Clinical Interventions in Aging最新文献

{"title":"One-Year Risk Prediction of Elevated Serum Uric Acid Levels in Older Adults: A Longitudinal Cohort Study.","authors":"Dexian Zhang, Xinxin Xu, Zhibin Ye, Zhenxing Zhang, Jing Xiao","doi":"10.2147/CIA.S476806","DOIUrl":"10.2147/CIA.S476806","url":null,"abstract":"<p><strong>Objective: </strong>To develop and externally validate a nomogram to predict elevated serum uric acid (SUA) levels in older adults.</p><p><strong>Study design: </strong>This is a longitudinal Chinese cohort study.</p><p><strong>Methods: </strong>A cohort of 2788 older adults was established at Huadong Hospital, followed-up for at least one year, and screened for risk factors for elevated SUA levels. A logistic regression model was built to predict elevated SUA, and its performance was validated.</p><p><strong>Results: </strong>The risk prediction model showed good discrimination ability in both the development cohort (area under the curve (AUC) = 0.82; 95% confidence interval (CI) =0.79~0.86) and the external validation cohort (AUC=0.76; 95% CI=0.70~0.82). The model was adequately calibrated, and the predictions correlated with the observed outcome (<i>χ</i> ² = 6.36, <i>P</i> = 0.607). Men were more prone to elevated SUA levels than women were, and a baseline SUA level ≥360 μmol/L was a common risk factor for both males and females. Proteinuria status was an additional risk factor for males, whereas a baseline estimated glomerular filtration rate (eGFR)<60 mL/min·1.73 m² and diabetes status were additional risk factors for females.</p><p><strong>Conclusion: </strong>The externally validated nomogram, which is predictive of elevated SUA in older adults, might aid in the detection of individual diseases, the development of preventive interventions and clinical decision-making.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1951-1964"},"PeriodicalIF":3.5,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741047","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 VISTA and Vascular Cognitive Impairment in Older Chinese Adults: A Cross-Sectional Study.","authors":"Dan Liu, Li-Jun Chi","doi":"10.2147/CIA.S474209","DOIUrl":"10.2147/CIA.S474209","url":null,"abstract":"<p><strong>Purpose: </strong>Vascular cognitive impairment(VCI) ranks as the second most prevalent type of dementia.Increasing evidence has shown that inflammation and multi-faceted neuro-immune interactions integrate systemic and central inflammatory pathways, thereby inducing vascular tissue injury and contributing to the development of vascular cognitive impairment (VCI).V-type immunoglobulin-like suppressor of T cell activation (VISTA) is an Negative checkpoint regulators(NCR) that is associated with CNS homeostasis, interactions with peripheral immunity and CNS inflammation.The primary objective of this study was to seek the correlation between VISTA and VCI in patients with cardiovascular risk factors.Our secondary objective was to explore the potential of VISTA as a biomarker for VCI.</p><p><strong>Patients and methods: </strong>We enrolled individuals with cardiovascular risk factors in this cross-sectional study research and categorized them into two groups: without cognitive impairment (control) and with cognitive impairment (VCI). VISTA expression in peripheral blood mononuclear cells (PBMCs) was analyzed using relative quantitative polymerase chain reaction. VISTA expression was identified in monocyte subsets using flow cytometry. We use Enzyme linked immunosorbent assay to detect inflammatory factors in serum.</p><p><strong>Results: </strong>In PBMC in patients with VCI, the expression of VSIR was significantly reduced. In contrast to controls, fasting glucose, fibrosis, and the levels of interleukin 6 (IL-6) in VCI patients were noticeably higher, and uric acid levels were significantly lower. Vsir mRNA expression in PBMCs correlated negatively with IL-6 levels, Trail Making Test B scores, and Hachinski scores and positively with Boston Naming Test scores. In intermediate monocytes, flow cytometry showed reduced Vsir expression, which was connected with VCI. The percentage of intermediate monocytes, uric acid, and the VISTA mean fluorescence intensity on intermediate monocytes were shown to be independent factors to VCI by multivariate logistic regression analysis.</p><p><strong>Conclusion: </strong>Decreased VISTA promotes the occurrence of VCI in patients with cardiovascular risk factors by promoting monocytes toward the proinflammatory intermediate monocyte subset. VISTA may serve as a potential biomarker for distinguishing VCI in individuals with cardiovascular risk factors.