Archives of gerontology and geriatrics最新文献

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Breaking the vicious cycle: Reciprocal influences between social isolation and functional disability and the buffering effect of digital inclusion 打破恶性循环:社会孤立和功能残疾之间的相互影响以及数字包容的缓冲作用
IF 3.5 3区 医学
Archives of gerontology and geriatrics Pub Date : 2025-04-23 DOI: 10.1016/j.archger.2025.105871
Mingyu Cui , Yang Liu , Mengjiao Yang , Kumi Watanabe Miura , Jinrui Zhang , Tokie Anme
{"title":"Breaking the vicious cycle: Reciprocal influences between social isolation and functional disability and the buffering effect of digital inclusion","authors":"Mingyu Cui ,&nbsp;Yang Liu ,&nbsp;Mengjiao Yang ,&nbsp;Kumi Watanabe Miura ,&nbsp;Jinrui Zhang ,&nbsp;Tokie Anme","doi":"10.1016/j.archger.2025.105871","DOIUrl":"10.1016/j.archger.2025.105871","url":null,"abstract":"<div><div>In aging societies like Japan, social isolation (SI) and functional disability (FD) critically impact older adults’ health, yet their bidirectional relationship and potential moderators remain underexplored. This prospective cohort study examined the bidirectional SI-FD association and tested digital inclusion’s (DI) moderating role among community-dwelling Japanese older adults.</div><div>We analyzed 480 adults aged ≥65 across three waves (baseline, 3-year, 6-year follow-ups) using multi-group random intercept cross-lagged panel models (RI-CLPM) to disentangle within-person and between-person effects.</div><div>At the between-person level, SI was positively connected with FD (β = 0.50, <em>p</em> &lt; 0.001). Within individuals, SI and FD demonstrated reciprocal worsening over time, with SI’s cross-lagged effect on subsequent FD (T1→T2: β = 0.42, <em>p</em> &lt; 0.001; T2→T3: β = 0.40, <em>p</em> &lt; 0.001) exceeding FD’s effect on SI (T1→T2: β = 0.21, <em>p</em> &lt; 0.01; T2→T3: β = 0.29, <em>p</em> &lt; 0.01). DI significantly attenuated SI’s adverse impacts: in the digitally included group (<em>n</em> = 291), SI’s autoregressive effects and cross-lagged effects on FD became nonsignificant (<em>p</em> &gt; 0.05), SI’s cross-lagged effect on subsequent FD also weakened (T1→T2: β = 0.19, <em>p</em> &lt; 0.05; T2→T3: β = 0.22, <em>p</em> &lt; 0.05).</div><div>Findings suggest bidirectional SI-FD links are partially mitigated by digital engagement. While social interventions remain critical, integrating digital literacy programs may disrupt SI’s cascading effects on disability. Study limitations include regional sampling and self-reported measures. Future research should validate these mechanisms across diverse populations and explore targeted digital-social hybrid interventions.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"135 ","pages":"Article 105871"},"PeriodicalIF":3.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between frailty and the progression trajectories of stroke and dementia comorbidity: insights from observational and genetic analyses 虚弱与卒中和痴呆共病进展轨迹之间的关联:来自观察和遗传分析的见解
IF 3.5 3区 医学
Archives of gerontology and geriatrics Pub Date : 2025-04-21 DOI: 10.1016/j.archger.2025.105862
Dongze Chen , Yali Zhang , Zhiqiang Ji , Yi Zhou , Zhisheng Liang
{"title":"Association between frailty and the progression trajectories of stroke and dementia comorbidity: insights from observational and genetic analyses","authors":"Dongze Chen ,&nbsp;Yali Zhang ,&nbsp;Zhiqiang Ji ,&nbsp;Yi Zhou ,&nbsp;Zhisheng Liang","doi":"10.1016/j.archger.2025.105862","DOIUrl":"10.1016/j.archger.2025.105862","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between frailty and the progression trajectories of stroke-dementia comorbidity remains inconclusive. This study aimed to determine whether there are associations between frailty and the progression trajectories of stroke-dementia comorbidity, including the transitions from enrollment to incident stroke/dementia, progression to stroke-dementia comorbidity, and ultimately to mortality.