Archives of Gerontology and Geriatrics Plus最新文献_第3页

Social frailty reflected by housebound status as an independent predictor of self-reported incidence fracture in community-dwelling older adults: A longitudinal cohort study 居家状态反映的社会脆弱性是社区居住老年人自我报告骨折发生率的独立预测因子：一项纵向队列研究

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-11-15 DOI: 10.1016/j.aggp.2025.100229

Hiromi Matsumoto , Chika Tanimura , Yuki Kitsuda , Takashi Wada , Shinji Tanishima , Hiroshi Hagino

Purpose

This study aims to determine whether frailty, assessed using the simple multidimensional frailty assessment tool, the Kihon Checklist (KCL), is associated with future fractures and, if so, to identify which frailty subtypes exhibit the strongest association with fracture incidence.

Methods

This study recruited local residents who visited government-organized examination sites for specific health check-ups for older adults, conducted over a three-day period each year and 468 community-dwelling older adults from 2014 to 2023 in Hino Town, Tottori Prefecture, Japan. Characteristics, physical structure and performance, and frailty were assessed at the baseline assessment. Frailty was assessed using KCL and categorized into six subtypes: lower motor function, malnutritional, lower oral function, housebound, reduced cognitive function, and possible depression. Self-Reported incidence fracture was determined through annual follow-up surveys. Kaplan-Meier survival analysis and Cox proportional hazards models were used to evaluate the association between frailty subtypes and fracture incidence.

Results

A total of 352 participants were followed for fracture incidence over a mean period of 6.9 years. During the follow-up period, 41 participants experienced at least one fracture, resulting in an incidence rate of 1.69 per 100 person-years. Both lower motor function and housebound were significantly associated with fracture incidence. However, after adjusting for previous fall history, and lower bone mass, housebound (HR = 2.436, 95 % CI: 1.125–5.271) remained significantly associated with fracture incidence.

Conclusions

Unlike previous studies emphasizing musculoskeletal frailty, our findings highlight housebound status as a factor associated with fractures. Fracture prevention strategies should integrate social engagement interventions alongside conventional musculoskeletal management.

目的本研究旨在确定使用简单多维脆弱性评估工具Kihon Checklist （KCL）评估的脆弱性是否与未来骨折有关，如果有，则确定哪些脆弱性亚型与骨折发生率最强相关。方法本研究于2014年至2023年在日本鸟取县日野镇招募每年前往政府组织的老年人专项健康检查点的当地居民和468名社区居住的老年人，每年进行为期三天的健康检查。在基线评估中评估患者的特征、身体结构和表现以及虚弱程度。使用KCL评估虚弱并将其分为六个亚型：运动功能低下、营养不良、口腔功能低下、足不出户、认知功能下降和可能的抑郁。自我报告的骨折发生率通过年度随访调查确定。Kaplan-Meier生存分析和Cox比例风险模型用于评估脆弱亚型与骨折发生率之间的关系。结果352名参与者的骨折发生率平均随访时间为6.9年。在随访期间，41名参与者经历了至少一次骨折，导致发病率为1.69 / 100人年。下肢运动功能和足不出户均与骨折发生率显著相关。然而，在调整了先前的跌倒史和较低的骨量后，足不出户（HR = 2.436, 95% CI: 1.125-5.271）仍然与骨折发生率显著相关。结论：与以往强调肌肉骨骼脆弱的研究不同，我们的研究结果强调足不出户是骨折的一个相关因素。骨折预防策略应结合社会参与干预和传统的肌肉骨骼管理。

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引用次数: 0

Analyzing COVID-19 fall occurrences amongst older adult populations 分析老年人群中COVID-19跌倒发生率

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-11-13 DOI: 10.1016/j.aggp.2025.100228

Aman Sandhu , Benjamin Millar , Faith Kean , Leah Pasch , Rhea Verma , Junchao Shen , Nancy Nagib , Rahul Kashyap

Introduction

The COVID-19 pandemic has been associated with increased health risks among elderly populations, who were often isolated and led more sedentary lifestyles. Prior studies on fall risks during the pandemic show variable results. This systematic review examines trends in elderly fall rates after the onset of COVID-19.

