Pub Date : 2025-12-01Epub Date: 2025-10-09DOI: 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.
{"title":"Trends in stroke mortality among older adults (≥65 years) with chronic kidney disease in the U.S. from 1999 to 2020","authors":"Muhammad Hasnain Azeem, Danish Hassan, Sahar Imtiaz, Abdullah Shahbaz, Inamullah Soomro, Syed Rayyan Ahmed, Sukoon Mehdi Raza, Safiullah Soomro, Sheikh Abdul Qadir Jillani","doi":"10.1016/j.aggp.2025.100215","DOIUrl":"10.1016/j.aggp.2025.100215","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>To assess temporal and regional trends in stroke-related mortality among older U.S. adults with CKD.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 4","pages":"Article 100215"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265471","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}
The Coronavirus Disease 2019 (COVID-19) pandemic has severely affected physical activity (PA) and social activity (SA) in older adults. In Japan, both PA and SA were restricted during the pandemic, and both began to recover after 2021 based on changes in the social climate. This study aimed to explore the trajectories of PA and SA among older adults during the pandemic and post-COVID-19 periods with a five-year follow-up period from 2020 to 2025.
Methods
The study participants included 610 community-dwelling older adults from Japan’s urban prefectures who completed an annual online survey assessing PA and SA. PA was measured using the Short Form of the International Physical Activity Questionnaire, SA was evaluated using a social activity score. Changes in total PA duration and total SA scores from 2020 to 2025 were analyzed.
Results
By 2023, PA has recovered fully, with the total PA time returning to pre-pandemic levels. The frequency of shopping and health promotion activities also increased during this period. However, SA remained low until 2025, showing a slower recovery than that of PA. By 2025, participation in activities such as volunteer and hobby groups will return to pre-pandemic levels, while engagement in neighborhood associations, town events, and jobs will remain limited.
Conclusion
PA and SA significantly declined during the pandemic but showed a recovery trend post-2021. Although PA has fully recovered, SA remains partially restricted as of 2025, emphasizing the need for continuous efforts to promote social engagement among older adults in the post-COVID-19 era.
{"title":"Changes in physical and social activities during and a post-COVID-19: A five-year panel survey (2020–2025)","authors":"Minoru Yamada , Yusuke Terao , Iwao Kojima , Shu Tanaka , Hiroki Saegusa , Miho Nambu , Shiho Soma , Hiroki Matsumoto , Masaya Saito , Kohei Okawa , Naoto Haga , Hidenori Arai","doi":"10.1016/j.aggp.2025.100203","DOIUrl":"10.1016/j.aggp.2025.100203","url":null,"abstract":"<div><h3>Introduction</h3><div>The Coronavirus Disease 2019 (COVID-19) pandemic has severely affected physical activity (PA) and social activity (SA) in older adults. In Japan, both PA and SA were restricted during the pandemic, and both began to recover after 2021 based on changes in the social climate. This study aimed to explore the trajectories of PA and SA among older adults during the pandemic and post-COVID-19 periods with a five-year follow-up period from 2020 to 2025.</div></div><div><h3>Methods</h3><div>The study participants included 610 community-dwelling older adults from Japan’s urban prefectures who completed an annual online survey assessing PA and SA. PA was measured using the Short Form of the International Physical Activity Questionnaire, SA was evaluated using a social activity score. Changes in total PA duration and total SA scores from 2020 to 2025 were analyzed.</div></div><div><h3>Results</h3><div>By 2023, PA has recovered fully, with the total PA time returning to pre-pandemic levels. The frequency of shopping and health promotion activities also increased during this period. However, SA remained low until 2025, showing a slower recovery than that of PA. By 2025, participation in activities such as volunteer and hobby groups will return to pre-pandemic levels, while engagement in neighborhood associations, town events, and jobs will remain limited.</div></div><div><h3>Conclusion</h3><div>PA and SA significantly declined during the pandemic but showed a recovery trend post-2021. Although PA has fully recovered, SA remains partially restricted as of 2025, emphasizing the need for continuous efforts to promote social engagement among older adults in the post-COVID-19 era.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 4","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903529","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}
Pub Date : 2025-12-01Epub Date: 2025-10-02DOI: 10.1016/j.aggp.2025.100214
Suleman Shah , Rahman Syed , Ameer Afzal Khan , Anfal Khan , Mohsin Ali , Fazal Syed
Background and Aim
Dementia, including Alzheimer’s disease and related dementias (ADRD), is a major cause of death among older adults in the United States. However, limited data exist on how dementia-related mortality patterns vary across urban and rural settings. This study aimed to examine national trends in dementia-related mortality from 1999 to 2020, with a focus on geographic disparities and differences in place of death.
