Aging Clinical and Experimental Research最新文献

{"title":"Cost-effectiveness of opportunistic osteoporosis screening using chest radiographs with deep learning in Germany","authors":"Jean-Yves Reginster,&nbsp;Ralf Schmidmaier,&nbsp;Majed Alokail,&nbsp;Mickael Hiligsmann","doi":"10.1007/s40520-025-03048-x","DOIUrl":"10.1007/s40520-025-03048-x","url":null,"abstract":"<div><h3>Background</h3><p>Osteoporosis is often underdiagnosed due to limitations in traditional screening methods, leading to missed early intervention opportunities. AI-driven screening using chest radiographs could improve early detection, reduce fracture risk, and improve public health outcomes.</p><h3>Aims</h3><p>To assess the cost-effectiveness of deep learning models (hereafter referred to as AI-driven) applied to chest radiographs for opportunistic osteoporosis screening in German women aged 50 and older.</p><h3>Methods</h3><p>A decision tree and microsimulation Markov model were used to calculate the cost per quality-adjusted life year (QALY) gained (€2024) for screening with AI-driven chest radiographs followed by treatment, compared to no screening and treatment. Patient pathways were based on AI model accuracy and German osteoporosis guidelines. Women with a fracture risk below 5% received no treatment, those with 5–10% risk received alendronate, and women 65 + with a risk above 10% received sequential treatment starting with romosozumab. Data was validated by a German clinical expert, incorporating real-world treatment persistence, DXA follow-up rates, and treatment initiation. Sensitivity analyses assessed parameter uncertainty.</p><h3>Results</h3><p>The cost per QALY gained from screening was €13,340, far below the typical cost-effectiveness threshold of €60,000. Optimizing follow-up, treatment initiation, and medication adherence further improved cost-effectiveness, with dominance achievable by halving medication non-persistence, and in women aged 50–64.</p><h3>Conclusion</h3><p>AI-driven chest radiographs for opportunistic osteoporosis screening is a cost-effective strategy for German women aged 50+, with the potential to significantly improve public health outcomes, reduce fracture burdens and address healthcare disparities. Policymakers and clinicians should consider implementing this scalable and cost-effective screening strategy.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03048-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143938709","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":"Global, regional, and national trends in peripheral arterial disease among older adults: findings from the global burden of disease study 2021","authors":"Xiaohan Qiu,&nbsp;Ben Hu,&nbsp;Jiahan Ke,&nbsp;Min Wang,&nbsp;Huasu Zeng,&nbsp;Jun Gu","doi":"10.1007/s40520-025-03037-0","DOIUrl":"10.1007/s40520-025-03037-0","url":null,"abstract":"<div><h3>Importance</h3><p>Lower extremity peripheral arterial disease (PAD) is a significant health concern among older adults globally, affecting both mortality and quality of life.</p><h3>Objective</h3><p>To evaluate the temporospatial trends and its risk factors in lower extremity PAD-related burden among adults aged 60 years and older from 1990 to 2021.</p><h3>Design, setting, and participants</h3><p>This repeated cross-sectional study utilized data from the Global Burden of Disease Study 2021, encompassing 204 countries and territories. The study population included adults aged 60 years and older.</p><h3>Exposure</h3><p>Lower extremity PAD among older adults from January 1990 to December 2021.</p><h3>Main outcomes and measures</h3><p>Primary outcomes included age-standardized prevalence rates (ASPR), mortality rates (ASMR), disability-adjusted life-years (DALYs), and average annual percentage changes (AAPCs). Trends were analyzed by age, sex, and sociodemographic index (SDI). Joinpoint regression analysis was used to identify significant trend changes.</p><h3>Results</h3><p>From 1990 to 2021, global trends showed decreases in lower extremity PAD-related prevalence, mortality, and DALYs. Significant geographical disparities were observed: high-SDI regions had the highest prevalence (11,171.66 per 100,000 in 2021) but showed declining trends (AAPC, -0.74; 95% CI, -0.80 to -0.68), while low-SDI regions had the lowest prevalence (4,842.40 per 100,000) but demonstrated increasing trends (AAPC, 0.22; 95% CI, 0.21 to 0.24). Regionally, although lower extremity PAD-related prevalence showed a decreasing trend in most regions from 1990 to 2021, there were still some regions with an increasing trend (North Africa and Middle East AAPC, 0.57; 95% CI, 0.55 to 0.59). Temporal analysis showed sex-specific divergent trends in recent years, with males exhibiting an upward trend since 2015 (APC, 0.15; 95% CI, 0.07 to 0.24), while females showed a slowed decline since 2014 (APC, -0.06; 95% CI, -0.12 to -0.01). Decomposition analysis identified population growth as the primary driver of PAD burden increase, with epidemiological changes showing contrasting effects across SDI regions. Among risk factors, high fasting glucose emerged as the leading contributor, while smoking’s contribution decreased.