Materials/Methods

PubMed and Embase were the primary databases used and screened via Rayyan Software. Reviewers independently screened articles with blinding enabled. Synonyms of “COVID-19,” “elderly,” and “fall rate” were used. Eligible studies were in English, focused on individuals aged >65, and included falls from level height. Studies required two data collection periods: one before and one after March 2020, with sample sizes and fall incidences reported. Recreational or accidental falls were excluded. The review was registered on PROSPERO (CRD42023418490).

Results

Of 913 articles, 6 met inclusion criteria, with a total of 27,055 patients. Pooled analysis showed increased odds of falls during the pandemic (OR=1.17, 95 % CI: 1.11–1.24, p < 0.00001). The difference in fall rates was statistically significant. Heterogeneity was high (I² = 88 %). Sensitivity analysis excluding the highest-weight article showed OR = 1.08 (95 % CI: 1.02–1.15, p = 0.0001), with I² = 85 %. Notable comorbidities included diabetes and hypertension.

Conclusion

This review highlights a statistically significant increase in elderly fall rates during the COVID-19 pandemic. Despite heterogeneity and comorbid risks, an upward trend in fall rates was evident, underscoring the need for improved at-home interventions and preventive strategies during public health crises.

2019冠状病毒病大流行与老年人健康风险增加有关，老年人往往与世隔绝，生活方式久坐不动。先前关于大流行期间跌倒风险的研究显示出不同的结果。本系统综述探讨了COVID-19发病后老年人跌倒率的趋势。材料/方法主要使用spubmed和Embase数据库，通过Rayyan软件进行筛选。审稿人独立筛选启用了盲法的文章。使用了“COVID-19”、“老年人”和“跌倒率”的同义词。符合条件的研究是用英语进行的，研究对象是65岁以上的人，包括从同一高度坠落的人。研究需要两个数据收集期：一个在2020年3月之前，一个在2020年3月之后，报告样本量和跌倒发生率。娱乐或意外跌倒被排除在外。该综述已在PROSPERO注册（CRD42023418490）。结果913篇文献中，6篇符合纳入标准，共纳入27055例患者。汇总分析显示，大流行期间跌倒的几率增加（OR=1.17, 95% CI: 1.11-1.24, p < 0.00001）。坠落率的差异有统计学意义。异质性高（I²= 88%）。排除最高权重文章的敏感性分析显示OR = 1.08 (95% CI: 1.02-1.15, p = 0.0001), I²= 85%。值得注意的合并症包括糖尿病和高血压。本综述强调了COVID-19大流行期间老年人跌倒率的统计学显著增加。尽管存在异质性和共病风险，但跌倒率明显呈上升趋势，这强调了在公共卫生危机期间改进家庭干预措施和预防战略的必要性。

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引用次数: 0

Additive and interactive effects of social, financial and environmental factors on gait speed among community dwelling older adults in Nigeria: A cross-sectional study 社会、经济和环境因素对尼日利亚社区老年人步态速度的叠加和交互影响：一项横断面研究

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-11-04 DOI: 10.1016/j.aggp.2025.100225

Francis Kolawole , Osakpolor V Oni , Ejehi Omoighe , Israel Adandom , Daniel Rayner , Henrietta Fawole , Michael Kalu

Objectives

Gait speed is considered the sixth vital sign in geriatric care, due to its predictive role in health and social outcomes. Although various factors influence gait speed, environmental and social factors are frequently overlooked, particularly in developed regions with distinct cultural perspectives. The study examines how these environmental, financial and social factors additively or interactively influence gait speed of community dwelling older adults in Nigeria.

