Aging and health research最新文献

{"title":"Cognitive outcomes following ischaemic stroke: a narrative review","authors":"Jananee Myooran ,&nbsp;Faiyaz Rahman ,&nbsp;Dennis Cordato ,&nbsp;Danielle Ní Chróinín","doi":"10.1016/j.ahr.2025.100232","DOIUrl":"10.1016/j.ahr.2025.100232","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment is a common sequela of ischaemic stroke, especially in older patients who are often predisposed to both delirium and dementia. Despite this, factors associated with cognitive impairment post-stroke are poorly evaluated in everyday clinical practice, including associated risk factors, the impact of reperfusion therapies on risk of post-stroke cognitive impairment, and effects on mortality and morbidity.</div></div><div><h3>Methods</h3><div>A literature review was conducted, using PubMed and EMBASE databases. 62 articles were included in the review.</div></div><div><h3>Results</h3><div>The review demonstrated several risk factors for cognitive impairment in patients with ischaemic stroke. Patient related factors include age, race, atrial fibrillation, diabetes and pre-stroke cognition. Stroke-related factors include extensive, multi-territorial infarcts. Only endovascular thrombectomy improved cognitive outcomes post stroke. Post stroke cognitive impairment is associated with greater risk of institutionalization, depression, delirium, stroke recurrence and mortality.</div></div><div><h3>Conclusion</h3><div>Moving forward, utilizing cognition as a primary outcome in trials, as well as exploring the impact of post-stroke cognition on patients is essential. Therefore, further research is required to delineate the relationship between ischaemic stroke and post-stroke cognitive impairment.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100232"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The associations between multimorbidity, healthcare resource utilisation and costs in individuals with Alzheimer's disease dementia","authors":"Sophie Edwards ,&nbsp;Marc Evans ,&nbsp;Craig Ritchie ,&nbsp;Julie Hviid Hahn-Pedersen ,&nbsp;Mei Sum Chan ,&nbsp;Benjamin D Bray ,&nbsp;Alice Clark ,&nbsp;Christian Ahmad Wichmann ,&nbsp;Dominic Trepel","doi":"10.1016/j.ahr.2025.100234","DOIUrl":"10.1016/j.ahr.2025.100234","url":null,"abstract":"<div><h3>Background</h3><div>Multimorbidity (having two or more comorbidities), is common among people with dementia and associated with lower survival and increased healthcare use. We aimed to identify comorbidity clusters in people living with Alzheimer’s disease (AD) dementia in the UK, describe comorbidity-cluster prevalence and patterns, and estimate associations of clusters with healthcare resource utilisation (HCRU) and costs.</div></div><div><h3>Methods</h3><div>This was a cohort study using Discover dataset (electronic health records from approximately 2.8 million North-West London residents). We identified individuals with AD dementia using diagnostic codes, and estimated HCRU and total healthcare costs (including primary and hospital-based care). Individuals were grouped based on comorbidity profile using k-medoids clustering. Multivariable modelling was used to estimate associations between comorbidity clusters and healthcare costs.</div></div><div><h3>Results</h3><div>Among 18,116 individuals with AD dementia, eight comorbidity clusters were identified. The three highest-cost clusters incurred mean costs per patient year(ppy) of £6355, £5560, and £5284 respectively. The highest-cost cluster had a high burden of comorbidities with the most prevalent: frailty (83.2 %), hypertension (81.8 %), type 2 diabetes mellitus (81.4 %), and chronic kidney disease (69.7 %). Costs in the three highest-cost clusters were 1.7 to 2.0 times higher than the lowest-cost cluster (mean cost £3160ppy), which featured the lowest overall comorbidity burden. The lowest median survival times were in the two highest-cost clusters. Cluster membership was strongly associated with costs even after adjusting for a wide range of demographic and clinical factors. Compared with the lowest-cost cluster the average marginal increases in costs for the clusters ranged between £1072 (95 %CI:£478-£1666) and £3531ppy (95 %CI: £2850-£4212).</div></div><div><h3>Conclusions</h3><div>HCRU and costs in individuals with AD dementia show notable differences, with a large proportion of costs attributable to a minority of individuals with multiple comorbidities (particularly cardiometabolic diseases and frailty). Health systems should ensure initiatives to improve timely diagnosis and treatment of people with AD taking account of the high multimorbidity prevalence in this population.