Aging Clinical and Experimental Research最新文献

{"title":"Causal association of sarcopenia-related traits with brain cortical structure: a bidirectional Mendelian randomization study","authors":"Yuxuan Zhan,&nbsp;Zhiyun Zhang,&nbsp;Siyi Lin,&nbsp;Bang Du,&nbsp;Kai Zhang,&nbsp;Jian Wu,&nbsp;Hongxia Xu","doi":"10.1007/s40520-025-02977-x","DOIUrl":"10.1007/s40520-025-02977-x","url":null,"abstract":"<div><h3>Background</h3><p>Patients with sarcopenia often experience cognitive decline, affecting cortical structures, but the causal link remains unclear. We used bidirectional Mendelian randomization (MR) to explore the relationship between sarcopenia-related traits and cortical structure.</p><h3>Methods</h3><p>We selected genetic variables from genome-wide association study data. Three different MR methods were used: inverse-variance weighted analysis, MR-Egger regression, and the weighted median test. For significant estimates, we further conducted Cochran’s Q test, MR-Egger intercept test, leave-one-out analyses, and MR-PRESSO to assess heterogeneity.</p><h3>Results</h3><p>In forward MR analysis, appendicular lean mass (ALM) decreased the thickness (TH) of lateral occipital gyrus and increased the TH of pars opercularis gyrus (β = -0.0079 mm, 95% CI: -0.0117 mm to -0.0041 mm, <i>P</i> &lt; 0.0001; β = 0.0080 mm, 95% CI: 0.0042 mm to 0.0117 mm, <i>P</i> &lt; 0.0001). In reverse MR analysis, a significant negative correlation was found between the TH of bankssts and ALM, while positive correlations were observed between the TH of frontal pole, rostral anterior cingulate, temporal pole, and ALM. The TH of temporal pole was positively correlated with right hand grip strength (HGS-R) (β = 0.1596 mm, 95% CI: 0.1349 mm to 0.1843 mm, <i>P</i> &lt; 0.0001), and the TH of pars triangularis was positively correlated with left-hand grip strength (HGS-L) (β = 0.3251 mm, 95% CI: 0.2339 mm to 0.4163 mm, <i>P</i> &lt; 0.0001).</p><h3>Conclusions</h3><p>Sarcopenia-related traits and cortical structure have bidirectional effects, supporting the muscle-brain axis theory. This links sarcopenia to neurocognitive diseases and provides new strategies for the prevention and intervention of both sarcopenia and cognitive decline.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-02977-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143496889","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":"Correction: Association between statin usage and mortality outcomes in aging U.S. cancer survivors: a nationwide cohort study","authors":"Shan Ding,&nbsp;Fengling Yang,&nbsp;Pan Lai,&nbsp;Jiang Weiwen,&nbsp;Minze Chen,&nbsp;Yijun Ge,&nbsp;Liting Zhou,&nbsp;Shaozhuang Chen,&nbsp;Jiaqi Zhang,&nbsp;Ye Yanrong","doi":"10.1007/s40520-024-02900-w","DOIUrl":"10.1007/s40520-024-02900-w","url":null,"abstract":"","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02900-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143496664","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":"Frailty as an independent risk factor for sepsis-associated delirium: a cohort study of 11,740 older adult ICU patients","authors":"Guoqiang Zheng,&nbsp;Jiajian Yan,&nbsp;Wanyue Li,&nbsp;Zhuoming Chen","doi":"10.1007/s40520-025-02956-2","DOIUrl":"10.1007/s40520-025-02956-2","url":null,"abstract":"<div><h3>Background</h3><p>Sepsis-associated delirium (SAD) is a common complication in intensive care unit (ICU) patients and is associated with increased mortality. Frailty, characterized by diminished physiological reserves, may influence the development of SAD, but this relationship remains poorly understood.</p><h3>Aims</h3><p>To comprehensively analyze the assessment of frailty as a predictive factor for sepsis-associated delirium in older adults.</p><h3>Methods</h3><p>A retrospective cohort analysis was performed on sepsis patients aged ≥ 65 years admitted to the ICU. Frailty was assessed using the Modified Frailty Index based on 11 items including comorbidities and functional status. Patients were categorized into non-frail (MFI: 0–2) and frail (MFI ≥ 3) groups. Delirium was assessed using the ICU Confusion Assessment Method (CAM-ICU) and retrospective nursing notes. Logistic regression analysis was used to examine the relationship between frailty in older patients and the risk of delirium, and odds ratios (OR) and their 95% confidence intervals (CI) were calculated.