Archives of gerontology and geriatrics最新文献

{"title":"Trajectories of health-related quality of life and their association with disability in older Australians","authors":"Syed Afroz Keramat ,&nbsp;Nhi Nguyen ,&nbsp;Danelle Kenny ,&nbsp;Rubayyat Hashmi ,&nbsp;Tracy Comans","doi":"10.1016/j.archger.2025.105864","DOIUrl":"10.1016/j.archger.2025.105864","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between various disabilities and the trajectories of HRQoL in older populations remains largely unexplored. Therefore, we aim to investigate the connections between HRQoL trajectories and different types of disabilities in older Australians.</div></div><div><h3>Methods</h3><div>The study participants' HRQoL was measured using the SF-6D utility index. We applied the group-based trajectory model to identify distinct HRQoL trajectories and employed multinomial logistic regression to examine the relationship between HRQoL trajectories and various types of disabilities.</div></div><div><h3>Results</h3><div>We identified three distinct trajectories of HRQoL among older Australians: low-declining, moderate-declining, and high-stable HRQoL groups. We found evidence indicating that the relative risks of being in the low-declining HRQoL group are greater for all types of disabilities. Older Australians living with physical disabilities (Relative Risk Ratio [RRR]: 6.62, 95 % CI: 4.76–9.22), psychosocial disabilities (RRR: 14.06, 95 % CI: 2.85–69.46), and other disabilities (RRR: 4.64, 95 % CI: 3.51–6.12) face a higher relative risk of being in the low-declining HRQoL group compared to their counterparts. Similarly, older Australians with work-limiting disabilities (RRR: 15.96, 95 % CI: 11.99- 21.24), disability onset (RRR: 10.61, 95 % CI: 8.19- 13.75), and multiple disabilities (RRR: 19.12, 95 % CI: 13.96- 26.18) also have a higher relative risk of being in a low-declining HRQoL group compared to their counterparts. Conclusions: Our findings emphasise the urgent need for targeted interventions and support services for older Australians with physical, psychosocial, and work-limiting disabilities to address their elevated risk of declining HRQoL and enhance their overall well-being.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"135 ","pages":"Article 105864"},"PeriodicalIF":3.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phosphatidylcholine and frailty: a Mendelian randomization study and immune mediation","authors":"Qunhua Han ,&nbsp;Suisui Luo ,&nbsp;Shunmei Huang ,&nbsp;Yunmei Yang ,&nbsp;Qin Zhang ,&nbsp;Lijun Zhu","doi":"10.1016/j.archger.2025.105863","DOIUrl":"10.1016/j.archger.2025.105863","url":null,"abstract":"<div><h3>Objective</h3><div>Lipid metabolism plays a significant role in the aging process, and the prevalence of frailty increases with advancing age. However, few studies have employed Mendelian randomization (MR) to investigate the associations between lipids and frailty.</div></div><div><h3>Methods</h3><div>This study utilized large-scale genome-wide association study (GWAS) and a bidirectional two-sample, two-step MR approach to explore the causal associations of 179 lipid species with the frailty index (FI) and the mediating effects of immune cells. The inverse variance weighted (IVW) method was used primarily to evaluate the MR results. Heterogeneity and horizontal pleiotropy were assessed via Cochran’s Q, the MR-Egger intercept, MR-PRESSO and leave-one-out analysis. Phenome-wide MR (Phe-MR) was used to analyse the potential roles of frailty-related phosphatidylcholine species in diseases.</div></div><div><h3>Results</h3><div>MR analysis revealed a causal relationship between PC species and FI. Specifically, PC (18:0_20:5), LPC (18:0_0:0), LPC (16:0_0:0), and ether-PC (O-16:0_22:5) are positively correlated with the FI, whereas PC(18:1_20:2), PC(16:0_18:3), PC(16:0_20:1), ether-PC (O-18:0_16:1), and ether-PC (O-16:1_16:0) are negatively correlated with the FI. Reverse MR analysis indicated no strong association between the FI and the nine PCs. Mediation analysis revealed that Sw mem %lymphocyte partially mediated the effect of LPC (18:0_0:0) on FI. Phe-MR analysis revealed that nine frailty-related PCs were broadly associated with various diseases.</div></div><div><h3>Conclusion</h3><div>This study provides novel evidence that supports the causal association between PC species and frailty, with the immune system playing a crucial role in this pathway. These findings offer new insights into potential targets for the intervention of frailty in the elderly population.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"135 ","pages":"Article 105863"},"PeriodicalIF":3.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916410","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":"Exploring the association between cumulative hs-CRP and all-cause mortality, with consideration of cardiometabolic mediators in middle-aged and elderly adults: Insights from observational study","authors":"Zhonghai Wang ,&nbsp;Qiaoqi Zheng ,&nbsp;Xin Chen ,&nbsp;Han Wang","doi":"10.1016/j.archger.2025.105861","DOIUrl":"10.1016/j.archger.2025.105861","url":null,"abstract":"<div><h3>Background</h3><div>Under a state of sustained relatively low inflammation, it is uncertain if cumulative high-sensitivity C-reactive protein (cumhs-CRP) can predict all-cause mortality, and its impact on it through cardiometabolic factors is also unknown.