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100234"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tooth loss and physical function among older adults related to race and ethnicity in Hawai‘i: A cross-sectional study from 2014 to 2020","authors":"Wei Zhang ,&nbsp;Yan Yan Wu ,&nbsp;Fran C. Woodworth ,&nbsp;Deborah J. Mattheus","doi":"10.1016/j.ahr.2025.100228","DOIUrl":"10.1016/j.ahr.2025.100228","url":null,"abstract":"<div><h3>Background</h3><div>Oral health and functional limitations are major health concerns among aging populations in the U.S. and globally. Although the relationship between tooth loss and physical disabilities is well documented, less is known about the role of race and ethnicity in this association. This study examined the association between tooth loss and ADL (activities of daily living) limitations across various racial/ethnic groups in Hawai‘i.</div></div><div><h3>Methods</h3><div>We examined severe tooth loss and functional limitations in relation to sociodemographic factors, including race/ethnicity, using four waves of data from the Hawaiʻi Behavioral Risk Factor Surveillance System collected between 2014 and 2020. Weighted Poisson regression was used to estimate the unadjusted and adjusted prevalence ratio of severe tooth loss and functional limitations.</div></div><div><h3>Results</h3><div>There was a significant association between severe tooth loss and the prevalence of ADL limitations among older adults in Hawai‘i. Notably, this association varied by race/ethnicity: After adjusting for sociodemographic covariates, it was stronger among White, Native Hawaiian, and Japanese respondents compared to Filipinos.</div></div><div><h3>Conclusions</h3><div>These results suggest that the relationship between severe tooth loss and physical decline is differentiated by race/ethnicity, and that socioeconomic variables (including education and income) play a complicated role in the association. Awareness of the unique challenges and inequities faced by older racially/ethnically marginalized populations is critical for policymakers to develop strategies to achieve health equity, which must entail addressing these interrelated health problems and their structural determinants at every level.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100228"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile of heart failure in geriatric patients in a tertiary cardiac hospital of Bangladesh","authors":"Mahbuba Yesmin ,&nbsp;Lutfun Nahar Nizhu ,&nbsp;Afroja Alam ,&nbsp;Abdullah Al Mamun","doi":"10.1016/j.ahr.2025.100227","DOIUrl":"10.1016/j.ahr.2025.100227","url":null,"abstract":"<div><div>This study included 100 geriatric patients admitted at National Institute of Cardiovascular Diseases (NICVD) in Bangladesh having clinical features of heart failure, possible other information (Framingham Criteria) and increase in natriuretic peptide or echocardiographic findings. It was a single center, cross sectional study. Regarding functional NYHA classification, 14 % presented with class I, 30 % with class II, 35 % presented with class III, 21 % presented with class IV heart failure.</div><div>Regarding left ventricular ejection fraction (LVEF), heart failure (HF) was classified into the following categories: (1) HF with reduced EF (HFrEF) - 19 %; (2) HF with improved EF (HFmpEF) - 13 %; (3) HF with mildly reduced EF (HFmrEF) - 22 % and (4) HF with preserved EF (HFpEF) - 46 % . 23 % of the study population had iron deficiency anemia and about one-third-patient had associated renal failure (AKI/CKD). This study revealed that a significant geriatric population has unrecognized heart failure (HFpEF).</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100227"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergistic effect of smoking and education on incident dementia among older adults: The Shanghai aging study","authors":"Chengyin Xu ,&nbsp;Zhenxu Xiao ,&nbsp;Xiaowen Zhou ,&nbsp;Xiaoniu Liang ,&nbsp;Qianhua Zhao ,&nbsp;Ding Ding ,&nbsp;Wei Deng","doi":"10.1016/j.ahr.2024.100212","DOIUrl":"10.1016/j.ahr.2024.100212","url":null,"abstract":"<div><h3>Background</h3><div>The association between smoking and dementia incidence remains controversial, while education is considered a cognitive safeguard. This study aims to explore the joint effect of smoking and education on incident dementia.</div></div><div><h3>Methods</h3><div>We enrolled 1647 community-dwelling residents, and divided them into three groups: non-smoker (Smoking Index [SI, cigarette-years] = 0), mild-smoker (0 &lt; SI &lt; 265), and severe-smoker (SI ≥ 265). Their education was categorized to high or low level (formal education &gt; 9 or ≤ 9 years). Dementia diagnosis was established according to the Diagnostic and Statistical Manual of Mental Disorders IV. Cox proportional hazards models were used for the analysis, and three indicators of additive interaction between low education and severe smoking were calculated.</div></div><div><h3>Results</h3><div>We identified 167 cases (10.1 %) of incident dementia during the 8544.2 person-years of follow-up. After adjusting for age, gender, and APOE ε4, a multiplicative interaction between severe smoking and low education was observed (Hazard Ratio (HR) = 4.01, 95 % CI: 1.29-12.48, <em>P</em> = 0.017), as well as an additive interaction between the two risk factors, with Relative Excess Risk due to Interaction was 2.63 (<em>P</em> = 0.017), Attributable Proportion due to Interaction was 0.60 (<em>P</em> &lt; 0.001), and Synergy Index was 4.46 (<em>P</em> = 0.022), and compared to highly educated non-smokers, less educated severe smokers had a 3.38-fold increased risk of dementia (<em>HR</em> = 4.38, 95 %CI: 2.50-7.67, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Severe smoking and low education may have synergistic effect on incident dementia. Targeted tobacco control interventions are crucial for dementia prevention.