</p><h3>Results</h3><p>Among 11,740 patients (median age approximately 76 years [interquartile range: 70.47–83.14], 44.3% female), frail patients tended to have longer ICU stays, higher severity scores, and potentially worse clinical outcomes. The study found a significant positive association between MFI and the risk of developing SAD (OR: 1.13, 95% CI: 1.09–1.17, <i>p</i> &lt; 0.001). Additionally, frail patients had a higher risk of developing SAD compared to non-frail patients (OR: 1.31, 95% CI: 1.20–1.43, <i>p</i> &lt; 0.001).</p><h3>Conclusions</h3><p>Frailty independently predicts SAD development in older adults with sepsis in the ICU, emphasizing the importance of early recognition and prevention.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-02956-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143496899","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":"Urinary 4-pyridoxic acid as a non-invasive biomarker for evaluating osteoarthritis severity: findings from the ROAD study","authors":"Noriko Yoshimura,&nbsp;Aiko Miyazaki,&nbsp;Toshiko Iidaka,&nbsp;Nobuo Ando,&nbsp;Gaku Tanegashima,&nbsp;Shigeyuki Muraki,&nbsp;Horiyuki Oka,&nbsp;Sakae Tanaka","doi":"10.1007/s40520-025-02944-6","DOIUrl":"10.1007/s40520-025-02944-6","url":null,"abstract":"<div><h3>Background</h3><p>The early detection of osteoarthritis (OA) requires reliable biomarkers; however, reports identifying such biomarkers remain limited.</p><h3>Aims</h3><p>This study aimed to evaluate the potential of urinary 4-pyridoxic acid (4PA) as a biomarker for the severity of knee osteoarthritis (KOA) and lumbar spondylosis (LS) in Japanese adults, using data from the population-based cohort study.</p><h3>Methods</h3><p>Data were analysed from 1566 participants (510 men and 1,056 women) aged ≥ 40 years, who were enrolled in the Research on Osteoarthritis/Osteoporosis against Disability (ROAD) cohort, a population-based study initiated in 2005. Participants underwent radiographic assessments of the knees and lumbar spine, and urinary 4PA levels were measured using high-performance liquid chromatography. Logistic regression analyses were performed to evaluate the association between urinary 4PA levels and the Kellgren–Lawrence (KL) grade of KOA and LS, adjusting for age, sex, body mass index (BMI), and lifestyle factors.</p><h3>Results</h3><p>Urinary 4PA levels were significantly higher in participants with KL grade 4 KOA compared to those with lower KL grades (p &lt; 0.001). This association remained significant after adjusting for confounding factors. In contrast, no significant differences in 4PA levels were observed across the KL grades for LS, although a slight increase in 4PA levels was noted in KL grade 4 cases.</p><h3>Discussion and conclusions</h3><p>These findings suggest that urinary 4PA could serve as a biomarker for assessing KOA severity, particularly in advanced stages. While the detection of early OA using 4PA remains challenging, the significant increase in KL grade 4 cases highlights its potential role in guiding treatment decisions, such as surgical intervention.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-02944-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489556","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":"Health beliefs mediates the association between the number of non-communicable diseases and preventive behaviors in middle-aged and older adults in southern China","authors":"Yali Huang,&nbsp;Tingjun Wang,&nbsp;Huajun Wang,&nbsp;Yongjun Zeng,&nbsp;Liangdi Xie","doi":"10.1007/s40520-025-02939-3","DOIUrl":"10.1007/s40520-025-02939-3","url":null,"abstract":"<div><h3>Background</h3><p>The triadic relationship among the number of NCDs, preventive behaviors and health beliefs has not been fully explored, especially the role of health beliefs.</p><h3>Aims</h3><p>To explore the association between the number of NCDs and preventive behaviors, as well as the mediating effect of health beliefs and its dimensions among middle-aged and older adults. Provide scientific evidence for developing targeted behavior intervention.</p><h3>Methods</h3><p>Data from 2095 middle-aged and older adults who completed demographic information, health beliefs and preventive behaviors questionnaire. Mediation analysis was used to explore the association of health beliefs and its dimensions between the number of NCDs and preventive behaviors.