</div></div><div><h3>Methods</h3><div>This prospective study was conducted based on the UK Biobank cohort. Frailty was assessed using the frailty index (FI) and categorized as robust (FI ≤ 0.10), prefrail (0.10 &lt; FI ≤ 0.25), or frail (FI &gt; 0.25). We used multi-state models and one-sample Mendelian randomization (MR) to investigate the relationships between frailty and the progression trajectories of stroke-dementia comorbidity. Population attributable fraction (PAF) analyses were conducted to assess the attributable risks of frailty and its components.</div></div><div><h3>Results</h3><div>The final analysis included 459,924 participants. In comparison to the robust, the frail group significantly elevated the risk of transitioning from enrollment to stroke [HR(95 %CI): 2.32(2.19–2.45)], from enrollment to dementia [2.56(2.31–2.83)], from enrollment to mortality [2.32(2.23–2.42)], from stroke to stroke-dementia comorbidity [1.59(1.23–2.05)], from dementia to stroke-dementia comorbidity [1.79(1.29–2.48)], and from stroke to mortality [1.25(1.11–1.40)]. MR analyses revealed that genetically predicted FI was causally associated with higher risks of stroke-dementia comorbidity. PAF analyses indicated that hypertension, diabetes, lung disease, and visual impairment were significant contributors to the risk of progression to stroke-dementia comorbidity.</div></div><div><h3>Conclusion</h3><div>Our findings revealed that frailty status increases the risk of post-stroke dementia, offering important insights for the clinical management and public health strategies.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105862"},"PeriodicalIF":3.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trajectories of health-related quality of life and their association with disability in older Australians 澳大利亚老年人与健康有关的生活质量轨迹及其与残疾的关系
IF 3.5 3区 医学
Archives of gerontology and geriatrics Pub Date : 2025-04-17 DOI: 10.1016/j.archger.2025.105864
Syed Afroz Keramat , Nhi Nguyen , Danelle Kenny , Rubayyat Hashmi , Tracy Comans
{"title":"Trajectories of health-related quality of life and their association with disability in older Australians","authors":"Syed Afroz Keramat ,&nbsp;Nhi Nguyen ,&nbsp;Danelle Kenny ,&nbsp;Rubayyat Hashmi ,&nbsp;Tracy Comans","doi":"10.1016/j.archger.2025.105864","DOIUrl":"10.1016/j.archger.2025.105864","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between various disabilities and the trajectories of HRQoL in older populations remains largely unexplored. Therefore, we aim to investigate the connections between HRQoL trajectories and different types of disabilities in older Australians.</div></div><div><h3>Methods</h3><div>The study participants' HRQoL was measured using the SF-6D utility index. We applied the group-based trajectory model to identify distinct HRQoL trajectories and employed multinomial logistic regression to examine the relationship between HRQoL trajectories and various types of disabilities.</div></div><div><h3>Results</h3><div>We identified three distinct trajectories of HRQoL among older Australians: low-declining, moderate-declining, and high-stable HRQoL groups. We found evidence indicating that the relative risks of being in the low-declining HRQoL group are greater for all types of disabilities. Older Australians living with physical disabilities (Relative Risk Ratio [RRR]: 6.62, 95 % CI: 4.76–9.22), psychosocial disabilities (RRR: 14.06, 95 % CI: 2.85–69.46), and other disabilities (RRR: 4.64, 95 % CI: 3.51–6.12) face a higher relative risk of being in the low-declining HRQoL group compared to their counterparts. Similarly, older Australians with work-limiting disabilities (RRR: 15.96, 95 % CI: 11.99- 21.24), disability onset (RRR: 10.61, 95 % CI: 8.19- 13.75), and multiple disabilities (RRR: 19.12, 95 % CI: 13.96- 26.18) also have a higher relative risk of being in a low-declining HRQoL group compared to their counterparts. Conclusions: Our findings emphasise the urgent need for targeted interventions and support services for older Australians with physical, psychosocial, and work-limiting disabilities to address their elevated risk of declining HRQoL and enhance their overall well-being.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"135 ","pages":"Article 105864"},"PeriodicalIF":3.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cognitive benefits of music in aerobic exercise: Evidence from a Bayesian network meta-analysis in adults with mild cognitive impairment 有氧运动中音乐的认知益处:来自轻度认知障碍成人贝叶斯网络荟萃分析的证据
