Archives of gerontology and geriatrics最新文献

{"title":"Multimorbidity clusters and their contribution to well-being among the oldest old: Results based on a nationally representative sample in Germany","authors":"André Hajek ,&nbsp;Razak M. Gyasi ,&nbsp;Karel Kostev ,&nbsp;Pinar Soysal ,&nbsp;Nicola Veronese ,&nbsp;Lee Smith ,&nbsp;Louis Jacob ,&nbsp;Hans Oh ,&nbsp;Supa Pengpid ,&nbsp;Karl Peltzer ,&nbsp;Hans-Helmut König","doi":"10.1016/j.archger.2024.105726","DOIUrl":"10.1016/j.archger.2024.105726","url":null,"abstract":"<div><h3>Aim</h3><div>Our aim was to identify multimorbidity clusters and, in particular, to examine their contribution to well-being outcomes among the oldest old in Germany.</div></div><div><h3>Methods</h3><div>Data were taken from the large nationally representative D80+ study including community-dwelling and institutionalized individuals aged 80 years and over residing in Germany (n = 8,773). The mean age was 85.6 years (SD: 4.1). Based on 21 chronic conditions, latent class analysis was carried out to explore multimorbidity (≥2 chronic conditions) clusters. Widely used tools were applied to quantify well-being outcomes.</div></div><div><h3>Results</h3><div>Approximately nine out of ten people aged 80 and over living in Germany were multimorbid. Four multimorbidity clusters were identified: relatively healthy class (30.2 %), musculoskeletal class (44.8 %), mental illness class (8.6 %), and high morbidity class (16.4 %). Being part of the mental disorders cluster was consistently linked to reduced well-being (in terms of low life satisfaction, high loneliness and lower odds of meaning in life), followed by membership in the high morbidity cluster.</div></div><div><h3>Conclusions</h3><div>Four multimorbidity clusters were detected among the oldest old in Germany. Particularly belonging to the mental disorders cluster is consistently associated with low well-being, followed by belonging to the high morbidity cluster. This stresses the need for efforts to target such vulnerable groups, pending future longitudinal research.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"130 ","pages":"Article 105726"},"PeriodicalIF":3.5,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866636","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":"Prevalence and risk factors of frailty in older patients with coronary heart disease: A systematic review and meta-analysis","authors":"Tao Li ,&nbsp;Wenting Shi ,&nbsp;Guorong Wang ,&nbsp;Yunlan Jiang","doi":"10.1016/j.archger.2024.105721","DOIUrl":"10.1016/j.archger.2024.105721","url":null,"abstract":"<div><h3>Objective</h3><div>To quantitatively synthesise evidence on the prevalence of and risk factors of frailty in older patients with coronary heart disease.</div></div><div><h3>Methods</h3><div>Nine electronic databases were searched from the inception to July 20th 2024. Random-effects model was performed to calculate to estimate the prevalence of frailty in older patients with coronary heart disease. Meta-regression analysis and subgroup analysis were conducted to explore the potential sources of heterogeneity. Sensitivity analysis was conducted using a study-by-study exclusion method. Meta-analysis of risk factors was performed using the Mantel-Haenszel or inverse variance method and only on the risk factors that have been reported in a minimum of two studies.</div></div><div><h3>Results</h3><div>A total of 42 studies from 5 countries met the inclusion criteria, involving 11954 older patients. The pooled prevalence in older adults with coronary heart disease was 36% (95%CI: 31%-40%) for frailty. We found a higher prevalence of frailty among older patients with coronary heart disease in females, ≥80 years, case-control studies, EFS evaluation tool and acute coronary syndrome. Age, female, cardiac classification, malnutrition, fall within 1 year, sleep disorder, hypoproteinemia (albumin&lt;35g/L), low level of literacy, depression, anxiety, low BMI, polypharmacy, comorbidities, CCI, diabetes, hypertension, high level of BNP, ADL disability, gait speed, living alone, low level of 25(OH)D₃ were risk factors of frailty among older patients with coronary heart disease.</div></div><div><h3>Conclusions</h3><div>Coronary heart disease patients have a significantly higher prevalence of frailty. Early screening and timely prevention of frailty by medical practitioners are needed to provide more targeted measures for CHD patients.