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 1","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline shock index and baroreflex function in older adults","authors":"Kenneth M. Madden ,&nbsp;Boris Feldman ,&nbsp;Graydon S. Meneilly","doi":"10.1016/j.ahr.2025.100220","DOIUrl":"10.1016/j.ahr.2025.100220","url":null,"abstract":"<div><div>Elevations in shock index (SI), defined as heart rate (HR)/systolic blood pressure (BP) are less discriminative of impending shock in older adults. We hypothesized baroreflex dysfunction as a potential explanation for lower baseline SI in older adults. 52 older adults (29 women, 23 men, age ≥ 65; mean age 77.8 ± 0.9 years) were recruited. SI, the modified shock index (MSI, HR/mean BP), and the age corrected SI (Age * SI) as well as baroreflex function (using the sequence method) was measured at baseline. SI (Standardized <strong>β</strong> = 0.392, <em>p</em> = 0.005), MSI (Standardized <strong>β</strong> = 0.385, <em>p</em> = 0.006) and Age * SI (Standardized <strong>β</strong> = 0.431, <em>p</em> = 0.002) showed significant positive associations with BRS_up. Age * SI also showed a significant positive association with BRS (Standardized <strong>β</strong> = 0.329, <em>p</em> = 0.019). Autonomic dysfunction is associated with lower SI in older adults, potentially masking circulatory instability.</div><div>ClinicalTrials.gov ID <span><span>NCT01914133</span><svg><path></path></svg></span></div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 1","pages":"Article 100220"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143128478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is height loss in adulthood associated with health in later life among the 1946 UK Birth Cohort (NSHD) participants?","authors":"Katarina L. Matthes,&nbsp;Kaspar Staub","doi":"10.1016/j.ahr.2025.100224","DOIUrl":"10.1016/j.ahr.2025.100224","url":null,"abstract":"<div><h3>Background</h3><div>Height increases as a product of physical growth until adulthood, then is stable between the ages of 20 and about 40, after which most people lose height as they biologically age. The aim of the present study was to investigate the relationship between height in childhood and relative height loss in adulthood, and to examine the association between height loss and health at older age.</div></div><div><h3>Methods</h3><div>Data from one of the oldest ongoing cohort studies, the National Survey of Health and Development (NSHD, 1946 UK Birth Cohort) were analysed. In total, 2,119 study participants were included who completed the nurse home visit during the 24^th and most recent available follow-up examination at age 69. Linear regression models were used to estimate the association between measured height in childhood years relative height loss between ages 36 and 69. Logistic regression models using generalized additive models were calculated to estimate the probability of worse health at age 69 (chronic disease score, general health status, osteoarthritis, and pain while walking) in association with height loss.</div></div><div><h3>Results</h3><div>Between the ages of 36 and 69, men lost an average of 2.0 cm and women 2.4 cm. Women lost significantly more height than men (<em>p</em> &lt; 0.001). The taller the participants were at a young age, the more height they lost in adulthood. There was a significant association between height loss in adulthood and general health, chronic disease score (in men), osteoarthritis (in men), and walking pain at age 69. These findings largely persisted after adjusting the models for overweight, sociodemographic information, and lifestyle factors earlier in life.</div></div><div><h3>Conclusions</h3><div>Height loss seems to be associated with deteriorating health as people age. Height measurement and assessment of height loss could potentially be part of regular examinations after the age of 40 to monitor general health status, especially in the case of severe height loss.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 1","pages":"Article 100224"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Minds in Motion, a fitness program for people living with dementia and their caregivers","authors":"Pria Nippak ,&nbsp;Jocelyn Badali ,&nbsp;Julien Meyer ,&nbsp;Housne Begum ,&nbsp;Nalini Sen ,&nbsp;Mya Rana-Nippak","doi":"10.1016/j.ahr.2025.100222","DOIUrl":"10.1016/j.ahr.2025.100222","url":null,"abstract":"<div><h3>Background</h3><div>Fitness is associated with better physical and mental outcomes in people living with dementia (PWD). This study evaluated Minds in Motion, a program designed to improve the physical fitness of PWD and their care partners (CP).