Hanna Pawluk, Renata Kołodziejska, Grzegorz Grześk, Mariusz Kozakiewicz, Agnieszka Kosinska, Mateusz Pawluk, Elżbieta Grzechowiak, Jakub Wojtasik, Grzegorz Kozera
Purpose: Glial fibrillary acidic protein (GFAP) and neuroglobin (NGB) are important biomarkers of cerebral hypoxia. For this reason, an attempt was made to assess their concentrations in various time intervals and their impact on the severity of neurological symptoms and functional prognosis of thrombolytic ischemic stroke patients. Patients and Methods: The study involved 94 patients reporting to the emergency department of the Collegium Medicum University Hospital in Bydgoszcz within < 4.5 hours of the onset of stroke symptoms. GFAP and neuroglobin levels were measured in plasma at indicated times using a commercial ELISA kit. Results: Based on the data gathered, statistically significant differences were found between the concentration of biomarkers in stroke patients and the control group. The concentrations of both biomarkers, GFAP and NGB, were elevated in patients after ischemic stroke and the changes in their concentrations in the subsequent stages of stroke may suggest their prognostic value strictly dependent on time. NGB was determined on the 7th day, and mRS - after a year (0.35). GFAP measured after 24 h and on day 7 could be a promising biomarker of functional outcome after one year (cut-off point ≤ 0.231 ng/mL, sensitivity 75.0%, specificity 61.2%, cut off point ≤ 0.235 ng/mL, sensitivity 75.0%, specificity 73.9%, respectively) and the severity of the patient’s neurological condition. At GFAP concentrations above 0.25 ng/mL, measured within 24 hours, a sharp increase in mortality was observed in stroke patients. In the case of NGB, at the time of stroke occurrence (14 ng/mL) and after 24 hours (10– 60 ng/mL). Differences in the concentrations of these biomarkers have been demonstrated in different stroke subtypes. Conclusion: NGB and GFAP are important biomarkers of ischemic brain injury and may also participate in predicting neurological outcomes.
{"title":"Expression of Acidic Fibrillar Protein and Neuroglobin in Thrombolytic Patients in Ischemic Stroke","authors":"Hanna Pawluk, Renata Kołodziejska, Grzegorz Grześk, Mariusz Kozakiewicz, Agnieszka Kosinska, Mateusz Pawluk, Elżbieta Grzechowiak, Jakub Wojtasik, Grzegorz Kozera","doi":"10.2147/cia.s469624","DOIUrl":"https://doi.org/10.2147/cia.s469624","url":null,"abstract":"<strong>Purpose:</strong> Glial fibrillary acidic protein (GFAP) and neuroglobin (NGB) are important biomarkers of cerebral hypoxia. For this reason, an attempt was made to assess their concentrations in various time intervals and their impact on the severity of neurological symptoms and functional prognosis of thrombolytic ischemic stroke patients.<br/><strong>Patients and Methods:</strong> The study involved 94 patients reporting to the emergency department of the Collegium Medicum University Hospital in Bydgoszcz within < 4.5 hours of the onset of stroke symptoms. GFAP and neuroglobin levels were measured in plasma at indicated times using a commercial ELISA kit.<br/><strong>Results:</strong> Based on the data gathered, statistically significant differences were found between the concentration of biomarkers in stroke patients and the control group. The concentrations of both biomarkers, GFAP and NGB, were elevated in patients after ischemic stroke and the changes in their concentrations in the subsequent stages of stroke may suggest their prognostic value strictly dependent on time. NGB was determined on the 7th day, and mRS - after a year (0.35). GFAP measured after 24 h and on day 7 could be a promising biomarker of functional outcome after one year (cut-off point ≤ 0.231 ng/mL, sensitivity 75.0%, specificity 61.2%, cut off point ≤ 0.235 ng/mL, sensitivity 75.0%, specificity 73.9%, respectively) and the severity of the patient’s neurological condition. At GFAP concentrations above 0.25 ng/mL, measured within 24 hours, a sharp increase in mortality was observed in stroke patients. In the case of NGB, at the time of stroke occurrence (14 ng/mL) and after 24 hours (10– 60 ng/mL). Differences in the concentrations of these biomarkers have been demonstrated in different stroke subtypes.<br/><strong>Conclusion:</strong> NGB and GFAP are important biomarkers of ischemic brain injury and may also participate in predicting neurological outcomes.<br/><br/><strong>Keywords:</strong> GFAP, NGB, stroke, oxidative stress, inflammation, thrombolysis<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"7 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142187281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jun-Peng Liu, Yatong Zhang, Zinan Zhao, Tianqi Zhang, Yifan Na, Yao Luo, Yuhao Wan, Ning Sun, Cheng Wu, Hua Wang, Jiefu Yang
Objective: To evaluate the impact of adverse health conditions, including multimorbidity, frailty, malnutrition, cognitive impairment, and polypharmacy, on clinical outcomes in older people with atrial fibrillation (AF). Patients and Methods: This prospective cohort study focused on patients aged 65 years and older with AF. They were admitted to the hospital between September 2018 and April 2019 and followed up for 1 year. We evaluated these participants for adverse health conditions including multimorbidity, frailty, malnutrition, cognitive impairment, and polypharmacy. The primary clinical outcome measured was a combination of all-cause mortality or rehospitalization. Results: 197 older patients (≥ 65 years) with AF (mean age, 77.5± 7.1 years; 57.4% men) were enrolled. During 1-year follow-up, Primary endpoint events (all-cause mortality or rehospitalization) occurred in 82 patients (41.6%). Compared with the non-event group, the Charlson comorbidity index (CCI) was higher (2.5± 1.9 vs 1.7± 1.3, p=0.004), more heart failure (32.9% vs 17.4%, p=0.01) and chronic kidney disease (17.1% vs 7.0%, p=0.03), with lower systolic blood pressure (125.3± 18.3 mmHg vs 132± 17.9 mmHg, p=0.005) in the event group. On multivariate Cox regression showed that the CCI was associated with a higher odds ratio of the composite outcome of all-cause mortality and rehospitalization (HR: 1.26; 95% CI: 1.02– 1.56, p=0.03). Other adverse health conditions showed no significant association with the composite outcome of all-cause mortality and rehospitalization. Conclusion: Among adverse health conditions in older people with AF, multimorbidity appears to be a significant determinant of adverse clinical outcomes. Clinical Trial Registration: ChiCTR1800017204; date of registration: 07/18/2018.