Methods
We analyzed mortality data from the CDC WONDER Multiple Cause of Death database for U.S. adults aged ≥65 years. Dementia-related deaths were identified using ICD-10 codes F01, F03, and G30. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Trends were assessed using joinpoint regression to estimate annual percent change (APC). Urbanization was classified using the 2013 NCHS Urban–Rural scheme. The place of death was examined by urban and rural residence.
Results
From 1999 to 2020, 6516,402 dementia-related deaths were recorded. The AAMR nearly doubled, increasing from 434.9 to 855.1 per 100,000. Females had higher AAMRs (from 444.5 to 905.9) than males (from 405.7 to 767.4). The steepest rise occurred in noncore rural counties (APC: 2.02 %; p < 0.001), while large central metropolitan areas showed slower growth (APC: 0.57 %). In rural areas, 61.8 % of dementia deaths occurred in nursing homes compared to 53.9 % in urban areas. Hospice facility deaths were less common in rural regions (2.1 % vs. 4.6 %), and home deaths were slightly lower (15.0 % vs. 18.6 %). Disparities persisted across age and racial/ethnic groups, with the oldest-old (≥85) and rural Black and White adults bearing the greatest burden.
Conclusion
Dementia-related mortality has increased significantly over two decades, with disproportionately higher rates and institutional deaths in rural communities. These findings call for targeted interventions to reduce geographic disparities in dementia care and end-of-life services.
{"title":"Urban–rural disparities in dementia-related mortality among older adults in the U.S. from 1999 to 2020","authors":"Suleman Shah , Rahman Syed , Ameer Afzal Khan , Anfal Khan , Mohsin Ali , Fazal Syed","doi":"10.1016/j.aggp.2025.100214","DOIUrl":"10.1016/j.aggp.2025.100214","url":null,"abstract":"<div><h3>Background and Aim</h3><div>Dementia, including Alzheimer’s disease and related dementias (ADRD), is a major cause of death among older adults in the United States. However, limited data exist on how dementia-related mortality patterns vary across urban and rural settings. This study aimed to examine national trends in dementia-related mortality from 1999 to 2020, with a focus on geographic disparities and differences in place of death.</div></div><div><h3>Methods</h3><div>We analyzed mortality data from the CDC WONDER Multiple Cause of Death database for U.S. adults aged ≥65 years. Dementia-related deaths were identified using ICD-10 codes F01, F03, and G30. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Trends were assessed using joinpoint regression to estimate annual percent change (APC). Urbanization was classified using the 2013 NCHS Urban–Rural scheme. The place of death was examined by urban and rural residence.</div></div><div><h3>Results</h3><div>From 1999 to 2020, 6516,402 dementia-related deaths were recorded. The AAMR nearly doubled, increasing from 434.9 to 855.1 per 100,000. Females had higher AAMRs (from 444.5 to 905.9) than males (from 405.7 to 767.4). The steepest rise occurred in noncore rural counties (APC: 2.02 %; <em>p</em> < 0.001), while large central metropolitan areas showed slower growth (APC: 0.57 %). In rural areas, 61.8 % of dementia deaths occurred in nursing homes compared to 53.9 % in urban areas. Hospice facility deaths were less common in rural regions (2.1 % vs. 4.6 %), and home deaths were slightly lower (15.0 % vs. 18.6 %). Disparities persisted across age and racial/ethnic groups, with the oldest-old (≥85) and rural Black and White adults bearing the greatest burden.</div></div><div><h3>Conclusion</h3><div>Dementia-related mortality has increased significantly over two decades, with disproportionately higher rates and institutional deaths in rural communities. These findings call for targeted interventions to reduce geographic disparities in dementia care and end-of-life services.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 4","pages":"Article 100214"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265353","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}
Pub Date : 2025-12-01Epub Date: 2025-08-24DOI: 10.1016/j.aggp.2025.100202
Oluranti Omolara Babalola , Adebobola Imeh-Nathaniel , Emmanuel I Nathaniel , Samuel I Nathaniel , Richard L. Goodwin , Laurie Theriot Roley , Ohmar Win , Thomas I. Nathaniel
Objective
This study aimed to examine the relationship between sociodemographic factors, psychotropic medication, and Alzheimer’s Dementia (AD) in patients with a history of Normal Pressure Hydrocephalus (ADNPH) and Mild Cognitive Impairment (ADMCI) and how it varies by sex, using the Social Determinants of Health (SDH) model.