IF 3.5 3区 医学
Archives of gerontology and geriatrics Pub Date : 2025-04-12 DOI: 10.1016/j.archger.2025.105848
Yixue Quan , Chi Yhun Lo , Lee Wolff , Jinyu Wang , Kirk N. Olsen , William Forde Thompson
{"title":"Cognitive benefits of music in aerobic exercise: Evidence from a Bayesian network meta-analysis in adults with mild cognitive impairment","authors":"Yixue Quan ,&nbsp;Chi Yhun Lo ,&nbsp;Lee Wolff ,&nbsp;Jinyu Wang ,&nbsp;Kirk N. Olsen ,&nbsp;William Forde Thompson","doi":"10.1016/j.archger.2025.105848","DOIUrl":"10.1016/j.archger.2025.105848","url":null,"abstract":"<div><div>Aerobic exercise improves cognitive functions in older adults with mild cognitive impairment (MCI), while dance, combining music and synchronized movement, offers additional cognitive benefits. Despite music's potential role in enhancing cognitive outcomes, most research on aerobic exercise has not considered the impact of accompanying music. This review compared the effectiveness of aerobic exercise with music, aerobic exercise without music, and dance on cognitive function in adults with MCI. A total of 38 papers from 25 randomized controlled trials (<em>N</em> = 2048) were synthesized. The multilevel meta-analyses showed that compared to the control group, global cognition was improved by aerobic exercise with music (<em>g</em> = 1.2 [0.47, 1.94]), aerobic exercise without music (<em>g</em> = 0.48 [0.18, 0.79]), and dance (<em>g</em> = 0.55 [0.13, 0.96]). Dance also enhanced short-term memory (<em>g</em> = 0.41 [0.24, 0.59]), learning efficiency (<em>g</em> = 0.39 [0.14, 0.65]), and retrieval fluency (<em>g</em> = 0.7 [0.19, 1.22]). Bayesian network meta-analyses indicated that aerobic exercise with music had the highest probability of being the most effective for improving global cognition, executive function, and processing speed. Dance was likely to be the most beneficial for enhancing short-term memory, learning efficiency, and retrieval fluency. This study supports that incorporating music in exercise amplifies the cognitive benefits beyond exercise alone for individuals with MCI. The “Music Exercise Synergy Model” is proposed to explain the cognitive benefits of combining music with exercise. Dance strategically uses music for coordination, offering psychological, social, cognitive, and neurobiological benefits and contributing to the observed enhancements in memory functions.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105848"},"PeriodicalIF":3.5,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Systematic review of interventions for pre-frail and frail older adults: Evidence from clinical trials on frailty levels 体弱多病和体弱多病老年人干预措施的系统评价:来自衰弱水平临床试验的证据
IF 3.5 3区 医学
Archives of gerontology and geriatrics Pub Date : 2025-04-11 DOI: 10.1016/j.archger.2025.105851
Andressa C. da Silva Sobrinho , Reisa Cristiane de Paula Venancio , Guilherme da Silva Rodrigues , Mariana Porto , Layana Liss Schwenger , Letícia Fernanda Belo , Luana K. Ferreira , Carlos Roberto Bueno Júnior , Grace Angelica de Oliveira Gomes
{"title":"Systematic review of interventions for pre-frail and frail older adults: Evidence from clinical trials on frailty levels","authors":"Andressa C. da Silva Sobrinho ,&nbsp;Reisa Cristiane de Paula Venancio ,&nbsp;Guilherme da Silva Rodrigues ,&nbsp;Mariana Porto ,&nbsp;Layana Liss Schwenger ,&nbsp;Letícia Fernanda Belo ,&nbsp;Luana K. Ferreira ,&nbsp;Carlos Roberto Bueno Júnior ,&nbsp;Grace Angelica de Oliveira Gomes","doi":"10.1016/j.archger.2025.105851","DOIUrl":"10.1016/j.archger.2025.105851","url":null,"abstract":"<div><h3>Introduction</h3><div>The increasing global longevity underscores the necessity of effective interventions for older adults. Pre-frailty and frailty affect 54.1 % and 26.3 % of the elderly population, respectively, leading to adverse physical and cognitive outcomes. This study systematically reviewed the effectiveness of interventions targeting robust, pre-frail, and frail older adults in randomized controlled trials, analyzing frailty levels both collectively and individually.