Archives of gerontology and geriatrics最新文献

{"title":"Advance care planning procedure in older patients at a high risk of death after discharge from the acute geriatric unit: A study protocol","authors":"Fabien Visade ,&nbsp;Guillaume Deschasse ,&nbsp;Frédéric Roca ,&nbsp;Cédric Villain ,&nbsp;Sylvia Pelayo ,&nbsp;Romaric Marcilly ,&nbsp;Matthieu Calafiore ,&nbsp;Paul Quindroit ,&nbsp;Chloé Prod'homme ,&nbsp;Clémence Levesque ,&nbsp;Williams Vandenberghe ,&nbsp;Laurène Norberciak ,&nbsp;Marie Buttitta ,&nbsp;Carla Di Martino ,&nbsp;Jean-Baptiste Beuscart","doi":"10.1016/j.archger.2025.105836","DOIUrl":"10.1016/j.archger.2025.105836","url":null,"abstract":"<div><div>The SAPHARI (“Home-based Nurse Intervention in the Care of High-Risk-of-Death Patients after Discharge from a Geriatric Department”) prospective, multicenter, randomized, controlled, open-label study has been designed to evaluate the effectiveness of implementing advance care planning (ACP) in older patients at a high risk of death. Patients aged 75 or over, at a high risk of death (according to the DAMAGE prognostic score) and discharged alive to home or to a nursing home from an acute geriatric unit will be included and followed up for 12 months. We plan to randomize 104 patients into a control group or an intervention group. The patients in the intervention group will receive an in-home intervention by an expert advanced practice nurse trained in the implementation of ACP. The primary outcome will focus on the intervention's feasibility: the proportion of patients included and randomized, the proportion completing in the study, and the proportion having engaged in ACP within a month of discharge. A secondary efficacy outcome will be compliance with advance directives (drafted at the time of ACP) at 12 months in each of the two study groups. Symptom's of anxiety and depression, the intervention's acceptability, and changes in quality of life will be documented in patients, family carers, and professional caregivers. The patients' and caregivers' experience of the intervention will be explored in qualitative analyses. Lastly, the intervention's implementation will be analyzed, with a view to understanding the results and identifying factors that will foster generalization of the conclusions. Through this project, we hope to lay the foundations for better care of very frail older patients at the end of life. The results of our study will provide robust, scientific evidence to fuel the long-standing but evolving social and political debate over the right to a dignified end of life.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105836"},"PeriodicalIF":3.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726085","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":"Tolerable blood pressure control levels do not impact mortality of patients over 80-year-old: Insights from NHANES 2009-2018","authors":"Yueqiao Si ,&nbsp;Binjun Lu ,&nbsp;Lanlan Ma ,&nbsp;Juanjuan Zheng ,&nbsp;Wei Eric Wang","doi":"10.1016/j.archger.2025.105828","DOIUrl":"10.1016/j.archger.2025.105828","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the impact of blood pressure levels on all-cause and cardiovascular disease (CVD) mortality in hypertensive patients over 80-year-old using data from the National Health and Nutrition Examination Survey (NHANES) 2009–2018.</div></div><div><h3>Methods</h3><div>A total of 8406 hypertensive patients under 80-year-old and 1082 hypertensive patients over 80-year-old were included. Kaplan-Meier curves, Cox proportional hazards regression models, and restricted cubic spline plots were employed.</div></div><div><h3>Results</h3><div>In patients over 80-year-old, neither systolic blood pressure (SBP) nor diastolic blood pressure (DBP) was significantly associated with all-cause or CVD mortality (<em>P</em> &gt; 0.05). However, in hypertensive patients under 80-year-old, significant differences in mortality were observed across different SBP and DBP subgroups (<em>P</em> &lt; 0.05), with an optimal SBP range of 120–140 mmHg associated with reduced all-cause mortality risk. In patients over 80-year-old, male patients, high urinary albumin-to-creatinine ratio, total cholesterol, red blood cells, and elevated lymphocyte and neutrophil percentages were associated with increased all-cause mortality; SBP interaction with these risk factors slightly reduced the hazard ratio values separately.