</div></div><div><h3>Methods</h3><div>This is a longitudinal national cohort study using CHARLS data. Specifically, we only included participants aged 45 and older with hs-CRP levels below 10mg/L in both 2012 and 2015. Cumhs-CRP derived through time-weighted averaging was employed as the key exposure. Death events were recorded as the primary outcome. All-cause mortality is defined as death occurring at any point from 2015 to 2018. Variables selection and interpretation were conducted by Boruta and Shapley Additive Explanations (SHAP). Further mediation analysis explored the possibility of cardiometabolic factors serving as mediators. Additional Mendelian randomization was conducted to demonstrate the robustness of the association.</div></div><div><h3>Results</h3><div>5052 Chinese adults over 45 years of age with hs-CRP levels below 10mg/L over time were included. Boruta identified 16 possible variables, with SHAP confirming the importance of cumhs-CRP. Multivariate analysis showed a significant association between cumhs-CRP and mortality (OR 1.05, 95 % CI 1.02 1.09, <em>p</em> = 0.003), and a linear relationship was observed (p-nonlinear = 0.184). Importantly, cumhs-CRP indirectly may affect the risk of death through systolic and diastolic blood pressure, fasting glucose, and uric acid, with proportions of 17.4 %, 8.2 %, 5.2 %, and 17 %, respectively.</div></div><div><h3>Conclusions</h3><div>Cumhs-CRP levels are associated with increased mortality risk, even in individuals with lower baseline levels. Regular monitoring of hs-CRP levels may aid in identifying individuals with elevated mortality risk.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"135 ","pages":"Article 105861"},"PeriodicalIF":3.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934570","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":"Cognitive benefits of music in aerobic exercise: Evidence from a Bayesian network meta-analysis in adults with mild cognitive impairment","authors":"Yixue Quan ,&nbsp;Chi Yhun Lo ,&nbsp;Lee Wolff ,&nbsp;Jinyu Wang ,&nbsp;Kirk N. Olsen ,&nbsp;William Forde Thompson","doi":"10.1016/j.archger.2025.105848","DOIUrl":"10.1016/j.archger.2025.105848","url":null,"abstract":"<div><div>Aerobic exercise improves cognitive functions in older adults with mild cognitive impairment (MCI), while dance, combining music and synchronized movement, offers additional cognitive benefits. Despite music's potential role in enhancing cognitive outcomes, most research on aerobic exercise has not considered the impact of accompanying music. This review compared the effectiveness of aerobic exercise with music, aerobic exercise without music, and dance on cognitive function in adults with MCI. A total of 38 papers from 25 randomized controlled trials (<em>N</em> = 2048) were synthesized. The multilevel meta-analyses showed that compared to the control group, global cognition was improved by aerobic exercise with music (<em>g</em> = 1.2 [0.47, 1.94]), aerobic exercise without music (<em>g</em> = 0.48 [0.18, 0.79]), and dance (<em>g</em> = 0.55 [0.13, 0.96]). Dance also enhanced short-term memory (<em>g</em> = 0.41 [0.24, 0.59]), learning efficiency (<em>g</em> = 0.39 [0.14, 0.65]), and retrieval fluency (<em>g</em> = 0.7 [0.19, 1.22]). Bayesian network meta-analyses indicated that aerobic exercise with music had the highest probability of being the most effective for improving global cognition, executive function, and processing speed. Dance was likely to be the most beneficial for enhancing short-term memory, learning efficiency, and retrieval fluency. This study supports that incorporating music in exercise amplifies the cognitive benefits beyond exercise alone for individuals with MCI. The “Music Exercise Synergy Model” is proposed to explain the cognitive benefits of combining music with exercise. Dance strategically uses music for coordination, offering psychological, social, cognitive, and neurobiological benefits and contributing to the observed enhancements in memory functions.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105848"},"PeriodicalIF":3.5,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of interventions for pre-frail and frail older adults: Evidence from clinical trials on frailty levels","authors":"Andressa C. da Silva Sobrinho ,&nbsp;Reisa Cristiane de Paula Venancio ,&nbsp;Guilherme da Silva Rodrigues ,&nbsp;Mariana Porto ,&nbsp;Layana Liss Schwenger ,&nbsp;Letícia Fernanda Belo ,&nbsp;Luana K. Ferreira ,&nbsp;Carlos Roberto Bueno Júnior ,&nbsp;Grace Angelica de Oliveira Gomes","doi":"10.1016/j.archger.2025.105851","DOIUrl":"10.1016/j.archger.2025.105851","url":null,"abstract":"<div><h3>Introduction</h3><div>The increasing global longevity underscores the necessity of effective interventions for older adults. Pre-frailty and frailty affect 54.1 % and 26.3 % of the elderly population, respectively, leading to adverse physical and cognitive outcomes. This study systematically reviewed the effectiveness of interventions targeting robust, pre-frail, and frail older adults in randomized controlled trials, analyzing frailty levels both collectively and individually.