Aging Clinical and Experimental Research最新文献

{"title":"Effects of 12-month physical and cognitive training on sarcopenia determinants in older adults: a subgroup analysis of a randomised clinical trial","authors":"Onni Oskari Hämäläinen,&nbsp;Tiina Marketta Savikangas,&nbsp;Anna-Katriina Tirkkonen,&nbsp;Markku Juhani Alén,&nbsp;Arto Jorma Hautala,&nbsp;Sarianna Sipilä","doi":"10.1007/s40520-025-02935-7","DOIUrl":"10.1007/s40520-025-02935-7","url":null,"abstract":"<div><h3>Background</h3><p>Low physical activity is a major risk for sarcopenia. Whether training according to physical activity guidelines accompanied with cognitive training is effective on sarcopenia, remains unclear.</p><h3>Aims</h3><p>We investigated whether the effects of 12-month physical and cognitive training (PTCT) and physical training (PT) on grip and knee extension strength, muscle mass, and walking speed differed between older adults with and without sarcopenia.</p><h3>Methods</h3><p>Community-dwelling older adults (<i>N</i> = 314, mean age 74.5 ± 3.8 years, 60% women) who did not meet physical activity guidelines were randomized to PTCT and PT groups. PT for both groups included supervised and home-based multicomponent physical training. Cognitive training (CT) included computer-based exercises for executive functioning. Sarcopenia was determined according to the European Working Group on Sarcopenia in Older People 2019 criteria. Generalized estimation equation analysis were conducted.</p><h3>Results</h3><p>Compared to PT, PTCT had no additive effect on strength, muscle mass, or walking speed in participants with or without sarcopenia. In pooled data (PT + PTCT) change in the grip strength was greater in sarcopenia (<i>n</i> = 49) group compared to non-sarcopenia (<i>n</i> = 264) group (interaction, <i>p</i> =.014). Both groups improved knee extension strength, and walking speed, but no statistically significant difference between the groups were observed. Muscle mass did not change in either group.</p><h3>Conclusion</h3><p>Physical training according to physical activity recommendations improves muscle strength, walking speed, and maintains muscle mass in sarcopenia. Additional cognitive training had no benefits on these outcomes.</p><h3>Trial registration number</h3><p>ISRCTN52388040 and date of registration 20/1/2017.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-02935-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143184670","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":"Stair-descent phenotypes in community-dwelling older adults determined using high-level balance tasks","authors":"Takahiro Tanaka,&nbsp;Kimitaka Hase,&nbsp;Kimihiko Mori,&nbsp;Masanori Wakida,&nbsp;Yasuaki Arima,&nbsp;Takanari Kubo,&nbsp;Meguru Taguchi","doi":"10.1007/s40520-025-02929-5","DOIUrl":"10.1007/s40520-025-02929-5","url":null,"abstract":"<div><h3>Background</h3><p>Falls on stairs are a major cause of severe injuries among older adults, with stair descent posing significantly greater risks than ascent. Variations in stair descent phenotypes may reflect differences in physical function and biomechanical stability, and their identification may prevent falls.</p><h3>Aims</h3><p>This study aims to classify stair descent phenotypes in older adults and investigate the biomechanical and physical functional differences between these phenotypes using hierarchical cluster analysis.</p><h3>Methods</h3><p>Eighty-two older adults participated in this study. Stair descent was measured using a three-dimensional motion analysis system. Physical function was assessed using measures of muscle strength, walking speed, the Timed Up and Go Test (TUG), and the Community Balance and Mobility Scale (CB&amp;M).</p><h3>Results</h3><p>Hierarchical cluster analysis was performed on kinematic data obtained during stair descent. Three phenotypes were identified: neutral (N-type; 24%), extension (E-type; 52%), and rotation (R-type; 23%). There were no significant differences in lower limb muscle strength or walking speed among the different types, and TUG scores showed no differences in terms of mobility or balance abilities. However, CB&amp;M scores were significantly lower for E-type and R-type compared to N-type. Sub-analyses revealed that while there were no differences in the mobility factor of CB&amp;M between E-type and R-type, the strength factors were significantly lower compared to those for N-type.</p><h3>Discussion</h3><p>These results suggest that E-type and R-type stair-descent patterns may be influenced by declines in standing balance ability and muscle strength.</p><h3>Conclusions</h3><p>These findings may inform fall-prevention training programs related to stair descent among older adults.