</p><h3>Results</h3><p>Health beliefs and self-efficacy positively impacted preventive behaviors, whereas perceived severity, while perceived barriers had negative effects. Health beliefs (<i>β</i> = − 0.1809, 95% CI − 0.2658 to − 0.0960) and its dimensions(Perceived barriers:<i>β</i> = − 0.0881, 95% CI − 0.1533 to − 0.0232, self-efficacy: <i>β</i> = − 0.2706, 95% CI − 0.3592 to − 0.1892) partially mediated the associations between the number of NCDs and preventive behaviors. The negative mediation effects indicates that as the number of NCDs increases, preventive behaviors decrease, partly due to a decline in health beliefs and self-efficacy, as well as an increase in perceived barriers (scored inversely, meaning higher barriers). These mediation pathways exhibited modest strength, highlighting the importance of health beliefs on behavior change.</p><h3>Conclusions</h3><p>An increasing number of NCDs is associated with reduced engagement in preventive behaviors. Health beliefs and its dimensions play a partial mediating role in this relationship. Effective intervention targeting health beliefs may help promote positive behavioral changes.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-02939-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481031","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":"Falls and physical function in older patients with Benign Paroxysmal Positional Vertigo (BPPV): findings from a placebo controlled, double blinded randomized control trial (RCT) investigating efficacy of vitamin D treatment in lowering the recurrence rate of BPPV","authors":"Xiaoting Huang,&nbsp;Kenneth Wei De Chua,&nbsp;Shirlene Pei Shi Moh,&nbsp;Heng Wai Yuen,&nbsp;David Yong Ming Low,&nbsp;Poongkulali Anaikatti,&nbsp;Arshad Iqbal,&nbsp;Barbara Helen Rosario","doi":"10.1007/s40520-025-02938-4","DOIUrl":"10.1007/s40520-025-02938-4","url":null,"abstract":"<div><h3>Background</h3><p>Benign Paroxysmal Positional Vertigo (BPPV) is the commonest cause of vertigo in older adults. Due to its high incidence in older adults presenting with falls, vestibular assessment is recommended in the World Guidelines for Falls Prevention. There is a paucity of evidence in well conducted randomised controlled trials (RCTs) to evaluate vitamin D for prevention of BPPV recurrence in relation to falls and function.</p><h3>Aims</h3><p>Primary outcome: does vitamin D supplementation and dietary interventions in combination with standard care impact falls, fear of falling and function in patients with BPPV.</p><h3>Methods</h3><p>Post hoc analyses of phase IIa single centre, placebo controlled, double blind RCT evaluating vitamin D supplementation with diet and Canalith Repositioning Procedure (CRP) [Group A] versus diet alone with CRP [Group B] in reducing BPPV recurrence rates and the consequent effects on falls and function.</p><h3>Results</h3><p>53 participants were recruited. 14 were vitamin D replete at baseline (Group C) with remaining 39 randomised into Groups A and B. Group A had better 5x sit to stand time and 0.75 fewer clinical BPPV recurrences per one person year (<i>P</i> = 0.035) compared to Group B. 25% of participants who fell reported fear of falling compared to 43% in those without falls in the 12 month follow up.</p><h3>Discussion</h3><p>Vitamin D supplementation alongside standard BPPV improved 5xchair stand test and reduced BPPV recurrence. Participants without an incident fall during follow up experience fear of falling, prompting further consideration.</p><h3>Conclusion</h3><p>Vitamin D replacement was associated with fewer BPPV recurrences and improved function assessed with 5x chair stand test.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-02938-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466006","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":"Treatment of postmenopausal osteoporosis with recombinant human parathyroid hormone and electromagnetic field","authors":"Miao Xuan,&nbsp;Bo Wang,&nbsp;Wanrong Bi,&nbsp;Ying Li,&nbsp;Lige Song,&nbsp;Zhuangli Xie,&nbsp;Qi Liu,&nbsp;Xiuzhen Zhang","doi":"10.1007/s40520-025-02932-w","DOIUrl":"10.1007/s40520-025-02932-w","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to investigate the effect of electromagnetic field (EMF) combined with recombinant human parathyroid hormone (rhPTH) on bone mineral density (BMD) and bone turnover indicators in postmenopausal osteoporosis (PMOP) patients.</p><h3>Methods</h3><p>A total of 336 PMOP patients were randomly assigned into three groups: EMF + rhPTH group (<i>n</i> = 115), rhPTHx group (<i>n</i> = 113) and EMF group (<i>n</i> = 108). The lumbar spine and femoral neck BMDs were measured before treatment and at 6, 12, and 18 months after treatment. Blood calcium, bone alkaline phosphatase (BSAP), type I procollagen N-terminal peptide (PINP), and type I collagen C-terminal peptide/creatinine ratio (CTX/Cr) levels were measured before treatment and at 3, 6, 12, and 18 months after treatment.