Archives of Gerontology and Geriatrics Plus最新文献_第7页

Thyroid-stimulating hormone and cognitive impairment in non-depressed non-demented multiethnic middle-aged and older US adults: Assessing sex-specific risk prediction 促甲状腺激素和非抑郁非痴呆多种族美国中老年成人的认知障碍：评估性别特异性风险预测

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-08-06 DOI: 10.1016/j.aggp.2025.100195

Asma Hallab , Alzheimer’s Disease Neuroimaging Initiative

Background

Understanding the particularities of thyroid-cognition interactions in older adults is crucial in assessing the risks and evaluating therapeutic options.

Methods

Cross-sectional analyses where participants from Alzheimer’s Disease Neuroimaging Initiative (ADNI) with mild cognitive impairment (MCI) and healthy controls (HC), with complete neurocognitive tests, thyroid stimulating hormone (TSH) <10 µIU/mL, and geriatric depression scale (GDS) <5, were eligible. Linear and logistic regression models, including testing for non-linearity, were performed. Sex strata were explored.

Results

Of the total 1845 multiethnic US-participants, with a median age of 73 (IQR: 68, 78); 887 (48 %) were females, and 1056 (57 %) had MCI. The median TSH level was 1.70 µIU/mL (IQR: 1.15, 2.40); significantly lower in MCI than HC (1.66 vs. 1.74 µIU/mL, p-value=0.02). There was a significant association between TSH and overall cognition only in males (adj. ß_Males=-0.40[-0.74, -0.07], p-value=0.019). The odds of being diagnosed with MCI at baseline decreased with higher TSH levels in the total study population (adj. OR_Total=0.87[0.79, 0.95], p-value=0.002) and in males (adj. OR_Males=0.80[0.70, 0.92], p-value=0.001).

Conclusions

There was a sex-specific, statistically significant association between TSH levels and cognition in multiethnic middle-aged and older ADNI adults. Lower TSH levels and worse global cognition were statistically associated only in males. To precisely delineate the chronological onset of these disorders, longitudinal clinical studies are needed.

背景了解老年人甲状腺认知相互作用的特殊性对于评估风险和评估治疗方案至关重要。方法采用横断面分析，来自阿尔茨海默病神经影像学计划（ADNI）的轻度认知障碍（MCI）和健康对照（HC）的参与者，进行完整的神经认知测试，促甲状腺激素（TSH） 10 μ IU/mL，老年抑郁量表（GDS） 5。进行了线性和逻辑回归模型，包括非线性检验。对性别阶层进行了探索。结果在总共1845名多种族美国参与者中，中位年龄为73岁（IQR: 68,78）；887例（48%）为女性，1056例（57%）为轻度认知障碍。中位TSH水平为1.70 μ IU/mL (IQR: 1.15, 2.40)；MCI显著低于HC （1.66 vs. 1.74 μ IU/mL， p值=0.02）。TSH与整体认知的相关性仅在男性中存在显著性差异（adi . ß male =-0.40[-0.74, -0.07]， p值=0.019）。随着TSH水平的升高，总体研究人群（adj. ORTotal=0.87[0.79, 0.95]， p值=0.002）和男性（adj. ormale =0.80[0.70, 0.92]， p值=0.001）在基线时被诊断为轻度认知障碍的几率降低。结论多种族中老年ADNI成人TSH水平与认知之间存在性别特异性、统计学意义显著的关联。较低的TSH水平和较差的整体认知仅在男性中有统计学关联。为了准确地描述这些疾病的发病时间，需要进行纵向临床研究。

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引用次数: 0

Coronary heart disease racial disparities among older adults in the U.S.: Systematic review, 2000-2024 美国老年人冠心病的种族差异：2000-2024年的系统回顾

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-08-05 DOI: 10.1016/j.aggp.2025.100194

Sanggon Nam

Background

Coronary heart disease (CHD) remains a leading cause of morbidity and mortality among older U.S. adults, with significant racial and ethnic disparities in prevalence, treatment, and outcomes. This systematic review synthesizes evidence from 44 studies published between 2000 and 2024 to examine these disparities among adults aged ≥65, focusing on prevalence, access to care, treatment quality, outcomes, contributing factors, and effective interventions.