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057627","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 association between preoperative lacunar infarcts and postoperative delirium in elderly patients undergoing major abdominal surgery: a prospective cohort study","authors":"Danni Li,&nbsp;Pan Gu,&nbsp;Yuhao Wang,&nbsp;Yuchen Yao,&nbsp;Dan Fan","doi":"10.1007/s40520-024-02909-1","DOIUrl":"10.1007/s40520-024-02909-1","url":null,"abstract":"<div><h3>Objective</h3><p>The primary goal was to investigate whether the presence of preoperative lacunar infarcts (LACI) was associated with postoperative delirium (POD) in elderly patients undergoing elective major abdominal surgery.</p><h3>Design</h3><p>A prospective cohort study.</p><h3>Setting and participants</h3><p>Patients aged ≥ 65 years from a tertiary level A hospital in China.</p><h3>Methods</h3><p>The POD was assessed once daily within the first postoperative 3 days using the Confusion Assessment Method. Neurocognitive tests using the Mini-mental State Examination (MMSE) and the Beijing version of the Montreal Cognitive Assessment scales were carried out within 3 days before surgery and 4–7 days after surgery. Regional cerebral oxygen saturation (rScO₂) was recorded in the operating room. Logistic regression analysis was used to evaluate the impact of preoperative LACI on POD and to explore the risk factors for POD.</p><h3>Results</h3><p>A total of 369 participants were analyzed, 161 in the preoperative LACI-positive group (P group), and 208 in the preoperative LACI-negative group (N group), respectively. The incidence of POD was 32.7% in our study. The incidence of POD was significantly higher in the P group than in the N group (39.1 vs 27.9%, risk ratio, 1.66; 95% CI 1.07–2.58; <i>P</i> = 0.022). Furthermore, the P group exhibited lower mean rScO₂ values during the procedure (<i>P</i> &lt; 0.001). In exploratory analysis, the advanced age (<i>P</i> = 0.005), sex (<i>P</i> = 0.038), and lower preoperative MMSE score (<i>P</i> = 0.019) were independent risk factors for POD in patients undergoing major abdominal surgery.</p><h3>Conclusions and implications</h3><p>Preoperative LACI was common, and constituted a risk factor for POD in older patients undergoing abdominal surgery. Despite the frequent subclinical nature, the preoperative LACI led to lower mean rScO₂ during the procedure. These findings could help early identification of high-risk POD patients.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057631","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":"Determinants of frailty among hospitalized older adults across various wards in a tertiary care hospital in Nepal","authors":"Prabha Shrestha,&nbsp;Lee Smith,&nbsp;Sarina Shakya,&nbsp;Yunika Acharya","doi":"10.1007/s40520-024-02895-4","DOIUrl":"10.1007/s40520-024-02895-4","url":null,"abstract":"<div><h3>Introduction</h3><p>Frailty, characterized by decreased resilience due to physiological decline, affects approximately 65% of community-dwelling elderly in Nepal. This study assessed frailty and its factors among hospitalized older adults in a tertiary hospital in Nepal.</p><h3>Methods</h3><p>This cross-sectional study included 124 participants aged 60 and above, admitted to a tertiary hospital in Nepal. Frailty was assessed using the Groningen Frailty Index (GFI), a validated self-reported tool. Univariable and multivariable logistic regression analyses were conducted to identify factors associated with frailty, using STATA version 13.0.</p><h3>Results</h3><p>Frailty was observed in 58.8% of participants. Adjusted analysis showed that, compared to those who cannot read and write, those with no formal education had 0.14 times lower odds of frailty (<i>p</i> = 0.01, 95% CI 0.03–0.66), while those with formal education had 0.19 times lower odds (<i>p</i> = 0.01, 95% CI = 0.04–0.73). Participants with comorbidities had 3.51 times higher odds of frailty (<i>p</i> = 0.01, 95% CI: 1.22–10.07), and those with a history of falls had 8.10 times higher odds (<i>p</i> = 0.005, 95% CI: 1.89–34.78).</p><h3>Conclusion</h3><p>Frailty was prevalent in over half of the respondents. Lower levels of educational achievement, comorbidities, and a history of falls were identified factors of frailty. Targeted interventions addressing multimorbidity and fall prevention may reduce frailty risk among high-risk older adults in Nepal.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051368","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":"Effects of different types of Tai Chi intervention on motor function in older adults: a systematic review","authors":"Xu Fan,&nbsp;Kim Geok Soh,&nbsp;Chan Yoke Mun,&nbsp;Kim Lam Soh","doi":"10.1007/s40520-024-02894-5","DOIUrl":"10.1007/s40520-024-02894-5","url":null,"abstract":"<div><h3>Background</h3><p>Tai Chi (TC) is widely acknowledged for its positive impact on improving motor function in older adults. Nevertheless, limited research has directly compared the effects of different TC styles on older adults with functional impairments.</p><h3>Objective</h3><p>This study aimed to assess the impact of different TC styles on motor function in older adults with functional impairments.