</div></div><div><h3>Conclusion</h3><div>Based on NHANES data from 2009 to 2018, tolerable SBP and DBP levels appear to have no significant impact on all-cause or CVD mortality in hypertensive patients over 80-year-old”.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105828"},"PeriodicalIF":3.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768548","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":"SGLT2 inhibitors and comprehensive approaches for heart failure management in frail older adults","authors":"Liang-Kung Chen","doi":"10.1016/j.archger.2025.105834","DOIUrl":"10.1016/j.archger.2025.105834","url":null,"abstract":"","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"133 ","pages":"Article 105834"},"PeriodicalIF":3.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712335","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":"Longitudinal associations between lipid panel and cognitive decline modified by APOE 4 carrier status in biracial community-dwelling older adults: Findings from the Chicago health and aging project","authors":"Ted K.S. Ng ,&nbsp;Todd Beck ,&nbsp;Xiaoran Liu ,&nbsp;Pankaja Desai ,&nbsp;Thomas Holland ,&nbsp;Klodian Dhana ,&nbsp;Kristin Krueger ,&nbsp;Robert S. Wilson ,&nbsp;Denis A. Evans ,&nbsp;Kumar B. Rajan","doi":"10.1016/j.archger.2025.105825","DOIUrl":"10.1016/j.archger.2025.105825","url":null,"abstract":"<div><h3>Background</h3><div>There have been contradictory findings on the associations between lipids and cognitive decline (CD), which may be attributed to the heterogeneity in the APOE4 carrier status, given APOE's lipid transportation roles. However, extant studies rarely examined the modifying effects of APOE4 carrier status on the associations between lipids and CD.</div></div><div><h3>Methods</h3><div>We analyzed the Chicago Health and Aging Project, a 20-year cohort study comprising older adults with lipid panel assayed, i.e., total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL), and longitudinal cognitive tests. We ran adjusted linear mixed-effects models, regressing cognitive test composite on each of the four lipids independently, first with the total sample and subsequently using interaction and stratified subgroup analyses, examining the modifying effects of APOE4 carrier status on the associations.</div></div><div><h3>Results</h3><div>3,496 biracial community-dwelling older adults were recruited from the South side of Chicago (58% African American &amp; 64% women; mean follow-up = 4.6 years). In the total sample, there was a borderline association between TG and CD, estimate (SD, p-value) = 0.0001 (0.0000,0.0565). No associations were detected with other lipids. In the interaction and subgroup analyses, only in ε4 carriers that higher TC levels were significantly associated with accelerated CD, -0.020 (0.009,0.035), whereas higher TG levels were significantly associated with decelerated CD, 0.001 (0.001,0.045). No modifying effects of ε4 carrier status were detected with other lipids.</div></div><div><h3>Discussion</h3><div>Specific lipids, i.e., TC and TG, were associated with CD only in the ε4 carriers, highlighting the potential importance of measuring APOE4 status to better inform risk prediction and treatment.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105825"},"PeriodicalIF":3.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746948","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":"Prevalence and prognostic significance of cachexia diagnosed by novel definition for Asian population among Chinese cirrhotic patients","authors":"Shuangzhe Yao ,&nbsp;Ziyi Yang ,&nbsp;Jia Li ,&nbsp;Binbin Peng ,&nbsp;Han Wang ,&nbsp;Jing Liang ,&nbsp;Chao Sun","doi":"10.1016/j.archger.2025.105833","DOIUrl":"10.1016/j.archger.2025.105833","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Cachexia is a multifaceted metabolic disorder often linked to chronic illnesses, characterized by substantial weight reduction, inflammatory states, and loss of appetite. The novel diagnostic criteria concerning cachexia established by the Asian Working Group for Cachexia (AWGC) have not been fully validated in Chinese populations with cirrhosis. To assess the prognostic impact of AWGC-defined cachexia among hospitalized cirrhotic patients and explore the synergistic impact of Model for End-Stage Liver Disease 3.0 (MELD 3.0) scores with cachexia status on prognosis.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed clinical data from patients with decompensated cirrhosis admitted to our tertiary hospital between January 2021 and December 2023. Cachexia was identified according to AWGC criteria, and disease severity was assessed using MELD 3.0 scores. The study's primary outcome was all-cause mortality within one year.