Archives of gerontology and geriatrics最新文献

{"title":"Neural substrates of cognitive frailty as a high-risk factor for dementia compared with mild cognitive impairment: A multimodal magnetic resonance imaging study","authors":"Kenji Harada ,&nbsp;Masanori Morikawa ,&nbsp;Kazuya Fujii ,&nbsp;Chiharu Nishijima ,&nbsp;Daisuke Kakita ,&nbsp;Kazuki Soma ,&nbsp;Takuto Okuya ,&nbsp;Hiroyuki Shimada","doi":"10.1016/j.archger.2026.106171","DOIUrl":"10.1016/j.archger.2026.106171","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive frailty (CF) is recognized as a high-risk state for dementia, defined by the coexistence of physical frailty (PF) and mild cognitive impairment (MCI). While both PF and MCI increase vulnerability to dementia, CF confers an even higher risk than either condition alone. However, the neural substrates distinguishing CF from MCI remain unclear. The objective of this study is to elucidate the neural differences between CF and MCI using multimodal MRI analyses.</div></div><div><h3>Methods</h3><div>We investigated the neural substrates of community-dwelling older adults with CF (<em>n</em> = 61) and MCI (<em>n</em> = 108) by performing between-group comparisons of multimodal MRI measures to comprehensively examine the underlying neural mechanisms. Whole-brain analyses were conducted to assess gray matter (GM) volume, white matter hyperintensities (WMHs), and both structural and resting-state functional connectivity. Age, sex, vascular risk factors, and intracranial volume were included as covariates.</div></div><div><h3>Results</h3><div>The CF group exhibited significantly greater GM atrophy than the MCI group in widespread brain regions, including the temporal lobe, fusiform gyrus, cerebellum, cuneus, precuneus, precentral and postcentral gyri, and caudate nucleus. In contrast, no significant differences were observed between groups in WMH volume or count, structural connectivity, or resting-state functional connectivity.</div></div><div><h3>Conclusions</h3><div>These findings suggest that widespread GM atrophy may be more evident in CF than in MCI, whereas no clear differences were observed in WMHs or structural or functional connectivity. This study provides new evidence on the neural basis of CF and highlights the utility of multimodal MRI in elucidating the neural substrates of frailty states.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"144 ","pages":"Article 106171"},"PeriodicalIF":3.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260287","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}

{"title":"Global, regional, and national burden of age-related hearing loss and Alzheimer’s disease, 1990–2021, with projections to 2040: A global burden of disease study","authors":"Dan Liu ,&nbsp;Yamin Zhang ,&nbsp;Sulin Zhang","doi":"10.1016/j.archger.2026.106170","DOIUrl":"10.1016/j.archger.2026.106170","url":null,"abstract":"<div><h3>Background</h3><div>Age-related hearing loss (ARHL) and Alzheimer’s disease (AD) are major contributors to disability in older adults, yet their long-term epidemiological trajectories have rarely been examined together. Evidence linking sensory decline with cognitive deterioration is growing, but global patterns, socioeconomic gradients, and future projections remain unclear.</div></div><div><h3>Methods</h3><div>Using data from the GBD 2021 study, we assessed global, regional, and national burdens of ARHL and AD from 1990 to 2021 and projected trends to 2040. We analyzed prevalence, incidence, mortality, and disability-adjusted life-years (DALYs), and evaluated age- and sex-specific patterns. Associations with the Socio-demographic Index (SDI) and cross-country performance were examined using frontier analysis. The epidemiological co-distribution of ARHL and AD was further explored using descriptive, country-level correlation analyses.</div></div><div><h3>Results</h3><div>The two conditions showed distinct but converging trajectories. ARHL burden remained relatively stable globally, whereas AD incidence and DALYs increased steadily, especially among women and in older age groups. Projections indicate further growth of both conditions by 2040, with AD rising more sharply. SDI displayed a non-linear association with disease burden: higher SDI corresponded to greater reported incidence, yet frontier analysis revealed diminishing returns and wide performance gaps. A positive cross-national association between ARHL prevalence and AD DALYs was observed, reflecting shared age structures, demographic pressures, and reporting contexts across populations.</div></div><div><h3>Conclusion</h3><div>This study provides an integrated, population-level description of the long-term and projected burdens of ARHL and AD using a unified analytical framework. The observed co-distribution of sensory and cognitive impairment highlights the importance of coordinated public health planning for aging populations, particularly in regions undergoing rapid demographic transition.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"144 ","pages":"Article 106170"},"PeriodicalIF":3.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776791","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}