Method

We employed a cross-sectional study design included 408 community-dwelling older adults (mean [S.D] = 68.0(6.6) years) from a city in Nigeria. We administer validated measures to assess nine neighborhood environmental factors, five social factors and self-reported income. Gait Speed was assessed using the 10-metre walk test and categorized < 0.8m/s (slow speed) and ≥0.8m/s (normal). Logistic regression analysis was used to determine the predictors of gait speed in this dichotomized form.

Results

Slow gait speed prevalence was 72.4 %. The additive model revealed that age (OR = 0.798, p < 0.001), social network (OR = 1.079, p < 0.01), and neighborhood surroundings (OR = 1.117, p < 0.01) were significant predictors of high gait speed. In the interaction model, age, social network, and neighborhood surroundings remained significant predictors and education level became significant: secondary education (OR = 3.986, p = 0.047) and tertiary education (OR = 4.580, p = 0.038) associated with higher odds of high gait speed.

Discussion

Findings suggest that enhancing social networks and improving neighborhood environments may be crucial in promoting better mobility outcomes, particularly among diverse older adults.

步态速度被认为是老年护理的第六大生命体征，因为它在健康和社会结果中具有预测作用。尽管影响步态速度的因素多种多样，但环境和社会因素往往被忽视，特别是在具有独特文化视角的发达地区。该研究考察了这些环境、经济和社会因素如何共同或相互影响尼日利亚社区居住老年人的步态速度。方法采用横断面研究设计，纳入408名居住在社区的老年人(平均[S。D] = 68.0（6.6）岁，来自尼日利亚的一个城市。我们管理有效的措施来评估9个社区环境因素，5个社会因素和自我报告的收入。采用10米步行试验评估步态速度，分为0.8m/s（慢速）和≥0.8m/s（正常）。Logistic回归分析用于确定这种二分类形式下步态速度的预测因子。结果慢步率为72.4%。加性模型显示，年龄（OR = 0.798, p < 0.001）、社会网络（OR = 1.079, p < 0.01）和社区环境（OR = 1.117, p < 0.01）是高步态速度的显著预测因子。在交互作用模型中，年龄、社会网络和社区环境仍然是显著的预测因素，教育水平变得显著：中等教育（OR = 3.986, p = 0.047）和高等教育（OR = 4.580, p = 0.038）与高步态速度的几率相关。研究结果表明，加强社会网络和改善社区环境可能是促进更好的流动性结果的关键，特别是在不同的老年人中。

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引用次数: 0

Longitudinal relationships between persistent moderate-to-severe pain and poor multidimensional sleep health with frailty among community-dwelling older adults 在社区居住的老年人中，持续的中度至重度疼痛与多维睡眠健康状况不佳和虚弱之间的纵向关系

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-11-04 DOI: 10.1016/j.aggp.2025.100224

Tuo-Yu Chen , Kai-Wen Hsu , Feng-Jen Tsai , Chyi-Huey Bai , Hui-Chuan Hsu , Yi-Hua Chen , Yi-Chun Kuan

Evidence supports that persistent pain, poor multidimensional sleep health, and frailty might be related among community-dwelling older adults. However, the associations of persistent pain and poor multidimensional sleep health with frailty are not yet fully understood, and it remains unclear whether better sleep could alleviate the impact of persistent pain on frailty. We investigated whether baseline persistent moderate-to-severe pain and poor multidimensional sleep health predicted frailty at 4-year follow-up among community-dwelling older adults and whether the relationship between persistent moderate-to-severe pain and frailty differed by multidimensional sleep health status. Data were from the Taiwan Longitudinal Study on Aging (N = 2490; 2011–2015). A frailty index based on the deficit accumulation model was built. Pain included four categories (no pain [reference], some pain, acute moderate-to-severe pain, and persistent moderate-to-severe pain). Multidimensional sleep health was assessed using the SATED model. Covariates included sociodemographic characteristics, health status, and health behaviors. The results showed that acute and persistent moderate-to-severe pain and poor multidimensional sleep health increased the risks of frailty at 4-year follow-up. A significant interaction effect was observed between persistent moderate-to-severe pain and poor multidimensional sleep health. Specifically, frailty risks exhibited a dose-response relationship with poor sleep health. Compared to no pain, poor multidimensional sleep health elevated already heightened risks of frailty by persistent moderate-to-severe pain. Our findings revealed that acute and persistent moderate-to-sever pain and poor multidimensional sleep health were important factors for future frailty. Improving multidimensional sleep health among community-dwelling older adults with persistent moderate-to-sever pain may help mitigate the risks of frailty.