</div></div><div><h3>Results</h3><div>A total of 368 patients were included in the analyses. The prevalence of cachexia was 61.7 %, and patients with cachexia had a significantly higher one-year all-cause mortality rate (26.4 % vs. 7.8 %, <em>P</em> &lt; 0.001). Multivariate Cox regression analysis showed that cachexia (HR 2.68, 95 %CI 1.40–5.13, <em>P</em> = 0.003), along with MELD 3.0 (HR 1.18, 95 %CI 1.13–1.23, <em>P</em> &lt; 0.001), were independent predictors of one-year mortality. The combined assessment of cachexia and MELD 3.0 scores yielded a higher discriminative ability for predicting one-year mortality compared to either metric alone.</div></div><div><h3>Conclusions</h3><div>AWGC-defined cachexia is a significant prognostic factor in hospitalized patients with cirrhosis. The integration of cachexia with MELD 3.0 scoring enhances prognostic prediction, underscoring the importance to introduce cachexia evaluation during clinical practice for this vulnerable setting.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"133 ","pages":"Article 105833"},"PeriodicalIF":3.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684593","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":"Association of neighborhood physical environment with falls and fear of falling in older adults: A prospective cohort study","authors":"Lucía Arias-Fernández ,&nbsp;Lucía Carcedo-Argüelles ,&nbsp;Esther García-Esquinas ,&nbsp;Francisco Félix Caballero ,&nbsp;Fernando Rodríguez-Artalejo ,&nbsp;Alberto Lana","doi":"10.1016/j.archger.2025.105831","DOIUrl":"10.1016/j.archger.2025.105831","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the prospective association between physical environment characteristics of the neighborhood and risk of falls/fear of falling among community-dwelling older adults.</div></div><div><h3>Study Design</h3><div>Prospective cohort analysis using data from the Seniors-ENRICA-2 cohort (metropolitan Madrid, Spain).</div></div><div><h3>Methods</h3><div>At baseline (2015–17), a neighborhood physical characteristics score was developed using the Physical Activity Neighborhood Environment Scale and an additional indicator of distance to green areas. In the second wave of follow-up (2019–20) we collected self-reported incident falls and fear of falling, assessed with the Short Falls Efficacy Scale International. Adjusted odds ratios (OR) and 95 % confidence intervals (CI) for the association between neighborhood environment perception and incidence of falls/fear of falling were calculated using logistic regression.</div></div><div><h3>Results</h3><div>Among 1823 participants, 27.7 % reported a fall during the previous year and 32.1 % were concerned about having a fall. Better neighborhood environment was associated with lower risk of falls (OR: 0.75; 95 %CI: 0.57–0.99) and fear of falling (0.73; 0.55–0.96). Specifically, low traffic intensity (0.68; 0.52–0.90) and sidewalks in good condition (0.75; 0.59–0.95) were associated with lower risk of falling. Moreover, available facilities for biking (0.77; 0.61–0.96), sidewalks in good condition (0.67; 0.52–0.86), night security (0.80; 0.60–0.99) and day security (0.62; 0.44–0.98) were independently associated with lower fear of falling.</div></div><div><h3>Conclusions</h3><div>Better neighborhood physical environments could play a key role in the prevention of falls and fear of falling among older adults. Policies aiming to improve residential environments can have broad implications for achieving healthy aging.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"133 ","pages":"Article 105831"},"PeriodicalIF":3.5,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684594","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":"Life-course socioeconomic inequalities, social mobility and healthy aging in older adults: A multi-cohort study","authors":"Ziting Huang ,&nbsp;Eric T.C. Lai ,&nbsp;Hideki Hashimoto ,&nbsp;Michael Marmot ,&nbsp;Jean Woo","doi":"10.1016/j.archger.2025.105829","DOIUrl":"10.1016/j.archger.2025.105829","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate how socioeconomic positions at different life stages, their relative importance, and social mobility influence IC across the USA, UK, Europe, China, and Japan among adults aged ≥50 years.