</p><h3>Method</h3><p>We searched five databases—PubMed, Scopus, Chinese National Knowledge Infrastructure (CNKI), Web of Science, and Wiley Online Library—including studies published up to September 2024. The selection of literature adhered to PRISMA guidelines, with quality assessment independently carried out by two researchers.</p><h3>Results</h3><p>Fourteen studies met the inclusion criteria for this review. The analysis revealed that TC interventions for functionally impaired older adults primarily employed Yang-style, Sun-style, Chen-style, and simplified-style TC. The populations studied included individuals with mild cognitive impairment (MCI), nonspecific low back pain (NS-LBP), preclinical disabilities, chronic diseases, poor balance, osteoarthritis (OA), Parkinson’s disease (PD), sarcopenia, and those at risk of falls. The findings indicated that motor function in functionally impaired older adults were closely linked to balance, gait, mobility, strength, and fall rates. Among the various TC styles, Yang-style was the most frequently utilised intervention.</p><h3>Conclusion</h3><p>This review examined four types of TC interventions and found strong evidence supporting the effectiveness of Yang-style TC in improving motor function in older adults with functional impairments. Additionally, five assessment methods—Single-Leg Stance (SL), Six-Minute Walk Test (6MWT), Timed Up and Go Test (TUGT), Chair Stand Test (CST), and Fall Efficacy Scale (FES)—were identified as suitable for evaluating this population. Based on the findings, it is recommended that individuals with functional impairments engage in Yang-style 24-movement TC, with an intervention duration of 12 weeks, practicing two to five times a week for 60 min each session.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02894-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142995634","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":"Hospitalizations of the older adults with and without dementia during the last two years of life: the impact of comorbidity and changes from 2002 to 2017","authors":"Saritha Susan Vargese,&nbsp;Marja Jylhä,&nbsp;Jani Raitanen,&nbsp;Leena Forma,&nbsp;Mari Aaltonen","doi":"10.1007/s40520-024-02918-0","DOIUrl":"10.1007/s40520-024-02918-0","url":null,"abstract":"<div><h3>Background</h3><p>Multimorbidity creates challenges for care and increases health care utilization and costs. People with dementia often have multiple comorbidities, but little is known about the role of these comorbidities in hospitalizations.</p><h3>Aims</h3><p>This study examines the frequency of hospitalizations during the last two years of life in older adults with and without dementia, the impact of comorbidities on hospitalizations, and their time trends.</p><h3>Methods</h3><p>The data came from national registers and covered all persons 70 and above who died in Finland in 2002–2017. The effect of dementia and comorbidities on hospitalizations in the last two years of life was determined using binary logistic regression and negative binomial regression.</p><h3>Results</h3><p>At all levels of comorbidity, people with dementia were less likely to be hospitalized and had a lower number of hospitalizations than people at the same level of comorbidity but no dementia. Hospitalizations were strongly associated with multimorbidity. During the study period, the overall hospitalization rates from home and LTC have declined.</p><h3>Discussion</h3><p>The declining trend of hospitalization during the 15-year study period should be interpreted in the context of the health and long-term care system.</p><h3>Conclusion</h3><p>Among people with dementia, comorbidities were the main driver for hospitalizations. Regardless of the number of comorbidities, people with dementia were hospitalized less often than people without dementia in last two years of life. It remains unclear whether the lower hospitalization rate is due to the improved ability to care for people with dementia outside the hospital or to the lack of sufficient medical care for them.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02918-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142995699","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":"Loneliness, social isolation, and living alone: a comprehensive systematic review, meta-analysis, and meta-regression of mortality risks in older adults","authors":"Agni Nakou,&nbsp;Elena Dragioti,&nbsp;Nikolaos-Stefanos Bastas,&nbsp;Nektaria Zagorianakou,&nbsp;Varvara Kakaidi,&nbsp;Dimitrios Tsartsalis,&nbsp;Stefanos Mantzoukas,&nbsp;Fotios Tatsis,&nbsp;Nicola Veronese,&nbsp;Marco Solmi,&nbsp;Mary Gouva","doi":"10.1007/s40520-024-02925-1","DOIUrl":"10.1007/s40520-024-02925-1","url":null,"abstract":"<div><p>Loneliness, social isolation, and living alone are significant risk factors for mortality, particularly in older