</div></div><div><h3>Methods</h3><div>Following the Joanna Briggs Institute (JBI) methodology and PRISMA guidelines, seven databases were searched for studies published between 2018 and 2023. Randomized controlled trials involving individuals aged ≥65 years were included. Methodological quality was assessed using the PEDro scale, with scores ranging from 7 to 10, indicating moderate to high quality.</div></div><div><h3>Results</h3><div>A total of 3416 records were identified, and 40 studies were included, encompassing 17,822 participants (82.3 % women, mean age: 68–79 years). Physical exercise interventions accounted for 42.5 % of the studies, while multicomponent programs constituted 27.5 %. Improvements in frailty levels were reported in 32.5 % of the studies, with significant gains in quality of life (+15.2 %), gait speed (+0.22 m/s), and muscle strength (+18.7 %). Pre-frail individuals exhibited the greatest responsiveness to interventions, reflecting their remaining adaptability and potential for improvement.</div></div><div><h3>Discussion</h3><div>Multifaceted interventions were found to be particularly effective for pre-frail individuals, emphasizing the need for standardized criteria for frailty assessment. Geographic variability and inconsistencies in assessment methods were noted. Physical activity emerged as a key component in improving outcomes, with most interventions led by physiotherapists and physical education professionals.</div></div><div><h3>Conclusion</h3><div>Integrated interventions significantly enhance health and functionality, particularly for pre-frail older adults, underscoring the importance of early and tailored approaches. This study highlights the need for standardized guidelines and multidisciplinary strategies to address the heterogeneity of the aging population effectively.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105851"},"PeriodicalIF":3.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Joint association of frailty index and biological aging with all-cause and cause-specific mortality: a population-based longitudinal cohort study 虚弱指数和生物衰老与全因和特定原因死亡率的联合关联:一项基于人群的纵向队列研究
IF 3.5 3区 医学
Archives of gerontology and geriatrics Pub Date : 2025-04-09 DOI: 10.1016/j.archger.2025.105856
Shichen Zhou , Guang Chen , Tung-Leong Fong , Guoyi Tang , Ruogu Xiong , Ya Xuan Sun , Junjie Lu , Ning Wang , Yibin Feng
{"title":"Joint association of frailty index and biological aging with all-cause and cause-specific mortality: a population-based longitudinal cohort study","authors":"Shichen Zhou ,&nbsp;Guang Chen ,&nbsp;Tung-Leong Fong ,&nbsp;Guoyi Tang ,&nbsp;Ruogu Xiong ,&nbsp;Ya Xuan Sun ,&nbsp;Junjie Lu ,&nbsp;Ning Wang ,&nbsp;Yibin Feng","doi":"10.1016/j.archger.2025.105856","DOIUrl":"10.1016/j.archger.2025.105856","url":null,"abstract":"<div><h3>Background</h3><div>The role of frailty in all-cause, cardiovascular, and cancer mortality is debatable, and the modification effect of biological aging remains unclear. Therefore, we aimed to evaluate the joint association of frailty index and biological aging with all-cause and cause-specific mortality.</div></div><div><h3>Methods</h3><div>In this population-based cohort study, data were obtained from the National Health and Nutrition Examination Survey (NHANES) and National Death Index (NDI). Demographic variables were extracted, frailty index was constructed, and biological aging was calculated. All-cause deaths, cancer deaths, and cardiovascular disease (CVD) deaths were extracted as outcomes. Cox proportional hazards regression models were used to estimate the correlations, stratified subgroup analyses were used to figure out effect modifiers, and sensitivity analyses were used to confirm the robustness.