Methods

The review adhered to PRISMA 2020 guidelines. A comprehensive search was conducted across six databases: PubMed, Embase, Scopus, Web of Science, CINAHL, and the Cochrane Library. Studies were included if they examined racial/ethnic differences in CHD among U.S. adults aged ≥65. Two independent reviewers screened titles and abstracts, followed by full-text review, with disagreements resolved by a third reviewer. Inter-rater reliability was assessed using Cohen’s kappa (0.85 for title/abstract, 0.90 for full-text). Quality assessment used the Newcastle-Ottawa Scale (NOS; high quality ≥7 points, moderate 4–6 points, low ≤3 points) for observational studies and the Cochrane Risk of Bias tool for randomized trials. Due to heterogeneity, a narrative synthesis was conducted, with subgroup analyses for key outcomes.

Results

The 44 included studies revealed persistent disparities in CHD prevalence, access, treatment, and outcomes, particularly affecting Black, Hispanic, and American Indian/Alaska Native (AI/AN) older adults. Minority groups exhibited higher CHD prevalence and risk factors (e.g., hypertension, diabetes), lower access to guideline-directed therapies, and worse outcomes, including higher readmission and mortality rates. Structural racism, socioeconomic factors, and systemic biases were key drivers. Interventions like policy reforms, community-based programs, and telehealth showed promise in reducing disparities.

Conclusions

Despite progress in acute care, significant disparities persist in long-term CHD management among minority older adults. Addressing social determinants, improving access to equitable care, and implementing culturally competent interventions are essential for health equity.

背景冠心病（CHD）仍然是美国老年人发病和死亡的主要原因，在患病率、治疗和结局方面存在明显的种族和民族差异。本系统综述综合了2000年至2024年间发表的44项研究的证据，以检查65岁以上成年人的这些差异，重点关注患病率、获得护理、治疗质量、结果、影响因素和有效干预措施。方法遵循PRISMA 2020指南。在六个数据库中进行了全面的搜索：PubMed， Embase, Scopus, Web of Science， CINAHL和Cochrane图书馆。如果研究在年龄≥65岁的美国成年人中检查了冠心病的种族/民族差异，则纳入研究。两位独立审稿人筛选标题和摘要，然后进行全文审稿，分歧由第三位审稿人解决。评估者间信度采用Cohen’s kappa（标题/摘要0.85，全文0.90）。质量评估采用纽卡斯尔-渥太华量表(NOS；高质量≥7分，中等4-6分，低质量≤3分)的观察性研究和随机试验的Cochrane偏倚风险工具。由于异质性，我们进行了叙事综合，并对关键结果进行了亚组分析。结果纳入的44项研究揭示了冠心病患病率、可及性、治疗和结局方面的持续差异，特别是对黑人、西班牙裔和美国印第安人/阿拉斯加原住民（AI/AN）老年人的影响。少数群体表现出更高的冠心病患病率和危险因素（如高血压、糖尿病），更少获得指导治疗，结果更差，包括更高的再入院率和死亡率。结构性种族主义、社会经济因素和系统性偏见是主要驱动因素。政策改革、社区项目和远程医疗等干预措施有望减少差距。结论：尽管在急症护理方面取得了进展，但少数民族老年人长期冠心病管理方面仍存在显著差异。解决社会决定因素，改善获得公平保健的机会，并实施具有文化竞争力的干预措施，对卫生公平至关重要。

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引用次数: 0

Can targeted cognitive intervention improve rehabilitation outcome in hip fracture patients: a randomized controlled trial 有针对性的认知干预能否改善髋部骨折患者的康复结果：一项随机对照试验

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-07-30 DOI: 10.1016/j.aggp.2025.100193

Yedida Borow, Renata Efrati, Noa Doron, Michal Tzin, Yaara Ginsburg, Daniela Gesner, Avital Hershkovitz

Background

Hip fractures lead to disability, loss of independence, and a decline in quality of life. Rehabilitation success depends on various factors, such as, age, pre-fracture function, level of cognitive function, nutritional status, comorbidity, and family support. Most studies exploring the question of whether cognitive-based interventions can lead to functional improvement were conducted on community-dwelling elderly individuals with acquired brain injury, dementia, and cognitive impairments. Our aim was to compare targeted cognitive intervention with conventional occupational therapy in improving rehabilitation outcomes amongst post-acute hip fracture patients.

