Archives of gerontology and geriatrics最新文献

{"title":"The effect of aging on hearing outcomes after sudden sensorineural hearing loss (SSNHL): A retrospective study","authors":"Jelena Vukelic ,&nbsp;Diana Marzic ,&nbsp;Anja Liovic ,&nbsp;Dubravko Manestar ,&nbsp;Dubravka Matesa Anic","doi":"10.1016/j.archger.2025.105932","DOIUrl":"10.1016/j.archger.2025.105932","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze the effect of aging on hearing outcomes following treatment for sudden sensorineural hearing loss (SSNHL).</div></div><div><h3>Materials and methods</h3><div>This retrospective study reviewed records of 106 SSNHL patients categorized into younger (&lt;65 years) and older (≥65 years). Hearing outcomes and related factors including sex, absolute gain, treatment timing, Hyperbaric Oxygen Therapy (HBOT), audiogram type, and contralateral ear thresholds were examined.</div></div><div><h3>Results</h3><div>Treatment outcomes between age groups showed no statistically significant difference (<em>p</em> = 0.053), though younger age was consistently linked to better recovery. A significant negative correlation between age and absolute hearing gain was observed (<em>r</em> = -0.296, <em>p</em> &lt; 0.05). Younger females showed superior outcomes compared to younger males (<em>p</em> &lt; 0.05). Early treatment predicted better recovery (χ² = 9.04, <em>p</em> &lt; 0.01). A normal contralateral ear threshold was associated with better recovery (<em>p</em> &lt; 0.05). A multivariate logistic regression model was developed (AUC = 0.781). Symptom duration (<em>p</em> &lt; 0.05) and intratympanic therapy (<em>p</em> &lt; 0.05) were significant predictors of hearing outcomes. Age was not a significant independent predictor (<em>p</em> = 0.054), but it improved model fit, supporting its clinical relevance.</div></div><div><h3>Conclusions</h3><div>The timing of treatment initiation is important for SSNHL prognosis. Although age did not reach statistical significance in the multivariate model, its consistent association with better outcomes and contribution to model fit highlight its continued clinical relevance. Early intervention is the key predictor of recovery, reinforcing the value of age-informed, personalized treatment strategies in managing SSNHL.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105932"},"PeriodicalIF":3.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262835","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":"Knowledge, awareness, beliefs, attitudes, current practices, and perceptions of responsibility to the identification and management of sarcopenia among Australian general practitioners and practice nurses: A national survey","authors":"Robin M. Daly ,&nbsp;David Scott ,&nbsp;Nicole Kiss ,&nbsp;Michael Tieland ,&nbsp;Brenton Baguley ,&nbsp;Jackson J. Fyfe ,&nbsp;Ramesh Manocha","doi":"10.1016/j.archger.2025.105923","DOIUrl":"10.1016/j.archger.2025.105923","url":null,"abstract":"<div><h3>Objective</h3><div>To explore Australian general practitioners’ (GPs) and practice nurses’ (PNs) awareness, understanding, knowledge, beliefs, attitudes current practices, perceptions of responsibility, confidence, barriers and enablers to identification and management of sarcopenia.</div></div><div><h3>Methods</h3><div>A national, anonymous 33-item, online purpose-designed survey covering the topics in the aims was conducted from March-May 2024.</div></div><div><h3>Results</h3><div>1364 participants (97 % GPs, 62 % female) participated. Two-thirds were familiar with sarcopenia and recognised it included low muscle mass (89 %), strength (66 %) and function (53 %), but 35 % incorrectly identified low physical fitness. Knowledge on common signs/symptoms, risk factors, consequences, and treatments was generally high, but only 10–18 % recognised stiff/inflexible muscles, cramps and persistent muscle pain are not signs/symptoms, and only 9–12 % recognised any form or aerobic exercise and eating more fruits/vegetables are ineffective treatments. Most (&gt;80 %) believed they should play an active role in sarcopenia identification/treatment, but only 23 % screened/assessed for it. Most indicated education (90 %) and screening/assessment (86 %) should be prioritized in primary care, but lack of priority (68 %), time (47 %) and confidence/knowledge (23 %) were obstacles to address sarcopenia in practice. Lack of referral options and access to appropriate tools were key barriers and protocol implementation and access to relevant training were the main enablers to identification/treatment.</div></div><div><h3>Conclusion</h3><div>Primary care clinicians in Australia are familiar with and have some intuitive understanding of, and positive attitudes/beliefs toward sarcopenia, recognising they should play a key role in identifying/managing it, but report it’s not a priority, they lack knowledge, confidence, referral options, appropriate tools and time to address it in practice.