目的评估不良健康状况（包括多病、虚弱、营养不良、认知障碍和多重用药）对心房颤动（房颤）老年人临床预后的影响：这项前瞻性队列研究主要针对 65 岁及以上的房颤患者。他们于 2018 年 9 月至 2019 年 4 月期间入院，随访 1 年。我们对这些参与者的不良健康状况进行了评估，包括多病、虚弱、营养不良、认知障碍和多重药物治疗。测量的主要临床结果是全因死亡率或再住院率：共纳入 197 名老年房颤患者（≥ 65 岁）（平均年龄为 77.5±7.1 岁；57.4% 为男性）。在为期一年的随访中，82名患者（41.6%）发生了主要终点事件（全因死亡或再次住院）。与非事件组相比，事件组的夏尔森合并症指数（CCI）较高（2.5± 1.9 vs 1.7±1.3，P=0.004），心衰（32.9% vs 17.4%，P=0.01）和慢性肾病（17.1% vs 7.0%，P=0.03）较多，收缩压较低（125.3± 18.3 mmHg vs 132± 17.9 mmHg，P=0.005）。多变量 Cox 回归显示，CCI 与全因死亡率和再次住院的复合结果的较高几率相关（HR：1.26；95% CI：1.02- 1.56，P=0.03）。其他不良健康状况与全因死亡率和再次住院的综合结果无明显关系：结论：在心房颤动老年人的不良健康状况中，多重疾病似乎是不良临床结局的重要决定因素：临床试验注册：ChiCTR1800017204；注册日期：2018年07月18日：关键词：房颤；老年人；多病症；预后
{"title":"Impact of Adverse Health Conditions on Clinical Outcomes of Older People with Atrial Fibrillation: Insights from a Prospective Cohort Study","authors":"Jun-Peng Liu, Yatong Zhang, Zinan Zhao, Tianqi Zhang, Yifan Na, Yao Luo, Yuhao Wan, Ning Sun, Cheng Wu, Hua Wang, Jiefu Yang","doi":"10.2147/cia.s464044","DOIUrl":"https://doi.org/10.2147/cia.s464044","url":null,"abstract":"<strong>Objective:</strong> To evaluate the impact of adverse health conditions, including multimorbidity, frailty, malnutrition, cognitive impairment, and polypharmacy, on clinical outcomes in older people with atrial fibrillation (AF).<br/><strong>Patients and Methods:</strong> This prospective cohort study focused on patients aged 65 years and older with AF. They were admitted to the hospital between September 2018 and April 2019 and followed up for 1 year. We evaluated these participants for adverse health conditions including multimorbidity, frailty, malnutrition, cognitive impairment, and polypharmacy. The primary clinical outcome measured was a combination of all-cause mortality or rehospitalization.<br/><strong>Results:</strong> 197 older patients (≥ 65 years) with AF (mean age, 77.5± 7.1 years; 57.4% men) were enrolled. During 1-year follow-up, Primary endpoint events (all-cause mortality or rehospitalization) occurred in 82 patients (41.6%). Compared with the non-event group, the Charlson comorbidity index (CCI) was higher (2.5± 1.9 vs 1.7± 1.3, p=0.004), more heart failure (32.9% vs 17.4%, p=0.01) and chronic kidney disease (17.1% vs 7.0%, p=0.03), with lower systolic blood pressure (125.3± 18.3 mmHg vs 132± 17.9 mmHg, p=0.005) in the event group. On multivariate Cox regression showed that the CCI was associated with a higher odds ratio of the composite outcome of all-cause mortality and rehospitalization (HR: 1.26; 95% CI: 1.02– 1.56, p=0.03). Other adverse health conditions showed no significant association with the composite outcome of all-cause mortality and rehospitalization.<br/><strong>Conclusion:</strong> Among adverse health conditions in older people with AF, multimorbidity appears to be a significant determinant of adverse clinical outcomes.<br/><strong>Clinical Trial Registration:</strong> ChiCTR1800017204; date of registration: 07/18/2018.<br/><br/><strong>Keywords:</strong> atrial fibrillation, older people, multimorbidity, prognosis<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"25 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142187283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: In recent times, growing uncertainty has emerged regarding the effectiveness of standard pressure ulcer (PU) risk assessment tools, which are suspected to be no better than clinical judgment, especially in the frail and comorbid elderly population. This study aimed to identify the primary clinical predictive variables for PU development and severity in hospitalized older adults, utilizing a multidimensional frailty assessment, and compare them with the Braden scale. Patients and methods: The population consisted of 316 patients, admitted to the Geriatric Unit and Transitional Care of San Bartolomeo Hospital in Sarzana (Italy) during the period 21/02/22-01/07/22. The collected information included both anamnestic and laboratory data. A comprehensive geriatric assessment was performed, including also anthropometric and physical performance measurements. Multivariate logistic analysis was used, both in a binary classification test and in the subsequent ordinal classification test of severity levels. The final performance of the model was assessed by ROC curve estimation and AUC comparison with the Braden scale. Results: Within the population, 152 subjects (48%) developed PU at different levels of severity. The results showed that age, Braden scale (subscales of mobility and friction/shear), Barthel scale, Mini Nutritional Assessment, hemoglobin, and albumin are predictors associated with the development of PU (AUC 85%). The result is an improvement over the use of the Braden scale alone (AUC 75%). Regarding the identification of predictive factors for PU severity, 4AT also emerges as potentially relevant. Conclusion: Assessing the subject’s nutritional status, physical performance, and functional autonomies enables the effective integration of the Braden scale in identifying patients most susceptible to developing PU. Our findings support the integration of a comprehensive set of methodologically robust frailty determinants into traditional risk assessment tools. This integration reflects the mutual interplay between patients’ frailty, skin frailty, and PU development in very old hospitalized patients.
