Clinical Interventions in Aging最新文献

{"title":"Assessing Sedation Depth with PSI in Elderly ERCP Patients: A Prospective Cohort Study.","authors":"Lei Huang, Lin-Lin Liu, Yong-da Lu, Min-Yuan Zhuang, Wei Dou, Hong Liu, Fu-Hai Ji, Ke Peng","doi":"10.2147/CIA.S504212","DOIUrl":"10.2147/CIA.S504212","url":null,"abstract":"<p><strong>Background: </strong>Adequate sedation is important for elderly patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). Patient state index (PSI) via the SedLine® system has been utilized for real-time monitoring of anesthesia depth in surgical patients. We aimed to assess the correlation between PSI and Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scores in elderly patients undergoing ERCP.</p><p><strong>Methods: </strong>This prospective cohort study included 57 elderly patients scheduled for ERCP procedures. Patients received target-controlled infusion of propofol, titrated to the sedation level of MOAA/S scores of 1 and 2. The MOAA/S scores and PSI values were recorded during sedation and recovery. We also documented procedure and recovery time, oversedation (PSI < 25 for at least 10 min and EEG burst suppression), adverse events, and fatigue scores (0-10, higher scores indicating more fatigue).</p><p><strong>Results: </strong>All patients completed this study (mean age of 73 years and 63% male), with a mean procedure time of 53 min and recovery time of 37 min. Five patients (8.8%) experienced PSI < 25 for at least 10 min, and three of them (5.3%) showed EEG burst suppression. No patients developed desaturation or intra-procedural awareness. Hypotension and abdominal pain were uncommon. Nine patients (15.8%) experienced mild dizziness or nausea. The median (IQR) fatigue score was 3 (2-4) at recovery room discharge. A significant correlation was observed between the MOAA/S scores and PSI values (Spearman correlation coefficient <i>ρ</i> = 0.742, <i>P</i> < 0.001). When patients were at the MOAA/S scores of 1 and 2, the median PSI was 50 (95% CI: 48 to 52).</p><p><strong>Conclusion: </strong>PSI provides a useful and real-time monitoring of sedation for elderly patients undergoing ERCP. Our results showed a significant correlation between the PSI values and MOAA/S scores and suggested a PSI value of 50 with a range of 48 to 52 for maintaining adequate sedation.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR2400079859).</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"137-145"},"PeriodicalIF":3.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434132","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":"Non-Immersive Virtual Reality Exercise Can Increase Exercise in Older Adults Living in the Community and in Long-Term Care: A Randomized Controlled Trial.","authors":"Lisa Sheehy, Lalita Bharadwaj, Kelsey Annie Nissen, Justine L Estey","doi":"10.2147/CIA.S498272","DOIUrl":"10.2147/CIA.S498272","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of an 8-week non-immersive virtual reality exercise program for older adults on 1) balance, physical function, community integration and quality of life; 2) falls, emergency room visits, hospital and long-term care admissions; 3) quantity of exercise performed; and 4) acceptance of non-immersive virtual reality.</p><p><strong>Patients and methods: </strong>This prospective, assessor-blinded, randomized controlled trial was carried out on two separate samples of older adults: those living in their own homes (\"home-based\") and those living in long-term care (\"facility-based\"). Participants were randomized to non-immersive virtual reality or usual activity. Non-immersive virtual reality consisted of 20-30 minutes of customized, gamified exercises for balance, stepping, strengthening, and aerobic conditioning, performed 3-5x/week for 8 weeks. Outcomes were measured before the intervention, immediately after, and 1 month later. Physical testing and questionnaires addressed objective 1). Counts for objectives 2) and 3) were reported by the participants and retrieved from the non-immersive virtual reality platform. Logbooks and a short interview addressed objective 4).</p><p><strong>Results: </strong>Recruitment was substantially impacted by the COVID-19 pandemic. The facility-based sample had 31 participants; the home-based sample had 16. There were no statistically-significant benefits to non-immersive virtual reality in either sample for objective 1), although the facility-based non-immersive virtual reality group showed a clinically-significant improvement in functional walking. Effect sizes were small (≤ 0.16). No falls occurred during non-immersive virtual reality exercise. The facility-based non-immersive virtual reality group did an average of 14.1 sessions (average 20.1 minutes/session) and the home-based non-immersive virtual reality group did an average of 17.2 sessions (22.6 minutes/session). Participants enjoyed the non-immersive virtual reality, found it challenging and motivating and felt that it improved balance and walking. Most were interested to continue beyond the study.