BMC Geriatrics最新文献

{"title":"Educational attainment and male-female health-survival paradox among older adults in China: a nationally representative longitudinal study.","authors":"He Chen, Man Li, Ye Zhang","doi":"10.1186/s12877-024-05598-7","DOIUrl":"10.1186/s12877-024-05598-7","url":null,"abstract":"<p><strong>Background: </strong>The male-female health-survival paradox is characterized by the phenomenon where \"women get sicker, but men die quicker.\" Health expectancy, as a composite metric that encompasses both the quantity and quality of life, serves as a unique tool for analyzing this gender paradox. In this study, we investigate the relationship between educational attainment and the gender paradox among older adults in China.</p><p><strong>Methods: </strong>Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), we focused on community-dwelling individuals aged 60 and above. Health was assessed using the Activities of Daily Living (ADLs). Educational attainment was dichotomized into low (primary education and below) and high (secondary education and above). We controlled for demographic, socioeconomic, and health behaviors confounders. Microsimulation techniques were employed to estimate total life expectancy (TLE), disability-free life expectancy (DFLE), and health ratio.</p><p><strong>Results: </strong>In China, educational attainment was positively associated with TLE and DFLE, with these benefits being more pronounced in females. Among individuals with lower educational attainment, females had significantly greater TLE (female-male difference: 3.82 years, 95% CI: 3.68 to 3.96) and DFLE (2.91 years, 95% CI: 2.78 to 3.04), but a lower health ratio (-2.14%, 95% CI: -2.41% to -1.87%) compared to males. In contrast, females with higher educational attainment not only lived longer but also healthier. Among these individuals, females had significantly greater TLE (5.89 years, 95% CI: 5.71 to 6.08), DFLE (6.02 years, 95% CI: 5.84 to 6.19), and a more favorable health ratio (95% CI: 2.60% to 3.19%) compared to males.</p><p><strong>Conclusions: </strong>Education plays a crucial role in enabling females to overcome disadvantages associated with the gender paradox in China. Enhancing gender equality in educational opportunities is expected to promote healthy longevity among females in the country.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"112"},"PeriodicalIF":3.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral healthcare for older adults in Swedish municipal healthcare-a qualitative study of healthcare professionals' experiences.","authors":"Maria Snogren, Kristina Ek, Ulrika Lindmark, Maria Browall, Irene Eriksson","doi":"10.1186/s12877-025-05764-5","DOIUrl":"10.1186/s12877-025-05764-5","url":null,"abstract":"<p><strong>Introduction: </strong>Oral health is multi-faceted and influences a person's daily life, and numerous potential barriers and factors can challenge and pose barriers to good oral health. Shortages of healthcare professionals or incorrect care practices can be barriers to performing good oral healthcare. A knowledge gap has been identified in qualitative research on description of healthcare professionals' experiences of oral healthcare among older adults in municipal healthcare.</p><p><strong>Aim: </strong>To describe healthcare professionals' experiences of oral healthcare among older adults in Swedish municipal healthcare.</p><p><strong>Design and methods: </strong>The study employed a qualitative design guided by a secondary qualitative analysis method comprising inductive qualitative content analysis. Data were collected through semi-structured individual interviews with healthcare professionals.</p><p><strong>Results: </strong>Good relationships and mutual trust create the conditions for delivering good oral healthcare. Knowledge provides confidence and trust in performing oral healthcare, experiences and strategies influence the individual adaptation of oral healthcare, and priorities and collaboration influence oral healthcare provision.</p><p><strong>Conclusion and implications: </strong>The performance of oral healthcare is complex and cannot be achieved without establishing a relationship with the older adult who needs care. Oral healthcare includes prerequisites such as routines, sufficient time, work-time planning, and collaboration between healthcare professionals. Registered nurses positively experience opportunities to collaborate with other healthcare professionals regarding oral healthcare and are seen as leaders in the Fundamentals of Care and are sharing good examples of oral healthcare in palliative care.