有证据表明，在社区居住的老年人中，持续疼痛、多维睡眠健康状况不佳和虚弱可能存在关联。然而，持续疼痛和多维睡眠健康状况不佳与虚弱之间的关系尚不完全清楚，更好的睡眠是否能减轻持续疼痛对虚弱的影响仍不清楚。我们调查了基线持续性中至重度疼痛和多维睡眠健康状况不佳是否预示着社区居住老年人4年随访中的虚弱，以及持续性中至重度疼痛和虚弱之间的关系是否因多维睡眠健康状况而不同。数据来自台湾老龄化纵向研究（N = 2490; 2011-2015）。建立了基于赤字积累模型的脆弱性指数。疼痛分为四类（无疼痛[参考文献]、部分疼痛、急性中重度疼痛和持续性中重度疼痛）。多维睡眠健康评估使用SATED模型。协变量包括社会人口学特征、健康状况和健康行为。结果显示，在4年随访中，急性和持续性中至重度疼痛以及多维睡眠健康状况不佳增加了虚弱的风险。在持续的中度至重度疼痛和多维睡眠健康不良之间观察到显著的相互作用效应。具体而言，虚弱风险与睡眠健康状况不佳呈剂量-反应关系。与没有疼痛相比，多维睡眠健康状况不佳会增加因持续中度至重度疼痛而已经增加的脆弱风险。我们的研究结果表明，急性和持续的中度至重度疼痛和多维睡眠健康状况不佳是未来虚弱的重要因素。改善社区居住的持续有中度至重度疼痛的老年人的多维睡眠健康可能有助于减轻虚弱的风险。

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引用次数: 0

New advances in the study of postmenopausal osteoporosis and arteriosclerosis: Exploration of metabolite changes and their mechanisms 绝经后骨质疏松和动脉硬化研究的新进展：代谢物变化及其机制的探索

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-10-15 DOI: 10.1016/j.aggp.2025.100222

Yang Lei , Li Misi , Chen Xiaoyun , An Yangxin , Hu Xueqin , Li Weijuan

Postmenopausal women face a significantly increased risk of osteoporosis and arteriosclerosis due to a marked decline in estrogen levels, making it an important issue in public health. In recent years, metabolomic studies have revealed dynamic changes in various charged metabolites in the bodies of postmenopausal women, which are closely related to abnormal bone metabolism and vascular lesions. Although some research has explored the correlation between osteoporosis and arteriosclerosis in postmenopausal women, systematic studies on metabolite changes and their mechanisms remain relatively scarce. This article reviews the latest research progress on postmenopausal osteoporosis and arteriosclerosis, focusing on the changes in metabolite profiles and their roles in the tricarboxylic acid cycle, urea cycle, and homocysteine metabolism, discussing their mechanisms affecting bone and vascular health. By integrating the latest metabolomic data and clinical studies, this article aims to provide theoretical basis and research directions for the early diagnosis and treatment of osteoporosis and arteriosclerosis in postmenopausal women.

由于雌激素水平明显下降，绝经后妇女患骨质疏松症和动脉硬化的风险显著增加，使其成为公共卫生的一个重要问题。近年来，代谢组学研究揭示了绝经后妇女体内各种带电代谢物的动态变化，这些变化与骨代谢异常和血管病变密切相关。虽然有研究探讨了绝经后妇女骨质疏松与动脉硬化之间的关系，但对代谢物变化及其机制的系统研究相对较少。本文综述了绝经后骨质疏松和动脉硬化的最新研究进展，重点介绍了代谢产物谱的变化及其在三羧酸循环、尿素循环和同型半胱氨酸代谢中的作用，并讨论了它们影响骨骼和血管健康的机制。结合最新代谢组学数据和临床研究，旨在为绝经后妇女骨质疏松和动脉硬化的早期诊断和治疗提供理论依据和研究方向。