</p><p><strong>Conclusion: </strong>Non-immersive virtual reality for home-based and facility-based older adults is safe, enjoyable and feasible and may increase users' weekly levels of physical activity leading to clinical benefits for functional walking in facility-based users.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT04083885; registered 2019-09-06).</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"109-124"},"PeriodicalIF":3.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391872","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":"Reducing Mortality in AIS Patients After EVT: Challenges and Prospective Strategies [Letter].","authors":"Yuqiu Lu, Lingtian Weng, Tianmei Zhou","doi":"10.2147/CIA.S516516","DOIUrl":"10.2147/CIA.S516516","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"107-108"},"PeriodicalIF":3.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383905","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 Metabolic Syndrome and Cardiac Autonomic Nervous Function and Cardiorespiratory Fitness in Older Adults: A Retrospective Observational Study with Propensity Score Overlap Weighting.","authors":"Ni Cui, Qiuxia Li, Jing Cheng, Tianhua Xing, Peiyao Shi, Yingmei Wang, Min Luo, Yaoshan Dun, Suixin Liu","doi":"10.2147/CIA.S489409","DOIUrl":"10.2147/CIA.S489409","url":null,"abstract":"<p><strong>Background: </strong>Delayed heart rate recovery (HRR) after exercise, an indicator of cardiac autonomic nervous function (CANF), has been found to be associated with metabolic syndrome (MetS) in general populations. However, this relationship has not been extensively studied in older adults. The present study aimed to investigate the association between MetS and HRRs at 1, 2, 3 and 6 minutes after exercise and cardiorespiratory fitness (CRF) in Chinese dwelling older adults.</p><p><strong>Methods: </strong>This retrospective, observational study consecutively enrolled participants aged 60 years or older who underwent physical examinations in Shenzhen District Yantian People's Hospital from September 2019 to July 2021. The participants were categorized into MetS and non-MetS groups according to the International Diabetes Federation criteria. Logistic regression analysis was applied to assess the association between MetS and CANF and CRF. Propensity score overlap weighting was used to adjust the covariates.</p><p><strong>Results: </strong>A total of 987 eligible participants were included (mean age±SD, 66±4 years; male, 47.1%), of whom, 506 were diagnosed with MetS. MetS group showed significantly lower peak heart rate, HRR1-3, HRR6, peak metabolic equivalents, and peak oxygen consumption compared to the non-MetS group. Furthermore, peak systolic and diastolic blood pressures in the MetS group were significantly higher. Logistic regression analysis showed that MetS was significantly associated with HRR2, HRR3 (odds ratio [95% CI], 0.997 [0.995,0.999], both; <i>P</i>=0.009 and 0.005, respectively) and HRR6 (0.996 [0.994,0.998], <i>P</i><0.001). The association between MetS and CRF was significant (0.98 [0.97,0.98], <i>P</i><0.001).</p><p><strong>Conclusion: </strong>Elderly Chinese with MetS tend to exhibit reduced CANF and lower CRF. It is recommended that they boost physical activity and closely monitor heart rate and blood pressure during exercise to mitigate exercise-related risks.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"93-105"},"PeriodicalIF":3.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081629","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":"Erratum: Dexmedetomidine Attenuates Inflammation in Elderly Patients Following Major Hepatobiliary and Pancreatic Surgery: A Randomized Clinical Trial [Corrigendum].","authors":"","doi":"10.2147/CIA.S516385","DOIUrl":"10.2147/CIA.S516385","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2147/CIA.S455987.].</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"81-82"},"PeriodicalIF":3.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081643","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 of C-Reactive Protein with Short-Term Outcomes in Spontaneous Intracerebral Hemorrhage Patients with or without Infection: From a Large-Scale Nationwide Longitudinal Registry.","authors":"Yang Du, Lijun Liu, Kaijiang Kang, Yijun Lin, Hongqiu Gu, Liheng Bian, Zixiao Li, Xingquan Zhao","doi":"10.2147/CIA.S489083","DOIUrl":"10.2147/CIA.S489083","url":null,"abstract":"<p><strong>Aim: </strong>To study the relationship between elevated C-reactive protein (CRP) levels, infection, and spontaneous intracerebral hemorrhage (ICH) outcomes.