</p><h3>Conclusions and relevance</h3><p>This study revealed significant disparities in lower extremity PAD burden across different SDI levels and regions, with low-SDI countries facing an increasing burden. The contrasting trends between high- and low-SDI regions, coupled with varying risk factor patterns (particularly the rise in high fasting glucose and decline in smoking), suggest the need for targeted interventions in resource-limited settings to address this growing health challenge among older adults.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03037-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143938614","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":"Language, literacy, and sensory impairments and missing cognitive test scores in the Harmonized Cognitive Assessment Protocol of the China Health and Retirement Longitudinal Study","authors":"Alden L. Gross,&nbsp;Ying Liu,&nbsp;Yuan S. Zhang,&nbsp;Yaohui Zhao,&nbsp;Chihua Li,&nbsp;Erik Meijer,&nbsp;Jinkook Lee,&nbsp;Lindsay C. Kobayashi","doi":"10.1007/s40520-025-03039-y","DOIUrl":"10.1007/s40520-025-03039-y","url":null,"abstract":"<div><h3>Background</h3><p>The potentially biasing impacts of low language fluency, illiteracy, and sensory impairments on cognitive test performance are unknown, which may have implications for understanding their roles in cognitive decline and dementia.</p><h3>Aims</h3><p>We investigated effects of these features on cognitive test item completion and performance among older adults in China, a multilingual country with high prevalence of illiteracy and sensory impairment.</p><h3>Methods</h3><p>We used cognitive test data from the Harmonized Cognitive Assessment Protocol of the China Health and Retirement Longitudinal Study conducted in 2018 (N = 9755, age 60 + years). We first tested associations of fluency in spoken Mandarin, literacy, and sensory impairment (hearing and vision) with missingness of cognitive items. We then tested for differential item functioning (DIF) in observed cognitive items by these features.</p><h3>Results</h3><p>We observed high levels of missing data in most cognitive test items – on average 13% and as high as 65%. Low fluency in spoken Mandarin, illiteracy, and impairments in hearing and vision were each associated with greater odds of missingness on nearly all tests. Partly because of differential missingness, there was minimal evidence of DIF by these features in items in which we expected a priori to find DIF (e.g., repetition of a spoken phrase among those with hearing impairment). Several cognitive test items exhibited statistically significant DIF, however there was minimal evidence of meaningful DIF.</p><h3>Conclusions</h3><p>Differential missingness in cognitive items by spoken language, literacy, and sensory impairments is potentially more of an inferential threat than measurement differences in test items.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03039-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143938551","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 implementation of the Italian guidelines on comprehensive geriatric assesment for the older persons","authors":"Alberto Castagna,&nbsp;Giovanni Ruotolo,&nbsp;Margherita Azzini,&nbsp;Pierangelo Lora Aprile,&nbsp;Nicola Vanacore,&nbsp;Alberto Pilotto,&nbsp;Nicola Veronese","doi":"10.1007/s40520-025-03036-1","DOIUrl":"10.1007/s40520-025-03036-1","url":null,"abstract":"<div><p>A fundamental phase in the life of new Guidelines is the implementation, which responds to the need to facilitate their adoption with interventions and procedures of proven effectiveness to increase their impact on public health. The implementation should follow a scientific method, and therefore shares many characteristics and the rigorous approach of clinical research. However, it differs in purposes, methods, and aims by addressing factors that include identifying and resolving barriers and facilitators in the adoption of evidence-based clinical innovations. The use of comprehensive geriatric assessment (CGA) can be facilitated by technological tools, with the possibility of early diagnosis of several chronic conditions, monitoring and management of the diseases typical of older people and, finally, to personalized care and optimization of healthcare resources. However, remote CGA also has limitations, including technology requirements, data security/privacy, and the need for comprehensive evaluation and simplicity. In this document we present the history and the model of implementation of the Italian guidelines on CGA in older persons. The standardization of CGA in older adults across different settings is particularly important in countries like Italy, that have among the oldest world population and where broader implementation of CGA, also outside traditional geriatric settings, has become a health priority that cannot longer be delayed.