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"130 ","pages":"Article 105721"},"PeriodicalIF":3.5,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866637","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":"A meta-analytic study of complex exercise interventions for cognitive performance in older adults","authors":"Jingting Ni ,&nbsp;Rong Zhang ,&nbsp;Xiaofeng Cao ,&nbsp;Xiaochen Li","doi":"10.1016/j.archger.2024.105725","DOIUrl":"10.1016/j.archger.2024.105725","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze the effect of complex exercise on cognitive ability of the elderly.</div></div><div><h3>Study Design</h3><div>By means of literature screening and quality assessment, high-quality studies were extracted to comprehensively analyze the effects of complex exercise on cognitive ability of the elderly.</div></div><div><h3>Method</h3><div>By searching databases such as Web of Science and CNKI, we integrated experimental studies on the effects of complex exercise on cognitive ability in the elderly, conducted literature quality assessment according to Cochrane bias risk assessment tool, and conducted meta-analysis using Review Manager 5.3.</div></div><div><h3>Results</h3><div>1) A total of 27 articles of high quality literature were included, containing 1072 subjects; 2) Complex exercise had a positive effect on cognitive abilities of older adults (<em>SMD</em> = 0.56; 95 % CI: 0.34, 0.78, <em>P</em> &lt; 0.00001), with differences in the effects on different cognitive abilities, with the best effect on cognitive inhibition (<em>SMD</em> = 0.79; 95 % CI: 0.17, 1.41, <em>P</em> = 0.01), followed by executive function (<em>SMD</em> = 0.76; 95 % CI: 0.41, 1.11, <em>P</em> &lt; 0.0001) and cognitive speed (<em>SMD</em> = 0.48; 95 % CI: 0.13, 0.84, <em>P</em> = 0.008), and a non-significant effect of memory intervention (<em>SMD</em> = 0.07; 95 % CI: -0.2, 0.33, <em>P</em> = 0.62); 3) The literature publication bias detection was more effective.</div></div><div><h3>Conclusion</h3><div>1) Complex exercise had a moderate effect in promoting cognitive performance in older adults. 2) By subgroup analysis, the order of intervention effect was cognitive inhibition, executive function, and cognitive speed, in descending order. 3) The intervention effect of complex exercise on memory in older adults was not significant.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"130 ","pages":"Article 105725"},"PeriodicalIF":3.5,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873690","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 of frailty in senile osteoporosis: A systematic review and meta-analysis","authors":"Yidie Hu ,&nbsp;Huiqiong Xu ,&nbsp;Wenting Ji ,&nbsp;Jing Yang ,&nbsp;Hang Li ,&nbsp;Kexin Li ,&nbsp;Li Zhang ,&nbsp;Chaoming Hou ,&nbsp;Jing Gao","doi":"10.1016/j.archger.2024.105718","DOIUrl":"10.1016/j.archger.2024.105718","url":null,"abstract":"<div><h3>Background</h3><div>The growing aging population has resulted in a rise in the prevalence of frailty among senile osteoporosis (SOP) patients, with frailty predisposing SOP patients to a higher risk of adverse health outcomes.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the prevalence of frailty in SOP patients through a systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A comprehensive search was performed in nine databases (Cochrane Library, PubMed, Web of Science, Embase, CINAHL, SinoMed, CNKI, VIP, and Wanfang) to identify relevant articles from inception to June 2023. Two investigators independently conducted literature screening and data extraction and evaluated the risk of bias using the cross-sectional study quality assessment scale recommended by the Agency for Healthcare Quality and Research (AHRQ) and the Newcastle-Ottawa Scale (NOS). The meta-analysis was performed using Stata 15.1 software. Lastly, meta-regression, subgroup analysis, and sensitivity analysis were carried out to explore sources of heterogeneity.