{"title":"The global prevalence of suicidal ideation in older adults: A systematic review and Meta-analysis","authors":"Xiaoyu Bai ,&nbsp;Senlin Wu ,&nbsp;Mengjie Zhang ,&nbsp;Hong Chen ,&nbsp;Yuelin Wang ,&nbsp;Le Li ,&nbsp;Jing Wang ,&nbsp;Yunlan Jiang","doi":"10.1016/j.archger.2026.106190","DOIUrl":"10.1016/j.archger.2026.106190","url":null,"abstract":"<div><h3>Background</h3><div>The global population is aging rapidly, and suicide among older adults aged 60 and over is a critical public health issue. Suicidal ideation (SI) is the strongest precursor to suicidal behavior. However, a comprehensive global synthesis of the prevalence and distribution of SI among older adults worldwide has been lacking.</div></div><div><h3>Objective</h3><div>This study aimed to systematically review the global prevalence of SI in older adults and explore its distribution across demographic, geographical, and methodological dimensions through subgroup analyses.</div></div><div><h3>Methods</h3><div>We systematically searched nine databases from inception to November 3, 2025, for observational studies. Two reviewers independently conducted study selection, data extraction, and quality assessment. Data were pooled using a random-effects model in Stata15.0 to calculate prevalence and perform subgroup analyses. The review was registered with PROSPERO (CRD420251233412).</div></div><div><h3>Findings</h3><div>Seventy-two studies comprising 625,891 older adults were included and the pooled prevalence was 12.8% (95%CI: 11.4% -14.1%). However, extreme heterogeneity was observed (I²=99.9%), and significant publication bias was present. The trim-and-fill adjusted prevalence was 5.7%. Subgroup analyses revealed significantly higher prevalence among the oldest old (≥80 years, 13.7%), women (17.8%), residents of Asia (13.8%), and developing countries (14.7%), and assessment of “current” SI reported significantly higher rates than other timeframes.</div></div><div><h3>Conclusion</h3><div>Although the precise pooled prevalence is uncertain due to substantial heterogeneity and publication bias, this study confirms that SI is prevalent concern among older adults globally, with risk disproportionately concentrated among the oldest old, women, and those in developing countries. The findings call for targeted public health strategies and underscore the imperative to use standardized assessment tools and address critical evidence gaps in future research.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"144 ","pages":"Article 106190"},"PeriodicalIF":3.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319134","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}

{"title":"Effects of peer support interventions for family caregivers of persons with dementia: A systematic review and meta-analysis","authors":"Dandan Xue ,&nbsp;Yifan Ye ,&nbsp;Zi Chen ,&nbsp;Yanqiu Hu ,&nbsp;Changrong Yuan ,&nbsp;Yanmei Wang","doi":"10.1016/j.archger.2026.106168","DOIUrl":"10.1016/j.archger.2026.106168","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effects of peer support interventions—where peer support is a complete or main component—on the psychological, social, competence/knowledge, and health-related quality of life (HRQoL) outcomes among family caregivers of persons with dementia.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis of randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>Seven English and three Chinese databases were searched from their inception to March 2025. Two reviewers independently performed the screening process, data extraction, and quality assessment of the included studies. The revised Cochrane’s Risk-of-Bias Tool for Randomized Trials (RoB 2.0) was used for quality appraisal. We employed random- or fixed-effects models for the meta-analysis and conducted narrative analysis, when appropriate. The Grading of Recommendations, Assessment, Development and Evaluations approach was used to assess the certainty of evidence.</div></div><div><h3>Results</h3><div>A total of 11 studies, which involved 1680 caregivers, were reviewed. Peer support interventions significantly reduced caregiver distress to behavioral symptoms (standardized mean difference [SMD], -0.28; 95% confidence interval [CI], -0.55 to -0.02; <em>p</em> = 0.03), increased social support (SMD, 0.37; 95% CI, 0.06 to 0.67; <em>p</em> = 0.02), and HRQoL (SMD, 0.76; 95% CI, 0.07 to 1.46; <em>p</em> = 0.03) postintervention. However, no significant effects were observed on depression/anxiety, loneliness, caregiving burden, and caregiving competence/knowledge postintervention. None of the outcomes showed sustained effects at follow up.</div></div><div><h3>Conclusions</h3><div>Peer support interventions suggest beneficial short-term effects on specific caregiver outcomes but lack long-term sustainability. Future research should prioritize high-quality RCTs to isolate the effects of peer support from other intervention components, incorporate maintenance strategies to prolong benefits, and include economic evaluations to inform implementation.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"144 ","pages":"Article 106168"},"PeriodicalIF":3.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172999","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}