目的：近来，标准压疮（PU）风险评估工具的有效性出现了越来越多的不确定性，人们怀疑这些工具并不比临床判断更好，尤其是在体弱多病的老年人群中。本研究旨在利用多维度虚弱程度评估，确定住院老年人压疮发生和严重程度的主要临床预测变量，并将其与布莱登量表进行比较：研究对象包括意大利萨尔扎纳圣巴托洛梅奥医院老年病科和过渡护理部在2002年2月21日至7月22日期间收治的316名患者。所收集的信息包括病理和实验室数据。此外，还进行了全面的老年病学评估，包括人体测量和体能测量。在二元分类测试和随后的严重程度序数分类测试中都使用了多变量逻辑分析。通过 ROC 曲线估算以及与布莱登量表的 AUC 比较，对模型的最终性能进行了评估：在研究人群中，152 名受试者（48%）出现了不同严重程度的 PU。结果显示，年龄、布莱登量表（移动性和摩擦/剪切力分量表）、巴特尔量表、迷你营养评估、血红蛋白和白蛋白是与 PU 发生相关的预测因子（AUC 85%）。这一结果比单独使用布莱登量表（AUC 75%）有所改进。在确定 PU 严重程度的预测因素方面，4AT 也具有潜在的相关性：结论：评估受试者的营养状况、体能表现和功能自主性可有效整合布莱登量表，以识别最易患 PU 的患者。我们的研究结果支持将一整套方法可靠的虚弱决定因素整合到传统的风险评估工具中。这种整合反映了高龄住院病人的虚弱、皮肤虚弱和PU发展之间的相互影响。 关键词：慢性伤口、营养、压力性损伤、健康分析、精准医学、慢性疾病
{"title":"Multidimensional-Based Prediction of Pressure Ulcers Development and Severity in Hospitalized Frail Oldest Old: A Retrospective Study","authors":"Silvia Ottaviani, Eleonora Rondanina, Floriana Arnone, Virna Brucato, Roberto Campigli, Massimo Della Bona, Luca Tagliafico, Ennio Ottaviani, Alessio Nencioni, Fiammetta Monacelli","doi":"10.2147/cia.s440943","DOIUrl":"https://doi.org/10.2147/cia.s440943","url":null,"abstract":"<strong>Purpose:</strong> In recent times, growing uncertainty has emerged regarding the effectiveness of standard pressure ulcer (PU) risk assessment tools, which are suspected to be no better than clinical judgment, especially in the frail and comorbid elderly population. This study aimed to identify the primary clinical predictive variables for PU development and severity in hospitalized older adults, utilizing a multidimensional frailty assessment, and compare them with the Braden scale.<br/><strong>Patients and methods:</strong> The population consisted of 316 patients, admitted to the Geriatric Unit and Transitional Care of San Bartolomeo Hospital in Sarzana (Italy) during the period 21/02/22-01/07/22. The collected information included both anamnestic and laboratory data. A comprehensive geriatric assessment was performed, including also anthropometric and physical performance measurements. Multivariate logistic analysis was used, both in a binary classification test and in the subsequent ordinal classification test of severity levels. The final performance of the model was assessed by ROC curve estimation and AUC comparison with the Braden scale.<br/><strong>Results:</strong> Within the population, 152 subjects (48%) developed PU at different levels of severity. The results showed that age, Braden scale (subscales of mobility and friction/shear), Barthel scale, Mini Nutritional Assessment, hemoglobin, and albumin are predictors associated with the development of PU (AUC 85%). The result is an improvement over the use of the Braden scale alone (AUC 75%). Regarding the identification of predictive factors for PU severity, 4AT also emerges as potentially relevant.<br/><strong>Conclusion:</strong> Assessing the subject’s nutritional status, physical performance, and functional autonomies enables the effective integration of the Braden scale in identifying patients most susceptible to developing PU. Our findings support the integration of a comprehensive set of methodologically robust frailty determinants into traditional risk assessment tools. This integration reflects the mutual interplay between patients’ frailty, skin frailty, and PU development in very old hospitalized patients.<br/><br/><strong>Keywords:</strong> chronic wounds, nutrition, pressure injury, health analytics, precision medicine, chronic diseases<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142187282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Li Zhou, Youlin Wu, Jiani Wang, Haiyun Wu, Yongjun Tan, Xia Chen, Xiaosong Song, Yu Ren, Qin Yang
Background and Purpose: Ischemic stroke is a leading cause of mortality and disability globally, necessitating accurate prediction of intra-hospital mortality (IHM) for improved patient care. This study aimed to develop a practical nomogram for personalized IHM risk prediction in ischemic stroke patients. Methods: A retrospective study of 422 ischemic stroke patients (April 2020 - December 2021) from Chongqing Medical University’s First Affiliated Hospital was conducted, with patients divided into training (n=295) and validation (n=127) groups. Data on demographics, comorbidities, stroke risk factors, and lab results were collected. Stroke severity was assessed using NIHSS, and stroke types were classified by TOAST criteria. Least absolute shrinkage and selection operator (LASSO) regression was employed for predictor selection and nomogram construction, with evaluation through ROC curves, calibration curves, and decision curve analysis. Results: LASSO regression and multivariate logistic regression identified four independent IHM predictors: age, admission NIHSS score, chronic obstructive pulmonary disease (COPD) diagnosis, and white blood cell count (WBC). A highly accurate nomogram based on these variables exhibited excellent predictive performance, with AUCs of 0.958 (training) and 0.962 (validation), sensitivities of 93.2% and 95.7%, and specificities of 93.1% and 90.9%, respectively. Calibration curves and decision curve analysis validated its clinical applicability. Conclusion: Age, admission NIHSS score, COPD history, and WBC were identified as independent IHM predictors in ischemic stroke patients. The developed nomogram demonstrated high predictive accuracy and practical utility for mortality risk estimation. External validation and prospective studies are warranted for further confirmation of its clinical efficacy.