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1939-1949"},"PeriodicalIF":3.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733658","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":"Postinduction Hypotension and Adverse Outcomes in Older Adults Undergoing Transcatheter Aortic Valve Replacement: A Retrospective Cohort Study.","authors":"Ting-Ting Ni, Yuan-Yuan Yao, Xiao-Xia Zhou, Tao Lv, Jing-Cheng Zou, Ge Luo, Jin-Ting Yang, Da-Wei Sun, Qi Gao, Ting-Ting Wang, Rui-Yu Wang, Xin-Chen Tao, Min Yan","doi":"10.2147/CIA.S487629","DOIUrl":"10.2147/CIA.S487629","url":null,"abstract":"<p><strong>Purpose: </strong>Postinduction hypotension (PIH), occurring between anaesthesia induction and surgical incision, is particularly concerning in older adults undergoing transcatheter aortic valve replacement (TAVR) due to their multiple comorbidities and age-related cardiovascular changes. This study aimed to assess the relationship between PIH and postoperative adverse events in TAVR patients.</p><p><strong>Patients and methods: </strong>A total of 777 patients underwent TAVR at The Second Affiliated Hospital of Zhejiang University School of Medicine from January 1, 2020 to February 28, 2023. Four thresholds of MAP were defined, including two absolute thresholds (<65, <60 mmHg) and two relative thresholds (20% and 30% lower than baseline). The relationships between PIH and the composite outcome, which included all-cause in-hospital mortality, stroke, acute kidney injury (AKI), and myocardial infarction (MI), were examined using unadjusted analysis, 1:1 propensity score matching(PSM), and inverse probability of treatment weighting (IPTW).</p><p><strong>Results: </strong>A total of 643 older adults were included in the study ultimately. The composite outcome incidence was significantly greater in patients with PIH than in those without PIH (relative risk [RR]: 2.47, 95% CI: 1.66-3.73 for MAP <60 mmHg; RR: 1.66, 95% CI: 1.14-2.46 for a >30% decrease from baseline). PIH was significantly associated with stroke (RR: 5.22, 95% CI: 1.98-17.75) and AKI (RR: 2.82, 95% CI: 1.73-4.79) with a MAP <60 mmHg.</p><p><strong>Conclusion: </strong>PIH significantly increases the risk of composite outcomes, especially stroke and AKI, in TAVR patients.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1919-1938"},"PeriodicalIF":3.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717571","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":"Values of H-Type Hypertension in Patients with Large Vessel Occlusion.","authors":"Dongjing Xie, Junfang Wan, Changwei Guo, Jie Yang, Jiacheng Huang, Zhouzhou Peng, Jiandi Huang, Linyu Li, Shitao Fan, Dahong Yang, Wenzhe Sun, Wenjie Zi, Fengli Li, Feng Peng, Jinrong Hu, Qingwu Yang","doi":"10.2147/CIA.S488000","DOIUrl":"10.2147/CIA.S488000","url":null,"abstract":"<p><strong>Background and purpose: </strong>Many patients who gained successful recanalization by endovascular treatment (EVT) with acute large vessel occlusion (LVO) did not have the favorable outcome. The study aimed to assess the association between H-type hypertension and clinical prognosis in patients with LVO after receiving EVT.</p><p><strong>Methods: </strong>Our study enrolled patients from the Endovascular Treatment With versus Without Tirofiban for Stroke Patients with Large Vessel Occlusion (RESCUE BT) Trial. H-type hypertension is defined as patients with hypertension and homocysteine (Hcy) ≥10µmol/L. The primary outcome was a favorable functional outcome, defined as a score of 0-2 on the modified Rankin Scale (mRS) at 90 days. The secondary outcomes were mortality, successful recanalization, futile recanalization, and symptomatic intracerebral hemorrhage (sICH).</p><p><strong>Results: </strong>The plasma homocysteine level was recorded for 215 patients with hypertension in our study. Among those patients, 172 patients (80%) were founded with Hcy ≥10µmol/L (H-type hypertension), and 43 patients (20%) with Hcy <10µmol/L (non-H-type hypertension). The probability of favorable outcome decreased with homocysteine increasing in patients with hypertension. H-type hypertension was associated with a low probability of favorable outcome (adjusted odds ratio (aOR), 0.38 [95% confidence interval (CI), 0.18-0.80]; <i>p</i> = 0.01) at 90 days. The effects of H-type hypertension on mortality (aOR, 1.90 [95% CI, 0.67-5.39]; <i>p</i> = 0.23) and sICH (aOR, 0.55 [95% CI, 0.13-2.29]; <i>p</i> = 0.41) were not significant.