{"title":"Neighborhood food store and subsequent health and well-being of older adults in Japan: an outcome-wide study","authors":"Shuhei Kobayashi ,&nbsp;Atsushi Nakagomi ,&nbsp;Kazushige Ide ,&nbsp;Yu-Ru Chen ,&nbsp;Masamichi Hanazato ,&nbsp;Katsunori Kondo ,&nbsp;Koichiro Shiba","doi":"10.1016/j.archger.2026.106186","DOIUrl":"10.1016/j.archger.2026.106186","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Evidence on neighborhood food stores and public health is limited. This study examined the association of availability of neighborhood food stores and health and well-being.</div></div><div><h3>Methods</h3><div>We used three-wave data (2013, 2016, and 2019) from a nationwide cohort study of physically and cognitively independent older adults ≥65 years old in Japan. Exposure was the perceived availability of neighborhood food stores in 2016. We assessed 40 health/well-being outcomes in 2019 across seven domains; physical/cognitive health, health behaviors, mental health, psychological well-being, social well-being, character and virtue, and cognitive social capital. We adjusted for pre-exposure covariates including prior outcome in 2013. We included 47,318 respondents for 4 outcomes (death, dementia, any level of functional disability, and level 2 or greater functional disability) and 34,181 respondents for 36 other outcomes. The primary analysis was performed using linear, logistic, and poisson regression analysis depending on the nature of the outcome, and Bonferroni correction was used to correct for multiple tests.</div></div><div><h3>Results</h3><div>Compared to older adults who reported having many availability of neighborhood food stores, those reporting fewer stores were associated with less favorable outcomes in 5 of 7 domains; physical/cognitive health (low self-rated health and Instrumental activities of daily living), health behaviors (low frequency of going out), mental health (more depressive symptoms and hopeless), psychological well-being (low happiness and life satisfaction), cognitive social capital (low community attachment). These associations remained statistically significant after Bonferroni correction (<em>p</em> &lt; 0.0013).</div></div><div><h3>Conclusions</h3><div>Improving the availability of neighborhood food stores may promote health and well-being.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"144 ","pages":"Article 106186"},"PeriodicalIF":3.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313423","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}

{"title":"Threshold divergence in triglyceride-glucose index and mortality among Chinese older adults across the glucose metabolism spectrum: a cohort study","authors":"Lingling Yu ,&nbsp;Fanshu Yan ,&nbsp;Jian Xu ,&nbsp;Tianyong Wu ,&nbsp;Jiayan Cao ,&nbsp;Yicheng Zhang ,&nbsp;Jinlei Qi ,&nbsp;Lijun Wang ,&nbsp;Maigeng Zhou ,&nbsp;Peng Yin","doi":"10.1016/j.archger.2026.106162","DOIUrl":"10.1016/j.archger.2026.106162","url":null,"abstract":"<div><h3>Background</h3><div>The triglyceride-glucose (TyG) index is a promising marker of insulin resistance, but its association with mortality in older adults across different glucose metabolism statuses remain unclear.</div></div><div><h3>Methods</h3><div>This prospective cohort study utilized data from 708,456 adults aged ≥ 65 in the Chinese national Basic Public Health Service program across 4 municipalities (2017–2018). Participants were categorized into three groups by glucose metabolism status: diabetes, prediabetes and non-diabetes. With follow-up until December 31, 2023, we further analysed the association between baseline TyG index and five outcomes in each group: all-cause, cardiovascular disease (CVD), cancer, respiratory disease, and endocrine, nutritional, and metabolic diseases mortality, using Cox proportional hazards regression model and restricted cubic spline.</div></div><div><h3>Results</h3><div>During a median 6.38-year follow-up, 124,945 deaths occurred. A higher TyG index was significantly associated with increased all-cause mortality risk across all glucose metabolism strata. Compared to the lowest quartile, the highest quartile had hazard ratios of 1.42 (95% CI: 1.37 - 1.47) for diabetes, 1.17 (95% CI: 1.11 - 1.23) for prediabetes, and 1.14 (95% CI: 1.12 - 1.17) for non-diabetes populations. Similarly graded increase risk with worsening glucose metabolism were observed for CVD mortality, and respiratory disease mortality. Nonlinear analysis revealed distinct risk patterns: a single high-risk threshold (TyG=8.51) in diabetes, versus dual-threshold “risk windows” in prediabetes and non-diabetes groups.</div></div><div><h3>Conclusions</h3><div>The TyG index effectively stratifies mortality risk in older adults. Risk interpretation requires consideration of individual glucose metabolism status, enabling tailored preventive strategies for the aging population.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"144 ","pages":"Article 106162"},"PeriodicalIF":3.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260317","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}