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"110"},"PeriodicalIF":3.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of remimazolam tosilate for injection (HR7056) versus sevoflurane on the incidence of postoperative delirium in older patients undergoing total hip arthroplasty: study protocol for a prospective, multicentre, two-arm, parallel-group, randomised controlled trial.","authors":"Lin-Yu Wang, Meng-Qing Zhang, Rui Sun, Liang Li, Dong-Liang Li","doi":"10.1186/s12877-025-05766-3","DOIUrl":"10.1186/s12877-025-05766-3","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative delirium (POD) is a common postoperative complication and is associated with numerous adverse outcomes. Advanced age and hip surgery are high risk factors for POD. Both remimazolam tosilate for injection and sevoflurane can be used as sedatives for the maintenance of general anesthesia, but the comparison of their impacts on the incidence of POD has not been reported. This study aims to compare the effect of remimazolam tosilate vernus sevoflurane on the incidence of POD in older patients undergoing total hip arthroplasty.</p><p><strong>Methods and analysis: </strong>This is a two-arm, parallel, prospective, multicenter, randomized controlled trial. A total of 456 older patients at six clinical trial centers in China will be randomly assigned in a 1:1 ratio to receive general anesthesia with remimazolam tosilate or sevoflurane as sedative. The primary outcome measure is the prevalence of POD during the first 4 postoperative days. Secondary outcomes include cognitive function [Mini-Mental State Examination (MMSE)], perioperative pain degree [Visual Analogue Scale (VAS)], postoperative nausea and vomiting (PONV) within 4 days after surgery, recovery time after drug withdrawal, the amount of vasoactive drugs used during operation, length of hospital stay, and in-hospital complications.</p><p><strong>Ethics and dissemination: </strong>The Research Ethics Committee of Qilu Hospital of Shandong University has approved the study protocol (REF: KYLL-202206-25), which is applicable to all research centers. Participant recruitment begins in August 2022. Written informed consent will be obtained from each patient before randomization. The findings will be published in an international peer-reviewed medical journal.</p><p><strong>Trial registration: </strong>The trial has been registered at the Chinese Clinical Trial Registry: ChiCTR2200062455; date of registration: 2022-08-08.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"109"},"PeriodicalIF":3.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does low body weight mediate the relationship between tooth loss and cognitive impairment? A longitudinal cohort study of an older Chinese population.","authors":"Pan Ke, Zuxun Lu, Wenqing Ni, Yan Zhang, Hongmin Zhang, Yijin Zheng, Xueli Yuan, Jian Xu, Xiaoxv Yin, Zhiguang Zhao","doi":"10.1186/s12877-025-05750-x","DOIUrl":"10.1186/s12877-025-05750-x","url":null,"abstract":"<p><strong>Objective: </strong>Our study aimed to investigate the relationship between the number of teeth remaining and cognitive impairment among Chinese older adults, and to explore the role of low body weight in this association.</p><p><strong>Methods: </strong>Data were drawn from 2011 to 2014 surveys of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), involving 4056 respondents who had no cognitive decline and aged ≥ 65 years at baseline. Cognitive function was measured by the Mini-Mental Status Examination (MMSE), and the cognitive impairment was classified according to the length of education. Number of natural teeth was self-reported (classified as ≥ 20, 10-19, 1-9, and 0). Low body weight was defined as having a body mass index (BMI) of less than 18.5 kg/m². Cox proportional hazards regression and mediation effect analyses were applied in the study.</p><p><strong>Results: </strong>Comparing with participants with ≥ 20 teeth, 10-19 teeth and 1-9 teeth, those with 0 teeth (HR:2.14, 95% CI: 1.51, 3.03) were significantly associated with higher cognitive impairment risk in the fully adjusted model. Compared with denture users, the fully adjusted HR (95% CI) for non-denture users was 1.33 (1.04, 1.70). no teeth with non-denture users had the highest cognitive impairment risk (HR:1.63, 95% CI: 1.10, 2.41). Low body weight mediated 6.74% (ranging from 3.49 to 11%) of the association between the number of teeth remaining and cognitive impairment.</p><p><strong>Conclusion: </strong>Tooth loss increases the risk of cognitive decline, and low body weight partially mediates this association.