Method
The study analyzed 33,735 patients who presented with ADMCI (n = 33,064) or ADNPH (n = 671) between February 2016 and August 2021 at Prisma Health-Upstate. Multivariable logistic regression identified key factors associated with ADNPH and ADMCI, including age, race, and medication use.
Results
African Americans (OR = 0.388, 95 % CI: 0.277–0.542), individuals with a history of tobacco use (OR = 1.175, 95 % CI: 1.004–1.375), and those treated with buspirone (OR = 1.415, 95 % CI: 1.116–1.794) were associated with ADNPH, whereas treatment with risperidone (OR = 0.217, 95 % CI: 0.103–0.459) was linked to ADMCI. In sex-stratified analyses, males with ADNPH were more likely to report a history of tobacco use (OR = 1.818, 95 % CI: 1.370–2.411, p < 0.001) and treated with citalopram (OR = 2.102, 95 % CI: 1.561–2.831, p < 0.001). Males with ADMCI were more frequently African Americans (OR = 0.312, 95 % CI: 0.174–0.559, p < 0.001) and reported alcohol use (OR = 0.685, 95 % CI: 0.531–0.885, p = 0.004). Among females, ADNPH were associated with alcohol use (OR = 1.684, 95 % CI: 1.359–2.087, p < 0.001) and treated with aripiprazole (OR = 1.690, 95 % CI: 1.163–2.458, p = 0.006) or memantine (OR = 1.752, 95 % CI: 1.283–2.392, p < 0.001). Females with ADMCI were African Americans (OR = 0.470, 95 % CI: 0.311–0.710, p < 0.001) and treated with donepezil (OR = 0.552, 95 % CI: 0.399–0.765, p < 0.001) or risperidone (OR = 0.046, 95 % CI: 0.006–0.330, p = 0.002).
Conclusion
Our findings highlight the need for targeted interventions that address social factors, psychotropic medication access, and disparities in healthcare to improve outcomes for patients with NPH and MCI.