</div></div><div><h3>Methods</h3><div>We included 54,217 participants from five nationally representative cohorts in the USA, UK, Europe, China, and Japan. Life-course socioeconomic positions were assessed in early-life (childhood socioeconomic positions), early-adulthood (education), and late-adulthood (household wealth). Healthy aging was measured by intrinsic capacity including cognition, psychological health, locomotion, vitality, and sensory functions. Linear mixed models were used to estimate the associations of intrinsic capacity with each socioeconomic position indicator and social mobility.</div></div><div><h3>Findings</h3><div>Higher levels of education and wealth were both significantly associated with better intrinsic capacity (<em>p</em> &lt; 0.05 in all cohorts).</div><div>Education had a stronger impact on intrinsic capacity than wealth in the USA, Europe, China, and Japan. Middle and high childhood socioeconomic positions were significantly linked to better intrinsic capacity compared with the low group (<em>p</em> &lt; 0.05 in all cohorts). Compared to stable groups, upward and downward social mobility groups were associated with better and worse intrinsic capacity, respectively.</div></div><div><h3>Conclusion</h3><div>Socioeconomic measures throughout the life course can predict healthy aging in the USA, Europe, and Asia. The long-term negative impact of disadvantaged childhood socioeconomic positions on healthy aging can be partially mitigated by upward mobility later in life. Policies need to narrow the social inequalities from early life and prevent adults from experiencing downward mobility, thereby reducing disparities in healthy aging.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"133 ","pages":"Article 105829"},"PeriodicalIF":3.5,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national burdens of hip fractures in elderly individuals from 1990 to 2021 and predictions up to 2050: A systematic analysis of the Global Burden of Disease Study 2021","authors":"Chuwei Tian ,&nbsp;Liu Shi ,&nbsp;Jinyu Wang ,&nbsp;Jun Zhou ,&nbsp;Chen Rui ,&nbsp;Yueheng Yin ,&nbsp;Wei Du ,&nbsp;Shimin Chang ,&nbsp;Yunfeng Rui","doi":"10.1016/j.archger.2025.105832","DOIUrl":"10.1016/j.archger.2025.105832","url":null,"abstract":"<div><h3>Purpose</h3><div>We aimed to analyse the global, regional, and national burdens of hip fractures in older adults from 1990 to 2021, with projections to 2050, on the basis of data from the GBD 2021 study.</div></div><div><h3>Methods</h3><div>We employed a joinpoint model to analyse trends in the burden of hip fractures from 1990‒2021. The estimated annual percentage change (EAPC) was used to quantify temporal trends over this period. We evaluated the relationship between the social development index and the burden of hip fracture in elderly people and conducted a health inequality analysis. Additionally, we applied Long-short Term Memory (LSTM) networks to forecast burden trends of hip fractures up to 2050.</div></div><div><h3>Results</h3><div>The global age-standardized incidence rate (ASIR) for hip fractures in older adults rose from 781.56 per 100,000 in 1990 to 948.81 in 2021. The 2021 age-standardized prevalence rate (ASPR) was 1,894.07, and the age-standardized YLD rate (ASDR) was 173.52. From 1990 to 2021, the incidence and prevalence increased by 168.71 % and 173.07 %, respectively, while the burden of DALYs decreased. Future trends were projected via the LSTM. The burden and risk factors for hip fractures varied significantly by sex, country, and region. Population and aging are primary contributors to the rising incidence of elderly hip fractures, with falls being the leading direct cause.</div></div><div><h3>Conclusion</h3><div>From 1990 to 2021, the global burden of hip fractures in the elderly population, especially among older women, steadily increased. Population ageing highlights the urgent need for targeted public health interventions and resource allocation, including early diagnosis, effective prevention strategies, and region-specific management approaches.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"133 ","pages":"Article 105832"},"PeriodicalIF":3.