</div></div><div><h3>Method</h3><div>Participants completed an 8-week program combining exercise and mindfulness recreational activities. Data were collected through a retrospective mixed-method design. Participants, staff, and volunteers completed data collection.</div></div><div><h3>Results</h3><div>Participants experienced significant improvements in chair stands (+12.9%), bicep curls (+17.2%), and 8 feet up &amp; go (+10.5%) but not in the chair sit and reach exercise. Almost all of the participants (99%) enjoyed the program and staff and volunteers (99%) self-reported improvement in their skills in working with people with dementia, with a strong reduction in the proportion of staff and volunteers disclosing “very limited skill” in dealing with PWD, from 15 to 18% to 9–12% of respondents.</div></div><div><h3>Conclusion</h3><div>This study, as an extension of the pilot, concluded that Minds in Motion program had a positive impact on PWD and CP's physical functioning following the program fitness training combined with mindfulness recreational activities, which aligned with their reported program satisfaction. The “sit and reach” exercise, may not be appropriate for them. Together, these findings highlight how fitness programs can assist PWD and CP with improved functioning through strength building.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 1","pages":"Article 100222"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The deprivation cascade hypothesis of dementia","authors":"Timothy Daly","doi":"10.1016/j.ahr.2024.100219","DOIUrl":"10.1016/j.ahr.2024.100219","url":null,"abstract":"<div><div>There are significant disparities in dementia risk and care burden in the global population. This review provides evidence of the effects of deprivation, understood as the absence of environmental resources required for brain health. Deprivation increases dementia risk and care burden due to biological, environmental, and social dimensions of risk. It is hypothesized that the major mediator between deprivation and dementia is reduced educational and professional attainment. It argues for structural interventions centered around improved attainment, particularly for girls and women across the globe, improved funding for primary and social care, and a rights-based approach to brain health to improve access to these resources and thereby reduce dementia disparities.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 1","pages":"Article 100219"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143127880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A longitudinal analysis on the effect of hormone use on allostatic load in perimenopausal women","authors":"Pamela Lamisi Alebna ,&nbsp;Joaquin Ignacio Armendano ,&nbsp;Nasim Maleki","doi":"10.1016/j.ahr.2024.100213","DOIUrl":"10.1016/j.ahr.2024.100213","url":null,"abstract":"<div><h3>Background</h3><div>Allostatic load (AL), a measure of physiologic dysregulation across multiple systems, has been shown to increase as women age and go through menopause. While hormone use has been shown to help with the relief of menopausal symptoms, it is not clear whether the use of hormone replacement therapy and hormonal contraceptives in the perimenopausal period has an impact on alleviating allostatic load in aging women.</div></div><div><h3>Methods</h3><div>We conducted a target trial emulation to estimate the on-treatment (i.e., per-protocol) effect of hormone replacement therapy or hormonal contraceptives use on AL score evolution over time. We included in our analysis 2,199 women from the SWAN cohort that were followed-up between 1996 and 2005. To estimate the effect of the continuous use of hormone replacement therapy or hormonal contraceptives on AL score evolution over the follow-up period we used marginal structural models estimated using inverse probability weighting.</div></div><div><h3>Results</h3><div>The mean AL score at baseline was 2.45 ± 1.85 (Mean ± SD). The AL score remained relatively stable in women that never used hormone replacement therapy or hormonal contraceptives, with an average increase of 0.014 ± 0.011 (Mean ± SE) per year, whereas in women that used hormone replacement therapy or hormonal contraceptives continuously, the AL score increased, on average 0.087 ± 0.014 (Mean ± SE) per year. We did not find conclusive evidence to support that continuous use of hormone replacement therapy or hormonal contraceptives modifies the AL score trajectory (mean difference between trends = 0.073; CI_95%: -0.027, 0.173; <em>P</em> = 0.1538).</div></div><div><h3>Conclusion</h3><div>Continuous use of hormone replacement therapy or hormonal contraceptives during the menopause transition period was not associated with increased allostatic load. The findings suggest continuous use of hormone therapy as a treatment for perimenopausal symptoms in aging women doesn't confer a risk for increased allostatic load.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 1","pages":"Article 100213"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143127877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}