adults. This systematic review and meta-analysis aimed to quantify their associations with all-cause and cause-specific mortality in older adults, broadening previous research by including more social factors. Comprehensive searches were conducted in PubMed, APA PsycINFO, and CINAHL until December 31, 2023, following PRISMA 2020 and MOOSE guidelines. Studies included were prospective cohort or longitudinal studies examining the relationship between loneliness, social isolation, living alone, and mortality. Quality was assessed using the Newcastle-Ottawa Scale. Meta-analyses used random-effects models with the Restricted Maximum Likelihood method. Subgroup and meta-regression analyses explored the relationships further. Of 11,964 identified studies, 86 met the inclusion criteria. Loneliness was associated with increased all-cause mortality (HR 1.14, 95% CI 1.10–1.18), with substantial heterogeneity (I² = 84.0%). Similar associations were found for social isolation (HR 1.35, 95% CI 1.27–1.43) and living alone (HR 1.21, 95% CI 1.13–1.30). Subgroup analyses revealed variations based on factors like sex, age, region, chronic diseases, and study quality. Meta-regression identified longer follow-up, female sex, validated social network indices, adjustments for cognitive function, and study quality as significant predictors of mortality risks. These findings highlight the need for public health interventions to address these social factors and improve health outcomes in older adults. However, further research is needed due to variability and heterogeneity across studies. Also studying the cumulative effect of these factors on mortality risks will be of considerable interest.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02925-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142995346","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":"Exploring and validating associations between six systemic inflammatory indices and ischemic stroke in a middle-aged and old Chinese population","authors":"Yulu Zheng,&nbsp;Zheng Guo,&nbsp;Jingzheng Wang,&nbsp;Zhiyuan Wu,&nbsp;Xiaolin Chen,&nbsp;Yahong Zhu,&nbsp;Guangle Shan,&nbsp;Haifeng Hou,&nbsp;Xingang Li","doi":"10.1007/s40520-024-02912-6","DOIUrl":"10.1007/s40520-024-02912-6","url":null,"abstract":"<div><h3>Background</h3><p>Inflammation and maladaptive immune mechanisms have been substantiated as integral components in the critical pathological processes of the injury cascade in ischemic stroke (IS). This study aimed to explore the associations between six systemic inflammatory indices and IS in a Chinese population.</p><h3>Methods</h3><p>This was a case-control study based on the retrospective review of electronic medical records from two hospitals in Shandong Province, China. Systemic inflammatory indices, including the systemic inflammation response index (SIRI), systemic immune inflammation index (SII), pan-immune-inflammation value (PIV), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and lymphocyte monocyte ratio (LMR), were calculated. Logistic regression models and classification analyses were employed to evaluate associations and discriminatory abilities.</p><h3>Results</h3><p>In total, 9392 participants aged 40–83 years old were included in the discovery (3620 pairs of IS-present cases and healthy controls) and validation (1076 pairs of IS-present cases and IS-absent controls with IS mimics) datasets. After adjusting for potential confounding factors, IS was found to be associated with all six systemic indices in the discovery dataset, including SIRI (odd ratio [OR] 8.77, 95% confidence interval [CI] 7.48–10.33), SII (1.03, 1.01–1.04), PIV (1.01, 1.01–1.01), NLR (2.23, 2.08–2.39), PLR (1.01, 1.01–1.01), and LMR (0.77, 0.75–0.78). Notably, only LMR exhibited significant associations with IS in both discovery and validation datasets (0.88, 0.83–0.93), suggesting an independent protective role of this index. SIRI, SII, PIV, NLR, and LMR showed good discriminative ability between IS patients and healthy controls in the discovery dataset (AUCs &gt; 0.70). However, they performed poorly in distinguishing IS patients from IS mimics in the validation dataset (AUCs &lt; 0.60).</p><h3>Conclusion</h3><p>This study provides valuable insights into the associations between systemic inflammatory indices and IS, offering potential implications for risk stratification. While these inflammatory indices are potential indicators for distinguishing IS from healthy conditions, additional biomarkers may be needed when differentiating IS from other chronic inflammatory conditions in clinical practice.