背景和目的：缺血性卒中是全球致死和致残的主要原因，因此需要准确预测院内死亡率（IHM）以改善患者护理。本研究旨在为缺血性中风患者的个性化院内死亡率风险预测开发一个实用的提名图：方法：对重庆医科大学附属第一医院的422例缺血性脑卒中患者（2020年4月-2021年12月）进行回顾性研究，将患者分为训练组（n=295）和验证组（n=127）。收集了人口统计学、合并症、卒中危险因素和实验室结果等数据。中风严重程度使用 NIHSS 评估，中风类型根据 TOAST 标准分类。采用最小绝对收缩和选择算子（LASSO）回归法进行预测因子选择和构建提名图，并通过 ROC 曲线、校准曲线和决策曲线分析进行评估：结果：LASSO 回归和多变量逻辑回归确定了四个独立的 IHM 预测因子：年龄、入院 NIHSS 评分、慢性阻塞性肺病（COPD）诊断和白细胞计数（WBC）。基于这些变量的高精度提名图显示出卓越的预测性能，AUC 分别为 0.958（训练）和 0.962（验证），灵敏度分别为 93.2% 和 95.7%，特异度分别为 93.1% 和 90.9%。校准曲线和决策曲线分析验证了其临床适用性：结论：年龄、入院 NIHSS 评分、慢性阻塞性肺病病史和白细胞被确定为缺血性卒中患者独立的 IHM 预测因子。结论：年龄、入院 NIHSS 评分、慢性阻塞性肺病病史和白细胞被确定为缺血性卒中患者独立的 IHM 预测因子。为进一步证实其临床疗效，需要进行外部验证和前瞻性研究。 关键词：缺血性卒中、提名图、预测因子、拉索、院内死亡率
{"title":"Development of a Predictive Nomogram for Intra-Hospital Mortality in Acute Ischemic Stroke Patients Using LASSO Regression","authors":"Li Zhou, Youlin Wu, Jiani Wang, Haiyun Wu, Yongjun Tan, Xia Chen, Xiaosong Song, Yu Ren, Qin Yang","doi":"10.2147/cia.s471885","DOIUrl":"https://doi.org/10.2147/cia.s471885","url":null,"abstract":"<strong>Background and Purpose:</strong> Ischemic stroke is a leading cause of mortality and disability globally, necessitating accurate prediction of intra-hospital mortality (IHM) for improved patient care. This study aimed to develop a practical nomogram for personalized IHM risk prediction in ischemic stroke patients.<br/><strong>Methods:</strong> A retrospective study of 422 ischemic stroke patients (April 2020 - December 2021) from Chongqing Medical University’s First Affiliated Hospital was conducted, with patients divided into training (n=295) and validation (n=127) groups. Data on demographics, comorbidities, stroke risk factors, and lab results were collected. Stroke severity was assessed using NIHSS, and stroke types were classified by TOAST criteria. Least absolute shrinkage and selection operator (LASSO) regression was employed for predictor selection and nomogram construction, with evaluation through ROC curves, calibration curves, and decision curve analysis.<br/><strong>Results:</strong> LASSO regression and multivariate logistic regression identified four independent IHM predictors: age, admission NIHSS score, chronic obstructive pulmonary disease (COPD) diagnosis, and white blood cell count (WBC). A highly accurate nomogram based on these variables exhibited excellent predictive performance, with AUCs of 0.958 (training) and 0.962 (validation), sensitivities of 93.2% and 95.7%, and specificities of 93.1% and 90.9%, respectively. Calibration curves and decision curve analysis validated its clinical applicability.<br/><strong>Conclusion:</strong> Age, admission NIHSS score, COPD history, and WBC were identified as independent IHM predictors in ischemic stroke patients. The developed nomogram demonstrated high predictive accuracy and practical utility for mortality risk estimation. External validation and prospective studies are warranted for further confirmation of its clinical efficacy.<br/><br/><strong>Keywords:</strong> ischemic stroke, nomogram, predictors, lasso, intra-hospital mortality<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"2 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141949433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: With the increasingly severe situation of obesity and population aging, there is growing concern about sarcopenia obesity (SO). SO refers to the coexistence of obesity and sarcopenia, which imposes a heavier burden on individuals and society compared to obesity or sarcopenia alone. Therefore, comprehending the pathogenesis of SO and implementing effective clinical interventions are vital for its prevention and treatment. This review uses a comprehensive literature search and analysis of PubMed, Web of Science, and CNKI databases, with search terms including “Sarcopenic obesity”, “exercise”, “cytokines”, “inflammation”, “mitochondrial quality control”, and “microRNA”, covering relevant studies published up to July 2024. The results indicate that the pathogenesis of SO is complex, involving mechanisms like age-related changes in body composition, hormonal alterations, inflammation, mitochondrial dysfunction, and genetic and epigenetic factors. Regarding exercise interventions for SO, aerobic exercise can reduce fat mass, resistance exercise can increase skeletal muscle mass and strength, and combined exercise can achieve both, making it the optimal intervention for SO. The potential mechanisms by which exercise may prevent and treat SO include regulating cytokine secretion, inhibiting inflammatory pathways, improving mitochondrial quality, and mediating microRNA expression. This review emphasizes the effectiveness of exercise interventions in mitigating sarcopenic obesity through comprehensive analysis of its multifactorial pathogenesis and the mechanistic insights into exercise’s therapeutic effects. Understanding these mechanisms informs targeted therapeutic strategies aimed at alleviating the societal and individual burdens associated with SO.