{"title":"Sociodemographic factors and psychotropic medication use among Alzheimer’s dementia patients diagnosed with normal pressure hydrocephalus and mild cognitive impairment: Sex variation in a retrospective cohort analysis","authors":"Oluranti Omolara Babalola , Adebobola Imeh-Nathaniel , Emmanuel I Nathaniel , Samuel I Nathaniel , Richard L. Goodwin , Laurie Theriot Roley , Ohmar Win , Thomas I. Nathaniel","doi":"10.1016/j.aggp.2025.100202","DOIUrl":"10.1016/j.aggp.2025.100202","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to examine the relationship between sociodemographic factors, psychotropic medication, and Alzheimer’s Dementia (AD) in patients with a history of Normal Pressure Hydrocephalus (ADNPH) and Mild Cognitive Impairment (ADMCI) and how it varies by sex, using the Social Determinants of Health (SDH) model.</div></div><div><h3>Method</h3><div>The study analyzed 33,735 patients who presented with ADMCI (<em>n</em> = 33,064) or ADNPH (<em>n</em> = 671) between February 2016 and August 2021 at Prisma Health-Upstate. Multivariable logistic regression identified key factors associated with ADNPH and ADMCI, including age, race, and medication use.</div></div><div><h3>Results</h3><div>African Americans (OR = 0.388, 95 % CI: 0.277–0.542), individuals with a history of tobacco use (OR = 1.175, 95 % CI: 1.004–1.375), and those treated with buspirone (OR = 1.415, 95 % CI: 1.116–1.794) were associated with ADNPH, whereas treatment with risperidone (OR = 0.217, 95 % CI: 0.103–0.459) was linked to ADMCI. In sex-stratified analyses, males with ADNPH were more likely to report a history of tobacco use (OR = 1.818, 95 % CI: 1.370–2.411, <em>p</em> < 0.001) and treated with citalopram (OR = 2.102, 95 % CI: 1.561–2.831, <em>p</em> < 0.001). Males with ADMCI were more frequently African Americans (OR = 0.312, 95 % CI: 0.174–0.559, <em>p</em> < 0.001) and reported alcohol use (OR = 0.685, 95 % CI: 0.531–0.885, <em>p</em> = 0.004). Among females, ADNPH were associated with alcohol use (OR = 1.684, 95 % CI: 1.359–2.087, <em>p</em> < 0.001) and treated with aripiprazole (OR = 1.690, 95 % CI: 1.163–2.458, <em>p</em> = 0.006) or memantine (OR = 1.752, 95 % CI: 1.283–2.392, <em>p</em> < 0.001). Females with ADMCI were African Americans (OR = 0.470, 95 % CI: 0.311–0.710, <em>p</em> < 0.001) and treated with donepezil (OR = 0.552, 95 % CI: 0.399–0.765, <em>p</em> < 0.001) or risperidone (OR = 0.046, 95 % CI: 0.006–0.330, <em>p</em> = 0.002).</div></div><div><h3>Conclusion</h3><div>Our findings highlight the need for targeted interventions that address social factors, psychotropic medication access, and disparities in healthcare to improve outcomes for patients with NPH and MCI.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 4","pages":"Article 100202"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903528","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}
Pub Date : 2025-12-01Epub Date: 2025-08-13DOI: 10.1016/j.aggp.2025.100199
Sara Uboldi , Lorenza Iannacci , Vanda Menon , Alessandro Bortolotti , Giulia Candeloro , Alessandro Crociata , Valeria Pica , Angelo Romagnoli , Maria Tartari , Andrea Fabbo , Alessandra Marasco , Pier Luigi Sacco
Introduction
The global rise in dementia prevalence necessitates innovative non-pharmacological interventions to enhance cognitive function and the quality of life of affected individuals. This pilot study evaluates the "Archives and Health" program, a creative arts-based initiative that uses archival materials to facilitate reminiscence therapy for individuals with dementia.
Methods
This mixed-methods study involved a total of 50 participants (aged 65-94), divided into three different activities, with varying levels of cognitive impairment, recruited from different care settings. The program featured three interventions: "Memory Box," "My Memory Box," and the "Pre-Texts Protocol," incorporating music to enhance personal engagement. Quantitative emotional well-being was assessed using the RADAR toolkit, while qualitative insights were derived from focus groups, interviews, and ethnographic observations
Results
The "My Memory Box" intervention led to a significant decrease in negative affect (Mean pre = 8.73, Mean post = 7.00, p = 0.007) without altering positive affect. Conversely, the "Pre-Texts Protocol" exhibited consistent increases in positive affect across sessions (p-values ranging from 0.0001 to 0.0023). Qualitative analyses indicated that the program effectively activated autobiographical memories, improved social interactions, and fostered emotional resonance through multisensory engagement, particularly via music. Participants expressed enhanced social connectivity and personal relevance during activities.
The results should be considered preliminary also in light of the mixed qualitative design evaluation, specifically chosen and studied by the researchers as a methodological reflection on the development of mixed qualitative methodologies.
Discussion
The "Archives and Health" program demonstrated potential in improving emotional and social well-being among individuals with dementia. Its ability to evoke positive emotional responses and decrease negative states indicates the utility of archival materials and creative engagement in therapeutic contexts. Future studies with larger samples are necessary to confirm these findings and explore their clinical implications more robustly.