</div></div><div><h3>Methods</h3><div>Following the Joanna Briggs Institute (JBI) methodology and PRISMA guidelines, seven databases were searched for studies published between 2018 and 2023. Randomized controlled trials involving individuals aged ≥65 years were included. Methodological quality was assessed using the PEDro scale, with scores ranging from 7 to 10, indicating moderate to high quality.</div></div><div><h3>Results</h3><div>A total of 3416 records were identified, and 40 studies were included, encompassing 17,822 participants (82.3 % women, mean age: 68–79 years). Physical exercise interventions accounted for 42.5 % of the studies, while multicomponent programs constituted 27.5 %. Improvements in frailty levels were reported in 32.5 % of the studies, with significant gains in quality of life (+15.2 %), gait speed (+0.22 m/s), and muscle strength (+18.7 %). Pre-frail individuals exhibited the greatest responsiveness to interventions, reflecting their remaining adaptability and potential for improvement.</div></div><div><h3>Discussion</h3><div>Multifaceted interventions were found to be particularly effective for pre-frail individuals, emphasizing the need for standardized criteria for frailty assessment. Geographic variability and inconsistencies in assessment methods were noted. Physical activity emerged as a key component in improving outcomes, with most interventions led by physiotherapists and physical education professionals.</div></div><div><h3>Conclusion</h3><div>Integrated interventions significantly enhance health and functionality, particularly for pre-frail older adults, underscoring the importance of early and tailored approaches. This study highlights the need for standardized guidelines and multidisciplinary strategies to address the heterogeneity of the aging population effectively.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105851"},"PeriodicalIF":3.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint association of frailty index and biological aging with all-cause and cause-specific mortality: a population-based longitudinal cohort study","authors":"Shichen Zhou ,&nbsp;Guang Chen ,&nbsp;Tung-Leong Fong ,&nbsp;Guoyi Tang ,&nbsp;Ruogu Xiong ,&nbsp;Ya Xuan Sun ,&nbsp;Junjie Lu ,&nbsp;Ning Wang ,&nbsp;Yibin Feng","doi":"10.1016/j.archger.2025.105856","DOIUrl":"10.1016/j.archger.2025.105856","url":null,"abstract":"<div><h3>Background</h3><div>The role of frailty in all-cause, cardiovascular, and cancer mortality is debatable, and the modification effect of biological aging remains unclear. Therefore, we aimed to evaluate the joint association of frailty index and biological aging with all-cause and cause-specific mortality.</div></div><div><h3>Methods</h3><div>In this population-based cohort study, data were obtained from the National Health and Nutrition Examination Survey (NHANES) and National Death Index (NDI). Demographic variables were extracted, frailty index was constructed, and biological aging was calculated. All-cause deaths, cancer deaths, and cardiovascular disease (CVD) deaths were extracted as outcomes. Cox proportional hazards regression models were used to estimate the correlations, stratified subgroup analyses were used to figure out effect modifiers, and sensitivity analyses were used to confirm the robustness.</div></div><div><h3>Results</h3><div>A total of 22,729 NHANES participants were included in this study, with 6786 all-cause deaths, 1830 CVD deaths, and 1396 cancer deaths occurred during an average follow-up of 8.5 years over a total of 192,601 person-years. The hazard ratios (HRs) of delayed aging group for all-cause mortality, CVD mortality, and cancer mortality were 0.45 (95 % CI: 0.41–0.49), 0.39 (95 % CI: 0.34–0.45), and 0.54 (95 % CI: 0.46–0.63), respectively, compared to accelerated aging group (P for all comparisons &lt; 0.001). Likewise, the frailty index score was positively associated with all-cause mortality (HR, 1.06 [95 % CI, 1.06–1.06] per 0.01 increase in the frailty index), cardiovascular (CVD) mortality (HR, 1.07 [95 % CI, 1.06–1.07] per 0.01 increase in the frailty index), and cancer mortality (HR, 1.04 [95 % CI, 1.03–1.04] per 0.01 increase in the frailty index). The associations of frailty index with all-cause mortality and CVD mortality were modified by biological aging (P for interaction = 0.044), but cancer mortality was not (P for interaction = 0.482).