Experimental gerontology最新文献

{"title":"Accelerated intermittent theta burst stimulation combined with cognitive training modulates cortical plasticity and brain activation in patients with amnestic mild cognitive impairment","authors":"Jiali Luo ,&nbsp;Zefeng Tan ,&nbsp;Pan Shang ,&nbsp;Shuyun Huang ,&nbsp;Yajing Liu ,&nbsp;Yukai Wang ,&nbsp;Haiqun Xie ,&nbsp;Qi Chen","doi":"10.1016/j.exger.2025.113009","DOIUrl":"10.1016/j.exger.2025.113009","url":null,"abstract":"<div><div>Amnestic mild cognitive impairment (aMCI) is the prodromal period of Alzheimer's disease without effective treatment. This research aimed to investigate the effects of accelerated intermittent theta burst stimulation (iTBS) combined with adaptive cognitive training (COG) on cognitive function in aMCI patients and explore the underlying neural mechanisms. Twenty-four aMCI patients participated in either the real (<em>n</em> = 12) or sham (n = 12) stimulation group. Both groups received adaptive COG, which comprised three sessions of real or sham iTBS delivered on the left dorsolateral prefrontal cortex (DLPFC) once a day for 14 days. The primary outcomes were the Montreal Cognitive Assessment (MoCA) and Alzheimer's Disease Assessment Scale–Cognitive Subscale (ADAS-Cog) scores. Secondary outcomes were changes in cortical plasticity measured by transcranial magnetic stimulation and brain activation monitored by functional near-infrared spectroscopy (fNIRS). Patients were evaluated before and after the intervention. Patients with aMCI who received iTBS combined with COG had a significant improvement in cognitive performance, as assessed by the ADAS-Cog and N-back. In the iTBS+COG group, cortical plasticity measured 30 min post-intervention correlated with ADAS-Cog changes (<em>r</em> = −0.59, <em>p</em> = 0.043). Furthermore, this plasticity was associated with 1-back activation (<em>r</em> = −0.58, <em>p</em> = 0.050), and 2-back activation correlated with ADAS-Cog changes (r = −0.59, <em>p</em> = 0.042). Accelerated iTBS targeted to the left DLPFC combined with adaptive COG promoted cognitive improvement in aMCI patients more effectively by modulating cortical plasticity and brain activation. Cortical plasticity and brain activation might be valuable measurements for understanding cognitive function (Chinese Clinical Trial Registry: ChiCTR2400087943).</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"213 ","pages":"Article 113009"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal association and potential mediators between obstructive sleep apnea and diabetic nephropathy: A Mendelian randomization study","authors":"Yonghang He ,&nbsp;Junxiang Wang ,&nbsp;Yun Wen ,&nbsp;Bo Yi ,&nbsp;Yong Wang","doi":"10.1016/j.exger.2025.112980","DOIUrl":"10.1016/j.exger.2025.112980","url":null,"abstract":"<div><h3>Background</h3><div>Previous observational studies have reported the association between obstructive sleep apnea (OSA) and diabetic nephropathy. However, it remains to be confirmed whether this association is causal. This study aimed to investigate the causal association of OSA with diabetic nephropathy and the mediating effect of common risk factors using Mendelian randomization (MR) design.</div></div><div><h3>Method</h3><div>The study data were sourced from genome-wide association studies (GWAS). Bidirectional two-sample MR and multivariable MR analyses were conducted to assess causal relationships between OSA and diabetic nephropathy. Potential mediation by common risk factors was evaluated through two-step MR. In addition, the MR results were supported by various sensitivity and validation analyses.</div></div><div><h3>Results</h3><div>We presented genetic evidence that OSA could unidirectionally increase the risk of diabetic nephropathy (OR = 1.30; 95 % CI: 1.13, 1.50; <em>p</em> = 2.51 × 10⁻⁴). After adjusting for BMI, high blood pressure, blood glucose levels, glycated hemoglobin levels, severe insulin resistance, years of schooling, nap during day, processed meat consumption, and coffee intake, the causal effect of OSA on diabetic nephropathy remained statistically significant. Further mediation MR analysis showed that BMI and high blood pressure may mediate the causal relationship between OSA and diabetic nephropathy, with a mediation effect of 26.35 % and 9.91 %, respectively.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that genetically predicted OSA is associated with a higher risk of diabetic nephropathy. Additionally, BMI and high blood pressure are involved in the mechanism of OSA-induced diabetic nephropathy.