Methods

A randomized controlled single blinded study. Eighty patients were randomly assigned to two groups: group A (intervention) received targeted cognitive intervention, based on concepts from "The multi-context approach to cognitive rehabilitation of executive dysfunction" and group B (controls) received conventional occupational therapy. T-test and chi-square tests assessed significant differences between demographic, clinical, functional variables. ANOVA with repeated measures assessed significant improvement in cognitive/functional test scores in the two groups.

Results

43 patients were assigned to the intervention group; 37 to the controls. All patients significantly improved in their cognitive tests. No significant differences were found between the groups regarding discharge scores of the cognitive test, degree of cognitive improvement, functional outcomes and patient reported outcome measures questions.

Conclusions

Targeted cognitive intervention did not lead to a better outcome in hip fracture patients. As most were cognitively impaired, further research is warranted in order to explore whether different cognitive interventions might improve their rehabilitation outcomes.

背景：髋部骨折会导致残疾、丧失独立性和生活质量下降。康复成功取决于多种因素，如年龄、骨折前功能、认知功能水平、营养状况、合并症和家庭支持。大多数探索基于认知的干预是否能导致功能改善的研究都是针对社区居住的老年获得性脑损伤、痴呆和认知障碍患者进行的。我们的目的是比较有针对性的认知干预与传统的职业治疗在改善急性髋部骨折后患者康复结果方面的效果。方法采用随机对照单盲研究。80例患者随机分为两组：A组（干预组）根据“执行功能障碍认知康复的多情境方法”的概念进行有针对性的认知干预，B组（对照组）接受常规的职业治疗。t检验和卡方检验评估了人口学、临床和功能变量之间的显著差异。重复测量的方差分析评估了两组认知/功能测试分数的显著改善。结果43例患者分为干预组；37号去控制。所有患者的认知测试都有显著改善。在认知测试的出院分数、认知改善程度、功能结果和患者报告的结果测量问题方面，两组之间没有发现显著差异。结论有针对性的认知干预并不能改善髋部骨折患者的预后。由于大多数患者有认知障碍，因此需要进一步研究以探索不同的认知干预是否可以改善他们的康复结果。

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引用次数: 0

A UK study: Menopausal and perimenopausal women’s biopsychosocial experiences, understanding of treatment options, and thoughts towards their future lives 英国的一项研究：绝经期和围绝经期妇女的生物心理社会经历，对治疗方案的理解，以及对未来生活的看法

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-07-27 DOI: 10.1016/j.aggp.2025.100191

Mandy Simpson, Cynthia Tuuli, Elizabeth Eate

Objective

This study aimed to draw attention and give voice to women’s experiences, knowledge, future thoughts and general understanding of perimenopause and menopause, exploring this natural event holistically through a biopsychosocial lens.

Methods

One focus group of four self-identified perimenopausal or menopausal women was conducted to gather data. Purposive sampling was used to recruit the participants through a social media campaign. Interpretative Phenomenological Analysis provided a framework to study this important topic through exploring and examining lived experiences in a small group sample size, using the framework’s seven-step data analysis to identify key themes within the data.

Results

Four main group experiential themes were highlighted through analysis of the participants' responses: (1) onset and impact of symptoms, (2) menopause and relationships, (3) the knowledge gap, and (4) future thoughts: a desire for change. A prominent overarching theme involved the participants showing less concern for how they were being personally affected by their climacteric experience but demonstrating greater concern for the impact of their perimenopause or menopause experience upon others. This overarching theme was evident within all four group experiential themes.

Conclusions

The participants were deeply concerned about how their symptoms affected others. They had limited knowledge when their own symptoms started, but after seeking support, particularly from people with lived experiences rather than academic literature, they became inspired to be a part of bringing about change for the next generation, so that in the future menopause experiences would not occur so unexpectedly for others.