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644800","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":"Brain Age Gap Associations with Body Composition and Metabolic Indices in an Asian Cohort: An MRI-Based Study","authors":"Han-Jui Lee ,&nbsp;Chen-Yuan Kuo ,&nbsp;Yu-Chung Tsao ,&nbsp;Pei-Lin Lee ,&nbsp;Kun-Hsien Chou ,&nbsp;Chung-Jung Lin ,&nbsp;Ching-Po Lin","doi":"10.1016/j.archger.2025.105830","DOIUrl":"10.1016/j.archger.2025.105830","url":null,"abstract":"<div><h3>Background</h3><div>Global aging raises concerns about cognitive health, metabolic disorders, and sarcopenia. Prevention of reversible decline and diseases in middle-aged individuals is essential for promoting healthy aging. We hypothesize that changes in body composition, specifically muscle mass and visceral fat, and metabolic indices are associated with accelerated brain aging. To explore these relationships, we employed a brain age model to investigate the links between the brain age gap (BAG), body composition, and metabolic markers.</div></div><div><h3>Methods</h3><div>Using T1-weighted anatomical brain MRIs, we developed a machine learning model to predict brain age from gray matter features, trained on 2,675 healthy individuals aged 18–92 years. This model was then applied to a separate cohort of 458 Taiwanese adults (57.8 years ± 11.6; 280 men) to assess associations between BAG, body composition quantified by MRI, and metabolic markers.</div></div><div><h3>Results</h3><div>Our model demonstrated reliable generalizability for predicting individual age in the clinical dataset (MAE = 6.11 years, <em>r</em> = 0.900). Key findings included significant correlations between larger BAG and reduced total abdominal muscle area (<em>r</em> = -0.146, <em>p</em> = 0.018), lower BMI-adjusted skeletal muscle indices, (<em>r</em> = -0.134, <em>p</em> = 0.030), increased systemic inflammation, as indicated by high-sensitivity C-reactive protein levels (<em>r</em> = 0.121, <em>p</em> = 0.048), and elevated fasting glucose levels (<em>r</em> = 0.149, <em>p</em> = 0.020).</div></div><div><h3>Conclusions</h3><div>Our findings confirm that muscle mass and metabolic health decline are associated with accelerated brain aging. Interventions to improve muscle health and metabolic control may mitigate adverse effects of brain aging, supporting healthier aging trajectories.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"133 ","pages":"Article 105830"},"PeriodicalIF":3.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684536","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":"From patterns to pathways: Latent class trajectories of self-perceptions of aging and their causal effects on multi-state functional transitions","authors":"Lingjun Liu ,&nbsp;Boshu Mao ,&nbsp;Fei Ji","doi":"10.1016/j.archger.2025.105827","DOIUrl":"10.1016/j.archger.2025.105827","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines the heterogeneous developmental trajectories of self-perceptions of aging (SPA) and their causal effects on functional health transitions in older adults. Specifically, we aim to identify latent classes of SPA development, assess their impact on multi-state functional transitions, and quantify the loss in healthy life expectancy attributable to negative SPA.</div></div><div><h3>Methods</h3><div>Drawing from the Chinese Longitudinal Healthy Longevity Survey (2008–2018; <em>n</em> = 14,020), we implemented latent class trajectory modeling to identify SPA developmental patterns. We then applied multi-state Markov models to examine the effects of SPA on transitions among functional states (fully independent, assistance needed, and deceased), and established a counterfactual framework to estimate the loss in multi-state life expectancy attributable to SPA.</div></div><div><h3>Results</h3><div>Analysis revealed two distinct SPA trajectories: a high-level group (57.75 %) and a low-level group (42.25 %), both exhibiting declining trends while maintaining consistent level differences. After adjusting for demographic characteristics, negative SPA significantly increased the risk of functional impairment (HR=1.31, 95 % CI: 1.20–1.44) and diminished the probability of functional recovery (HR=0.61, 95 % CI: 0.53–0.71). At age 65, negative SPA was associated with a 2.18-year reduction in total life expectancy, with substantial disparities in healthy life expectancy (10.93 vs. 7.96 years).</div></div><div><h3>Discussion</h3><div>This study reveals two distinct trajectories of SPA in later life and demonstrates its causal effects on health state transitions. Early interventions targeting negative aging perceptions, particularly before age 65, may effectively extend healthy life expectancy.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"133 ","pages":"Article 105827"},"PeriodicalIF":3.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629067","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}