</div></div><div><h3>Results</h3><div>Eighteen studies involving 9,664 patients were included in the meta-analysis. The results revealed that the prevalence of frailty in SOP patients was 37.8% [95% <em>CI</em> (25.2%, 50.4%)]. Additionally, subgroup analyses indicated a prevalence of frailty of 47.4% [95% <em>CI</em> (23.7%, 71.1%)] in SOP patients aged 60–74 years and 33.3% [95% <em>CI</em> (17.7%, 48.8%)] in those aged ≥75 years. The prevalence rates of frailty in female and male SOP patients were 27.7% [95% <em>CI</em> (6.4%, 48.9%)] and 12.3% [95% <em>CI</em> (0.8%, 23.9%)], respectively. Meanwhile, the prevalence of frailty in SOP patients in developed and developing countries was 23.2% [95% <em>CI</em> (7%, 39.5%)] and 42.3% [95% <em>CI</em> (27.8%, 56.8%)], respectively. The prevalence of frailty in SOP patients, as measured by the Fried Frailty Phenotype Scale (FP), the J-CHS criteria, and the Frailty Assessment (FRAIL) scale, was 26.3% [95% <em>CI</em> (10.6%, 41.9%)], 38.1% [95% <em>CI</em> (31.5%, 44.6%)], and 47.2% [95% <em>CI</em> (31.0%, 63.5%)], respectively. Finally, the prevalence of frailty in SOP patients surveyed in 2005–2015 and 2016–2020 was 22.9% [95% <em>CI</em> (9.5%, 36.2%)] and 47.4% [95% <em>CI</em> (33.2%, 61.6%)], respectively. Meta-regression did not identify significant sources of heterogeneity.</div></div><div><h3>Conclusion</h3><div>The prevalence of frailty in SOP patients is high, especially in female patients, in developing countries, post-2015, and using the FRAIL scale assessments. Healthcare professionals are recommended to employ assessment tools with high reliability and validity to improve screening for frailty in SOP patients and implement timely interventions to prevent frailty in SOP patients.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"130 ","pages":"Article 105718"},"PeriodicalIF":3.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822955","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 determinants and infrastructures of global longevity societies","authors":"Liang-Kung Chen","doi":"10.1016/j.archger.2024.105723","DOIUrl":"10.1016/j.archger.2024.105723","url":null,"abstract":"","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"130 ","pages":"Article 105723"},"PeriodicalIF":3.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847810","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":"Cross-sectional and longitudinal associations between physical activity and intrinsic capacity in healthy older adults from the MAPT study","authors":"Jérémy Raffin ,&nbsp;Marie Fourteau ,&nbsp;Kelly Virecoulon Giudici ,&nbsp;Yves Rolland ,&nbsp;Bruno Vellas ,&nbsp;Philipe de Souto Barreto ,&nbsp;MAPT/DSA Group","doi":"10.1016/j.archger.2024.105724","DOIUrl":"10.1016/j.archger.2024.105724","url":null,"abstract":"<div><h3>Background</h3><div>The construct of intrinsic capacity (IC) has been recently developed with the aim of assessing and monitoring life-long individuals’ functional trajectories. Physical activity (PA) is recognized for its benefits on health but its associations with IC remain less investigated. We explored the cross-sectional and longitudinal associations of PA with IC in non-demented older adults.</div></div><div><h3>Methods</h3><div>Eight hundred and thirty-seven males and females aged 70 years and over, were included in the present work. IC and its domains (mobility, vitality, cognition, psychology and sensory) were assessed over 2 years and converted to a 0–100 scale. Participants were categorized into 5 PA groups (0–29; 30–499; 500–999; 1000–1999; and 2000+ MET-min/week) using questionnaires. The associations between PA and IC variables (all reflected and square-root-transformed) observed over 2 years were examined using mixed-effect linear regressions.</div></div><div><h3>Findings</h3><div>Over the 2-year follow-up, ordinal PA was associated with higher scores in IC (<em>B</em> = -0.066, SE = 0.015, <em>p</em> &lt; .001) In addition, compared to the inactive group, most of the active groups had a slower decline in IC (B_{30–499 MET-min/week} = -0.196, SE = 0.078; B_{500–999 MET-min/week} = -0.208, SE = 0.076; B_{1000–1999 MET-min/week} = -0.165, SE = 0.073; B₂₀₀₀₊_MET-min/week = -0.187, SE = 0.074; all <em>p</em> &lt; .05). Subdomain analyses revealed that these associations were driven by mobility, vitality and psychological domain.</div></div><div><h3>Interpretation</h3><div>This study suggests that PA may help preventing IC decline, especially mobility, vitality, and psychology in older adults.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"130 ","pages":"Article 105724"},"PeriodicalIF":3.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866627","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":"Physical performance tests for preliminary cognitive screening in older adults: A systematic review of strength, walking, and balance assessments","authors":"Pau Ferrer-Ramos ,&nbsp;Manuel V. Garnacho-Castaño ,&nbsp;Montserrat Girabent-Farrés ,&nbsp;Marcos Faundez-Zanuy ,&nbsp;Noemí Serra-Payá","doi":"10.1016/j.archger.2024.105722","DOIUrl":"10.1016/j.archger.2024.105722","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this systematic review is to determine which physical tests, particularly those assessing strength, walking abilities and balance stability, can provide the most pertinent information for a preliminary screening of cognitive status, facilitating further cognitive evaluation.