</div></div><div><h3>Results</h3><div>A total of 22,729 NHANES participants were included in this study, with 6786 all-cause deaths, 1830 CVD deaths, and 1396 cancer deaths occurred during an average follow-up of 8.5 years over a total of 192,601 person-years. The hazard ratios (HRs) of delayed aging group for all-cause mortality, CVD mortality, and cancer mortality were 0.45 (95 % CI: 0.41–0.49), 0.39 (95 % CI: 0.34–0.45), and 0.54 (95 % CI: 0.46–0.63), respectively, compared to accelerated aging group (P for all comparisons &lt; 0.001). Likewise, the frailty index score was positively associated with all-cause mortality (HR, 1.06 [95 % CI, 1.06–1.06] per 0.01 increase in the frailty index), cardiovascular (CVD) mortality (HR, 1.07 [95 % CI, 1.06–1.07] per 0.01 increase in the frailty index), and cancer mortality (HR, 1.04 [95 % CI, 1.03–1.04] per 0.01 increase in the frailty index). The associations of frailty index with all-cause mortality and CVD mortality were modified by biological aging (P for interaction = 0.044), but cancer mortality was not (P for interaction = 0.482).</div></div><div><h3>Conclusions</h3><div>Accelerated biological aging is associated with higher frailty index, whereas delayed biological aging is inversely associated with risk of all-cause mortality, CVD mortality, and cancer mortality. Biological aging is effect modification among the associations of frailty index with all-cause mortality and CVD mortality, but not for cancer mortality. These findings suggest that for people with high frailty index and acceleration biological aging, to lower frailty degree and decrease biological aging acceleration by approaches such as lifestyle modifications might be beneficial for individual's longevity and lifespan.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105856"},"PeriodicalIF":3.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cancer-treatment-induced accelerated aging in older adult cancer survivors: A call for actions for future perspectives in geriatric oncology 癌症治疗诱导的老年癌症幸存者的加速衰老:对老年肿瘤学未来前景的行动呼吁
IF 3.5 3区 医学
Archives of gerontology and geriatrics Pub Date : 2025-04-08 DOI: 10.1016/j.archger.2025.105858
Médéa Locquet (epidemiologist)
{"title":"Cancer-treatment-induced accelerated aging in older adult cancer survivors: A call for actions for future perspectives in geriatric oncology","authors":"Médéa Locquet (epidemiologist)","doi":"10.1016/j.archger.2025.105858","DOIUrl":"10.1016/j.archger.2025.105858","url":null,"abstract":"<div><div>Cancer treatment has significantly improved survival rates, but older adult cancer survivors remain at risk of cancer-treatment-induced late effects such as cardiac complications and second primary cancers. A new hypothesis emerged in the literature suggesting that such late effects can indeed be the manifestation of an accelerated aging process induced by cancer treatments. The cancer-treatment-induced accelerated aging could first arise from clinical and biological manifestations such as frailty, sarcopenia, cognitive impairments, cellular senescence, telomere attrition, and chronic inflammation, paralleling hallmarks of aging. Older adult cancer survivors frequently demonstrated early-onset frailty, sarcopenia, osteoporosis, cognitive impairments, diminished physical function, and increased levels of aging biomarkers compared to cancer-free age-matched older adults. However, existing studies are limited by their narrow focus on specific cancers, the use of single aging outcome measures, and short follow-up durations. A holistic research approach, incorporating comprehensive geriatric assessments and aging biomarkers, is crucial for describing the induced health burden and the mechanisms underlying these induced aging vulnerabilities. Addressing these gaps through large-scale longitudinal studies could lead to personalized interventions, improved treatment protocols, and supportive care strategies in older adult cancer survivors. Such efforts will enhance quality of life, promote healthy aging trajectories, and mitigate societal and economic burdens. To this end, concrete actions, such as establishing international consortia that include patient advocacy, are encouraged. Efforts should also include developing a centralized, registry-based repository for clinical and biological aging outcomes.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105858"},"PeriodicalIF":3.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development, validation, and clinical utility of a risk prediction model to identify older women with dementia for proactive palliative care 开发、验证和临床应用的风险预测模型,以确定老年痴呆妇女主动姑息治疗