目的探讨女性对围绝经期和绝经期的经历、认识、未来思考和总体认识，并从生物心理社会的角度对这一自然事件进行全面探讨。方法对4名自我认定为围绝经期或绝经期妇女进行焦点小组调查，收集资料。有目的的抽样是通过社交媒体活动来招募参与者。解释性现象学分析提供了一个框架，通过在小样本中探索和检查生活经验来研究这一重要主题，使用该框架的七步数据分析来确定数据中的关键主题。结果通过对参与者反应的分析，突出了四个主要的小组体验主题：(1)症状的发生和影响，(2)更年期和关系，(3)知识差距，(4)未来的想法：改变的愿望。一个突出的总体主题是，参与者对自己的更年期经历如何影响个人表现出较少的关注，但对自己的围绝经期或更年期经历对他人的影响表现出更多的关注。这一总体主题在所有四组体验主题中都很明显。参与者非常关心他们的症状如何影响他人。当她们自己的症状开始出现时，她们的知识有限，但在寻求支持后，特别是从有实际经历的人那里寻求支持，而不是从学术文献中寻求支持，她们受到鼓舞，成为为下一代带来改变的一部分，这样在未来，更年期的经历就不会如此出乎意料地发生在其他人身上。

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引用次数: 0

Translating inflammaging: The bidirectional relationship between oral and systemic health in geriatric prosthodontics 翻译炎症：口腔和全身健康在老年口腔修复中的双向关系

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-07-26 DOI: 10.1016/j.aggp.2025.100192

Olga Naka, Panagiota Chatzidou, Katia Sarafidou, Vassiliki Anastassiadou

The aging population presents complex challenges to oral health, particularly due to inflammaging, a chronic, low-grade systemic inflammation linked to tissue degeneration and frailty syndrome. Despite its relevance, inflammaging remains underexplored in geriatric prosthodontics. This scoping review aimed to systematically examine and classify existing literature on oral-systemic inflammaging, with emphasis on diagnostic biomarkers, therapeutic strategies, and interdisciplinary integration. Bloom’s cognitive taxonomy was used to structure the evidence according to levels of complexity and clinical application. Following the PRISMA-ScR guidelines, 1686 records were screened across four databases (PubMed, Scopus, Web of Science, and Embase), and 49 studies met the inclusion criteria. The review employed a dual framework: the PICO model for clinical relevance and Bloom’s instructional taxonomy to categorize evidence from recall-level biological markers to higher-order insights, such as senotherapeutics, multi-omics diagnostics, and digital integration. Findings highlighted strong correlations between systemic inflammatory markers and oral aging conditions. Novel interventions, including senolytics, mTOR inhibitors, and microbiome-targeted therapies, showed translational promise. However, gaps persist in standardized biomarker panels, long-term clinical trials, and integration of frailty metrics into prosthodontic care. In conclusion, inflammaging offers a compelling biological perspective for transitioning prosthodontic strategies from mechanical approaches to precision-based methodologies. Integrating concepts including geroscience, salivary diagnostics, and personalized biomaterials can enhance outcomes and resilience in older adults. Future research should prioritize biologically informed protocols, interdisciplinary collaboration, and AI-supported predictive tools to align prosthodontics with the broader goals of healthy aging.

人口老龄化给口腔健康带来了复杂的挑战，特别是由于炎症，一种与组织变性和虚弱综合征相关的慢性、低度全身炎症。尽管炎症具有相关性，但在老年口腔修复学中仍未得到充分研究。本综述旨在系统地检查和分类现有的关于口腔全身炎症的文献，重点是诊断生物标志物、治疗策略和跨学科整合。布鲁姆的认知分类法被用来根据复杂程度和临床应用来构建证据。按照PRISMA-ScR指南，在四个数据库（PubMed、Scopus、Web of Science和Embase）中筛选了1686条记录，49项研究符合纳入标准。该综述采用了双重框架：临床相关性的PICO模型和Bloom的教学分类法，将证据从回忆水平的生物标记物分类到更高层次的见解，如老年治疗、多组学诊断和数字集成。研究结果强调了全身炎症标志物与口腔衰老状况之间的强烈相关性。新的干预措施，包括抗衰老药、mTOR抑制剂和微生物组靶向治疗，显示出了转化的希望。然而，在标准化的生物标志物面板、长期临床试验和将脆弱指标整合到修复护理中，差距仍然存在。总之，炎症为修复策略从机械方法过渡到基于精确的方法提供了令人信服的生物学观点。整合包括老年科学、唾液诊断和个性化生物材料在内的概念可以提高老年人的预后和恢复能力。未来的研究应优先考虑生物学知情协议、跨学科合作和人工智能支持的预测工具，以使修复学与健康老龄化的更广泛目标保持一致。