</p><p><strong>Conclusion: </strong>Our findings suggest that patients with H-type hypertension have a lower likelihood of achieving favorable outcomes but do not have an increased mortality rate within 90 days.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1907-1917"},"PeriodicalIF":3.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716644","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":"Blood Pressure Control for Patients with Middle Cerebral Artery Severe Stenosis or Occlusion.","authors":"Zheng Li, Guang-Xin Duan, Jia-Hui Zhang, Yun Xu, Yun Luo","doi":"10.2147/CIA.S477281","DOIUrl":"10.2147/CIA.S477281","url":null,"abstract":"<p><strong>Background: </strong>Chronic hypertension is an independent risk factor for ischemic stroke and worsens prognosis. However, the level of blood pressure control in hypertensive patients with severe intracranial stenosis is controversial.</p><p><strong>Purpose: </strong>To investigate the effect of different levels of blood pressure on cerebral perfusion in patients with middle cerebral artery severe stenosis or occlusion.</p><p><strong>Materials and methods: </strong>A total of 105 patients with isolated steno-occlusive middle cerebral artery (MCA) diagnosed by digital subtraction angiography (DSA) were enrolled, and PWI was compulsory. Relative risk factors were obtained by intergroup analysis in both hypertensive and non-hypertensive groups, and multivariable logistic regression was performed to determine whether hypertension was independently associated with PWI values. Next, the effects of different levels of blood pressure levels on cerebral perfusion as a whole and subgroup were further compared.</p><p><strong>Results: </strong>The hypertension (HT) group (Am 1.04±0.05, Lm 1.07±0.06, Pm 1.07±0.05) demonstrated lower cerebral perfusion pressure at a larger rMTT (p=0.0001, 0.004, 0.006) than the nonhypertension (NHT) group (Am 1.01±0.21, Lm 1.04±0.04, Pm 1.04±0.04). After adjustment for age, diabetes, and fibrinogen (FIB), HT was independently associated with the rMTT of Am, Lm, and Pm (P=0.015, 0.001, 0.022). Significant differences were observed with HT+SBP<140 (p=0.035, 0.048, 0.049) and HT+DBP<80 (p=0.034, 0.045, 0.055) in rMTT compared with NHT.</p><p><strong>Conclusion: </strong>Chronic hypertension might damage cerebral perfusion. Strictly control of blood pressure (<140/80mmHg) in hypertensive patients with intracranial artery stenosis will further reduce ipsilateral cerebral perfusion.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1897-1905"},"PeriodicalIF":3.5,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711594","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":"Beware of Hip Fractures in the Elderly [Response to Letter].","authors":"Cristina Bermejo Boixareu, Cristina Ojeda-Thies, Ainhoa Guijarro Valtueña, Bernardo Abel Cedeño Veloz, María Gonzalo Lázaro, Laura Navarro Castellanos, Rocío Queipo Matas, Paloma Gómez Campelo, Ana Royuela Vicente, Juan Ignacio González-Montalvo, Pilar Sáez-López","doi":"10.2147/CIA.S501059","DOIUrl":"10.2147/CIA.S501059","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1895-1896"},"PeriodicalIF":3.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683166","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 [Letter].","authors":"Jijun Cao, Wen Zhang","doi":"10.2147/CIA.S498371","DOIUrl":"10.2147/CIA.S498371","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1893-1894"},"PeriodicalIF":3.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648711","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 Understanding of Acute Ischemic Stroke Research in the Elderly: A Discussion on the Importance of Inflammatory Markers [Letter].","authors":"Zhongqiu Tang, Mengjun Zeng, Zhaohui Tang","doi":"10.2147/CIA.S501971","DOIUrl":"10.2147/CIA.S501971","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1891-1892"},"PeriodicalIF":3.