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02912-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142995283","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":"Suggestions for the decision making in subjective cognitive complaints","authors":"Benedetta Basagni,&nbsp;Eduardo Navarrete","doi":"10.1007/s40520-024-02875-8","DOIUrl":"10.1007/s40520-024-02875-8","url":null,"abstract":"<div><p>In recent years, the increasing life expectancy has underscored the importance of cognitive health alongside physical well-being, particularly because healthy adults may report subjective cognitive complaints (SCC), often related to memory. These complaints may or may not align with objective cognitive impairments, fueling ongoing debates about whether SCC could serve as an early indicator of dementia. While some studies suggest SCC as a potential precursor to dementia, others propose that these complaints may merely co-occur with cognitive decline. Despite the lack of consensus, addressing SCC remains crucial for early intervention, especially as emerging treatments for dementia show promise when applied at early stages. Risk factors associated with dementia, such as age, education, family history, and comorbid conditions like depression and diabetes, have been incorporated into predictive models. However, clinical practice continues to rely heavily on neuropsychological assessments to bridge subjective complaints with objective cognitive performance and may often require additional investigations, such as neuroimaging. Factors such as cognitive reserve, depression, stress, sleep disturbances, and personality traits also play significant roles in the interpretation of SCC. Some of these conditions may potentially mask underlying cognitive decline. A comprehensive clinical evaluation, integrating neuropsychological testing with a thorough anamnesis, can help distinguish between cognitive disorders and other contributing factors. Here, we propose a flowchart to guide clinicians in the management of SCC, integrating key factors to enhance diagnostic accuracy and inform treatment decisions. Despite the challenges involved, a careful and holistic approach remains essential for effective patient care.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02875-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142995282","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 non-highdensity lipoprotein cholesterol to highdensity lipoprotein cholesterol ratio (NHHR) and subsequent hypertension and heart diseases: findings from the CHARLS cohort","authors":"Feng Zhang,&nbsp;Zhuqing Li,&nbsp;Meng Wang,&nbsp;Yanxin Wang,&nbsp;Chengzhi Lu","doi":"10.1007/s40520-024-02919-z","DOIUrl":"10.1007/s40520-024-02919-z","url":null,"abstract":"<div><h3>Purpose</h3><p>NHHR, the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol, is a novel lipid marker associated with the risk of heart diseases and various health conditions. However, there is limited evidence regarding the relationship between NHHR and the onset of hypertension and heart diseases. The aim of this study was to investigate the association between NHHR and the new-onset hypertension and heart diseases among the Chinese middle-aged and older general population.</p><h3>Methods</h3><p>This prospective cohort study utilized data from a nationally representative sample of Chinese residents aged 45 and older, sourced from the China Health and Retirement Longitudinal Study (CHARLS). The primary outcomes of the study were new-onset hypertension and heart diseases. To investigate the relationship between the NHHR and the risk of new-onset hypertension and heart diseases, multivariate logistic regression models and the restricted cubic spline (RCS) method were employed. Additionally, the mediating effects of hypertension on the association between NHHR and heart diseases were assessed using the bootstrap method.</p><h3>Results</h3><p>A total of 5349 participants were included in the final analysis and three groups of NHHR were identified, including low-stable, medium-stable, and high-stable NHHR. By 2020, 1,631 participants (30.5%) had been newly diagnosed with hypertension, while 1233 (23.1%) developed heart diseases. Compared to those with a low-stable NHHR, individuals in the other two groups showed a significantly increased risk of developing hypertension and heart diseases. The findings remained consistent across various sensitivity analyses. According to the RCS analysis, a partial U-shaped relationship existed between the NHHR and the risk of developing hypertension and heart diseases (P for nonlinear &lt; 0.001). Furthermore, hypertension was found to partially mediate the association between NHHR and heart diseases.</p><h3>Conclusion</h3><p>The NHHR was closely associated with an increased risk of developing hypertension and heart diseases. In addition, the NHHR partially mediated the development of heart diseases by promoting hypertension progression. In the prevention and treatment of heart diseases, managing both lipid levels and blood pressure is crucial.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02919-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142995698","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}