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"213 ","pages":"Article 112980"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A subtle association raising bigger questions: Implicit and explicit ageism in the Dutch age IAT","authors":"Belia Schuurman ,&nbsp;Jolanda Lindenberg ,&nbsp;Tineke A. Abma ,&nbsp;Wilco P. Achterberg","doi":"10.1016/j.exger.2025.112988","DOIUrl":"10.1016/j.exger.2025.112988","url":null,"abstract":"<div><div>This study presents the first baseline analysis of the Dutch Age Implicit Association Test (IAT) data, examining both implicit and explicit ageism measures in the Netherlands. Analyzing data from 8680 participants over a range of 12 years, we investigated implicit ageism scores, their association with explicit ageism measures, and associations with demographic characteristics. Results position the Netherlands in the international midfield for implicit ageism. Significant gender differences emerged, with men showing higher implicit ageism scores than women. We found no significant relationship between age and implicit ageism. The study revealed small to moderate yet significant correlations between implicit and explicit ageism measures, suggesting these are subtly related yet distinct constructs. These findings contribute to the international comparative literature on ageism by establishing a Dutch baseline and emphasize the need for further research into the association between implicit and explicit ageism. To tackle the prevalence and consequences of ageism in our social lives and institutions, the mechanisms underlying age-related biases across different contexts need to be investigated further.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"213 ","pages":"Article 112988"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct patterns of cortical activity associated with cognitive and motor decline in community-dwelling older adults","authors":"Eun-Seon Noh ,&nbsp;Jiwon Yang ,&nbsp;Kai Wang ,&nbsp;Seongryu Bae ,&nbsp;Hyuntae Park","doi":"10.1016/j.exger.2025.113000","DOIUrl":"10.1016/j.exger.2025.113000","url":null,"abstract":"<div><div>This study aimed to examine whether resting-state EEG markers show potential for distinguishing individuals as healthy control, mild cognitive impairment (MCI), and motoric cognitive risk syndrome (MCR), based on their levels of cognitive and motor decline. In this cross-sectional study, we enrolled 87 participants and classified them into three groups. Motor functions were measured by gait speed. Cognitive function was assessed by neuropsychologists using standardized tools, including the Mini-Mental State Examination (MMSE), the Symbol Digit Substitution Test (SDST), and the Paired Associates Learning (PAL) task. Resting-state EEG data were recorded for five minutes with eyes closed, using a 19-channel wireless EEG system. Our results showed that individuals with MCI and MCR exhibited increased frontal theta power and widespread default mode network (DMN) connectivity, reflecting underlying neuropsychological changes. These alterations were most pronounced in the MCR group and were associated with both cognitive and motor decline. Our findings highlight the potential of resting-state EEG as a biomarker for the early detection of cognitive and motor decline in community-dwelling older adults.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"213 ","pages":"Article 113000"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic assessment of sepsis-induced acute respiratory distress syndrome in older patients using clinical and CT-based radiomic features","authors":"Xiya Wang ,&nbsp;Bowen Zhang ,&nbsp;Ying Chen ,&nbsp;Xinzhen Gao ,&nbsp;Yongshen Bai ,&nbsp;Shuxing Wei ,&nbsp;Shubin Guo ,&nbsp;Xue Mei","doi":"10.1016/j.exger.2025.112987","DOIUrl":"10.1016/j.exger.2025.112987","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis-induced acute respiratory distress syndrome (SI-ARDS) is associated with high mortality rates, necessitating early risk stratification. This study aimed to develop and validate a radiomics-based nomogram integrating computed tomography (CT) features and clinical parameters to predict 28-day mortality in older patients with SI-ARDS.