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105923"},"PeriodicalIF":3.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296857","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":"Determinant of functional independence in older patients with heart failure: physical function vs. muscle mass","authors":"Suguru Honma ,&nbsp;Satoshi Katano ,&nbsp;Toshiyuki Yano ,&nbsp;Ryohei Nagaoka ,&nbsp;Aki Habaguchi ,&nbsp;Ryo Numazawa ,&nbsp;Katsuhiko Ohori ,&nbsp;Hidemichi Kouzu ,&nbsp;Masaki Katayose ,&nbsp;Nobuhiro Yoshioka ,&nbsp;Masato Furuhashi ,&nbsp;Akiyoshi Hashimoto","doi":"10.1016/j.archger.2025.105933","DOIUrl":"10.1016/j.archger.2025.105933","url":null,"abstract":"<div><h3>Aim</h3><div>While sarcopenia affects functional independence in older patients with heart failure (HF), the differential impact of its components—including muscle mass (MM), muscle strength (MS), and physical function (PF)—remain underexplored. We investigated these components’ independent and synergistic associations with functional independence in older patients with HF, including sex-specific differences.</div></div><div><h3>Methods</h3><div>We studied 587 older patients with HF (299 women; mean age, 79±7 years). MM, MS, and PF were assessed using dual-energy X-ray absorptiometry, handgrip strength, and physical performance tests (gait speed, five-times sit-to-stand test [FTSS], short physical performance battery [SPPB]), respectively. Cutoffs for each component followed the Asian Working Group for Sarcopenia 2019 criteria. Functional independence was assessed using the Barthel Index (BI).</div></div><div><h3>Results</h3><div>Sarcopenia was associated with lower BI scores. Poor PF independently predicted reduced BI scores (slow gait speed: 8.4 points; prolonged FTSS: 10.9 points; low SPPB: 14.8 points; all <em>p</em> &lt; 0.001), whereas low MM and weak MS did not. Low MM amplified the negative impact of poor PF on BI scores consistently across sexes. Machine-learning analysis revealed MM status-specific predictors of PF: clinical factors (female sex, HF symptoms) and comorbidities predicted poor PF in patients with normal MM; renin-angiotensin system inhibition, and cardiomyopathy were associated with preserved PF in patients with low MM.</div></div><div><h3>Conclusions</h3><div>In older patients with HF, sarcopenia is closely and negatively associated with BI score primarily through poor PF; MM potentially modifies this relationship independent of sex. MM status-specific factors associated with PF suggest the importance of phenotype-specific approaches in facilitating functional independence.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105933"},"PeriodicalIF":3.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330192","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":"How the combined approach of subjective and functional health improves the early identification of the older adults at risk of adverse events?","authors":"Yvanna Simon ,&nbsp;Antoine Gbessemehlan ,&nbsp;Luc Letenneur ,&nbsp;Catherine Helmer ,&nbsp;Camille Ouvrard ,&nbsp;Valérie Bergua ,&nbsp;Hélène Amiéva ,&nbsp;Karine Pérès","doi":"10.1016/j.archger.2025.105934","DOIUrl":"10.1016/j.archger.2025.105934","url":null,"abstract":"<div><h3>Background</h3><div>Combining the assessment of subjective health and functional health may provide a more comprehensive approach to characterize and address the health needs of the older adults.</div></div><div><h3>Objective</h3><div>To explore the relationship between functional (IADL-limitation) health combined with self-rated health (SRH), and the risk of adverse events: mortality, ADL-limitation and institutionalization.</div></div><div><h3>Methods</h3><div>The sample included 4429 participants aged 65 years and over from three French population-based cohorts followed up to 20 years. An indicator combining a SRH item and IADL-limitation was created to define four \"health status\" groups: (1) Good SRH without IADL-limitation (reference); (2) Poor SRH without IADL-limitation; (3) Good SRH with IADL-limitation; (4) Poor SRH with IADL-limitation. Survival models analyzed separately the association between health status and risk of death, ADL-limitation or institutionalization.</div></div><div><h3>Results</h3><div>Compared with participants with good SRH and no IADL-limitations, individuals without IADL-limitations who reported poor SRH also had an increased risk of death, ADL-limitation and institutionalization. In addition, those with IADL limitations, regardless of their SRH status, had at least twice the risk of death and subsequent ADL-limitations.</div></div><div><h3>Conclusion</h3><div>Our findings revealed that as soon as perceived a poor SRH, even in the absence of IADL-limitation, the risk of adverse health events increases. These risks are higher for individuals with IADL-limitations, regardless of their SRH status. These preliminary findings emphasize that taking into account perception of decline in absence of limitations can help to identify early symptoms before irreversible losses occur, allowing for the implementation of targeted prevention strategies for older adults.