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引用次数: 0

Development and evaluation of a Protection Motivation Theory-based intervention to promote life planning and reduce ageism among younger people 基于保护动机理论的干预措施的发展与评价：促进年轻人的生活规划和减少年龄歧视

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-07-25 DOI: 10.1016/j.aggp.2025.100189

Yuho Shimizu

Previous studies have developed interventions aimed at simultaneously promoting long-term life planning and reducing ageism among younger individuals. Building on this work, the present study developed a novel intervention based on Protection Motivation Theory and evaluated its effectiveness in a sample of younger participants (N = 498). The intervention comprised the following components: a free-writing task addressing potential negative future events (to target threat appraisal), an explanatory text aimed at reducing ageism, a free-writing task designed to enhance hope for the future, and an explanatory text intended to strengthen the perception that life planning is both meaningful and achievable (to target coping appraisal). Following the intervention, participants demonstrated increased emphasis on life planning, stronger behavioral intentions regarding life planning, and greater hope for the future. Additionally, levels of ageism and aging anxiety significantly decreased. Given its effectiveness in enhancing a wide range of psychological and attitudinal outcomes, this intervention shows strong potential for implementation in educational settings targeting younger populations.

先前的研究已经开发出干预措施，旨在同时促进长期生活规划和减少年轻人中的年龄歧视。在这项工作的基础上，本研究开发了一种基于保护动机理论的新型干预措施，并评估了其在年轻参与者样本中的有效性（N = 498）。干预包括以下组成部分：解决潜在负面未来事件的自由写作任务（目标威胁评估），旨在减少年龄歧视的解释性文本，旨在增强对未来的希望的自由写作任务，以及旨在加强人生规划既有意义又可实现的认知的解释性文本（目标应对评估）。在干预之后，参与者表现出对生活规划的重视程度增加，对生活规划的行为意愿更强，对未来的希望更大。此外，年龄歧视和衰老焦虑的水平也显著下降。鉴于其在提高广泛的心理和态度结果方面的有效性，这种干预在针对年轻人群的教育环境中显示出强大的实施潜力。

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引用次数: 0

Association of non-exercise physical activity with sarcopenia compared with that of exercise habits among community-dwelling older adults: A 7-year follow-up from the Kashiwa Cohort Study 非运动性体育活动与社区老年人运动习惯与肌肉减少症的关系：来自Kashiwa队列研究的7年随访

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-07-25 DOI: 10.1016/j.aggp.2025.100188

Weida Lyu , Tomoki Tanaka , Bo-Kyung Son , Yasuyo Yoshizawa , Katsuya Iijima

Aim

This study investigated the relationship of moderate-to-vigorous-intensity non-exercise physical activity (NEPA) and exercise habits (EH) with sarcopenia in community-dwelling older adults.

Methods

A 7-year longitudinal analysis was conducted using data of 863 older adults from the Kashiwa Cohort Study in Japan, with baseline assessment in 2014 and follow-up in 2016, 2018, and 2021. Sarcopenia was assessed using the Asian Working Group for Sarcopenia 2019 criteria. NEPA status and EH were evaluated using the Global Physical Activity Questionnaire and a self-reported questionnaire according to the Japanese National Health and Nutrition Survey, respectively.

Results

Cox regression analysis identified baseline NEPA and EH as predictors of cumulative sarcopenia incidence. The incidence of new-onset sarcopenia and adjusted hazard ratios (95 % confidence interval [CI]) were 10.7 % and 0.49 (0.25–0.94) for NEPA only, 9.6 % and 0.44 (0.23–0.85) for EH only, and 8.0 % and 0.40 (0.22–0.72) for both, respectively, compared with 18.9 % for the neither NEPA nor EH group. Generalized estimating equations (GEE) analysis revealed that the odds of sarcopenia were significantly lower in the NEPA only, EH only, and both NEPA and EH groups, with adjusted odds ratios (95 % CI) of 0.52 (0.28–0.96), 0.48 (0.24–0.95), and 0.36 (0.20–0.63), respectively.

Conclusions

Both NEPA and EH were independently associated with a lower sarcopenia incidence. Therefore, NEPA may be a practical alternative to structured exercises for older adults.