</p><p><strong>Methods: </strong>Patients were classified into four groups (Q1-Q4). Logistic regression was used to analyze the relationship between different CRP levels and functional disability (mRS score of 3-5) at discharge, intracerebral hematoma evacuation, and in-hospital mortality. Subgroup analysis was conducted on patients with or without infection during hospitalization.</p><p><strong>Results: </strong>A total of 14,529 patients with ICH were enrolled in this study. In the multivariate logistic regression model, compared with the reference CRP quartile group (Q1), the Q4 group had a higher proportion of functional disability (adjusted OR, 1.30, 95% CI 1.16-1.45) and hematoma evacuation (adjusted OR, 1.88, 95% CI 1.58-2.23). In patients without infection, compared with the Q1 group, the Q4 group had a higher risk of functional disability (adjusted OR, 2.16, 95% CI 1.71-2.73) and hematoma evacuation (adjusted OR, 1.15, 95% CI 1.00-1.31).</p><p><strong>Conclusion: </strong>A significantly increased CRP level was associated with a higher risk of early functional disability and hematoma evacuation in patients with ICH, regardless of the presence or absence of infectious complications. Infection may increase the risk of poor outcomes in patients with ICH, but caution is needed when facing abnormally high CRP levels in patients with ICH without infection.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"83-91"},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081641","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 Weight-Adjusted Waist Index and Cognitive Function in Older Adults Without Diabetes: A Cross-Sectional Study.","authors":"Qing Wang, Yishan Yin, Wei Liu, Lingyu Li, Zhen Wang, Yue Tian, Jing Fan","doi":"10.2147/CIA.S499221","DOIUrl":"10.2147/CIA.S499221","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the correlation between the weight-adjusted waist index (WWI) and cognitive performance in the senior American population, focusing on those without diabetes from 2011 to 2014.</p><p><strong>Methods: </strong>We analyzed data from the 2011-2012 and 2013-2014 National Health and Nutrition Examination Surveys (NHANES), focusing on non-diabetic participants aged 60 and older who completed cognitive tests: Establish a Registry for Alzheimer's disease (CERAD), the Animal Fluency test (AFT), and Digit Symbol Substitution test (DSST). WWI was calculated using waist circumference divided by the square root of body weight. We employed linear univariate and multivariate analyses, along with curve fitting, we conducted subgroup and interaction analyses to elucidate the relationships under investigation.</p><p><strong>Results: </strong>The study incorporated a cohort of 1649 participants aged 60 years and older, each with a complete set of data, enabling a thorough analysis. After adjusting for confounding factors, significant negative correlations were found between WWI and both CERAD (β: -0.48; 95% CI: -0.92 to -0.05; P=0.03) and DSST (β: -1.15; 95% CI: -2.09 to -0.21; P=0.017) scores, suggesting a link to cognitive decline. No association was found with AFT scores. The relationship between WWI and DSST was found to be nonlinear (P for non-linearity=0.022). Additionally, the association between WWI and CERAD was also observed (P for non-linearity=0.042). However, linear relationships were observed between WWI and AFT (P for non-linearity=0.418). The subgroup analysis was overall stable.</p><p><strong>Conclusion: </strong>Our cross-sectional study indicates a strong link between a high WWI and reduced cognitive function in non-diabetic older Americans, as shown by CERAD and DSST scores. Attaining an optimal WWI may be vital for cognitive decline, highlighting its role in a potential preventative approach.</p><p><strong>Clinical trial registry number and website where it was obtained: </strong>The study design and data are publicly accessible at www.cdc.gov/nchs/nhanes/.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"69-79"},"PeriodicalIF":3.5,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11777681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069039","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 Preliminary Screening Tool for High-Risk Frailty in Older Adults Patients with Pulmonary Tuberculosis.","authors":"Hui-Juan Li, Yue-Ying Zhou, He-He Yu, Jian Jiang, Yu-Wei Cai","doi":"10.2147/CIA.S493887","DOIUrl":"10.2147/CIA.S493887","url":null,"abstract":"<p><strong>Objective: </strong>To understand the current status and analyse the factors influencing frailty in older adults patients with pulmonary tuberculosis.