{"title":"Step counts over time with the burden of 105 non-communicable diseases in older adults from the All of Us Research Program","authors":"Jiseung Kang ,&nbsp;Hyeon Jin Kim ,&nbsp;Christa J. Nehs ,&nbsp;Dong Keon Yon","doi":"10.1016/j.archger.2026.106187","DOIUrl":"10.1016/j.archger.2026.106187","url":null,"abstract":"<div><h3>Background</h3><div>As the impact of daily step counts on the risk and burden of various non-communicable diseases (NCDs) in older adults remains unclear, we investigated this association using wearable device data from a large, diverse cohort.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort study using the <em>All of Us</em> Research Program, including 2969 older adults (≥55 years) who wore Fitbit devices. Fitbit data were linked with electronic health records, and follow-up continued until July 1, 2022, to assess daily step counts and NCDs. We estimated the new-onset risks (adjusted-hazard ratios [aHRs]) and burdens (years lived with disability [YLDs]) for 105 NCDs.</div></div><div><h3>Results</h3><div>Of the 2969 participants aged ≥55, participants were categorized into a control group with ≥6000 step counts (mean [SD] age, 66.4 [6.9] years; female, 1243 [62.7%]) and a low-step counts with &lt;6000 steps (67.9 [7.4]; 710 [72.1%]). Lower daily step counts were associated with increased risk and/or burden across various NCDs. First, for cardiovascular disease (aHR, 1.17 [95% CI, 1.04–1.33]; YLD, 85.2 [28.9–141.4] per 100,000 populations), chronic respiratory disease (1.23 [1.08–1.40]; 138.5 [4.7–272.3]), digestive diseases (1.18 [1.04–1.34]; 116.9 [37.3–196.4]), and diabetes and kidney diseases (1.29 [1.11–1.51]; 186.3 [11.8–360.7]), lower step counts were linked to both increased risk and burden. Second, for neurological disorders, mental disorders, and substance use disorders, lower-step counts were associated with a higher risk but not burden. Third, for neoplasms and sense organ disorders, lower-step counts were linked to higher burden without changes in risk.</div></div><div><h3>Conclusions</h3><div>This study provides real-world evidence supporting the critical role of daily step counts in reducing the risk and/or burden of NCDs.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"144 ","pages":"Article 106187"},"PeriodicalIF":3.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319165","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}