</p><p><strong>Clinical trial number: </strong>This is a retrospective cohort study targeting a population survey, which does not involve clinical trials and does not have clinical trial numbers.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"111"},"PeriodicalIF":3.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the impact: understanding long-term care workers' experiences and their perceptions of resident challenges amidst the COVID-19 pandemic.","authors":"Donna M Halperin, Krista Whitfield, Julie A Bettinger, Marian Orhierhor, Katherine L Salter, Bailey M Selig, Anna Mack, Brian R Condran, Alexa Davis, Camryn Salyzyn, Janet A Parsons, Melissa Kervin, Scott A Halperin","doi":"10.1186/s12877-024-05656-0","DOIUrl":"10.1186/s12877-024-05656-0","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, long-term care (LTC) facilities in Canada were confronted with many rapidly changing public health safety guidelines. Based on the guidelines, LTC facilities had to implement a series of virus containment and mitigation measures, presenting significant challenges for both workers and residents. This research aims to provide insights that could be used to guide improvements in the experiences of LTC workers, and of residents, in future pandemic crises.</p><p><strong>Methods: </strong>A qualitative multi-case study was used to explore the pandemic experiences of a demographically diverse group of LTC workers in Canada, focusing on how public health safety guidelines impacted them, and their perceptions of challenges faced by residents. Fourteen workers were engaged from facilities in Nova Scotia and British Columbia, which are regions distinct geographically and with differences in safety guidelines and implementation. Semi-structured interviews were conducted between April to October 2021. Using thematic analysis, we identified patterns within and across the interview transcripts.</p><p><strong>Results: </strong>The thematic analysis provided an understanding of the experiences and perspectives of LTC workers. There were four key themes: (1) Tangling with Uncertainty, that describes the effects of ambiguous messaging and shifting COVID-19 safety guidance on workers; (2) Finding Voice, that highlights how workers coped with feelings of helplessness during the healthcare crisis; (3) Ripple Effects, of pandemic pressures on workers beyond resident care, that included strengthening of inter-colleague support as well as financial challenges, and; (4) Loss of Home, where workers perceived that protection of residents led to a loss of the residents' home environment, personal freedom, and autonomy.</p><p><strong>Conclusions: </strong>The findings suggest that LTC workers' experiences during future pandemics may be improved by their inclusion in the development of public health safety guidelines, facilitating inter-colleague support systems, and ensuring worker financial stability. A balance should be found between preventing infection in LTC facilities and retaining the principles of holistic and resident-centered care for workers' and residents' mental health benefits.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"108"},"PeriodicalIF":3.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid hormones and frailty in older adults: systematic review and dose-response meta-analysis.","authors":"Wen-Chun Chia, Yang-Ching Chen, Shuang-Ling Xiu, Sen-Te Wang","doi":"10.1186/s12877-025-05748-5","DOIUrl":"10.1186/s12877-025-05748-5","url":null,"abstract":"<p><strong>Objective: </strong>To investigate (1) whether the association of thyroid hormone with frailty risk is linear or nonlinear and (2) which range of thyroid hormones or thyroid stimulating hormone (TSH) is more associated with a higher risk of frailty in older adults.</p><p><strong>Design: </strong>Systematic review and dose-response meta-analysis.</p><p><strong>Methods: </strong>Medical electronic databases were searched for cross-sectional or longitudinal studies, published from database inception to February 2022. We focused on the relationship between TSH and frailty. Data on TSH reference range, TSH exposure categories, sample size of each exposure category, and adjusted odds ratios (ORs) for frailty with 95% confidence interval (CI) were extracted. In the dose-response meta-analysis, we set the OR for frailty as 1 at 0.3 mIU/L TSH.</p><p><strong>Results: </strong>The systematic review included 10 studies, whereas the meta-analysis included 3 studies (n = 6388). TSH levels ranged from 0.3 to 4.8 mIU/L, and the dose-response meta-analysis revealed a significant J-shaped association (p = 0.0071). Frailty OR (95% CI) increased from 1.30 (1.06-1.59) for 2.7 mIU/L TSH to 2.06 (1.18-3.57) for 4.8 mIU/L TSH.