</p><p><strong>Methods: </strong>This retrospective case-control study included 204 older adults patients with pulmonary tuberculosis. The enrolled patients were divided into a frailty group (n = 101) and a non-frailty group (n = 103). The study further collected and compared the data of various scores.</p><p><strong>Results: </strong>The total frailty score among the patients ranged from 0 to 15 points, with an average score of 5.23 ± 2.31 points. The total social support score ranged from 15 to 47 points, with an average of 33.43 ± 6.11 points. The physical function level scores ranged from 10 to 100 points, with an average of 84.58 ± 14.48 points. Additionally, univariate analysis showed significant differences between the groups in terms of age, body mass index (BMI), duration of disease, types of long-term medication and the number of complications and comorbidities (<i>P</i> < 0.05). Correlation analysis revealed negative correlations of social support (<i>P</i> < 0.001) and physical function (<i>P</i> < 0.001) with the overall frailty score and a positive correlation of depression levels (<i>P</i> < 0.001) with the overall frailty score. Further regression analysis indicated that being over 80 years old, having a low BMI, long-term polypharmacy and a high depression score were risk factors. High social support and physical function scores were protective factors against frailty in older adults patients with pulmonary tuberculosis.</p><p><strong>Conclusion: </strong>In older adults patients with pulmonary tuberculosis, the overall frailty score shows negative correlations with social support and physical function and a positive correlation with depression level.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"57-68"},"PeriodicalIF":3.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048386","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":"U-Shaped Relationship Between MSpO2 Levels and the Incidence of Frailty in Elderly OSA Patients: Findings from a Multicenter Cohort Study [Letter].","authors":"Hanqin Zhu, Lei Dong","doi":"10.2147/CIA.S513894","DOIUrl":"10.2147/CIA.S513894","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"55-56"},"PeriodicalIF":3.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048402","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":"Intervention for Social Frailty Focusing on Physical Activity and Reducing Loneliness: A Randomized Controlled Trial.","authors":"Aki Gen, Yumi Higuchi, Tetsuya Ueda, Tomoko Hashimoto, Wataru Kozuki, Tatsunori Murakami, Mio Ishigami","doi":"10.2147/CIA.S491979","DOIUrl":"10.2147/CIA.S491979","url":null,"abstract":"<p><strong>Purpose: </strong>During the COVID-19 pandemic, older adults living in the community experienced reduced physical activity (PA) and heightened loneliness, particularly those with less frequent outings-a key factor of social frailty. Promoting PA may foster social participation, increase outings, and reduce loneliness. This study investigates the effects of a multi-component intervention on PA and loneliness in socially frail older adults.</p><p><strong>Materials and methods: </strong>This single-blind, randomized controlled trial included 64 participants aged ≥ 60 years with social frailty and pre-frailty defined according to Makizako's Social Frailty Index. Participants were randomly assigned to either the intervention (n = 34) or the control (n = 30) group. Over eight weeks, the intervention group attended a weekly 60-min multi-component program that included health education, exercise, and self-monitoring. A simple exercise booklet was distributed to the control group at baseline. For both groups, outcome measures were assessed at baseline and after eight weeks. PA was assessed using a triaxial accelerometer. Loneliness was measured using the three-item version of the UCLA Loneliness Scale. We used repeated-measures analysis of variance with group-by-time interactions to estimate the intervention effects following the intention-to-treat approach.</p><p><strong>Results: </strong>PA was not affected by the intervention. A significant group-by-time interaction was observed for loneliness, with a medium effect size (p < 0.05), indicating that loneliness was significantly reduced in the intervention group compared to the control group.</p><p><strong>Conclusion: </strong>The multi-component program aimed at promoting PA may contribute to the building of social relationships and reducing loneliness in older adults with social frailty and pre-frailty.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"43-53"},"PeriodicalIF":3.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014528","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}