摘要：随着肥胖和人口老龄化形势的日益严峻，人们越来越关注肌肉疏松性肥胖症（Sarcopenia obesity，SO）。肌肉疏松性肥胖症是指肥胖和肌肉疏松同时存在，与单纯的肥胖或肌肉疏松相比，给个人和社会带来更沉重的负担。因此，了解肌肉疏松症的发病机制并实施有效的临床干预措施对预防和治疗肌肉疏松症至关重要。本综述对 PubMed、Web of Science 和 CNKI 数据库进行了全面的文献检索和分析，检索词包括 "肌少症肥胖"、"运动"、"细胞因子"、"炎症"、"线粒体质量控制 "和 "microRNA"，涵盖了截至 2024 年 7 月发表的相关研究。结果表明，肥胖症的发病机制十分复杂，涉及与年龄相关的身体成分变化、激素改变、炎症、线粒体功能障碍以及遗传和表观遗传因素等机制。关于对 SO 的运动干预，有氧运动可以减少脂肪量，阻力运动可以增加骨骼肌的质量和力量，而综合运动则可以同时达到这两种效果，因此是对 SO 的最佳干预。运动预防和治疗SO的潜在机制包括调节细胞因子分泌、抑制炎症途径、改善线粒体质量和介导微RNA表达。本综述通过对肌肉疏松性肥胖的多因素致病机理的全面分析，以及对运动治疗效果机理的深入了解，强调了运动干预在缓解肌肉疏松性肥胖方面的有效性。了解这些机制有助于制定有针对性的治疗策略，以减轻与肌肉疏松性肥胖相关的社会和个人负担。关键词：肌肉疏松性肥胖；运动；细胞因子；微RNA；线粒体质量控制；炎症
{"title":"Research Progress on the Effect and Mechanism of Exercise Intervention on Sarcopenia Obesity","authors":"Jun Chen, Shaohui Jia, Chenggen Guo, Zhiwei Fan, Weiyi Yan, Kunwei Dong","doi":"10.2147/cia.s473083","DOIUrl":"https://doi.org/10.2147/cia.s473083","url":null,"abstract":"<strong>Abstract:</strong> With the increasingly severe situation of obesity and population aging, there is growing concern about sarcopenia obesity (SO). SO refers to the coexistence of obesity and sarcopenia, which imposes a heavier burden on individuals and society compared to obesity or sarcopenia alone. Therefore, comprehending the pathogenesis of SO and implementing effective clinical interventions are vital for its prevention and treatment. This review uses a comprehensive literature search and analysis of PubMed, Web of Science, and CNKI databases, with search terms including “Sarcopenic obesity”, “exercise”, “cytokines”, “inflammation”, “mitochondrial quality control”, and “microRNA”, covering relevant studies published up to July 2024. The results indicate that the pathogenesis of SO is complex, involving mechanisms like age-related changes in body composition, hormonal alterations, inflammation, mitochondrial dysfunction, and genetic and epigenetic factors. Regarding exercise interventions for SO, aerobic exercise can reduce fat mass, resistance exercise can increase skeletal muscle mass and strength, and combined exercise can achieve both, making it the optimal intervention for SO. The potential mechanisms by which exercise may prevent and treat SO include regulating cytokine secretion, inhibiting inflammatory pathways, improving mitochondrial quality, and mediating microRNA expression. This review emphasizes the effectiveness of exercise interventions in mitigating sarcopenic obesity through comprehensive analysis of its multifactorial pathogenesis and the mechanistic insights into exercise’s therapeutic effects. Understanding these mechanisms informs targeted therapeutic strategies aimed at alleviating the societal and individual burdens associated with SO.<br/><br/><strong>Keywords:</strong> sarcopenic obesity, exercise, cytokines, microRNA, mitochondrial quality control, inflammation<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"39 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141949432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christine K Kim, Melisa Z Karslioglu, Sharon H Zhao, Olivia L Lee
Abstract: Infectious keratitis (IK) represents a significant global health concern, ranking as the fifth leading cause of blindness worldwide despite being largely preventable and treatable. Elderly populations are particularly susceptible due to age-related changes in immune response and corneal structure. However, research on IK in this demographic remains scarce. Age-related alterations such as increased permeability and reduced endothelial cell density further compound susceptibility to infection and hinder healing mechanisms. Additionally, inflammaging, characterized by chronic inflammation that develops with advanced age, disrupts the ocular immune balance, potentially exacerbating IK and other age-related eye diseases. Understanding these mechanisms is paramount for enhancing IK management, especially in elderly patients. This review comprehensively assesses risk factors, clinical characteristics, and management strategies for bacterial, viral, fungal, and acanthamoeba keratitis in the elderly population, offering crucial insights for effective intervention.