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引用次数: 0

Association between gait performance at discharge and total anticholinergic burden in elderly patients after hip fracture surgery: A single-center retrospective cohort study 老年髋部骨折术后患者出院时步态表现与总抗胆碱能负荷的关系：一项单中心回顾性队列研究

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-10-15 DOI: 10.1016/j.aggp.2025.100223

Daisuke Komiya , Hirofumi Takeya , Kenta Minakami , Katsuki Egoh , Kohji Iwai , Keisuke Hatase

Background

Although the association between total anticholinergic burden (Total ACB) and rehabilitation outcomes following hip fracture (HF) surgery has been suggested, the specific impact of Total ACB on gait performance remains uncertain. This study aimed to investigate the relationship between Total ACB and gait performance at hospital discharge.

Methods

This retrospective cohort study included 273 patients with HFs (median age: 87 [interquartile range (IQR): 80–91], 78.8 % female) admitted to a 320-bed acute care hospital between April 2017 and August 2023. The primary outcome was gait performance at discharge, evaluated using the Functional Ambulation Categories (FAC), with FAC ≤2 defined as requiring physical assistance. Total ACB was assessed using the Japanese Anticholinergic Risk Scale. Multivariable logistic regression and receiver operating characteristic (ROC) analyses were conducted to estimate associations and quantify discrimination.

Results

Total ACB was significantly associated with limited gait performance at discharge (FAC ≤2) after adjustment for predefined covariates, and the association remained in sensitivity analyses. ROC analysis showed modest discrimination, with the highest discrimination in the 75–84 age group.

Conclusions

Higher Total ACB was associated with a greater likelihood of requiring physical assistance for walking at discharge after HF surgery. Given the modest overall discrimination, these findings are hypothesis-generating. An age-stratified analysis suggested higher discrimination in those aged 75–84 years, but this subgroup result is exploratory and not part of the primary conclusion. We did not evaluate whether deprescribing or modifying anticholinergic therapy improves gait outcomes; external validation and interventional studies are needed before clinical implementation.

虽然总抗胆碱能负荷（total anti - cholinergic burden， ACB）与髋部骨折（HF）手术后康复结果之间存在关联，但总抗胆碱能负荷对步态表现的具体影响仍不确定。本研究旨在探讨总ACB与出院时步态表现的关系。方法本回顾性队列研究纳入273例HFs患者（中位年龄：87岁[四分位数间距（IQR）： 80-91]， 78.8%为女性），于2017年4月至2023年8月在一家拥有320张床位的急诊科医院就诊。主要终点是出院时的步态表现，使用功能行走分类（FAC）进行评估，FAC≤2定义为需要身体辅助。总ACB采用日本抗胆碱能风险量表评估。采用多变量logistic回归和受试者工作特征（ROC）分析来估计相关性和量化歧视。结果调整预定义协变量后，总ACB与出院时受限步态表现（FAC≤2）显著相关，且在敏感性分析中仍存在相关性。ROC分析显示适度歧视，75-84岁年龄组歧视程度最高。结论：HF术后出院时，总ACB越高，需要肢体辅助行走的可能性越大。考虑到适度的总体歧视，这些发现是假设产生的。一项年龄分层分析显示，75-84岁人群的歧视程度更高，但这一亚组结果是探索性的，并非主要结论的一部分。我们没有评估是否减少或改变抗胆碱能治疗改善步态结果；临床应用前需要外部验证和介入研究。

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引用次数: 0

The moderating effect of health status and physical problems on the relationship between life satisfaction and psychological resilience in older adults: An examination by age groups 健康状况和身体问题对老年人生活满意度与心理弹性关系的调节作用：一项不同年龄组的检验

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-10-10 DOI: 10.1016/j.aggp.2025.100220

Zeynep Seray AKYOL, Dilek ŞİRVANLI ÖZEN, Burak Emre GÜRSOY

Objective

This study aims to examine the moderating effect of health status and physical problems on the relationship between life satisfaction and psychological resilience in older adults, considering different age groups. In this context, it investigates how health status and physical problems shape this relationship across various age groups.