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105934"},"PeriodicalIF":3.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271309","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":"Using machine learning to identify predictors of self-perceptions of aging among older adults in England","authors":"Mohsen Joshanloo","doi":"10.1016/j.archger.2025.105922","DOIUrl":"10.1016/j.archger.2025.105922","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to identify the strongest predictors of self-perceptions of aging (SPA) from an extensive set of 55 variables, including demographic, psychological, social, and economic factors.</div></div><div><h3>Methods</h3><div>Data were drawn from the English Longitudinal Study of Ageing, comprising over 7,000 adults aged 50 and older. Two advanced machine learning models, Random Forest and extreme gradient boosting (XGBoost), were used for data analysis. This approach allowed for a comprehensive evaluation of the relative importance of each predictor.</div></div><div><h3>Results</h3><div>Psychological factors emerged as the strongest predictors of positive SPA, outweighing health-related and demographic variables. Sense of control was identified as the strongest predictor, followed by pleasure derived from daily life experiences and the perception of life as worthwhile. Other significant predictors included components of emotional well-being (e.g., anxiety and happiness), autonomy, self-realization, and the quality of interpersonal relationships.</div></div><div><h3>Discussion</h3><div>The results indicate that a sense of competence, autonomy, and relatedness forms a vital foundation for positive self-perceptions of aging. These factors are enhanced by both hedonic and eudaimonic experiences, which contribute to the emotional and existential richness of the aging process. The findings highlight opportunities for targeted interventions and the refinement of existing theoretical models.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105922"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213501","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 impacts of multimorbidity trajectories and patterns on functional limitations over time in middle-aged and older adults","authors":"Yan Wu ,&nbsp;Xiao Niu ,&nbsp;Bosen Lv ,&nbsp;Xiaohui Li ,&nbsp;Weijing Wang ,&nbsp;Wenjing Feng ,&nbsp;Haiping Duan ,&nbsp;Yili Wu","doi":"10.1016/j.archger.2025.105919","DOIUrl":"10.1016/j.archger.2025.105919","url":null,"abstract":"<div><h3>Background</h3><div>Although multimorbidity is a risk factor for functional limitations, few studies have simultaneously examined the impacts of multimorbidity trajectories and patterns on long-term functional limitations change. We aim to identify multimorbidity trajectories and patterns and explore their relationships with functional limitations in middle-aged and older adults.</div></div><div><h3>Methods</h3><div>This study included 6302 participants aged ≥50 from the English Longitudinal Study of Ageing survey 2008–2021. Group-based trajectory model was conducted to identify multimorbidity trajectories from 22 chronic conditions (2008–2014). Exploratory factor analysis was employed to assess multimorbidity pattern using data collected in 2014. The impacts of multimorbidity trajectories and patterns on the change in functional limitations across the subsequent 7 years (2014–2021) were examined through generalized estimating equation models.</div></div><div><h3>Results</h3><div>This study identified four multimorbidity trajectories: low-maintaining, new-increasing, moderate-increasing, and high-maintaining trajectory and four multimorbidity patterns: multi-system, cardiovascular, vision impairment, and metabolic-skeletal patterns. Across all multimorbidity trajectories and patterns, functional limitations showed sustained increases over time, with levels consistently higher than reference groups (all <em>P</em> &lt; 0.001). There were significant interactions of multimorbidity trajectories and patterns with time, particularly for high-maintaining trajectory (T6:<em>β</em> = -0.218, <em>P</em> = 0.007; T7:<em>β</em> = -0.271, <em>P</em> = 0.004), multi-system pattern (T6:<em>β</em> = -0.323, <em>P</em> = 0.001; T7:<em>β</em> = -0.593, <em>P</em> &lt; 0.001), and metabolic-skeletal pattern (T6:<em>β</em> = -0.313, <em>P</em> &lt; 0.001; T7:<em>β</em> = -0.481, <em>P</em> &lt; 0.001), indicating the high-maintaining multimorbidity trajectory, multi-system and metabolic skeletal patterns accelerated the progression of functional limitations.</div></div><div><h3>Conclusions</h3><div>Implement targeted preventive interventions and personalized health management strategies for high-risk multimorbidity patients to delay disability onset.