya Cai, Fen Luo, Wen Jiang, Jialu Wang, Xiangxiang Ning, Haixia Tu, Zhiqin Yin","doi":"10.2147/CIA.S486663","DOIUrl":"https://doi.org/10.2147/CIA.S486663","url":null,"abstract":"<p><strong>Purpose: </strong>Intrinsic capacity (IC), a crucial indicator for the United Nations Decade of Healthy Ageing 2021-2030, is defined by WHO as the foundation of functional ability, representing the composite of all physical and mental capacities of an individual. IC spans five function domains: Locomotor, psychological, cognitive, vitality, and sensory (including vision and hearing). Accurate IC assessment is vital for effective interventions, yet comparative analyses of these tools are scarce. Consequently, we evaluated the diagnostic accuracy of three IC assessment tools in individuals aged 80 and above-Integrated care for older people (ICOPE) Step 1, ICOPE Step 2, and the Lopez-Ortiz's IC scoring system.</p><p><strong>Patients and methods: </strong>This cross-sectional analysis included a total of 475 participants aged ≥80 years between July 2023 and January 2024 in 11 nursing homes in Ningbo, Zhejiang Province, China. To assess that included sociodemographic and health-related information alongside the three IC tools. Diagnostic efficacy was gauged using sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), accuracy, Youden index, and the area under the curve (AUC).</p><p><strong>Results: </strong>The detection of IC decline exceeded 85% across all methods. Using ICOPE Step 2 as a benchmark, ICOPE Step 1 showed robust performance across four domains of locomotion, psychological, cognitive, and vitality, whereas the Lopez-Ortiz's IC scoring system was generally ineffective.</p><p><strong>Conclusion: </strong>All three IC assessment methods have limitations. To save resources, ICOPE Step 1 can be considered for direct assessment in non-sensory domains. Conversely, the ICOPE Step 2 and Lopez-Ortiz's IC scoring systems exhibited overly stringent and lenient thresholds, respectively. At this stage, IC assessment tools cannot balance subjectivity and objectivity; thus, it is recommended that the appropriate tool be selected according to actual application scenarios. Continuous improvement of IC assessment tools remains a requirement for future studies.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"2179-2194"},"PeriodicalIF":3.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933225","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":"Enhancing the Predictive Utility of MHR for Senile Osteoporosis: Unaddressed Considerations and Future Directions [Response to Letter].","authors":"Dang Li, Nan Lin","doi":"10.2147/CIA.S510489","DOIUrl":"10.2147/CIA.S510489","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"2165-2166"},"PeriodicalIF":3.5,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923443","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 Cognitive Frailty and Depression: A Prospective Cohort Study of Adults Aged 45 Years and Older in China.","authors":"Jiang Wang, Aizhang Zhu, Jie Chen, Rui Zeng, Siyi Wang, Lihuan Chen, Ying Chen, Qianqian Min, Wei Li, Dongmei Ye, Ruohan Wu, Fayi Xie, Tenghui Fan, Ke Zhu, Wan Zhu, Hongmei Hu, Conghua Wang, Xiaoming Zhang","doi":"10.2147/CIA.S484352","DOIUrl":"10.2147/CIA.S484352","url":null,"abstract":"<p><strong>Background: </strong>The interplay between cognitive frailty and depression remains inadequately understood, with a paucity of evidence from prospective cohort studies. Our study aims to elucidate the relationship between cognitive frailty and the risk of incident depression.</p><p><strong>Methods: </strong>Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011, 2013, and 2015, subjects were classified according to cognitive frailty criteria established by an international consensus panel. Multiple logistic regression models were employed to examine the cross-sectional and longitudinal associations between frailty, cognitive impairment, cognitive frailty, and depression. Subgroup analyses and interaction tests were conducted to identify potential effect modifiers.