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03036-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143938548","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":"Establishment and validation of early prediction model for post-stroke dysphagia","authors":"Chunyan Lu,&nbsp;Yao Zhou,&nbsp;Yufei Shen,&nbsp;Yun Wang,&nbsp;Shuxia Qian","doi":"10.1007/s40520-025-03060-1","DOIUrl":"10.1007/s40520-025-03060-1","url":null,"abstract":"<div><h3>Background</h3><p>Stroke is a leading cause of death and disability worldwide, with dysphagia being a common complication that worsens patient outcomes.</p><h3>Methods</h3><p>Data from 200 stroke patients (development cohort) and 50 stroke patients (validation cohort) were analyzed to develop a nomogram for predicting post-stroke dysphagia (PSD). Risk factors were identified through univariate analysis, Least Absolute Shrinkage and Selection Operator (LASSO) regression, and multivariate logistic regression.</p><h3>Results</h3><p>Univariate analysis revealed substantial differences in age, body mass index (BMI), diabetes, atrial fibrillation, National Institute of Health Stroke Scale (NIHSS) score, Activities of Daily Living (ADL) score, lesion site, stroke type, and several laboratory indicators across the groups. Further analysis of individual NIHSS items showed significant differences in consciousness level, best gaze, facial palsy, motor arm, motor leg, dysarthria, etc. LASSO regression identified three predictors: ADL score, motor leg, and dysarthria. Multivariable logistic regression revealed that ADL score [0.96 (0.94–0.97)], motor leg [5.70 (2.14–15.22)], and dysarthria [5.26 (2.00–13.82)] were independent risk factors for PSD. The prediction model’s AUC was 0.915 (0.874–0.955), with a sensitivity of 0.920 (0.867–0.973), specificity of 0.800 (0.722–0.878), positive predictive value (PPV) of 0.821 (0.750–0.892), negative predictive value (NPV) of 0.909 (0.849–0.969), and F1 score of 0.859. External validation yielded an AUC of 0.995 (0.984–1.000).</p><h3>Conclusions and Implications</h3><p>ADL score, motor leg, and dysarthria are independent predictors of PSD. The prediction model based on these factors shows high accuracy, sensitivity, balance, consistency, and clinical applicability. This nomogram can support decision-making for ultra-early rehabilitation care, ultimately improving patient prognosis.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03060-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932309","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 U-curve associations of birth interval with prevalence of osteoarthritis in postmenopausal women","authors":"Long Chen,&nbsp;Feng Gao,&nbsp;Xin Wang,&nbsp;Wenjing Fan,&nbsp;Xuyan Shen,&nbsp;Jiajia Wang","doi":"10.1007/s40520-025-03057-w","DOIUrl":"10.1007/s40520-025-03057-w","url":null,"abstract":"<div><h3>Background</h3><p>To explore associations of birth interval, age at first birth (AFB), age at last birth (ALB) with prevalence of osteoarthritis (OA) in United States (U.S.) postmenopausal women with two deliveries.</p><h3>Methods</h3><p>Cross-sectional analysis of 3088 postmenopausal women with two deliveries from the National Health and Nutrition Examination Survey (1999–2018). Weighted multivariable logistic regression, subgroup analysis and restricted cubic spline (RCS) models were used to examine association of reproductive factors (birth interval, AFB and ALB) with OA risk.</p><h3>Results</h3><p>The prevalence of OA was 30.6%. According to RCS, we found the U-shaped relationships were observed between AFB, ALB, birth interval and risk or OA in postmenopausal women. 24–25 years for AFB, 25–30 years for ALB, and 4–6 years for birth interval were associated with lowest OA risk. These associations persisted across various subgroups.</p><h3>Conclusions</h3><p>AFB, ALB and birth interval shown the U-shaped associations with OA prevalence in postmenopausal women with two deliveries. These findings highlight the potential long-term impacts of reproductive history on musculoskeletal health and may inform strategies for OA prevention in U.S. postmenopausal women.