</div></div><div><h3>Conclusions</h3><div>Accelerated biological aging is associated with higher frailty index, whereas delayed biological aging is inversely associated with risk of all-cause mortality, CVD mortality, and cancer mortality. Biological aging is effect modification among the associations of frailty index with all-cause mortality and CVD mortality, but not for cancer mortality. These findings suggest that for people with high frailty index and acceleration biological aging, to lower frailty degree and decrease biological aging acceleration by approaches such as lifestyle modifications might be beneficial for individual's longevity and lifespan.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105856"},"PeriodicalIF":3.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inpatient healthcare utilization among formerly married adults in India: Evidence from the Longitudinal Ageing Study in India (LASI-1)","authors":"Saurabh Singh,&nbsp;Akancha Singh,&nbsp;Neha Shri","doi":"10.1016/j.archger.2025.105859","DOIUrl":"10.1016/j.archger.2025.105859","url":null,"abstract":"<div><div>India has been on the brink of rapid socio-economic changes and these changes have manifested themselves through improvements in health and overall living standards of the general population. Although several health strategies and policies have addressed the equitable distribution of health care in India, not many studies have been undertaken on this topic, especially among formerly married older adults. The aim of this paper is to evaluate income related-inequalities in healthcare utilization among formerly married older population in India. This study utilizes individual level data from the first wave of the Longitudinal Ageing Study in India. Logistic regression was employed to examine the effect of the socio-economic characteristics on the health seeking behavior of the formerly married older adult population. The magnitude of socio-economic inequity in health care utilization was quantified using Wagstaff decomposition analysis. The regression results revealed that with higher levels of education, the odds of getting inpatient health care utilization decreased. For instance, the health care utilization was 32 % less among individuals with 10+ years of schooling than those who did not have any formal level of education [OR: 0.68; 95 % C.I.:0.52–0.88]. The odds of inpatient health care utilization was higher among those who had morbidity [one morbidity, OR:1.98; 95 % C.I.:1.68–2.36 &amp; multimorbidity OR: 2.68; 95 % C.I.:2.25–3.20]. Additionally, presence of multi-morbidity (83 %) and geographical regions (50 %) were two of the largest contributors to inequality in healthcare utilization. Findings from the current study point towards the need for having improved social security systems in place to protect the households from distress financing and reducing inequalities.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"135 ","pages":"Article 105859"},"PeriodicalIF":3.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916411","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":"Cancer-treatment-induced accelerated aging in older adult cancer survivors: A call for actions for future perspectives in geriatric oncology","authors":"Médéa Locquet (epidemiologist)","doi":"10.1016/j.archger.2025.105858","DOIUrl":"10.1016/j.archger.2025.105858","url":null,"abstract":"<div><div>Cancer treatment has significantly improved survival rates, but older adult cancer survivors remain at risk of cancer-treatment-induced late effects such as cardiac complications and second primary cancers. A new hypothesis emerged in the literature suggesting that such late effects can indeed be the manifestation of an accelerated aging process induced by cancer treatments. The cancer-treatment-induced accelerated aging could first arise from clinical and biological manifestations such as frailty, sarcopenia, cognitive impairments, cellular senescence, telomere attrition, and chronic inflammation, paralleling hallmarks of aging. Older adult cancer survivors frequently demonstrated early-onset frailty, sarcopenia, osteoporosis, cognitive impairments, diminished physical function, and increased levels of aging biomarkers compared to cancer-free age-matched older adults. However, existing studies are limited by their narrow focus on specific cancers, the use of single aging outcome measures, and short follow-up durations. A holistic research approach, incorporating comprehensive geriatric assessments and aging biomarkers, is crucial for describing the induced health burden and the mechanisms underlying these induced aging vulnerabilities. Addressing these gaps through large-scale longitudinal studies could lead to personalized interventions, improved treatment protocols, and supportive care strategies in older adult cancer survivors. Such efforts will enhance quality of life, promote healthy aging trajectories, and mitigate societal and economic burdens. To this end, concrete actions, such as establishing international consortia that include patient advocacy, are encouraged. Efforts should also include developing a centralized, registry-based repository for clinical and biological aging outcomes.