Method

The research was conducted between 2023 and 2024 with 337 individuals aged 60 to 97 living in Turkey. During the data collection process, the Demographic Information Form, the Life Satisfaction Scale and the Brief Resilience Scale were used. Regression and moderation analyses were performed to assess the relationship between life satisfaction and psychological resilience, and the varying effects of health status and physical problems across different age groups were tested.

Results

Life satisfaction showed a significant association with psychological resilience. Moderation analyses showed that the effects of health status and physical problems on this relationship varied across age groups. It was found that the relationship between life satisfaction and psychological resilience was stronger in individuals with moderate and poor health status, while there was no significant relationship in individuals with very good health status. While this relationship was determined to be the strongest in the 71-80 age group, it varied at different levels in other age groups.

Conclusion

The findings indicate that health status and physical problems shape the relationship between life satisfaction and psychological resilience, and this effect varies across age groups. Life satisfaction was observed to have a stronger association with psychological resilience among individuals experiencing health problems. Accordingly, it is emphasized that interventions aimed at enhancing life satisfaction should be designed with sensitivity to age and health status.

目的探讨健康状况和身体问题在老年人生活满意度与心理弹性关系中的调节作用。在这种情况下，它调查了健康状况和身体问题如何影响不同年龄组的这种关系。该研究于2023年至2024年在土耳其进行，共有337名年龄在60至97岁之间的人。在数据收集过程中，使用了人口统计信息表、生活满意度量表和简要弹性量表。通过回归分析和调节分析评估了生活满意度与心理弹性之间的关系，并测试了不同年龄组健康状况和身体问题的不同影响。结果生活满意度与心理弹性呈显著相关。适度分析表明，健康状况和身体问题对这种关系的影响因年龄组而异。研究发现，生活满意度与心理弹性的关系在健康状况中、差的个体中较强，而在健康状况非常好的个体中无显著关系。虽然这种关系在71-80岁年龄组中最为明显，但在其他年龄组中也存在不同程度的差异。结论健康状况和身体问题决定了生活满意度与心理弹性之间的关系，且这种影响在不同年龄组之间存在差异。在经历健康问题的个体中，人们观察到生活满意度与心理弹性有更强的联系。因此，强调旨在提高生活满意度的干预措施的设计应考虑到年龄和健康状况。

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引用次数: 0

Trends in stroke mortality among older adults (≥65 years) with chronic kidney disease in the U.S. from 1999 to 2020 1999年至2020年美国老年（≥65岁）慢性肾病患者中风死亡率趋势

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-10-09 DOI: 10.1016/j.aggp.2025.100215

Muhammad Hasnain Azeem, Danish Hassan, Sahar Imtiaz, Abdullah Shahbaz, Inamullah Soomro, Syed Rayyan Ahmed, Sukoon Mehdi Raza, Safiullah Soomro, Sheikh Abdul Qadir Jillani

Background

The U.S. population is aging alongside rising rates of chronic kidney disease (CKD). However, trends in stroke-related mortality among adults with CKD, particularly those aged >65 years, remain under-explored nationally.

Objectives

To assess temporal and regional trends in stroke-related mortality among older U.S. adults with CKD.

Methods

Mortality data from the CDC WONDER database were analyzed from 1999 to 2020 for stroke-related deaths in adults with CKD aged >65 years. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated and stratified by year, sex, race/ethnicity, and geographic region.