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105919"},"PeriodicalIF":3.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213500","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":"Cachexia defined by the Asian Working Group for Cachexia 2023 criteria as a determinant of functional recovery in post-stroke patients capable of oral intake","authors":"Fumihiko Nagano ,&nbsp;Yoshihiro Yoshimura ,&nbsp;Ayaka Matsumoto ,&nbsp;Yoichi Sato ,&nbsp;Takafumi Abe ,&nbsp;Sayuri Shimazu ,&nbsp;Ai Shiraishi ,&nbsp;Takahiro Bise ,&nbsp;Yoshifumi Kido ,&nbsp;Takenori Hamada ,&nbsp;Aomi Kuzuhara ,&nbsp;Kouki Yoneda","doi":"10.1016/j.archger.2025.105921","DOIUrl":"10.1016/j.archger.2025.105921","url":null,"abstract":"<div><h3>Background and aims</h3><div>Cachexia is a common condition in stroke patients, yet its prevalence and impact on functional outcomes based on the Asian Working Group for Cachexia (AWGC) 2023 criteria remain unclear. This study aimed to determine the prevalence of cachexia and examine its association with functional prognosis in post-acute stroke patients capable of oral intake.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 856 post-stroke patients (mean (SD) age: 78 (7) years; 52 % men) admitted to a Japanese rehabilitation hospital between 2015 and 2023. Cachexia was diagnosed at admission using the AWGC 2023 criteria. Functional outcomes were assessed using the Functional Independence Measure (FIM)-motor score at discharge and FIM-motor gain. The association between cachexia and functional outcomes was analyzed using multiple linear regression, adjusting for age, sex, stroke type, baseline FIM-motor and FIM-cognitive scores, and other confounders.</div></div><div><h3>Results</h3><div>Cachexia was diagnosed in 20 % (172/856) of patients. The mean (SD) length of hospital stay was 85 (44) days. Stroke types were cerebral infarction (<em>n</em> = 634, 74 %), cerebral hemorrhage (<em>n</em> = 188, 22 %), and subarachnoid hemorrhage (<em>n</em> = 34, 4 %). The most common underlying diseases were cancer (<em>n</em> = 120, 14 %), chronic heart failure (<em>n</em> = 52, 6 %), and chronic kidney disease (<em>n</em> = 26, 3 %). After adjusting for confounders, cachexia remained independently associated with lower FIM-motor at discharge (β=-0.092, <em>P</em> = 0.009) and lower FIM-motor gain (β=-0.079, <em>P</em> = 0.024).</div></div><div><h3>Conclusion</h3><div>Cachexia, as defined by the AWGC 2023 criteria, was prevalent in post-stroke patients and negatively impacted functional recovery. Early identification and targeted interventions may be essential for improving rehabilitation outcomes and quality of life.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105921"},"PeriodicalIF":3.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254191","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":"Successful aging rates of global older adults: A subgroup meta-analysis","authors":"Xuan Zhang ,&nbsp;Yurong Liu ,&nbsp;Haixia Hao,&nbsp;Wen Li,&nbsp;Xiangrui Fu,&nbsp;Chenxiao Jia,&nbsp;Yuan Wang,&nbsp;Wenli Lu","doi":"10.1016/j.archger.2025.105920","DOIUrl":"10.1016/j.archger.2025.105920","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to assess the successful aging (SA) rates of individuals aged 60 and above in different subgroups based on gender, age, region, etc., in order to provide a scientific basis for improving the quality of life of the older adults.</div></div><div><h3>Setting and Participants</h3><div>Older adults (≥60 years).</div></div><div><h3>Methods</h3><div>A systematic review was conducted by searching six electronic databases including PubMed, Embase, CINAHL, Web of Science, SCOPUS, and PsycINFO as of July 17, 2023. Quality assessment, screening, data extraction, and analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. A total of 64 studies involving 546 228 individuals aged 60 and above were included, and subgroup analyses were conducted based on sex, age, region, study time, and study quality. Statistical analyses were conducted using Revman 5.3 and Stata 11.0.</div></div><div><h3>Results</h3><div>The SA rate was higher in males (26.0 %, 95 % CI 22.0 %-30.0 %) compared to females (19.0 %, 95 % CI 16.0 %-22.0 %). The SA rates in older adults in the 60–69 (36.0 %), 70–79 (30.0 %), and 80+ (19.0 %) age groups showed a decreasing trend. In regional subgroup analysis, SA rates were higher in North America (30.0 %) and South America (26.0 %), and lower in Asia (19.0 %), Africa (17.0 %), Oceania (16.0 %) and Europe (15.0 %). The SA rate before 2010 (26.0 %) was higher than that 2010 and after (22.0 %). Compared to low quality studies (18.0 %), high quality studies (27.0 %) had a higher SA rate.</div></div><div><h3>Conclusions and Implications</h3><div>The study found that males had a higher SA rate than females, and the SA rate decreased with age. There were regional differences in SA rates. Variations in economic and educational levels among different countries may affect the likelihood of achieving SA in the older population. Measures are recommended to improve the living conditions of older adults with low education and economic status.