{"title":"Social support, oral health literacy, and self-efficacy: psychosocial pathways to better oral health behaviors among community-dwelling older adults in central Vietnam","authors":"Nguyen Dieu Hang ,&nbsp;Mei-Ju Chi","doi":"10.1016/j.archger.2026.106184","DOIUrl":"10.1016/j.archger.2026.106184","url":null,"abstract":"<div><h3>Background</h3><div>Although associations among oral health literacy, social support, self-efficacy, and oral health behaviors have been examined, the underlying pathways mechanism remains unclear. This study aimed to explore the role of oral health literacy as a mediator and self-efficacy as a moderator on the pathway relationship between social support and oral health behaviors among community-dwelling older adults in central Vietnam.</div></div><div><h3>Methods</h3><div>In total, 1185 community-dwelling older adults were recruited between November 2024 and March 2025 using a multistage sampling method. Oral health behaviors were assessed using the WHO Basic Methods for Oral Health Survey, and its predictors were assessed with the Short Form of the Health Literacy in Dentistry, the General Self-Efficacy Scale, and the Multidimensional Scale of Perceived Social Support. Mediation and moderated mediation analyses were conducted using PROCESS macro vers. 4.0 with bias-corrected bootstrapping method.</div></div><div><h3>Results</h3><div>The average age of participants was 71.3 (SD=8.66) with a mean score for oral health behaviors of 4.78 (SD=1.54). Age, educational level, daily care resources, and alcohol consumption were significantly associated with oral health behaviors (<em>p</em>&lt;0.001). Oral health literacy partially mediated the association between social support and oral health behaviors (<em>β</em>=0.0145, Boot confidence interval (CI)=0.0113, 0.0179). Self-efficacy significantly moderated the path relationship between oral health literacy and oral health behaviors (<em>β</em>=0.0003, Boot CI=0.0000, 0.0005). This model explained 38.2% of the total variance in oral health behaviors.</div></div><div><h3>Conclusions</h3><div>Social support should be tailored to individual needs to empower older adults. Enhancing oral health literacy and self-efficacy may be effective strategies for improving oral health behaviors in this population.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"144 ","pages":"Article 106184"},"PeriodicalIF":3.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313480","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}

{"title":"Trends, burden, and outcomes of hypoglycemia hospitalizations in older adults: a territory-wide study in Hong Kong, 2012-2021","authors":"Hong-jie Yu ,&nbsp;Eric T.C. Lai ,&nbsp;Grace L.H. Wong ,&nbsp;Jean Woo","doi":"10.1016/j.archger.2026.106188","DOIUrl":"10.1016/j.archger.2026.106188","url":null,"abstract":"<div><h3>Background</h3><div>Severe hypoglycemia is typically regarded as a temporary metabolic issue in diabetes management. We aimed to examine trends, clinical outcomes, and post-hypoglycemia comorbidity patterns among hospitalized older adults, regardless of diabetes status.</div></div><div><h3>Methods</h3><div>This population-based cohort study analyzed 4,832,869 hospitalizations of older adults (≥65 years) in Hong Kong (2012–2021). We assessed annual hypoglycemia hospitalization rates, using 1:2 propensity score matching to compare outcomes between 14,879 cases and 29,758 controls, and applied network analysis to characterize post-hypoglycemia comorbidity phenotypes. Outcomes included all-cause mortality, hospital readmissions, and cumulative length of stay (LOS).</div></div><div><h3>Results</h3><div>Hypoglycemia hospitalization rates more than doubled from 2.77 to 5.17 per 1,000 episodes (2012–2015) before plateauing, coinciding with a shift toward unspecified diagnostic coding. Hypoglycemia was associated with significantly increased mortality (HR=2.149, 95 % CI: 2.061–2.241), readmission rates (IRR=2.019, 95 % CI: 1.970–2.069), and LOS (IRR=2.098, 95 % CI: 2.030–2.169). Network analysis identified three communities: Neuro-Metabolic-Respiratory Syndrome (dominant community), Cardiorenal-Vascular Degeneration Axis (network hub), and Gastro-Oncological &amp; Traumatic group (peripheral community). Patient stratification revealed four phenotypes: Gastro-Oncological-dominant patients had the poorest survival; Neuro-Metabolic-Respiratory patients showed the highest frailty; Cardiorenal-Vascular patients experienced multisystem organ dysfunction; and Complex Multi-Morbidity patients had preserved survival but higher healthcare utilization.</div></div><div><h3>Conclusions</h3><div>Severe hypoglycemia in older adults signals accelerated multimorbidity accumulation rather than being an isolated metabolic issue. Comorbidities form distinct phenotypes that enable targeted risk stratification and intervention. This necessitates viewing severe hypoglycemia as a critical transition point for comprehensive geriatric vulnerability assessment and informed care planning, irrespective of diabetes status.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"144 ","pages":"Article 106188"},"PeriodicalIF":3.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319146","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}

{"title":"Between convenience and consequence: Ultraprocessed foods, protein nutrition, and the future of healthy aging","authors":"Liang-Kung Chen","doi":"10.1016/j.archger.2026.106193","DOIUrl":"10.1016/j.archger.2026.106193","url":null,"abstract":"","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"144 ","pages":"Article 106193"},"PeriodicalIF":3.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328501","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}