</div></div><div><h3>Methods</h3><div>A systematic search was conducted using the PubMed and Web of Science databases. Studies that assessed both strength or balance stability and cognitive state in community-dwelling adults aged ≥60 years old were selected for inclusion.</div></div><div><h3>Results</h3><div>The search strategy identified a total of 864 studies. After removing duplicates and applying inclusion and exclusion criteria, ten studies comprising a total of 6868 subjects were included in the review. According to the GRADE system, the studies were classified as low quality. Cognitively healthy individuals exhibited better balance, higher strength levels, greater gait speed and higher instrumental activities of daily living scores compared to those with mild cognitive impairment or cognitive impairment.</div></div><div><h3>Conclusion</h3><div>The assessment of physical function in older adults may serve as a useful tool in identifying impairments associated with physical frailty, sarcopenia, and cognitive decline. Early screening based on physical performance could assist healthcare professionals in determining the need for further cognitive assessment, potentially aiding in the prevention or early detection of cognitive decline.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"130 ","pages":"Article 105722"},"PeriodicalIF":3.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847811","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":"Adverse changes in close social ties in aging women and men: A population-based longitudinal study of the CLSA (2011–2021)","authors":"Gilciane Ceolin ,&nbsp;Gerry Veenstra ,&nbsp;Nadia A. Khan ,&nbsp;Rana Madani Civi ,&nbsp;Sanaz Mehranfar ,&nbsp;Annalijn I. Conklin","doi":"10.1016/j.archger.2024.105720","DOIUrl":"10.1016/j.archger.2024.105720","url":null,"abstract":"<div><div>Close social ties are important for health but these can decline as people age. Moreover, losses of close social ties may be worse for women, older age and low socioeconomic groups. We characterized alterations in both marital status or living arrangement over 6 years by gender, and assessed patterns by age, country of origin, geographic location, education, wealth, and household income. We used three waves of Canadian Longitudinal Study on Aging data on 25,327 adults (45–85 years at baseline) to construct transition variables and multinomial logistic regressions with post-estimated predicted probabilities. Close social ties were stable over time, with most Canadians remaining partnered (77 % of men and 62 % of women) or co-living (82 % of men and 72 % of women). Adverse close social ties over time were gendered and socially patterned, with women 75+ years and of low socioeconomic status (SES) having the greatest risks. Becoming widowed or remaining non-partnered was relatively more likely for women with oldest age (RRR range: 6.08–15.64) or with low SES (RRRs: 2.29–47.06), and for men with oldest age (RRRs: 1.07–8.77) or low SES (RRRs: 2.03–31.72). Becoming or remaining lone-living was relatively more likely for women of oldest age (RRRs: 5.57–8.72) or low SES (RRRs: 2.16–65.78) and also for men of oldest aged (RRRs: 2.33–2.57) or low SES (RRRs: 2.08–49.62). Tailored healthy aging strategies to foster close social connections of women or men in older and low SES groups seems warranted.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"130 ","pages":"Article 105720"},"PeriodicalIF":3.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831195","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":"Exercise prescription prescriptions for frailty improvement in older adults: An evidence-based approach based on the 2024 older adult compendium","authors":"Wanli Zang ,&nbsp;Mingqing Fang ,&nbsp;Lingyue Meng ,&nbsp;Lingyu Kong ,&nbsp;Ningkun Xiao ,&nbsp;Jingxian Xue ,&nbsp;Ziyi Liu ,&nbsp;Jiarong Wu ,&nbsp;Yue Zhang ,&nbsp;Xinhui Wei ,&nbsp;Zijun Zhang ,&nbsp;Qiuxia Zhang","doi":"10.1016/j.archger.2024.105717","DOIUrl":"10.1016/j.archger.2024.105717","url":null,"abstract":"<div><h3>Objective</h3><div>This study explored the dose-response relationship of exercise prescriptions for improving frailty in older adults, based on the 2024 Older Adult Compendium. It aims to provide evidence-based support for developing frailty intervention programs and their clinical application.