</p><p><strong>Conclusions: </strong>A significant nonlinear, J-shaped association was noted between TSH level and frailty. TSH levels within the upper half (2.7-4.8mIU/L) of reference range was noted to significantly higher risk of frailty; by contrast, those in the lower half (0.6-1.5 mIU/L) had a lower risk of frailty, though not significantly so.</p><p><strong>Trail registration: </strong>This systematic review was registered with PROSPERO (registration number: CRD42022299214).</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"104"},"PeriodicalIF":3.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Do the gait domains change in PD patients with freezing of gait during their 'interictal' period?","authors":"Jiahao Zhao, Chen Liu, Ying Wan, Xiaobo Zhu, Lu Song, Zhenguo Liu, Jing Gan","doi":"10.1186/s12877-025-05770-7","DOIUrl":"10.1186/s12877-025-05770-7","url":null,"abstract":"","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"106"},"PeriodicalIF":3.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mealtime situations in nursing homes from the residents' perspective - an integrative review.","authors":"Carina Werkander Harstäde, Stefan Andersson, Erika Lagerbielke, Anna Sandgren, Kristiina Heikkilä","doi":"10.1186/s12877-025-05753-8","DOIUrl":"10.1186/s12877-025-05753-8","url":null,"abstract":"<p><strong>Background: </strong>When moving to a nursing home, the new resident also meets a new kind of culture, including communal, shared meals. Gaining greater insight into the resident experience of mealtimes in nursing homes is essential to identify the meaning that mealtime situations have and highlight the potential barriers and facilitators to the implementation of mealtime situations that create wellbeing for residents. The aim of this integrative review was therefore to shed light on mealtime situations in nursing homes from the residents' perspective.</p><p><strong>Methods: </strong>The literature search was performed using a combination of MeSH keywords and free text terms in ASSIA, CINAHL, PsycInfo, PubMed, and Web of Science. After scrutinizing the articles and quality checks, 13 articles were chosen. The analysis was performed following Whittemore and Knafl's instructions for integrative reviews.</p><p><strong>Results: </strong>The experiences of the mealtime situations were partly connected to residents' personhood and partly to the nursing home's organization of the mealtimes. Three main categories emerged: mealtimes as a source of well-being in nursing home life, mealtimes (re)creating continuity in life and preserving identity, and mealtimes as a balancing act between autonomy and need of support. Residents in nursing homes want the possibility to choose both what to eat, with whom they will eat and where they eat. The mealtimes in nursing homes and how they are constructed have an important role in residents' feelings of having control over their life situation and can also strengthen residents' identity and autonomy.</p><p><strong>Conclusion: </strong>Staff needs to be aware of the meaning of mealtimes to promote person-centered care in regard to meals. Further research is needed to explore how different mealtime situations have an impact on nursing home residents' lives as well as on the care the staff gives.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"103"},"PeriodicalIF":3.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pictorial fit-frail scale: a novel tool for frailty assessment in critically ill older adults.","authors":"Liran Statlender, Olga Theou, Regina Merchshiev, Tzippy Shochat, Ilya Kagan, Lisa Cooper","doi":"10.1186/s12877-025-05773-4","DOIUrl":"10.1186/s12877-025-05773-4","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a state of high vulnerability to adverse health outcomes. It is an important factor influencing the prognosis of older, critically ill patients. Several methods to assess frailty were evaluated in the critical care setting. The Pictorial Fit-Frail Scale (PFFS) is a validated quick and easy-to-use tool for frailty assessment. It takes < 5 min to fill by the patient or caregiver; it requires no clinical examination by medical staff. This study evaluated the use of the PFFS in an intensive care unit (ICU).