</p><p><strong>Results: </strong>In 2011, the study encompassed 4514 participants, with 2330 individuals followed up through 2015. Cross-sectional analyses revealed that participants classified in frailty, cognitive impairment, and cognitive frailty exhibited multivariable-adjusted odds ratios (ORs) for depression of 1.87 (95% CI 1.60-2.18; P < 0.001), 1.97 (95% CI 1.58-2.47; P < 0.001), and 3.38 (95% CI 2.66-4.29; P < 0.001), respectively, compared to no diseased group. Longitudinal analyses from 2011 to 2015 indicated that participants in frailty, cognitive impairment, and cognitive frailty had multivariable-adjusted ORs of 1.28 (95% CI 1.05-1.58; P = 0.0165), 1.39 (95% CI 1.01-1.91; P = 0.0411), and 1.57 (95% CI 1.05-2.35; P = 0.0273), respectively, for new-onset depression relative to no diseased group.</p><p><strong>Limitations: </strong>The definition of depression relied solely on self-reported data.</p><p><strong>Conclusion: </strong>In the middle-aged and elderly Chinese population, patients with cognitive frailty have a higher risk of depression than those with only frailty and cognitive impairment. This may suggest that health care providers should pay more attention to the mental health of those patients with cognitive frailty.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"2167-2178"},"PeriodicalIF":3.5,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923502","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 Commentary on \"A Comparison Between Two Different Definitions of Contrast-Associated Acute Kidney Injury for Long-Term Mortality in Patients with Chronic Kidney Disease Undergoing Coronary Angiography\" [Letter].","authors":"Jiawei Xu, Lu Ye","doi":"10.2147/CIA.S510094","DOIUrl":"10.2147/CIA.S510094","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"2163-2164"},"PeriodicalIF":3.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883269","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":"Addressing Limitations and Future Directions in Assessing Risk Factors for Pulmonary Complications after Femur Fracture Surgery in Elderly Patients [Response to Letter].","authors":"Jina Chai, Jiyeon Kang, Woo Jung Seo, Hyung Koo Kang, Hyeon-Kyung Koo, Hyoung-Keun Oh, Suk Kyu Choo, Jieun Kang","doi":"10.2147/CIA.S510335","DOIUrl":"10.2147/CIA.S510335","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"2157-2158"},"PeriodicalIF":3.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883282","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":"Reflections on the Clinical Implications of Glial Fibrillary Acidic Protein and Neuroglobin in Ischemic Stroke [Response to Letter].","authors":"Hanna Pawluk, Renata Kołodziejska, Grzegorz Grześk, Mariusz Kozakiewicz, Agnieszka Kosinska, Mateusz Pawluk, Elżbieta Grzechowiak, Jakub Wojtasik, Grzegorz Kozera","doi":"10.2147/CIA.S506719","DOIUrl":"10.2147/CIA.S506719","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"2161-2162"},"PeriodicalIF":3.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883188","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":"Assessing the Role of VISTA in Vascular Cognitive Impairment: Addressing Limitations and Exploring Future Research Directions [Letter].","authors":"Lingtian Weng, Xuhong Jiang","doi":"10.2147/CIA.S511127","DOIUrl":"10.2147/CIA.S511127","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"2159-2160"},"PeriodicalIF":3.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878554","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":"Characteristics of Mortality After Endovascular Thrombectomy in Patients with Acute Ischemic Stroke.","authors":"Jian Wang, Qian Liu, Fayun Hu, Hongbo Zheng, Xin Jiang, Lizhang Chen, Muke Zhou, Jian Guo, Hong Chen, Fuqiang Guo, Yufeng Tang, Jinglun Li, Dong Zhou, Li He","doi":"10.2147/CIA.S496733","DOIUrl":"10.2147/CIA.S496733","url":null,"abstract":"<p><strong>Purpose: </strong>Despite significant advancements in the treatment of acute ischemic stroke (AIS) with endovascular thrombectomy (EVT), post-EVT mortality remains a considerable concern. However, there is a lack of real-world epidemiological data delineating the characteristics of mortality for EVT, particularly in recent years following the widespread promotion of EVT treatment for stroke patients.