Results

Between 1999 and 2020, 115935 stroke-related deaths occurred among adults with CKD aged >65 years. The AAMR declined from 14.4 in 1999 to 14.3 in 2020, with fluctuating trends throughout the period. Similar patterns were observed across sexes. Black individuals had the highest AAMRs, followed by American Indians and Hispanics. Regional variation was substantial, with the highest AAMRs in the West (13.5), and the lowest in the Northeast (9.6). Rural areas had higher AAMRs (13.5) than urban areas (12.4). States in the top 90th percentile of stroke-related mortality had approximately double the AAMRs compared to those in the lowest 10th percentile.

Conclusions

Stroke-related mortality among older adults with CKD has fluctuated over time, with a recent upward trend since 2014. Disparities by race, region, and rurality persist. Targeted interventions are needed to reduce stroke mortality in this high-risk population.

美国人口正在老龄化，慢性肾脏疾病（CKD）的发病率也在上升。然而，在全国范围内，CKD成年患者，特别是65岁以上的患者，中风相关死亡率的趋势仍未得到充分研究。目的评估美国老年CKD患者卒中相关死亡率的时间和地区趋势。方法分析1999年至2020年CDC WONDER数据库中65岁CKD成人卒中相关死亡数据。计算每10万人的年龄调整死亡率（AAMRs）和年变化百分比（APC），并按年份、性别、种族/民族和地理区域进行分层。结果1999年至2020年间，65岁成人CKD患者中发生115935例卒中相关死亡。平均死亡率从1999年的14.4下降到2020年的14.3，在整个期间呈波动趋势。在两性之间也观察到类似的模式。黑人的aamr最高，其次是美洲印第安人和西班牙人。区域差异较大，西部aamr最高（13.5），东北最低（9.6）。农村aamr（13.5）高于城市（12.4）。在中风相关死亡率最高的90个百分位数的州，其aamr大约是最低的10个百分位数的两倍。老年CKD患者卒中相关死亡率随时间波动，自2014年以来呈上升趋势。种族、地区和农村之间的差异依然存在。需要有针对性的干预措施来降低这一高危人群的卒中死亡率。

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引用次数: 0

Depression and chronic diseases among older adults: The moderating role of smoking 老年人的抑郁和慢性病：吸烟的调节作用

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-10-08 DOI: 10.1016/j.aggp.2025.100219

Yong Kang Cheah , Sharifah Nazeera Syed Anera , Mohd Azahadi Omar , Noor Hazilah Abd Manaf , Zera Zuryana Idris

Depression and chronic diseases often coexist. They possess negative impacts on health outcomes among older adults. The present study explores the associations between depression and chronic diseases, as well as the moderating role of smoking within a large sample of older adults. Cross-sectional data from the Malaysian National Health and Morbidity Survey 2018 were utilised. Probit models were used to assess parameters influencing the probability of experiencing depression. The moderating effect of smoking was examined by adding diabetes-smoking and hypertension-smoking interaction terms to the regression models. Results showed that older adults with diabetes and hypertension were more likely to experience depression compared to their non-diabetic and non-hypertensive counterparts. While smoking was not independently associated with depression, it moderated the relationship between diabetes and depression. However, the hypertension-depression relationship was not moderated by smoking. Other factors that were correlated with depression included gender, ethnicity, marital status, education, income, physical activity and body mass index (BMI). In conclusion, smoking played an important role in strengthening the relationship between depression and diabetes. Anti-depression policies should give particular consideration to diabetic older adults who smoked tobacco. Interventions to reduce the prevalence of depression should also take account of older adults’ demographic traits and lifestyles.

抑郁症和慢性病常常并存。它们对老年人的健康结果有负面影响。目前的研究探讨了抑郁症和慢性疾病之间的联系，以及吸烟在老年人中起到的调节作用。使用了2018年马来西亚国家健康和发病率调查的横断面数据。Probit模型用于评估影响抑郁发生概率的参数。通过在回归模型中加入糖尿病-吸烟和高血压-吸烟的相互作用项来检验吸烟的调节作用。结果显示，与非糖尿病和非高血压的老年人相比，患有糖尿病和高血压的老年人更容易患抑郁症。虽然吸烟与抑郁症没有独立的联系，但它缓和了糖尿病和抑郁症之间的关系。然而，吸烟并没有缓和高血压与抑郁的关系。与抑郁症相关的其他因素包括性别、种族、婚姻状况、教育程度、收入、体育活动和身体质量指数（BMI）。总之，吸烟在加强抑郁症和糖尿病之间的关系方面发挥了重要作用。抗抑郁政策应特别考虑到吸烟的糖尿病老年人。减少抑郁症患病率的干预措施还应考虑到老年人的人口特征和生活方式。