摘要：传染性角膜炎（IK）是全球关注的重大健康问题，尽管在很大程度上可以预防和治疗，但它仍是全球第五大致盲原因。由于与年龄相关的免疫反应和角膜结构的变化，老年人群尤其容易受到感染。然而，针对这一人群的 IK 研究仍然很少。与年龄相关的变化，如渗透性增加和内皮细胞密度降低，进一步加剧了感染的易感性，并阻碍了愈合机制。此外，随着年龄的增长而出现的慢性炎症，破坏了眼部免疫平衡，可能会加重 IK 和其他与年龄相关的眼部疾病。了解这些机制对于加强 IK 的管理至关重要，尤其是对老年患者而言。这篇综述全面评估了老年人群中细菌性、病毒性、真菌性和棘阿米巴性角膜炎的危险因素、临床特征和管理策略，为有效干预提供了重要的见解。关键词：衰老、炎症、细菌性角膜炎、病毒性角膜炎、真菌性角膜炎、棘阿米巴性角膜炎
{"title":"Infectious Keratitis in Patients Over 65: A Review on Treatment and Preserving Eyesight","authors":"Christine K Kim, Melisa Z Karslioglu, Sharon H Zhao, Olivia L Lee","doi":"10.2147/cia.s467262","DOIUrl":"https://doi.org/10.2147/cia.s467262","url":null,"abstract":"<strong>Abstract:</strong> Infectious keratitis (IK) represents a significant global health concern, ranking as the fifth leading cause of blindness worldwide despite being largely preventable and treatable. Elderly populations are particularly susceptible due to age-related changes in immune response and corneal structure. However, research on IK in this demographic remains scarce. Age-related alterations such as increased permeability and reduced endothelial cell density further compound susceptibility to infection and hinder healing mechanisms. Additionally, inflammaging, characterized by chronic inflammation that develops with advanced age, disrupts the ocular immune balance, potentially exacerbating IK and other age-related eye diseases. Understanding these mechanisms is paramount for enhancing IK management, especially in elderly patients. This review comprehensively assesses risk factors, clinical characteristics, and management strategies for bacterial, viral, fungal, and acanthamoeba keratitis in the elderly population, offering crucial insights for effective intervention.<br/><br/><strong>Keywords:</strong> aging, inflammaging, bacterial keratitis, viral keratitis, fungal keratitis, acanthamoeba keratitis<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"213 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141868841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Frailty epitomizes the most complex consequence of an aging population. This study aimed to evaluate the impact of frailty, measured using the Clinical Frailty Scale (CFS), on outcomes of older people in an emergency department (ED). Methods: We conducted a prospective observational study enrolling patients aged 65 years and older in a medical center of Taiwan between March 8, 2021, and November 30, 2021. The primary outcome was 90-day mortality rate. Individuals were categorized into three groups based on the CFS scores. Logistic regression was employed to examine the influence of frailty on clinical outcomes following covariate adjustment. Survival analysis was conducted using Kaplan–Meier curves and Log rank tests. Results: A total of 473 individuals were included in the study, with a mean age of 82.1 years, and 60.5% of them were males. The 90-day mortality rate was 10.6%. Among these groups, the CFS score 7– 9 group had the highest 90-day mortality rate (15.9%), followed by the CFS score 4– 6 group (8.0%) and the CFS score 1– 3 group (7.1%). The multiple logistic regression analyses demonstrated a significant impact of CFS score on prognosis, with adjusted odd ratios of 1.24 (95% CI 1.06– 1.47) for 90-day mortality, 1.18 (95% CI 1.06– 1.31) for hospitalization, and 1.30 (95% CI 1.12– 1.52) for 180-day mortality. The Kaplan–Meier curves revealed a significantly higher 90-day mortality rate for patients with high CFS scores (Log rank tests, p = 0.019). Conclusion: In the older ED population, the severity of frailty assessed by the CFS emerged as a significant and important prognostic factor for hospitalization, 90-day mortality, and 180-day mortality.
{"title":"The Association Between Frailty Evaluated by Clinical Frailty Scale and Mortality of Older Patients in the Emergency Department: A Prospective Cohort Study","authors":"Jin-Wei Lin, Pei-Ying Lin, Tse-Yao Wang, Ying-Ju Chen, David Hung-Tsang Yen, Hsien-Hao Huang","doi":"10.2147/cia.s472991","DOIUrl":"https://doi.org/10.2147/cia.s472991","url":null,"abstract":"<strong>Background:</strong> Frailty epitomizes the most complex consequence of an aging population. This study aimed to evaluate the impact of frailty, measured using the Clinical Frailty Scale (CFS), on outcomes of older people in an emergency department (ED).<br/><strong>Methods:</strong> We conducted a prospective observational study enrolling patients aged 65 years and older in a medical center of Taiwan between March 8, 2021, and November 30, 2021. The primary outcome was 90-day mortality rate. Individuals were categorized into three groups based on the CFS scores. Logistic regression was employed to examine the influence of frailty on clinical outcomes following covariate adjustment. Survival analysis was conducted using Kaplan–Meier curves and Log rank tests.<br/><strong>Results:</strong> A total of 473 individuals were included in the study, with a mean age of 82.1 years, and 60.5% of them were males. The 90-day mortality rate was 10.6%. Among these groups, the CFS score 7– 9 group had the highest 90-day mortality rate (15.9%), followed by the CFS score 4– 6 group (8.0%) and the CFS score 1– 3 group (7.1%). The multiple logistic regression analyses demonstrated a significant impact of CFS score on prognosis, with adjusted odd ratios of 1.24 (95% CI 1.06– 1.47) for 90-day mortality, 1.18 (95% CI 1.06– 1.31) for hospitalization, and 1.30 (95% CI 1.12– 1.52) for 180-day mortality. The Kaplan–Meier curves revealed a significantly higher 90-day mortality rate for patients with high CFS scores (Log rank tests, p = 0.019).<br/><strong>Conclusion:</strong> In the older ED population, the severity of frailty assessed by the CFS emerged as a significant and important prognostic factor for hospitalization, 90-day mortality, and 180-day mortality.<br/><br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"5 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141783471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Citra Windani Mambang Sari, Vina Nur Khoeriyah, Mamat Lukman
Abstract: Indonesia is experiencing an increase in the elderly population, which is a challenge for health services. One of the health programs specifically designed for older people is the integration health program, known as “Posbindu”. Posbindu is a community-based health service that provides health promotion, disease prevention, and early detection services for the elderly. However, its utilization has not been maximized, so a study was conducted to analyze the factors related to the utilization of Posbindu in Indonesia. The research design used a scoping review and data analysis narrative approach. The researcher searched articles using the PCC framework, with the elderly as the population (including pre-elderly), the factors as concept, and the context as utilization of Posbindu. It used Indonesian and English keywords in the Google Scholar, Pubmed, ProQuest, and Researchgate databases. Then, the article selection process used the PRISMA-ScR flow chart, and 201 articles were obtained that matched the inclusion criteria, 192 articles, and the final result was nine articles were analyzed. The results of the article analysis showed that the average value of older people’s participation in Posbindu was 47.51%, which means it did not reach the target. Factors related to this are predisposition factors found in eight articles (intentions, knowledge, attitudes, education, traditions, beliefs, and control over actions), enabling factors in five articles (distance to Posbindu, access to information, and quality of Posbindu for older people), and reinforcing factors in seven articles (family support and health voluntary support). From all p-values for these factors, the most strongly related to Posbindu for the elderly was reinforcing elements, with a p-value of less than 0.03 in all analyzed articles. So, it can be concluded that the reinforcing factor is the most related to the utilization of the elderly Posbindu. So, it is crucial to involve all sector to increase the participation of older people in Posbindu program.