</p><p><strong>Methods: </strong>This multicenter, retrospective study collected data from 721 AIS patients who died following EVT across 33 hospitals in Sichuan Province, China, from January 2019 to September 2022. The analysis sought to identify the primary causes of death within 30 days post-EVT and explore their related clinical features.</p><p><strong>Results: </strong>The leading causes of death were malignant cerebral edema (MCE) in 365 patients (50.6%), pneumonia in 180 patients (25%), and symptomatic intracranial hemorrhage (sICH) in 94 patients (13%). MCE was the predominant cause of death in anterior circulation strokes, while pneumonia prevailed in posterior circulation strokes. MCE was also the primary cause of death within one week post-EVT, but pneumonia became increasingly dominant over time. Large vessel occlusion and lower reperfusion success rate were significantly correlated with MCE. Advanced age increases the risk of death from pneumonia. Tandem occlusion and procedural complications tend to correlate with mortality from sICH.</p><p><strong>Conclusion: </strong>This study revealed that the principal causes of death after EVT included MCE, sICH, and pneumonia. MCE was found to be correlated with unsuccessful reperfusion. sICH was associated with procedural complications and the operators' experience. Pneumonia was linked to post-EVT management, particularly for those who survived for one week.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"2145-2155"},"PeriodicalIF":3.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878576","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":"Comparing Cognitive Recovery of Remimazolam versus Propofol in Elderly Patients Undergoing Colonoscopy: A Randomized Controlled Trial.","authors":"Shuying Lin, Ying Wei, Yifen Zhuo, Shiqin Que, Xuepeng Jin, Yusheng Yao, Bin Qian","doi":"10.2147/CIA.S490330","DOIUrl":"10.2147/CIA.S490330","url":null,"abstract":"<p><strong>Background: </strong>Remimazolam, a novel ultra-short-acting benzodiazepine, shows promise for procedural sedation. This study compared the cognitive recovery of remimazolam versus propofol in elderly patients undergoing colonoscopy.</p><p><strong>Patients and methods: </strong>In this prospective, randomized, double-blind, controlled trial, 228 patients aged ≥ 65 years undergoing outpatient colonoscopies were recruited. Patients received intravenous sufentanil 0.05 μg/kg, followed by either remimazolam 0.2 mg/kg or propofol 1 mg/kg for sedation induction. The assigned study drug (remimazolam 0.1 mg/kg or propofol 0.5 mg/kg) was titrated to maintain a Modified Observer's Assessment of Alertness/Sedation scale score < 3 during the procedure. The primary outcome was the incidence of cognitive recovery, assessed using the Postoperative Quality of Recovery Scale (PostopQRS) cognitive domain on postoperative day 3. Secondary outcomes included overall and other PostopQRS domains recovery, time to discharge, patient satisfaction, and adverse events.</p><p><strong>Results: </strong>Cognitive recovery on day 3 was similar between remimazolam (84.2%) and propofol (85.1%) groups (risk ratio = 0.99; 95% CI: 0.89-1.11; p = 0.854). No significant differences were observed in overall recovery, other domains, or discharge time. Remimazolam patients reported higher satisfaction (p = 0.001) and experienced lower incidences of hypotension (21.9% vs 53.5%; p < 0.001), hypoxemia (6.1% vs 16.7%; p = 0.024), and injection site pain (15.8% vs 41.2%; p < 0.001) compared to propofol.</p><p><strong>Conclusion: </strong>In elderly patients undergoing colonoscopy, remimazolam demonstrated comparable cognitive recovery to propofol, with higher patient satisfaction and a more favorable safety profile. Remimazolam may be the preferred alternative to propofol for procedural sedation in this vulnerable population.</p><p><strong>Trial registration: </strong>The Chinese Clinical Trial Registry, ChiCTR2200066689.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"2133-2143"},"PeriodicalIF":3.5,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878589","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}