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引用次数: 0

Measuring mobile device proficiency: a cross-sectional validation of the shortened japanese version of the mobile device proficiency questionnaire 移动设备熟练度的测量：移动设备熟练度问卷简写日文的横断面验证

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-10-08 DOI: 10.1016/j.aggp.2025.100221

Suguru Shimokihara , Hiroyuki Tanaka , Walter R. Boot , Yoshikazu Iwakura , Arisa Nishitani , Yuta Tanaka , Takayuki Tabira

Background

Mobile devices enhance the independence and quality of life of older adults by supporting communication, information access, and daily functioning. However, many older individuals struggle to effectively use such technologies. Accurate assessment of mobile device proficiency is essential for tailoring support and promoting digital inclusion in the aging population. Although the Japanese version of the Mobile Device Proficiency Questionnaire (MDPQ-J) has demonstrated strong validity, its 46-item format imposes a burden on respondents and limits its utility in field settings.

Objective

This study aimed to develop and validate shortened versions of the MDPQ-J using item response theory to provide efficient and psychometrically sound tools for assessing mobile device proficiency in older Japanese adults.

Methods

A total of 229 Japanese participants, including 108 older adults (aged >65years), completed the full 46-item MDPQ-J. Rasch analysis and item response theory were applied to evaluate dimensionality, item fit, and local independence.

Results

A reduction in the number of items in the MDPQ-J was appropriate, and two shortened versions were developed: MDPQ-J14 for the general population and MDPQ-J20OA for older adults. Items were selected based on model fit, local independence, and discrimination parameters. In MDPQ-J14, “Use video-messaging apps” showed the highest discrimination, whereas in MDPQ-J20OA, “Copy and paste text using the touchscreen” demonstrated the strongest item discrimination.

Conclusions

The MDPQ-J14 and MDPQ-J20OA are efficient, valid, and culturally appropriate tools for assessing mobile device proficiency. Their brevity and flexibility make them suitable for wide application in research, education, and gerontechnology interventions in aging societies.

移动设备通过支持通信、信息获取和日常功能，提高了老年人的独立性和生活质量。然而，许多老年人很难有效地使用这些技术。对移动设备熟练程度的准确评估对于在老龄化人口中提供量身定制的支持和促进数字包容至关重要。尽管日本版的移动设备熟练度问卷（MDPQ-J）已经证明了很强的有效性，但其46项的格式给受访者带来了负担，并限制了其在现场设置中的实用性。目的：本研究旨在利用项目反应理论开发和验证MDPQ-J的精简版本，为评估日本老年人的移动设备熟练程度提供有效和心理测量学上健全的工具。方法共有229名日本参与者，其中包括108名65岁的老年人，完成了完整的46项MDPQ-J。运用Rasch分析和项目反应理论评估维度、项目契合度和局部独立性。结果MDPQ-J量表的条目数量适当减少，并开发了两种精简版本：适用于普通人群的MDPQ-J14和适用于老年人的MDPQ-J20OA。根据模型拟合、局部独立性和判别参数选择项目。在MDPQ-J14中，“使用视频信息应用程序”的歧视程度最高，而在MDPQ-J20OA中，“使用触摸屏复制粘贴文本”的歧视程度最高。结论MDPQ-J14和MDPQ-J20OA是评估移动设备熟练程度的有效、有效和文化适宜的工具。它们的简洁性和灵活性使它们适合于在老龄化社会的研究、教育和老年技术干预中广泛应用。

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引用次数: 0