{"title":"Factors Related to The Utilization of Integration Health Program (Posbindu) Among Older Adults in Indonesia: A Scoping Review","authors":"Citra Windani Mambang Sari, Vina Nur Khoeriyah, Mamat Lukman","doi":"10.2147/cia.s462621","DOIUrl":"https://doi.org/10.2147/cia.s462621","url":null,"abstract":"<strong>Abstract:</strong> Indonesia is experiencing an increase in the elderly population, which is a challenge for health services. One of the health programs specifically designed for older people is the integration health program, known as “Posbindu”. <em>Posbindu</em> is a community-based health service that provides health promotion, disease prevention, and early detection services for the elderly. However, its utilization has not been maximized, so a study was conducted to analyze the factors related to the utilization of <em>Posbindu</em> in Indonesia. The research design used a scoping review and data analysis narrative approach. The researcher searched articles using the PCC framework, with the elderly as the population (including pre-elderly), the factors as concept, and the context as utilization of <em>Posbindu</em>. It used Indonesian and English keywords in the Google Scholar, Pubmed, ProQuest, and Researchgate databases. Then, the article selection process used the PRISMA-ScR flow chart, and 201 articles were obtained that matched the inclusion criteria, 192 articles, and the final result was nine articles were analyzed. The results of the article analysis showed that the average value of older people’s participation in <em>Posbindu</em> was 47.51%, which means it did not reach the target. Factors related to this are predisposition factors found in eight articles (intentions, knowledge, attitudes, education, traditions, beliefs, and control over actions), enabling factors in five articles (distance to <em>Posbindu</em>, access to information, and quality of <em>Posbindu</em> for older people), and reinforcing factors in seven articles (family support and health voluntary support). From all p-values for these factors, the most strongly related to <em>Posbindu</em> for the elderly was reinforcing elements, with a p-value of less than 0.03 in all analyzed articles. So, it can be concluded that the reinforcing factor is the most related to the utilization of the elderly <em>Posbindu</em>. So, it is crucial to involve all sector to increase the participation of older people in <em>Posbindu</em> program.<br/><br/><strong>Keywords:</strong> elderly, posbindu, integration, utilization, factors<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"72 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141783392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Purpose: Ageing has become one of the major global public issues and active ageing has become a global goal. Accurate and reproducible assessment tools are a prerequisite for robust and reliable measurement of active ageing and policy formulation. However, a broad scoping review describing the characteristics and heterogeneity of assessment tools for active ageing is lacking. This study aims to comprehensively portray current active ageing assessment tools and their features. Methods: We conducted a scoping review, focusing on the Active Ageing Assessment Tool, and searched seven databases: CNKI, WanFang, PubMed, Embase, Web of Science Core Collection, Medline, and Proquest. The research process adhered to the methodological framework of Arkey and O’Malley and the PRISMA-ScR specification. More so, we registered the research program with the Open Science Framework. Results: Ultimately, we included twenty-two pieces of literature. The development of the active ageing assessment tool predominantly occurred between 2012 and 2023, with a focus on foreign countries (16 studies). All included literature presented multidimensional Active ageing assessment tools. Eighteen studies examined active ageing assessment tools at the macro level, while four studies focused on the individual level. Also, fourteen out of the twenty-two studies were based on the World Health Organization’s Theoretical Framework for Active Ageing. The literature contained only two active ageing assessment tools designed for specific subgroups of older people. Conclusion: Future development of active ageing assessment tools should integrate more comprehensive concepts and social theories of active ageing. Additionally, there is a need to explore active ageing measurement tools tailored for diverse subgroups of the older adults at various levels.