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03057-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143925704","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":"Urban health inequities and healthy longevity: traditional and emerging risk factors across the cities and policy implications","authors":"Stefano Cacciatore,&nbsp;Sofia Mao,&nbsp;Mayra Villalba Nuñez,&nbsp;Claudia Massaro,&nbsp;Luigi Spadafora,&nbsp;Marco Bernardi,&nbsp;Francesco Perone,&nbsp;Pierre Sabouret,&nbsp;Giuseppe Biondi-Zoccai,&nbsp;Maciej Banach,&nbsp;Riccardo Calvani,&nbsp;Matteo Tosato,&nbsp;Emanuele Marzetti,&nbsp;Francesco Landi","doi":"10.1007/s40520-025-03052-1","DOIUrl":"10.1007/s40520-025-03052-1","url":null,"abstract":"<div><p>Urbanization is reshaping global health, with over 55% of the world’s population residing in urban areas, a figure projected to reach 68% by 2050. This demographic shift presents significant challenges and opportunities for public health, as urban environments exacerbate health disparities rooted in social determinants of health, such as economic stability, education, neighborhood conditions, and access to healthcare. Rapid urban growth, particularly in low- and middle-income countries, has led to the emergence of inequitable living conditions, environmental hazards, and limited access to essential health services, contributing to the early onset of multimorbidity and rising non-communicable disease burdens. Urbanization-driven factors such as obesogenic environments, sedentary lifestyles, air pollution, and inadequate sleep exacerbate cardiovascular and metabolic risks, while social exclusion, overcrowding, and inadequate mental health services heighten vulnerabilities. Emerging risks, including urban heat islands, noise pollution, and exposure to endocrine-disrupting chemicals, further compound urban health inequities. Effective mitigation requires multi-sectoral policies that prioritize health-promoting infrastructure, reduce environmental pollutants, foster equitable healthcare access, and address systemic barriers affecting marginalized groups. This review explores the intersections between urbanization and health inequities, emphasizing the importance of addressing traditional and emerging risk factors across the lifespan. Policy implications include promoting green infrastructure, enhancing urban mobility, expanding mental health care, and leveraging participatory governance to foster resilient and inclusive cities. By adopting an integrated approach that prioritizes social equity and sustainability, cities can mitigate health disparities and create healthier, more inclusive urban environments that support the well-being of all residents.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03052-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913877","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":"Calf circumference predicts changes of bone mineral density in postmenopausal osteoporotic women receiving denosumab","authors":"Cecilia Oliveri,&nbsp;Anastasia Xourafa,&nbsp;Nunziata Morabito,&nbsp;Adele Di Giovanni,&nbsp;Elisa Lupo,&nbsp;Giorgio Basile,&nbsp;Agostino Gaudio,&nbsp;Antonino Catalano","doi":"10.1007/s40520-025-02989-7","DOIUrl":"10.1007/s40520-025-02989-7","url":null,"abstract":"<div><h3>Background</h3><p>Aging is associated with deterioration of muscle and bone health, resulting in increased fragility fracture risk. It is not known whether muscle mass and strength could impact the osteoporosis pharmacological response.</p><h3>Aim</h3><p>The aim of this study was to analyze the association between muscle mass and strength with the response to denosumab in osteoporosis.</p><h3>Methods</h3><p>Postmenopausal women at high fracture risk receiving denosumab (60 mg subcutaneously administered every 6 months) were considered. The likelihood of sarcopenia was estimated by administering the SARC-F questionnaire, muscle mass and performance were assessed by measuring calf circumference (CC) and hand grip strength, respectively. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry.</p><h3>Results</h3><p>130 women (age 70.2 ± 9.4 years) were recruited. Baseline BMD T-score values were − 2.6 ± 1.1 SD and − 2.3 ± 0.7 SD at lumbar spine and femoral neck, respectively; while CC and grip strength were 31.9 ± 2.9 cm and 22.7 ± 6.7 kg, respectively. The SARC-F score was associated with the 10-year probability of major osteoporotic fracture (r = 0.21, p &lt; 0.05). The CC was positively associated with the T-score values of both lumbar spine (r = 0.262, p = 0.034) and femoral neck (r = 0.359, p = 0.004). Denosumab administration (treatment duration 43 months), lead to BMD improvement by + 9.6% at the lumbar spine and + 7.3% at the femoral neck (p^all &lt; 0.05). After adjustment for comorbidities, fracture risk and treatment duration, the CC (β = 1.76, SE = 0.82, p = 0.03) and the baseline femoral BMD (β = − 94.19, SE = 26.09, p = 0.0009) were independently associated with femoral BMD gain over time.</p><h3>Conclusion</h3><p>In postmenopausal osteoporotic women, the CC was positively and independently associated with denosumab treatment response.