{"title":"Archives and Health program for dementia: A pilot study of a non-pharmacological creative arts-based intervention protocol","authors":"Sara Uboldi , Lorenza Iannacci , Vanda Menon , Alessandro Bortolotti , Giulia Candeloro , Alessandro Crociata , Valeria Pica , Angelo Romagnoli , Maria Tartari , Andrea Fabbo , Alessandra Marasco , Pier Luigi Sacco","doi":"10.1016/j.aggp.2025.100199","DOIUrl":"10.1016/j.aggp.2025.100199","url":null,"abstract":"<div><h3>Introduction</h3><div>The global rise in dementia prevalence necessitates innovative non-pharmacological interventions to enhance cognitive function and the quality of life of affected individuals. This pilot study evaluates the \"Archives and Health\" program, a creative arts-based initiative that uses archival materials to facilitate reminiscence therapy for individuals with dementia.</div></div><div><h3>Methods</h3><div>This mixed-methods study involved a total of 50 participants (aged 65-94), divided into three different activities, with varying levels of cognitive impairment, recruited from different care settings. The program featured three interventions: \"Memory Box,\" \"My Memory Box,\" and the \"Pre-Texts Protocol,\" incorporating music to enhance personal engagement. Quantitative emotional well-being was assessed using the RADAR toolkit, while qualitative insights were derived from focus groups, interviews, and ethnographic observations</div></div><div><h3>Results</h3><div>The \"My Memory Box\" intervention led to a significant decrease in negative affect (Mean pre = 8.73, Mean post = 7.00, p = 0.007) without altering positive affect. Conversely, the \"Pre-Texts Protocol\" exhibited consistent increases in positive affect across sessions (p-values ranging from 0.0001 to 0.0023). Qualitative analyses indicated that the program effectively activated autobiographical memories, improved social interactions, and fostered emotional resonance through multisensory engagement, particularly via music. Participants expressed enhanced social connectivity and personal relevance during activities.</div><div>The results should be considered preliminary also in light of the mixed qualitative design evaluation, specifically chosen and studied by the researchers as a methodological reflection on the development of mixed qualitative methodologies.</div></div><div><h3>Discussion</h3><div>The \"Archives and Health\" program demonstrated potential in improving emotional and social well-being among individuals with dementia. Its ability to evoke positive emotional responses and decrease negative states indicates the utility of archival materials and creative engagement in therapeutic contexts. Future studies with larger samples are necessary to confirm these findings and explore their clinical implications more robustly.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 4","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878830","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}
Pub Date : 2025-12-01Epub Date: 2025-10-02DOI: 10.1016/j.aggp.2025.100216
Muhammad Faisal Iqbal , Rayyan Nabi , Shahreena Athar Siddiqui , Marhaba Fatima , Muzamil Akhtar , Muhammad Ahmed , Saqib Jan Shah , Saadullah Khalid , Tabeer Zahid , Ali Hasan , Raheel Ahmed
Background
Hip fractures and cardiovascular disease (CVD) represent major, interrelated health burdens among older adults in the United States. This study characterizes national trends in CVD‐related mortality among individuals aged ≥ 65 years with hip fractures from 1999 through 2019.
Methods
We conducted a cross‐sectional analysis of CDC WONDER mortality data, identifying deaths with CVD (ICD-10: I00–I99) recorded as the underlying cause and hip-fracture codes (S72.0–S72.9) listed as contributing causes. Crude and age‐adjusted mortality rates (AAMRs) per 100,000 population were calculated annually and standardized to the 2000 U.S. population. Joinpoint regression estimated annual percent changes (APCs) with 95 % confidence intervals (CIs). Trends were stratified by sex, race/ethnicity, metropolitan status, geographic region, and 10-year age groups.