Keywords: ageing, active ageing, healthy ageing, scope review
{"title":"Measuring Active Ageing: A Scoping Review and the Applicability to the Situation in China","authors":"Jiechenming Xiao, Dan Xu, Heng Yang, Huiping Mao","doi":"10.2147/cia.s471000","DOIUrl":"https://doi.org/10.2147/cia.s471000","url":null,"abstract":"<strong>Background and Purpose:</strong> Ageing has become one of the major global public issues and active ageing has become a global goal. Accurate and reproducible assessment tools are a prerequisite for robust and reliable measurement of active ageing and policy formulation. However, a broad scoping review describing the characteristics and heterogeneity of assessment tools for active ageing is lacking. This study aims to comprehensively portray current active ageing assessment tools and their features.<br/><strong>Methods:</strong> We conducted a scoping review, focusing on the Active Ageing Assessment Tool, and searched seven databases: CNKI, WanFang, PubMed, Embase, Web of Science Core Collection, Medline, and Proquest. The research process adhered to the methodological framework of Arkey and O’Malley and the PRISMA-ScR specification. More so, we registered the research program with the Open Science Framework.<br/><strong>Results:</strong> Ultimately, we included twenty-two pieces of literature. The development of the active ageing assessment tool predominantly occurred between 2012 and 2023, with a focus on foreign countries (16 studies). All included literature presented multidimensional Active ageing assessment tools. Eighteen studies examined active ageing assessment tools at the macro level, while four studies focused on the individual level. Also, fourteen out of the twenty-two studies were based on the World Health Organization’s Theoretical Framework for Active Ageing. The literature contained only two active ageing assessment tools designed for specific subgroups of older people.<br/><strong>Conclusion:</strong> Future development of active ageing assessment tools should integrate more comprehensive concepts and social theories of active ageing. Additionally, there is a need to explore active ageing measurement tools tailored for diverse subgroups of the older adults at various levels.<br/><br/><strong>Keywords:</strong> ageing, active ageing, healthy ageing, scope review<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"23 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141783391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: It has been shown that lower Barthel’s index (BI) at admission is associated with a higher in-hospital mortality. There is a lack of evidence regarding the association between the change in BI during hospitalization and mortality after discharge. Our purpose was to determine whether the BI change during hospitalization is associated with all-cause mortality in older adults with COVID-19 pneumonia. Patients and Methods: We conducted a retrospective cohort study of 330 participants at Peking University Third Hospital during the COVID-19 pandemic period. In order to analyze the time to death data, a Kaplan-Meier survival curve was used. We used restricted cubic splines to analyze the association between BI change and all-cause mortality among COVID-19 pneumonia patients aged over 80 years old. Threshold effect analysis was used to assess the ability of BI change score to predict all-cause mortality. Results: Our study included 330 patients aged over 80 years with COVID-19 pneumonia. The Kaplan-Meier curve for mortality showed significantly worst survival with reduced BI among three groups (χ2= 6.896, P < 0.05). There was a non-linear association between the BI change and all-cause mortality (P for all over < 0.001). The effect sizes on the left and right sides of the inflection point were 0.958 (HR: 0.958, 95% CI 0.932– 0.958, P < 0.05) and 1.013 (HR: 1.013, 95% CI 0.967– 1.062, P > 0.05), respectively. Conclusion: Reduced BI during hospitalization was associated with the highest mortality risk. It is crucial to monitor BI change among COVID-19 pneumonia patients aged over 80 years old.
Keywords: COVID-19 pneumonia, activities of daily living, mortality, older adult
目的：研究表明，入院时较低的巴特尔指数（BI）与较高的院内死亡率有关。关于住院期间 BI 变化与出院后死亡率之间的关系，目前还缺乏相关证据。我们的目的是确定在患有 COVID-19 肺炎的老年人中，住院期间 BI 的变化是否与全因死亡率有关：我们对 COVID-19 大流行期间北京大学第三医院的 330 名患者进行了回顾性队列研究。为了分析死亡时间数据，我们使用了 Kaplan-Meier 生存曲线。我们使用限制性三次样条曲线分析了 COVID-19 肺炎 80 岁以上患者中 BI 变化与全因死亡率之间的关系。阈值效应分析用于评估 BI 变化评分预测全因死亡率的能力：我们的研究纳入了 330 名 80 岁以上的 COVID-19 肺炎患者。死亡率的 Kaplan-Meier 曲线显示，在三组患者中，BI 降低的患者生存率明显最差（χ2= 6.896，P <0.05）。BI 变化与全因死亡率之间存在非线性关联（P 均大于 <0.001）。拐点左右两侧的效应大小分别为0.958（HR：0.958，95% CI 0.932-0.958，P <；0.05）和1.013（HR：1.013，95% CI 0.967-1.062，P >；0.05）：结论：住院期间 BI 降低与最高的死亡风险相关。结论：住院期间 BI 降低与最高死亡风险相关，监测 80 岁以上 COVID-19 肺炎患者的 BI 变化至关重要：COVID-19肺炎 日常生活活动 死亡率 老年人
{"title":"Association Between Barthel’s Index Change and All-Cause Mortality Among COVID-19 Pneumonia Patients Aged Over 80 Years Old: A Retrospective Cohort Study","authors":"Yanting Hao, Hua Zhang, Fan Zhang","doi":"10.2147/cia.s469073","DOIUrl":"https://doi.org/10.2147/cia.s469073","url":null,"abstract":"<strong>Purpose:</strong> It has been shown that lower Barthel’s index (BI) at admission is associated with a higher in-hospital mortality. There is a lack of evidence regarding the association between the change in BI during hospitalization and mortality after discharge. Our purpose was to determine whether the BI change during hospitalization is associated with all-cause mortality in older adults with COVID-19 pneumonia.<br/><strong>Patients and Methods:</strong> We conducted a retrospective cohort study of 330 participants at Peking University Third Hospital during the COVID-19 pandemic period. In order to analyze the time to death data, a Kaplan-Meier survival curve was used. We used restricted cubic splines to analyze the association between BI change and all-cause mortality among COVID-19 pneumonia patients aged over 80 years old. Threshold effect analysis was used to assess the ability of BI change score to predict all-cause mortality.<br/><strong>Results:</strong> Our study included 330 patients aged over 80 years with COVID-19 pneumonia. The Kaplan-Meier curve for mortality showed significantly worst survival with reduced BI among three groups (χ<sup>2</sup>= 6.896, <em>P</em> < 0.05). There was a non-linear association between the BI change and all-cause mortality (<em>P</em> for all over < 0.001). The effect sizes on the left and right sides of the inflection point were 0.958 (HR: 0.958, 95% CI 0.932– 0.958, <em>P</em> < 0.05) and 1.013 (HR: 1.013, 95% CI 0.967– 1.062, <em>P</em> > 0.05), respectively.<br/><strong>Conclusion:</strong> Reduced BI during hospitalization was associated with the highest mortality risk. It is crucial to monitor BI change among COVID-19 pneumonia patients aged over 80 years old.<br/><br/><strong>Keywords:</strong> COVID-19 pneumonia, activities of daily living, mortality, older adult<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"15 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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