IF 3.5 3区 医学
Archives of gerontology and geriatrics Pub Date : 2025-04-07 DOI: 10.1016/j.archger.2025.105853
Begashaw Melaku Gebresillassie , John Attia , Dominic Cavenagh , Melissa L. Harris
{"title":"Development, validation, and clinical utility of a risk prediction model to identify older women with dementia for proactive palliative care","authors":"Begashaw Melaku Gebresillassie ,&nbsp;John Attia ,&nbsp;Dominic Cavenagh ,&nbsp;Melissa L. Harris","doi":"10.1016/j.archger.2025.105853","DOIUrl":"10.1016/j.archger.2025.105853","url":null,"abstract":"<div><h3>Background</h3><div>Accurately estimating one-year mortality risk in older women with dementia can inform clinical decision-making, facilitate timely advanced care planning, and optimise palliative care delivery. This study aimed to develop, validate, and assess the clinical utility of a prediction model for one-year all-cause mortality in this population using a nationally representative Australian cohort.</div></div><div><h3>Methods</h3><div>This prognostic study utilised data from the 1921–26 cohort of the nationally representative, population-based Australian Longitudinal Study on Women's Health (ALSWH) and linked national and state-based administrative health records. Candidate predictors were identified through a systematic review and expert consultation, then refined using a data-driven statistical approach. A multivariable binary logistic regression model was developed and validated to predict one-year all-cause mortality.</div></div><div><h3>Results</h3><div>The analysis included 1576 older women with dementia (mean age, 72.6 ± 1.5 years). The model demonstrated good discrimination (AUC: 75.1 %, 95 % CI: 72.7 %–77.5 %) and excellent calibration (slope = 1.00, 95 % CI: 0.87–1.13; intercept = 0.00, 95 % CI: 0.11 – 0.11). Model validation using both 10-fold cross-validation and 1000 bootstrap iterations showed minimal optimism in its predictive performance, with AUC optimism of 0.0047 and 0.0042, respectively. Decision curve analysis indicated a net benefit across probability thresholds from 0.24 to 0.88, supporting the model's clinical utility for guiding palliative care decisions.</div></div><div><h3>Conclusion</h3><div>This prediction model, incorporating readily available predictors, demonstrated compelling performance and clinical utility for identifying older women with dementia at high risk of one-year mortality. The model has the potential to facilitate timely palliative care interventions and is publicly accessible via a web-based calculator. Further external validation in diverse populations and healthcare settings is warranted to confirm its generalisability.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105853"},"PeriodicalIF":3.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Respiratory symptoms in preserved ratio impaired spirometry: Link to comorbidities and increased mortality risk 保留比例肺量受损患者的呼吸症状:与合并症和死亡风险增加有关
IF 3.5 3区 医学
Archives of gerontology and geriatrics Pub Date : 2025-04-07 DOI: 10.1016/j.archger.2025.105855
Ping Lin , Faming Jiang , Yu Wang, Zongan Liang, Ting Wang
{"title":"Respiratory symptoms in preserved ratio impaired spirometry: Link to comorbidities and increased mortality risk","authors":"Ping Lin ,&nbsp;Faming Jiang ,&nbsp;Yu Wang,&nbsp;Zongan Liang,&nbsp;Ting Wang","doi":"10.1016/j.archger.2025.105855","DOIUrl":"10.1016/j.archger.2025.105855","url":null,"abstract":"<div><h3>Backgroundx</h3><div>Respiratory symptoms are frequently observed in subjects with Preserved Ratio Impaired Spirometry (PRISm); however, their association with comorbidities and mortality in this population remains poorly understood.</div></div><div><h3>Methods</h3><div>Data from the National Health and Nutrition Examination Survey (2007–2012) were analyzed. Logistic regression was used to assess the association between respiratory symptoms and comorbidities, while Cox regression was applied to evaluate mortality risks.