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105858"},"PeriodicalIF":3.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development, validation, and clinical utility of a risk prediction model to identify older women with dementia for proactive palliative care","authors":"Begashaw Melaku Gebresillassie ,&nbsp;John Attia ,&nbsp;Dominic Cavenagh ,&nbsp;Melissa L. Harris","doi":"10.1016/j.archger.2025.105853","DOIUrl":"10.1016/j.archger.2025.105853","url":null,"abstract":"<div><h3>Background</h3><div>Accurately estimating one-year mortality risk in older women with dementia can inform clinical decision-making, facilitate timely advanced care planning, and optimise palliative care delivery. This study aimed to develop, validate, and assess the clinical utility of a prediction model for one-year all-cause mortality in this population using a nationally representative Australian cohort.</div></div><div><h3>Methods</h3><div>This prognostic study utilised data from the 1921–26 cohort of the nationally representative, population-based Australian Longitudinal Study on Women's Health (ALSWH) and linked national and state-based administrative health records. Candidate predictors were identified through a systematic review and expert consultation, then refined using a data-driven statistical approach. A multivariable binary logistic regression model was developed and validated to predict one-year all-cause mortality.</div></div><div><h3>Results</h3><div>The analysis included 1576 older women with dementia (mean age, 72.6 ± 1.5 years). The model demonstrated good discrimination (AUC: 75.1 %, 95 % CI: 72.7 %–77.5 %) and excellent calibration (slope = 1.00, 95 % CI: 0.87–1.13; intercept = 0.00, 95 % CI: 0.11 – 0.11). Model validation using both 10-fold cross-validation and 1000 bootstrap iterations showed minimal optimism in its predictive performance, with AUC optimism of 0.0047 and 0.0042, respectively. Decision curve analysis indicated a net benefit across probability thresholds from 0.24 to 0.88, supporting the model's clinical utility for guiding palliative care decisions.</div></div><div><h3>Conclusion</h3><div>This prediction model, incorporating readily available predictors, demonstrated compelling performance and clinical utility for identifying older women with dementia at high risk of one-year mortality. The model has the potential to facilitate timely palliative care interventions and is publicly accessible via a web-based calculator. Further external validation in diverse populations and healthcare settings is warranted to confirm its generalisability.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105853"},"PeriodicalIF":3.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory symptoms in preserved ratio impaired spirometry: Link to comorbidities and increased mortality risk","authors":"Ping Lin ,&nbsp;Faming Jiang ,&nbsp;Yu Wang,&nbsp;Zongan Liang,&nbsp;Ting Wang","doi":"10.1016/j.archger.2025.105855","DOIUrl":"10.1016/j.archger.2025.105855","url":null,"abstract":"<div><h3>Backgroundx</h3><div>Respiratory symptoms are frequently observed in subjects with Preserved Ratio Impaired Spirometry (PRISm); however, their association with comorbidities and mortality in this population remains poorly understood.</div></div><div><h3>Methods</h3><div>Data from the National Health and Nutrition Examination Survey (2007–2012) were analyzed. Logistic regression was used to assess the association between respiratory symptoms and comorbidities, while Cox regression was applied to evaluate mortality risks.</div></div><div><h3>Results</h3><div>This study included 5612 adults aged 40 years and older with normal spirometry and 754 participants with PRISm. Among the PRISm group, 331 subjects (43.8 %) reported one or more respiratory symptoms. Compared to individuals with normal spirometry, PRISm subjects with respiratory symptoms exhibited a significantly higher prevalence of comorbidities, including hypertension, diabetes, angina, myocardial infarction, heart failure, and stroke, as well as increased risks of all-cause and cardiovascular mortality. In contrast, PRISm without respiratory symptoms was primarily associated with diabetes and an elevated mortality risk. When comparing PRISm subjects with and without respiratory symptoms, those with symptoms had a markedly higher prevalence of hypertension (OR 1.10, 95 % CI: 1.08–1.11), myocardial infarction (OR 5.75, 95 % CI: 2.25–14.67), heart failure (OR 5.52, 95 % CI: 2.50–12.19), and cancer (OR 2.34, 95 % CI: 1.12–4.86). Additionally, PRISm subjects with respiratory symptoms faced a significantly elevated risk of cardiovascular mortality (HR 1.55, 95 % CI: 1.38–1.74).</div></div><div><h3>Conclusions</h3><div>Respiratory symptoms were associated with a significantly higher burden of comorbidities and an increased risk of cardiovascular mortality in PRISm subjects.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105855"},"PeriodicalIF":3.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}