Results
From 1999 to 2019, 214,992 CVD‐related deaths occurred in older adults with hip fractures. The overall AAMR declined from 29.99 in 1999 to 21.50 in 2013 (APC –2.72; 95 % CI, –3.97 to –2.43), followed by a nonsignificant decrease to 21.16 by 2019 (APC –0.52; 95 % CI, –1.27 to 0.81). Disparities in AAMR were seen among all variables with highest mortality rates observed among females, non-metropolitan areas and White individuals. Mortality increased markedly with age, up to 124.30 in those ≥ 85 years.
Conclusion
Although CVD-related mortality with hip fracture as a contributing cause has generally declined over two decades, substantial disparities persist by sex, race, geography, and age. Integrated, equity‐centered public health and clinical interventions targeting both cardiovascular and bone health are needed to further reduce preventable mortality in this vulnerable population.
{"title":"National trends in cardiovascular mortality with hip fracture as a contributing cause among older adults in the United States, 1999–2019","authors":"Muhammad Faisal Iqbal , Rayyan Nabi , Shahreena Athar Siddiqui , Marhaba Fatima , Muzamil Akhtar , Muhammad Ahmed , Saqib Jan Shah , Saadullah Khalid , Tabeer Zahid , Ali Hasan , Raheel Ahmed","doi":"10.1016/j.aggp.2025.100216","DOIUrl":"10.1016/j.aggp.2025.100216","url":null,"abstract":"<div><h3>Background</h3><div>Hip fractures and cardiovascular disease (CVD) represent major, interrelated health burdens among older adults in the United States. This study characterizes national trends in CVD‐related mortality among individuals aged ≥ 65 years with hip fractures from 1999 through 2019.</div></div><div><h3>Methods</h3><div>We conducted a cross‐sectional analysis of CDC WONDER mortality data, identifying deaths with CVD (ICD-10: I00–I99) recorded as the underlying cause and hip-fracture codes (S72.0–S72.9) listed as contributing causes. Crude and age‐adjusted mortality rates (AAMRs) per 100,000 population were calculated annually and standardized to the 2000 U.S. population. Joinpoint regression estimated annual percent changes (APCs) with 95 % confidence intervals (CIs). Trends were stratified by sex, race/ethnicity, metropolitan status, geographic region, and 10-year age groups.</div></div><div><h3>Results</h3><div>From 1999 to 2019, 214,992 CVD‐related deaths occurred in older adults with hip fractures. The overall AAMR declined from 29.99 in 1999 to 21.50 in 2013 (APC –2.72; 95 % CI, –3.97 to –2.43), followed by a nonsignificant decrease to 21.16 by 2019 (APC –0.52; 95 % CI, –1.27 to 0.81). Disparities in AAMR were seen among all variables with highest mortality rates observed among females, non-metropolitan areas and White individuals. Mortality increased markedly with age, up to 124.30 in those ≥ 85 years.</div></div><div><h3>Conclusion</h3><div>Although CVD-related mortality with hip fracture as a contributing cause has generally declined over two decades, substantial disparities persist by sex, race, geography, and age. Integrated, equity‐centered public health and clinical interventions targeting both cardiovascular and bone health are needed to further reduce preventable mortality in this vulnerable population.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 4","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265472","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}
Pub Date : 2025-12-01Epub Date: 2025-10-15DOI: 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.
{"title":"New advances in the study of postmenopausal osteoporosis and arteriosclerosis: Exploration of metabolite changes and their mechanisms","authors":"Yang Lei , Li Misi , Chen Xiaoyun , An Yangxin , Hu Xueqin , Li Weijuan","doi":"10.1016/j.aggp.2025.100222","DOIUrl":"10.1016/j.aggp.2025.100222","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 4","pages":"Article 100222"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362595","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}
Pub Date : 2025-12-01Epub Date: 2025-11-11DOI: 10.1016/j.aggp.2025.100226
Madhusmita Tipiria M.A. , Ujjwal Das Ph.D.
Background
Hypertension is one of the major causes of premature death and one of the leading risk factors for multi-morbidity. Multi-morbidity with hypertension is more prevalent in older adults as compare to younger people. This study aims to assess the prevalence and risk factors of multi-morbidity among older adults with hypertension in India.