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, 302 older patients (≥60 years) diagnosed with SI-ARDS between January 2019 and December 2023 were enrolled. Radiomic features were extracted from admission chest CT images. Patients were randomly allocated to training (n = 242) and validation (n = 60) cohorts. Three predictive models—radiomic, clinical, and combined—were constructed using Maximum Relevance Minimum Redundancy (MRMR) algorithm and Least Absolute Shrinkage and Selection Operator (LASSO) regression. Model performance was assessed using the concordance index (C-index), calibration curves, and decision curve analysis. A nomogram was developed based on the optimal model for clinical application.</div></div><div><h3>Results</h3><div>The fusion model achieved superior discrimination compared with the radiomic model, clinical model, and Sequential Organ Failure Assessment score in both cohorts (C-index: training, 0.850 vs. 0.798, 0.781, and 0.654; validation, 0.839 vs. 0.768, 0.779, and 0.696; all <em>p</em> &lt; 0.001). The model demonstrated excellent calibration and provided greater net clinical benefit across threshold probabilities of 10 %–90 %. Risk stratification using the nomogram identified distinct prognostic groups with significantly different 28-day survival (log-rank <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The nomogram developed from the fusion model demonstrated superior predictive performance for 28-day mortality in older patients with SI-ARDS compared to conventional scoring systems, though multicenter validation is required to confirm clinical utility.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"213 ","pages":"Article 112987"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent musculoskeletal pain and subsequent falls in China: Evidence from CHARLS with exploratory frailty mediation analyses","authors":"Ruizheng Zhu ,&nbsp;Guangjun Tang ,&nbsp;Manhong Yang ,&nbsp;Junde Wu ,&nbsp;Zhaojun Chen","doi":"10.1016/j.exger.2025.113005","DOIUrl":"10.1016/j.exger.2025.113005","url":null,"abstract":"<div><h3>Background</h3><div>Musculoskeletal pain (MSP) is prevalent among middle-aged and older adults and may increase fall risk through functional decline, but evidence on pain persistence and the potential role of frailty in China remains limited.</div></div><div><h3>Methods</h3><div>This study utilized data from the 2011 and 2015 China Health and Retirement Longitudinal Study (CHARLS), involving 13,057 participants in 2011 and a cohort of 7390 who reported no falls in 2011 and completed the 2015 follow-up. Among them, 1046 had persistent MSP identified using standardized CHARLS pain items. Participants indicated body pain locations, with MSP noted if pain was present anywhere. Baseline MSP was recorded in 2011, and persistent MSP was reported in both 2011 and 2015. Falls were self-reported. Survey-weighted logistic regression analyzed associations, while mediation analyses used baseline MSP (2011) as exposure and frailty in 2015 as a mediator, employing a counterfactual framework to decompose effects, interpreted cautiously due to standard assumptions and a two-year fall recall window. Baseline characteristics were compared between included and excluded participants to evaluate potential selection bias.</div></div><div><h3>Results</h3><div>In the longitudinal cohort, 1072 incident falls were recorded, with a higher fall rate among participants with persistent MSP than among those without (25.69 % vs 12.48 %). Adjusted models showed baseline MSP increased fall risk (OR 1.36, 95 % CI 1.15–1.60), with a stronger link for persistent MSP (OR 2.08, 95 % CI 1.70–2.54). Similar trends were observed for multisite pain. Mediation analysis indicated frailty partially mediated the effect of baseline MSP on falls, accounting for about 29 % of the effect, though results were interpreted cautiously due to the two-year fall recall period.</div></div><div><h3>Conclusions</h3><div>In middle-aged and older Chinese adults, MSP increases fall risk, particularly with ongoing pain. Frailty might partly explain this risk, indicating the importance of combining pain management with anti-frailty measures for fall prevention.