</p><h3>Results</h3><p>The lumbar spine BMD was significantly increased at 6, 12, and 18 months after treatment, and the neck BMD was increased markedly at 18 months in both EMF + rhPTH group and rhPTH group as compared to those before treatment. There was significant difference in the lumbar spine BMD between EMF + rhPTH group and EMF group and between rhPTH group and EMF group at 6, 12, and 18 months after treatment. In the EMF + rhPTH group, at 3, 6, 12, and 18 months after treatment, blood calcium level was increased by 5.2%, 2.8%, 2.7%, and 3.1%, respectively; BASP level was increased by 80.9%, 120.3%, 84.1%, and 67.7%, respectively; PINP level was increased by 65.4%, 79.7%, 89.7%, and 74.5%, respectively; CTX/Cr was increased by 80.9%, 120.3%, 84.1%, and 67.7%, respectively; the bone metabolism indicators were markedly higher than those before treatment. In the rhPTH group, at 3, 6, 12, and 18 months after treatment, blood calcium level was increased by 5.1%, 3.3%, 3.0%, and 2.1%, respectively; BSAP level was increased by 51.6%, 81.4%, 101.1% and 56.3% respectively; PINP level was increased by 48.5%, 69.8%, 80.7% and 70.5% respectively; CTX/Cr was increased by 29.8%, 29.9%, 55.7%, and 44.8% respectively; the bone turnover indicators were significantly different from those before treatment (<i>P</i> &lt; 0.01).</p><h3>Conclusion</h3><p>The combination of EMF and rhPTH can significantly improve the bone turnover and BMD of PMOP patients, and may serve as a clinical treatment of PMOP.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-02932-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466005","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":"Musculoskeletal diseases, infections and vaccines: state of the art, research perspectives and educational needs","authors":"Fiona Ecarnot,&nbsp;Jotheeswaran Amuthavalli Thiyagarajan,&nbsp;Mario Barbagallo,&nbsp;Jane Barratt,&nbsp;Stefan Constantinescu,&nbsp;Ori Elkayam,&nbsp;Luigi Ferrucci,&nbsp;Mickaël Hiligsmann,&nbsp;Meliha Kapetanovic,&nbsp;Francesco Macchia,&nbsp;Jean-Pierre Michel,&nbsp;Alberto Migliore,&nbsp;Alberto Pilotto,&nbsp;Cornel Sieber,&nbsp;Anja Strangfeld,&nbsp;Nicola Veronese,&nbsp;Davide Liborio Vetrano,&nbsp;Stefania Maggi,&nbsp;René Rizzoli","doi":"10.1007/s40520-025-02940-w","DOIUrl":"10.1007/s40520-025-02940-w","url":null,"abstract":"<div><p>Musculoskeletal disorders are a significant public health burden concern, projected to increase in the coming decades, and will substantially contribute to the rising prevalence of functional impairment, frailty and disability in a growing global population. Since persons with musculoskeletal disorders tend to have immune dysfunction, inflammation or be taking immunosuppressive medication, prevention of vaccine-preventable diseases (VPDs) in this group is particularly important. The European Interdisciplinary Council for Aging (EICA) and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) jointly convened a 2-day in-person and virtual meeting on 26–27 September 2023, to review the state of the evidence on the link between musculoskeletal diseases, infections and vaccines. We present here the Executive Summary of the proceedings of this meeting. We review the importance of physical activity in preventing or mitigating both musculoskeletal diseases and risk of infection. We summarize current knowledge of the impact of common VPDs on the development and progression of musculoskeletal diseases, and the role of selected vaccines in preventing onset and worsening of frailty and disability in these individuals. This report summarizes the evidence presented at the two-day meeting, highlighting the need to raise awareness among scientists, healthcare professionals, decision-makers, civil society and the general public about the long-term sequelae of VPDs, with focus on the health status of older patients with musculoskeletal diseases.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-02940-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471950","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":"Machine learning based on nutritional assessment to predict adverse events in older inpatients with possible sarcopenia","authors":"Chengyu Liu,&nbsp;Hongyun Huang,&nbsp;Moxi Chen,&nbsp;Mingwei Zhu,&nbsp;Jianchun Yu","doi":"10.1007/s40520-024-02916-2","DOIUrl":"10.1007/s40520-024-02916-2","url":null,"abstract":"<div><h3>Background</h3><p>The accuracy of current tools for predicting adverse events in older inpatients with possible sarcopenia is still insufficient to develop individualized nutrition-related management strategies. The objectives were to develop a machine learning model based on nutritional assessment for the prediction of all-cause death and infectious complications.