目的探讨中高强度非运动体力活动（NEPA）和运动习惯（EH）与社区老年人肌肉减少症的关系。方法采用日本柏华队列研究（Kashiwa Cohort Study）的863名老年人数据进行为期7年的纵向分析，在2014年进行基线评估，并在2016年、2018年和2021年进行随访。肌肉减少症的评估采用2019年亚洲肌肉减少症工作组的标准。根据日本国家健康和营养调查，分别使用全球身体活动问卷和自我报告问卷对NEPA状态和EH进行评估。结果scox回归分析确定基线NEPA和EH是累积性肌少症发病率的预测因子。NEPA组新发肌肉减少症的发生率和校正风险比（95%可信区间[CI]）分别为10.7%和0.49 (0.25-0.94)，EH组为9.6%和0.44(0.23-0.85)，两者分别为8.0%和0.40(0.22-0.72)，而NEPA组和EH组均为18.9%。广义估计方程（GEE）分析显示，NEPA组、EH组以及NEPA组和EH组肌肉减少症的发生率显著降低，校正比值比（95% CI）分别为0.52（0.28-0.96）、0.48（0.24-0.95）和0.36（0.20-0.63）。结论NEPA和EH与较低的肌少症发生率独立相关。因此，对于老年人来说，NEPA可能是结构化锻炼的实用替代方案。

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引用次数: 0

Advancing frailty and functional decline assessment 推进脆弱性和功能衰退评估

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-07-21 DOI: 10.1016/j.aggp.2025.100190

Liang-Kung Chen MD, PhD

引用次数: 0

Examining early adversities, demographic, health and psychosocial factors associated with lifetime depression among older Canadians: Findings from a nationally representative study 调查与加拿大老年人终生抑郁相关的早期逆境、人口、健康和社会心理因素：一项具有全国代表性的研究结果

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-07-12 DOI: 10.1016/j.aggp.2025.100187

Megha Goel , Esme Fuller-Thomson

Purpose

Depression among older adults is associated with greater negative physical health, social, and economic outcomes than in younger populations. The objective of this study was to examine factors associated with lifetime depression in a nationally representative sample of Canadian older adults, highlighting characteristics linked to both vulnerability and resilience.

Methods

Secondary analysis of the 2022 Mental Health Access to Care Survey (MHACS) was conducted to estimate the prevalence and factors associated with lifetime depression among adults aged 55 and older (n = 3,535). The MHACS measured depression using the World Health Organization’s Composite International Diagnostic Interview (WHO-CIDI). Multivariable logistic regression of lifetime depression was conducted analyzing demographic and socioeconomic variables, adverse childhood experiences, physical health measures, health behaviors, and protective psychosocial factors.

Results

One in eleven older adults (9.2%) had experienced depression at some point in their lives. Middle-aged adults (55–64 years) compared to older respondents, and females compared to males had twice the odds of lifetime depression. Other factors associated with depression included childhood physical or sexual abuse, higher educational attainment, history of substance use disorders, multiple chronic physical health conditions, lower sense of life meaning, and higher spirituality.

Conclusion

Lifetime depression in older adults is associated with a complex interplay of risk and protective factors. Identifying these factors can support early recognition and targeted intervention, potentially improving outcomes and quality of life in this population.

目的：与年轻人群相比，老年人抑郁症对身体健康、社会和经济的负面影响更大。本研究的目的是在具有全国代表性的加拿大老年人样本中检查与终生抑郁症相关的因素，突出与脆弱性和适应力相关的特征。方法对2022年心理健康可及性保健调查（MHACS）进行二次分析，估计55岁及以上成年人（n = 3535）终生抑郁的患病率和相关因素。MHACS使用世界卫生组织的综合国际诊断访谈（WHO-CIDI）来测量抑郁症。对终生抑郁症的人口统计学和社会经济变量、不良童年经历、身体健康措施、健康行为和保护性心理社会因素进行多变量logistic回归分析。结果每11个老年人中就有一个（9.2%）在他们生命中的某个阶段经历过抑郁症。中年人（55-64岁）患抑郁症的几率是老年人的两倍，女性患抑郁症的几率是男性的两倍。与抑郁症相关的其他因素包括童年时期的身体虐待或性虐待、较高的教育程度、物质使用障碍史、多种慢性身体健康状况、较低的生活意义感和较高的灵性。结论老年人终生抑郁与危险因素和保护因素的复杂相互作用有关。识别这些因素可以支持早期识别和有针对性的干预，潜在地改善这一人群的预后和生活质量。