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"213 ","pages":"Article 113005"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic imbalance of autophagy: A molecular link between age-related hearing loss and cognitive dysfunction","authors":"Haixu Fang ,&nbsp;Shuyun Liu ,&nbsp;Yan Qiu ,&nbsp;Lanyin Chang ,&nbsp;Yuanhui Chen ,&nbsp;Sanmei Enzha ,&nbsp;Hengyan Liu ,&nbsp;Ye Yang ,&nbsp;Zedeng Yin","doi":"10.1016/j.exger.2025.112997","DOIUrl":"10.1016/j.exger.2025.112997","url":null,"abstract":"<div><div>Age-related hearing loss (ARHL) and cognitive dysfunction are established comorbidities, yet their molecular links remain unclear. This study employed a D-galactose-induced ARHL guinea pig model, along with multimodal analysis, to elucidate the bridging role of autophagy. ARHL animals exhibited significantly elevated hearing thresholds (&gt;65 dB SPL) and spatial memory deficits (Morris Water Maze escape latency increased 0.77-fold). PET/CT revealed a 28.57 % reduced hippocampal glucose metabolism (SUV), negatively correlating with cognitive impairment. Molecular analysis revealed that the autophagic marker LC3B was initially upregulated (0–8 weeks) and then declined (12–16 weeks), while P62 paradoxically mirrored the dynamics of LC3B, indicating an imbalance in autophagy homeostasis. Transmission electron microscopy identified mitochondrial cristae dissolution, postsynaptic density thinning, and widened synaptic clefts, linking ultrastructural damage to metabolic compromise via autophagy dysregulation. We establish an evidence chain: “ARHL–autophagy imbalance–hippocampal hypometabolism–cognitive decline”. Autophagy initially exerts neuroprotection by clearing damage but transitions to neurotoxicity under chronic dysregulation, causing neuronal energy insufficiency. These findings reveal novel mechanisms connecting ARHL and cognitive impairment, providing a foundation for autophagy-targeted therapies.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"213 ","pages":"Article 112997"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring how exercise frequency impacts muscle strength and balance in institutionalized older adults: Protocol for a randomized controlled trial","authors":"Filipe Rodrigues ,&nbsp;Bernardo Pereira ,&nbsp;Elisabete Silva ,&nbsp;Diogo Monteiro ,&nbsp;Raul Antunes","doi":"10.1016/j.exger.2025.112985","DOIUrl":"10.1016/j.exger.2025.112985","url":null,"abstract":"<div><div>This protocol for a randomized controlled trial aims to evaluate the impact of exercise frequency on muscle strength, balance, and fall risk among institutionalized older adults. Recognizing the unique physical and functional limitations of this population, the study will test whether two or three weekly sessions of multicomponent exercise yield differential outcomes. Sixty participants residing in nursing homes will be randomly assigned to one of two groups: a control group performing exercise twice weekly and an experimental group training three times weekly, over a 12-week intervention period. All sessions will follow international guidelines for older adults, incorporating aerobic, strength, balance, and flexibility training at light-to-moderate intensity. Primary outcomes include lower- and upper-body strength and dynamic balance; secondary outcomes comprise waist circumference, body mass index, and fall incidence. The program is designed with progressive adaptation and safety in mind, employing the Talk Test to regulate intensity and standardized measures to monitor physiological responses. The rationale stems from the gap in existing literature regarding optimal exercise frequency for institutionalized populations. While two sessions per week have been associated with functional improvements, it remains unclear whether an additional weekly session provides significant incremental benefits. By isolating frequency as the primary variable, the trial addresses the need to define the minimum effective dose of structured exercise for enhancing physical activity, functional capacity, and reducing fall risk. Results are expected to inform tailored physical activity guidelines and implementation strategies in long-term care settings, balancing clinical efficacy with feasibility and safety constraints typical of institutional environments.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"213 ","pages":"Article 112985"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social isolation and intrinsic capacity decline in older adults: Mediating roles of sleep duration and pain","authors":"Wenhua Yu ,&nbsp;Yaru Zhou ,&nbsp;Xvyan Gao ,&nbsp;Jiayu Han ,&nbsp;Li Zhang ,&nbsp;Lina Ma","doi":"10.1016/j.exger.2025.112991","DOIUrl":"10.1016/j.exger.2025.112991","url":null,"abstract":"<div><h3>Background</h3><div>The decline of intrinsic capacity is a key determinant of healthy aging. While social isolation is recognized as a risk factor for functional deterioration in older adults, the pathways through which it influences intrinsic capacity, particularly via sleep duration and pain, remain underexplored.