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648695","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":"Development and Validation of Virtual Reality Cognitive Training for Older Adults with Mild Cognitive Impairment: Protocol for a Mixed-Methods Program Evaluation Study.","authors":"I-Chen Chen, Ching-Yi Wu, Yi-Ling Hu, Yen-Ming Huang","doi":"10.2147/CIA.S471547","DOIUrl":"10.2147/CIA.S471547","url":null,"abstract":"<p><strong>Introduction: </strong>As research on cognitive training methods for older adults with mild cognitive impairment (MCI) progresses, fully immersive virtual reality cognitive training (fi-VRCT) has shown promise in enhancing cognitive function. However, its effectiveness in improving instrumental activities of daily living (IADL) and fostering independence is still unclear. This study aims to address these uncertainties by developing and validating a fi-VRCT program focused on IADL, with the goal of enhancing both cognitive function and IADL performance in older adults with MCI.</p><p><strong>Methods and analysis: </strong>This mixed methods program evaluation study consists of three phases: feasibility, intervention, and extension. In the feasibility phase, we will implement fi-VRCT in real-world community settings and invite 20 older adults with MCI to participate in a single training session. Participants will provide feedback through questionnaires and individual interviews. The intervention phase will involve a double-blind, cluster-randomized controlled trial with 52 older adults with MCI, who will be randomly assigned to either the fi-VRCT or control groups. Both groups will complete 16 sessions over eight weeks, with cognitive and functional performance assessed at various intervals. During the extension phase, feedback will be gathered from 26 participants who underwent fi-VRCT through focus group interviews and ongoing questionnaires. Quantitative and qualitative findings will be synthesized to refine the fi-VRCT program and elucidate training outcomes. Ultimately, fi-VRCT has the potential to enhance cognitive and functional abilities in older adults with MCI in community settings.</p><p><strong>Ethics and dissemination: </strong>Ethical approval has been obtained from the Research Ethics Committee at National Taiwan Normal University (202312EM009). The research findings will be disseminated through reputable, peer-reviewed journals and professional international conferences to engage and inform academic and clinical audiences.</p><p><strong>Trial registration: </strong>NCT06392412.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1855-1865"},"PeriodicalIF":3.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630848","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 Scalp Nerve Block Combined with Intercostal Nerve Block Improves Recovery After Deep Brain Stimulation in Patients with Parkinson's Disease: A Prospective, Randomized Controlled Trial.","authors":"Wenbin Lu, Xinning Chang, Wei Wu, Peipei Jin, Shengwei Lin, Lize Xiong, Xiya Yu","doi":"10.2147/CIA.S473421","DOIUrl":"10.2147/CIA.S473421","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effect of scalp nerve block (SNB) combined with intercostal nerve block (ICNB) on quality of recovery (QoR) after deep brain stimulation (DBS) in patients with Parkinson's disease (PD).</p><p><strong>Methods: </strong>We conducted a prospective randomized controlled trial in which 88 patients with PD were randomly assigned to undergo SNB combined with ICNB (SNB group) or not (control group) before surgery. The primary outcome was the 15-item QoR (QoR-15) score 24 h after surgery. The secondary outcomes included QoR-15 scores at 72 h and 1 month after surgery, pain-related events, recovery events in post-anesthesia care unit (PACU), duration of anesthesia and surgery, and nerve block-related adverse events.</p><p><strong>Results: </strong>The QoR-15 score at 24 h after surgery was significantly higher in SNB group than Control group: 122.0 ± 7.6 vs 113.5 ± 11.3 (<i>P</i> = 0.006). SNB combined with ICNB improved QoR-15 scores at 72 h (<i>P</i> = 0.004) but not at 1 month after surgery (<i>P</i> = 0.230). The SNB group was positively related to QoR-15 scores 24 h after surgery (β = 8.92; 95% CI = 4.52~13.32) after adjusting for confounding variables. The numeric rating scale pain scores at PACU discharge and at 24 h, intraoperative opioid consumption, rescue analgesic use, and the incidence of postoperative nausea and vomiting (PONV) in SNB group were significantly lower than Control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Preoperative SNB combined with ICNB improved QoR and analgesia after surgery, and reduced intraoperative opioid consumption and the incidence of PONV in patients with PD who underwent DBS.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1881-1889"},"PeriodicalIF":3.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630874","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}