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, OVID, Cochrane Library, Web of Science, and Scopus from inception to November 5th, 2024. Randomized controlled trials (RCTs) related to exercise interventions in older adults were included. Relevant studies meeting the inclusion criteria were selected, and data were extracted for further analysis. The quality of the included studies was assessed. Meta-analysis was performed using R, and the standardized mean difference (SMD) with 95 % confidence intervals (95 % CI) was used to quantify effect sizes.</div></div><div><h3>Results</h3><div>A total of 16 eligible RCTs comprising 2,716 older adults were included. The meta-analysis revealed that exercise significantly improved frailty among older adults [SMD = -0.81, 95 % CI (-1.25, -0.38), <em>P</em> &lt; 0.001]. However, high-intensity exercise did not demonstrate a significant effect on frailty improvement [SMD = -0.45, 95 % CI (-0.96, 0.06), <em>P</em> = 0.3]. The analysis indicated a nonlinear dose-response relationship between exercise and frailty improvement. The predicted values for frailty improvement at the minimum and maximum exercise doses recommended by the World Health Organization (600 MET-minutes/week and 1200 MET-minutes/week, respectively) were -0.79 (95 % CI [-1.17, -0.41]) and -1.39 (95 % CI [-2.62, -0.15]), respectively.</div></div><div><h3>Conclusion</h3><div>Low- to moderate-intensity exercise significantly improves frailty among older adults, while high-intensity exercise programs are not recommended.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"130 ","pages":"Article 105717"},"PeriodicalIF":3.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822976","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 prognostic value of estimated glomerular filtration rate change in elderly patients undergoing valvular replacement surgery","authors":"Le Yang ,&nbsp;Zhang-jun Wu ,&nbsp;Han Weng ,&nbsp;Di Wu ,&nbsp;Jun-quan Lu ,&nbsp;Sheng-long Chen","doi":"10.1016/j.archger.2024.105719","DOIUrl":"10.1016/j.archger.2024.105719","url":null,"abstract":"<div><h3>Background</h3><div>While the estimated glomerular filtration rate (eGFR) is a common metric for assessing kidney function, its prognostic value in elderly patients undergoing valvular replacement surgery remains uncertain.</div></div><div><h3>Methods</h3><div>A total of 4531 elderly patients (aged ≥ 60 years) who underwent valvular replacement surgery at Guangdong Provincial People's Hospital in China were retrospectively included in the study, covering the period from January 2010 to April 2019. The patients were divided into four groups based on the difference between early postoperative and preoperative estimated glomerular filtration rates (eGFR): ΔeGFR ≤ 0, 0 &lt; ΔeGFR ≤ 25, 25 &lt; ΔeGFR &lt; 50, and ΔeGFR ≥ 50. The association between postoperative eGFR changes and both in-hospital and one-year mortality was examined using univariate and multivariate analyses. Kaplan-Meier curves were used to illustrate cumulative hazard rates.</div></div><div><h3>Result</h3><div>Overall, 204 patients (4.5 %) died during their hospital stay, and 344 patients (7.59 %) patients died within one year. Our analysis revealed significant differences in clinical outcomes between patients with ΔeGFR ≤ 0 and those with ΔeGFR ≥ 50. Patients with ΔeGFR ≥ 50 had higher rates of postoperative dialysis (<em>P</em> &lt; 0.001), acute heart failure (<em>P</em> = 0.037), and in-hospital mortality (<em>P</em> &lt; 0.001). Cumulative survival curves showed a markedly higher one-year mortality rate among patients with ΔeGFR ≥ 50 compared to the other three groups (<em>p</em> &lt; 0.0001). Multivariable analyses demonstrated a significant association between ΔeGFR ≥ 50 and both in-hospital mortality (OR = 2.939, <em>P</em> &lt; 0.001) and one-year all-cause mortality (HR = 2.567, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Our study identified ΔeGFR ≥ 50 as an independent risk factor for clinical events and in-hospital mortality.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"130 ","pages":"Article 105719"},"PeriodicalIF":3.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796731","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}