</div></div><div><h3>Objectives</h3><div>To evaluate the association between social isolation and intrinsic capacity in older adults, and to assess whether sleep duration and pain complaints mediate this relationship.</div></div><div><h3>Methods</h3><div>Data were obtained from the 2011 wave China Health and Retirement Longitudinal Study (CHARLS). Intrinsic capacity was assessed across five domains: locomotion, vitality, cognition, psychology, and sensory. Social isolation was measured using a composite index incorporating marital status, living arrangements, contact with children, and social participation. Logistic regression was used to examine the association between social isolation and intrinsic capacity. Mediation analyses were performed using multiple linear regression to estimate the mediating roles of sleep duration and pain complaints.</div></div><div><h3>Results</h3><div>Among 2451 participants, 1897 (77.4 %) exhibited decline in at least one intrinsic capacity domain. Prevalence of decline by domain was: locomotion (23.3 %), vitality (18.9 %), cognition (46.7 %), psychology (26.9 %), and sensory (44.2 %). 877 participants (35.8 %) were identified as socially isolated. After adjustment for sociodemographic and health-related factors, social isolation was associated with increased odds of intrinsic capacity decline. Furthermore, social isolation was positively correlated with decline in intrinsic capacity, with both sleep duration and pain complaints serving as mediators in this relationship.</div></div><div><h3>Conclusions</h3><div>In this nationally representative sample of Chinese older adults, social isolation is associated with greater decline of intrinsic capacity, partially mediated through inadequate sleep duration and pain complaints. These findings suggest that interventions aimed at mitigating social isolation, along with integrated management of sleep and pain, may help preserve intrinsic capacity in aging populations.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"213 ","pages":"Article 112991"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing recovery after a hip fracture: Protocol of a randomized controlled trial to study the effects, costs, and cost-effectiveness of a combined protein and exercise intervention in older adults after a hip fracture (ProBUS study)","authors":"Emma Treijtel ,&nbsp;Hugo H. Wijnen ,&nbsp;Nienke M.S. Golüke ,&nbsp;Marian A.E. de van der Schueren ,&nbsp;Lisette C.P.G.M. de Groot ,&nbsp;Inge Groenendijk","doi":"10.1016/j.exger.2025.112999","DOIUrl":"10.1016/j.exger.2025.112999","url":null,"abstract":"<div><h3>Background</h3><div>Hip fractures are common among older adults and typically occur alongside accumulating comorbidities and age-related musculoskeletal decline. While nutritional or exercise interventions can support recovery, the effect of a combined approach during rehabilitation remains unclear. This study aims to evaluate the effects, costs, and cost-effectiveness of a high-protein diet plus exercise intervention on functional recovery after a hip fracture.</div></div><div><h3>Methods</h3><div>This randomized controlled trial will include 102 older adults (≥65 years) recovering in a rehabilitation centre after a hip fracture. Participants will be randomly assigned (1:1) to the intervention or control group, stratified by sex and hospital. The intervention group will receive weekly dietitian support to comply with a high-protein diet (≥1.2 g/kg body weight/day) and will participate in progressive resistance exercise training twice weekly for 3 months. The control group will receive usual care. Due to the nature of the intervention, participant and staff blinding is not feasible, but analyses will be performed blinded. Measurements will be performed in the first week after surgery, at rehabilitation discharge, and 3 months after baseline. The primary outcome is physical functioning using the Short Physical Performance Battery. Secondary outcomes include handgrip strength, muscle mass, bone density, quality of life, daily functioning, nutritional status, bone metabolism biomarkers, and costs.</div></div><div><h3>Discussion</h3><div>The intervention is expected to enhance recovery, attenuate postoperative bone and muscle loss, and improve quality of life. Implementation into standard care could improve efficiency and cost-effectiveness.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"213 ","pages":"Article 112999"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}