</p><h3>Methods</h3><p>A cohort of older patients with possible sarcopenia (divided into training group [70%] and validation group [30%]) from 30 hospitals in 14 major cities in China was retrospectively analyzed. Clinical characteristics, laboratory examination, Nutritional risk Screening-2002 (NRS-2002) and mini-nutritional Assessment-Short form (MNA-SF) were used to construct machine learning models to predict in-hospital adverse events, including all-cause mortality and infectious complications. The applied algorithms included decision tree, random forest, gradient boosting machine (GBM), LightGBM, extreme gradient boosting and neural network. Model performance was assessed according to learning a series of learning metrics including area under the receiver operating characteristic curve (AUC) and accuracy.</p><h3>Results</h3><p>Among 3 999 participants (mean age 75.89 years [SD 7.14]; 1 805 [45.1%] were female), 373 (9.7%) had adverse events, including 62 (1.6%) of in-hospital death and 330 (8.5%) of infectious complications. The decision tree model showed a better AUC of 0.7072 (95% CI 0.6558–0.7586) in the validation cohort, using the five most important variables (i.e., mobility, reduced food intake, white blood cell count, upper arm circumference, and hypoalbuminemia).</p><h3>Conclusions</h3><p>Machine learning prediction models are feasible and effective for identifying adverse events, and may be helpful to guide clinical nutrition decision-making in older inpatients with possible sarcopenia.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02916-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471952","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":"Phenotyping to predict 12-month health outcomes of older general medicine patients","authors":"Richard John Woodman,&nbsp;Kimberly Bryant,&nbsp;Michael J. Sorich,&nbsp;Campbell H. Thompson,&nbsp;Patrick Russell,&nbsp;Alberto Pilotto,&nbsp;Aleksander A. Mangoni","doi":"10.1007/s40520-024-02924-2","DOIUrl":"10.1007/s40520-024-02924-2","url":null,"abstract":"<div><h3>Background</h3><p>A variety of unsupervised learning algorithms have been used to phenotype older patients, enabling directed care and personalised treatment plans. However, the ability of the clusters to accurately discriminate for the risk of older patients, may vary depending on the methods employed.</p><h3>Aims</h3><p>To compare seven clustering algorithms in their ability to develop patient phenotypes that accurately predict health outcomes.</p><h3>Methods</h3><p>Data was collected for <i>N</i> = 737 older medical inpatients during their hospital stay for five different types of medical data (ICD-10 codes, ATC drug codes, laboratory, clinic and frailty data). We trialled five unsupervised learning algorithms (K-means, K-modes, hierarchical clustering, latent class analysis (LCA), and DBSCAN) and two graph-based approaches to create separate clusters for each method and datatype. These were used as input for a random forest classifier to predict eleven health outcomes: mortality at one, three, six and 12 months, in-hospital falls and delirium, length-of-stay, outpatient visits, and readmissions at one, three and six months.</p><h3>Results</h3><p>The overall median area-under-the-curve (AUC) across the eleven outcomes for the seven methods were (from highest to lowest) 0.758 (hierarchical), 0.739 (K-means), 0.722 (KG-Louvain), 0.704 (KNN-Louvain), 0.698 (LCA), 0.694 (DBSCAN) and 0.656 (K-modes). Overall, frailty data was most important data type for predicting mortality, ICD-10 disease codes for predicting readmissions, and laboratory data the most important for predicting falls.</p><h3>Conclusions</h3><p>Clusters created using hierarchical, K-means and Louvain community detection algorithms identified well-separated patient phenotypes that were consistently associated with age-related adverse health outcomes. Frailty data was the most valuable data type for predicting most health outcomes.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"37 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02924-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466009","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}