</div></div><div><h3>Results</h3><div>This study included 5612 adults aged 40 years and older with normal spirometry and 754 participants with PRISm. Among the PRISm group, 331 subjects (43.8 %) reported one or more respiratory symptoms. Compared to individuals with normal spirometry, PRISm subjects with respiratory symptoms exhibited a significantly higher prevalence of comorbidities, including hypertension, diabetes, angina, myocardial infarction, heart failure, and stroke, as well as increased risks of all-cause and cardiovascular mortality. In contrast, PRISm without respiratory symptoms was primarily associated with diabetes and an elevated mortality risk. When comparing PRISm subjects with and without respiratory symptoms, those with symptoms had a markedly higher prevalence of hypertension (OR 1.10, 95 % CI: 1.08–1.11), myocardial infarction (OR 5.75, 95 % CI: 2.25–14.67), heart failure (OR 5.52, 95 % CI: 2.50–12.19), and cancer (OR 2.34, 95 % CI: 1.12–4.86). Additionally, PRISm subjects with respiratory symptoms faced a significantly elevated risk of cardiovascular mortality (HR 1.55, 95 % CI: 1.38–1.74).</div></div><div><h3>Conclusions</h3><div>Respiratory symptoms were associated with a significantly higher burden of comorbidities and an increased risk of cardiovascular mortality in PRISm subjects.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105855"},"PeriodicalIF":3.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Understanding physical aging in relation to biological aging, telomere length: A systematic review 了解物理老化与生物老化、端粒长度的关系:一项系统综述
IF 3.5 3区 医学
Archives of gerontology and geriatrics Pub Date : 2025-04-07 DOI: 10.1016/j.archger.2025.105854
Kyi Mar Wai , Arkar Min Paing , Thinzar Swe
{"title":"Understanding physical aging in relation to biological aging, telomere length: A systematic review","authors":"Kyi Mar Wai ,&nbsp;Arkar Min Paing ,&nbsp;Thinzar Swe","doi":"10.1016/j.archger.2025.105854","DOIUrl":"10.1016/j.archger.2025.105854","url":null,"abstract":"<div><h3>Background</h3><div>Telomere length (TL) serves as a marker for biological aging, influenced by chronological aging but distinct from it. This systematic review aims to synthesize the evidence on the associations between components of physical aging and TL in the elderly population.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in online databases of PubMed, Web of Science, ProQuest, and ScienceDirect to identify the eligible papers published until 1st August 2024. The authors independently extracted data using the standardized form. The quality of the included studies was evaluated for the risks of biases.</div></div><div><h3>Results</h3><div>A total of 1080 records were initially identified using the predefined search strategy. A total of 40 eligible records were included in this review. When assessing physical aging, the nature and type of measurements across studies vary, including subjective, objective, and a combination of both approaches. Subjective assessments of general health or physical limitations may be linked with TL, while frailty, whether measured subjectively or objectively, shows associations with TL in less than 35 percent of total studies. In contrast, composite measures of physical performance/ability are consistently associated with TL in the elderly population.</div></div><div><h3>Conclusions</h3><div>In conclusion, we demonstrated that the associations between physical aging and TL varies depending on the type and nature of physical aging assessments. Composite measures of physical performance/ability demonstrate a strong and consistent parameter of physical aging to link with TL. Future research should prioritize standardized, multidimensional approaches to measure physical aging to understand better its association with TL to support healthy aging strategies.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105854"},"PeriodicalIF":3.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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