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引用次数: 0

Sex differences in risk factors associated with Alzheimer’s dementia patients with irritability and anger 性别差异与阿尔茨海默氏症痴呆患者易怒和愤怒相关的危险因素

Archives of Gerontology and Geriatrics Plus

Pub Date : 2025-07-04 DOI: 10.1016/j.aggp.2025.100184

Philip Cole Brewer , Timi Kehinde Ojo , Killian Joseph Bucci , Connor John O-Brien , Dami Taiwo Ojo , Emmanuel I. Nathaniel , Nathan Gerhard Faulstich , Adebobola Imeh-Nathaniel , Richard Goodwin , Thomas I Nathaniel

Background

The objective of this study is to identify risk factors that contribute to sex differences in Alzheimer dementia (AD) patients that also present with irritability and anger (ADIA) and determine whether these factors are different between male and female patients with ADIA.

Method

We used data from the of database for AD with a history of irritability and collected from a large academic center from 2016 to 2020. A total of 128,769 patients with AD were identified: 72,896 females and 55,873 males. Univariate was used to stratified risk factors base on sex and presence or absence of anger and irritability among AD patients. The adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) for each risk factor or demographic were used to predict the odds of a specific risk factors being associated with male or female ADIA.

Result

In the adjusted analysis, male ADIA patients were more likely to present with hypertension (OR = 2.894, 95 % CI, 2.079–4.028), insomnia (OR = 1.736, 95 % CI, 1.132–2.663), dyslipidemia (OR = 1.974, 95 % CI, 1.119–3.482), and peripheral vascular disease (OR = 44.135, 95 % CI, 4.344–448.364). Females were more likely to present with osteoporosis (OR = 0.002, 95 % CI, 0.001–0.023), gait dysfunction (OR = 0.034, 95 % CI, 0.003–0.452), anxiety (OR = 0.634, 95 % CI, 0.472–0.852), urinary tract infection (OR = 0.157, 95 % CI, 0.063–0.393), headaches (OR = 0.121, 95 % CI, 0.052–0.282) and pneumonia (OR = 0.209, 95 % CI, 0.114–0.384).

Conclusion

This study reveals key sex differences in ADIA patients. A population-based approach that tackles inequalities in risk factors may offer population-based healthcare and care of male and female ADIA patients.

本研究的目的是确定导致伴有易怒和愤怒（ADIA）的阿尔茨海默氏痴呆（AD）患者性别差异的危险因素，并确定这些因素在患有ADIA的男性和女性患者之间是否存在差异。方法使用2016 - 2020年在某大型学术中心收集的有烦躁史AD数据库中的数据。共发现128,769例AD患者：72,896例女性，55,873例男性。采用单变量对AD患者中基于性别和是否存在愤怒和易怒的危险因素进行分层。每个危险因素或人口统计学的校正优势比（ORs）和95%置信区间（ci）用于预测特定危险因素与男性或女性ADIA相关的几率。结果在校正分析中，男性ADIA患者更容易出现高血压（OR = 2.894, 95% CI, 2.079 ~ 4.028）、失眠（OR = 1.736, 95% CI, 1.132 ~ 2.663）、血脂异常（OR = 1.974, 95% CI, 1.119 ~ 3.482）和周围血管疾病（OR = 44.135, 95% CI, 4.344 ~ 448.364）。女性更容易出现骨质疏松（OR = 0.002, 95% CI, 0.001-0.023）、步态功能障碍（OR = 0.034, 95% CI, 0.003-0.452）、焦虑（OR = 0.634, 95% CI, 0.472-0.852）、尿路感染（OR = 0.157, 95% CI, 0.063-0.393）、头痛（OR = 0.121, 95% CI, 0.052-0.282）和肺炎（OR = 0.209, 95% CI, 0.114-0.384）。结论本研究揭示了ADIA患者的关键性别差异。解决风险因素不平等的以人口为基础的办法可以为男性和女性ADIA患者提供以人口为基础的保健和护理。

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