Methods
The study using the data from the Longitudinal Ageing Study in India (LASI) conducted in 2017-18. Multi-nominal regression models were used to examine the association between multi-morbidity and various socio-demographic factors among older adults with hypertension. Additionally, Structural Equation Model was employed to identify the direct effects of exogeneous factors on Multi-morbidity with Hypertension.
Results
The finding represents that the risk of multi-morbidity with hypertension is higher at the age of 75 and above (RRR= 8.23) as compared to young age people. The prevalence of multi-morbidity with hypertension increases with age, economic status, education. Gender difference indicates that females had 39 % lower risk of multimorbidity than males. SEM result shows that among all the exogenous factor age, social group, education and MPCE of the respondent showed the highest direct effect on multi-morbidity with hypertension. The prevalence of multi-morbidity with Hypertension is higher in the state Punjab (41.92 %) and followed by Jammu & Kashmir, and the lower prevalence of multi-morbidity with Hypertension in the state Nagaland (12.57 %).
Conclusion
This research provides valuable insights into the healthcare needs of older adults with hypertension and inform policy interventions for better management of chronic diseases in aging populations.
{"title":"Coexisting morbidities among older adults with hypertension in India: Prevalence and risk analysis","authors":"Madhusmita Tipiria M.A. , Ujjwal Das Ph.D.","doi":"10.1016/j.aggp.2025.100226","DOIUrl":"10.1016/j.aggp.2025.100226","url":null,"abstract":"<div><h3>Background</h3><div>Hypertension is one of the major causes of premature death and one of the leading risk factors for multi-morbidity. Multi-morbidity with hypertension is more prevalent in older adults as compare to younger people. This study aims to assess the prevalence and risk factors of multi-morbidity among older adults with hypertension in India.</div></div><div><h3>Methods</h3><div>The study using the data from the Longitudinal Ageing Study in India (LASI) conducted in 2017-18. Multi-nominal regression models were used to examine the association between multi-morbidity and various socio-demographic factors among older adults with hypertension. Additionally, Structural Equation Model was employed to identify the direct effects of exogeneous factors on Multi-morbidity with Hypertension.</div></div><div><h3>Results</h3><div>The finding represents that the risk of multi-morbidity with hypertension is higher at the age of 75 and above (RRR= 8.23) as compared to young age people. The prevalence of multi-morbidity with hypertension increases with age, economic status, education. Gender difference indicates that females had 39 % lower risk of multimorbidity than males. SEM result shows that among all the exogenous factor age, social group, education and MPCE of the respondent showed the highest direct effect on multi-morbidity with hypertension. The prevalence of multi-morbidity with Hypertension is higher in the state Punjab (41.92 %) and followed by Jammu & Kashmir, and the lower prevalence of multi-morbidity with Hypertension in the state Nagaland (12.57 %).</div></div><div><h3>Conclusion</h3><div>This research provides valuable insights into the healthcare needs of older adults with hypertension and inform policy interventions for better management of chronic diseases in aging populations.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 4","pages":"Article 100226"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617721","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}
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.
{"title":"Social frailty reflected by housebound status as an independent predictor of self-reported incidence fracture in community-dwelling older adults: A longitudinal cohort study","authors":"Hiromi Matsumoto , Chika Tanimura , Yuki Kitsuda , Takashi Wada , Shinji Tanishima , Hiroshi Hagino","doi":"10.1016/j.aggp.2025.100229","DOIUrl":"10.1016/j.aggp.2025.100229","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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, <em>housebound</em> (HR = 2.436, 95 % CI: 1.125–5.271) remained significantly associated with fracture incidence.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 4","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571450","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}
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。
{"title":"Association between gait performance at discharge and total anticholinergic burden in elderly patients after hip fracture surgery: A single-center retrospective cohort study","authors":"Daisuke Komiya , Hirofumi Takeya , Kenta Minakami , Katsuki Egoh , Kohji Iwai , Keisuke Hatase","doi":"10.1016/j.aggp.2025.100223","DOIUrl":"10.1016/j.aggp.2025.100223","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 4","pages":"Article 100223"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320795","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号