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-02989-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904859","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":"Comparative efficacy and safety of antidiabetic drugs for obese patients with knee osteoarthritis: a network meta-analysis of randomized controlled trials","authors":"Guangyao Jiang,&nbsp;Xiangyu Yang,&nbsp;Guanghui Zhu,&nbsp;Tang Liu","doi":"10.1007/s40520-025-03017-4","DOIUrl":"10.1007/s40520-025-03017-4","url":null,"abstract":"<div><h3>Background</h3><p>Obesity-related knee osteoarthritis (KOA) is a significant public health concern, affecting quality of life. Recent evidence suggests some antidiabetic drugs may help manage KOA in obese patients due to their anti-inflammatory and weight-reducing effects.</p><h3>Objective</h3><p>This study aimed to compare the efficacy and safety of antidiabetic drugs for managing pain and adverse events in obese KOA patients through a network meta-analysis of randomized controlled trials (RCTs).</p><h3>Methods</h3><p>A systematic search of multiple databases identified relevant RCTs on antidiabetic drugs for KOA. Treatment efficacy was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score improvement, and safety was evaluated based on the incidence of serious adverse events. The Surface Under the Cumulative Ranking Curve (SUCRA) scores were used to rank the treatments, and effect sizes were reported as mean differences (MD) with 95% confidence intervals (CI).</p><h3>Results</h3><p>A total of nine RCTs were included in the analysis. For pain relief, metformin demonstrated the largest effect size with a mean difference of − 1.13 (95% CI − 1.48, − 0.78) compared to usual care, followed by Metformin-Phosphatidylcholine (MFPH) (− 0.92, 95% CI − 1.70, − 0.13) and semaglutide (− 0.90, 95% CI − 1.48, − 0.32). In terms of safety, usual care exhibited the lowest risk of adverse events, with liraglutide (0.09, 95% CI − 0.74, 0.92) and semaglutide (0.21, 95% CI − 0.46, 0.88) also showing favorable safety profiles. The SUCRA rankings further supported these findings, with metformin ranking highest for efficacy (SUCRA: 86.8%) and usual care ranking highest for safety (SUCRA: 75.7%). However, these rankings should be interpreted alongside the effect sizes and clinical context to fully assess the trade-offs between efficacy and safety across interventions.</p><h3>Conclusions</h3><p>Metformin and MFPH are promising for managing KOA pain in obese patients. Semaglutide offers a balanced efficacy and safety profile, while liraglutide may be a safe option for selected patients. Further research is needed to confirm these findings and assess long-term outcomes.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03017-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908851","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":"Social isolation, loneliness and the relationship with serum biomarkers, functional parameters and mortality in older adults","authors":"Stefanie Braig,&nbsp;Michael D. Denkinger,&nbsp;Dhayana Dallmeier,&nbsp;Jochen Klenk,&nbsp;Dietrich Rothenbacher,&nbsp;for the ActiFE Study Group","doi":"10.1007/s40520-025-03041-4","DOIUrl":"10.1007/s40520-025-03041-4","url":null,"abstract":"<div><h3>Background</h3><p>Pathways between social isolation (SI), loneliness and health are unclear.</p><h3>Aims</h3><p>To analyze the relationship between SI and loneliness with biomarkers of inflammation, cardiac and immune function, functional parameters, and mortality.</p><h3>Methods</h3><p>SI (Lubben Social Network Scale) from family, friends, and overall as well as loneliness (single direct question) were assessed at baseline in a population-based cohort study of 1459 community-dwelling adults aged 65 + in Germany. Serum biomarkers and functional parameters measured at baseline and at three-year follow-up included high-sensitivity C reactive protein (hs-CRP), growth differentiation factor-15 (GDF-15), N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hs-cTnI), high-sensitivity troponin T (hs-cTnT), gait speed, and hand grip strength. We used linear and Cox regression analyses adjusted for age and sex (model 1) and established confounders (model 2).</p><h3>Results</h3><p>High SI from friends was associated with small but significant adverse associations with some biomarkers (hs-CRP, GDF-15, hs-cTnT) at follow-up (model 1). High SI from family associated with NT-proBNP (model 2), high SI and moderate to severe loneliness with lower gait speed. Loneliness was linked to hs-CRP at baseline, but SI was a stronger predictor of biomarker levels. High SI overall (Hazard ratio 1.39, 95% CI 1.15; 1.67, model 2) was associated with increased 10-year mortality.</p><h3>Discussion</h3><p>Mainly SI from friends is linked to unfavorable biomarker profiles with small associations. Overall SI was negatively associated with functional parameters and positively with mortality.</p><h3>Conclusions</h3><p>Further research should confirm our findings using, e.g. a multidimensional assessment of loneliness.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03041-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902751","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}