</p><p><strong>Methods: </strong>A single-center retrospective study, performed in an 18-bed mixed medical-surgical ICU in a university-affiliated tertiary hospital. As of 1/9/2022, all older patients are routinely asked to fill out the PFFS. Patients were grouped based on their PFFS score. Baseline characteristics and admission outcomes were compared. Correlation between the PFFS and prognostic scores was examined. Mortality was analyzed using logistic and Cox regressions.</p><p><strong>Results: </strong>168 patients were included. 56 (33.33%) patients were non-frail, 81 (48.21%) were mildly-moderately frail, and 31 (18.45%) were severely frail. There were no differences in baseline characteristics or prognostic scores between frailty groups. No correlation was found between PFFS, age, APACHE2, and SOFA24. Multivariate logistic regression demonstrated an association between frailty and 90d but not with ICU mortality. Cox regression demonstrated higher mortality in the mild-moderate frailty (HR 2.053, 95%CI 1.009, 4.179) and severe frailty (HR 4.353, (95% CI 1.934, 9.801)) groups compared to the non-frail group.</p><p><strong>Conclusion: </strong>Frailty assessment by the PFFS in the ICU is feasible. Frailty is a distinct characteristic of older, critically ill patients and is independently associated with 90d mortality.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"105"},"PeriodicalIF":3.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of dynapenic abdominal obesity and its components with cognitive impairment among hemodialysis patients.","authors":"Chaomin Zhou, Jing Peng, Zuping Qian, Lin Zhan, Jing Yuan, Yan Zha","doi":"10.1186/s12877-024-05580-3","DOIUrl":"10.1186/s12877-024-05580-3","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive impairment (CI) is a prevalent and significant health concern among patients undergoing maintenance hemodialysis (MHD). Recent studies have highlighted the growing interest in dynapenic abdominal obesity (DAO), which combines both low muscle strength and excess abdominal fat. Despite the increasing recognition of DAO, its association with CI in MHD patients remains uncertain. The objective of this study was to investigate the relationship between DAO and CI in MHD patients.</p><p><strong>Methods: </strong>We conducted a multicenter, cross-sectional study in twenty dialysis centers, encompassing 3767 adult MHD patients. Participants were categorized into four distinct groups based on the criteria for abdominal obesity (AO), defined as waist circumference (WC) ≥ 90 cm for men and ≥ 85 cm for women, and dynapenia, characterized by handgrip strength (HGS) < 28 kg in men and < 18 kg in women. The groups were: non-dynapenic/non-abdominal obesity (NDNAO), non-dynapenic/abdominal obesity (NDAO), dynapenic/non-abdominal obesity (DNAO), and dynapenic/abdominal obesity (DAO). Cognitive function was assessed using the Mini-Mental State Examination (MMSE), with a score below 27 indicating cognitive impairment (CI). Multivariate logistic models were used to investigate the correlations between DAO and its components with the risk of CI. Smooth curve fittings were used to identify the potential nonlinear relationship between WC and the MMSE scores. The piecewise regression model was used for fitting while the log-likelihood ratio test was used to determine whether a significant inflection point existed. Additionally, we conducted a series of subgroup analyses to test the robustness of our results.</p><p><strong>Results: </strong>The multi-variable adjusted odds ratios (ORs) of CI for DNAO and DAO were 2.10 (1.68-2.62, P < 0.001) and 1.81 (1.40-2.33, P < 0.001), respectively. These findings were consistently observed across subgroup analyses, indicating robustness in our results. AO was associated with increased risk of CI in the crude model (OR 1.22, 95%CI 1.05-1.41; P = 0.008), however, it became a protective factor after adjusting for potential confounders (OR 0.84, 95%CI 0.71-0.98; P = 0.03). We identified a significant nonlinear relationship between WC, HGS, and MMSE scores (P for non-linearity < 0.05). Notably, an inflection point at 23.29 kg for HGS was determined through threshold effect analysis. Below a WC threshold of 101 cm, MMSE scores demonstrated a positive correlation with WC (β = 0.03, 95% CI 0.01-0.04, P < 0.001). However, this relationship did not achieve statistical significance for WC values above 101 cm.</p><p><strong>Conclusions: </strong>Both DAO and DNAO are associated with increased odds of CI in MHD patients, with dynapenia being the major factor contributing to the increased odds of CI, while AO appears to play a protective role against CI.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"107"},"PeriodicalIF":3.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}