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105920"},"PeriodicalIF":3.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262833","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":"Predictors for in-hospital outcomes in older patients with hip fracture and atrial fibrillation: A Nationwide Inpatient Sample analysis","authors":"Kuan-Ju Chen ,&nbsp;Jr-Kai Chen","doi":"10.1016/j.archger.2025.105916","DOIUrl":"10.1016/j.archger.2025.105916","url":null,"abstract":"<div><h3>Purpose</h3><div>Older adults with pre-existing atrial fibrillation (AF) who sustain a hip fracture that requires surgery are at increased risk of morbidity and mortality. This study aims to identify predictors of in-hospital mortality and prolonged length of stay (LOS) in these patients.</div></div><div><h3>Methods</h3><div>The United States (US) Nationwide Inpatient Sample (NIS) database was retrospectively reviewed for patients ≥ 60 years old with AF who underwent surgical management of a hip fracture between 2016 and 2020. Outcomes evaluated were in-hospital mortality and prolonged LOS (≥ 7 days). Multivariable logistic regressions were performed to identify risk factors for these outcomes.</div></div><div><h3>Results</h3><div>Among 43,667 eligible patients, the strongest predictors for in-hospital mortality were sepsis (adjusted odds ratio [aOR] = 6.45), respiratory failure (aOR = 5.91), liver disorders (aOR = 2.61), and acute kidney injury (aOR = 2.40). Other predictors were pneumonia, advanced age, high Injury Severity Score (ISS ≥ 16), deep vein thrombosis, pulmonary embolism, and heart failure with reduced ejection fraction (HFrEF). For prolonged LOS, the strongest independent predictors included sepsis (aOR = 4.84), pneumonia (aOR = 3.25), deep vein thrombosis (aOR = 4.62), respiratory failure, and advanced age.</div></div><div><h3>Conclusion</h3><div>These results indicate the impact of critical complications and comorbidities on in-hospital mortality and LOS in elderly hip fracture patients with pre-existing AF. These findings particularly support the need for vigilance and enhanced perioperative management targeting sepsis, respiratory complications, and kidney function to improve outcomes in this high-risk group.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105916"},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222625","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":"Cumulative disadvantages in nursing home COVID-19 infections and deaths: implications of ownership status and location","authors":"Sungjae Hong,&nbsp;Shannon T. Mejía","doi":"10.1016/j.archger.2025.105918","DOIUrl":"10.1016/j.archger.2025.105918","url":null,"abstract":"<div><h3>Objective</h3><div>Disadvantages accumulated over the span of residents’ lives before nursing home placement can compound within nursing homes, potentially amplifying the effects of those disadvantages on resident outcomes. This study examined the extent to which nursing home location and ownership differentiated the outcome trajectories and susceptibility to the impact of momentary threats, the time-varying stressors that can influence COVID-19 outcomes during a specific period.</div></div><div><h3>Methods</h3><div>The COVID-19 Nursing Home Data provided weekly reports of COVID-19 infections and deaths from June 2020 to January 2021 from 11,088 nursing homes. Nursing homes were categorized by for-profit vs. not-for-profit ownership and rural vs. urban location. Momentary threats included the nursing home and county-level COVID-19 infection rate and staff shortage. Multilevel multinomial negative binomial regression nested weekly observations within nursing homes and tested the impact of nursing home factors on the trajectory and momentary threats.</div></div><div><h3>Results</h3><div>COVID-19 infection/mortality rates were higher in for-profit than in non-profit nursing homes, showing worsening disparities over time. At baseline, rural nursing homes had lower COVID-19 infection/mortality rates than urban nursing homes, but rural nursing homes reported higher rates than urban nursing homes over time. Weekly county-level COVID-19 infection had stronger impacts in rural nursing homes. However, the impact of weekly variation in nursing home COVID-19 infections on deaths was smaller in for-profit and rural nursing homes.</div></div><div><h3>Conclusion</h3><div>This study revealed cumulative disadvantage of nursing home characteristics in COVID-19 infections and deaths, implying the importance of addressing inequalities in prevention and control of COVID-19 within nursing homes.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105918"},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262834","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}