Geriatrics & Gerontology International最新文献

Aim: With an increasingly aging population, the management of heart failure (HF) in older adult patients warrants greater attention. This study aimed to identify somatic symptom profiles by using the person-oriented approach, explore the association between somatic symptom profiles and quality of life (QoL) and examine the mediating effect of depressive symptoms on this association among older adult patients with HF.

Methods: This cross-sectional study involved a convenience sample of 445 older adult patients with HF from two tertiary hospitals in China. Patients' somatic symptoms, depressive symptoms and QoL were measured using self-reported questionnaires. Latent profile analysis, linear regression analysis and mediation analysis were used to analyze the data.

Results: Among the 445 patients (71.84 ± 7.61 years, 49.7% women), four somatic symptom profiles were identified: mild symptoms, high dyspnea symptoms, high difficulty sleeping symptoms and severe symptoms. Considering the mild symptoms profile as a reference, the high difficulty sleeping symptoms and severe symptoms profiles were associated with reduced physical and mental QoL (β = -0.277 to -0.179, all P < 0.001), whereas the high dyspnea symptoms profile was associated with reduced mental QoL (β = -0.105, P = 0.041). Furthermore, both the high difficulty sleeping symptoms and severe symptoms profiles had significantly indirect effects on physical and mental QoL through depressive symptoms.

Conclusions: Our findings showed that older adult patients with different HF somatic symptom profiles experience varying levels of QoL. Tailored interventions that facilitate somatic symptom management and alleviate depressive symptoms might improve older adult patients' physical and mental QoL. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: To identify sarcopenia markers in urinary odor.

Methods: We performed solid-phase microextraction from the headspace and gas chromatography-mass spectrometry analysis of urinary volatile organic compounds (VOCs) in 71 healthy individuals and 68 patients diagnosed with sarcopenia according to the Asian Working Group on Sarcopenia 2019 criteria. The mass-to-charge ratios (m/z) of 10 VOCs with a significant difference in the total ion chromatogram of 220 VOCs detected in this study were compared by U-test. To calculate the predictive values for sarcopenia, binomial logistic regression analyses were conducted with sarcopenia (0, 1) as the dependent variable and the m/z values of each of the 10 VOCs and all 10 VOCs as independent variables. Receiver operating characteristic (ROC) curves for predictive values were generated to evaluate diagnostic accuracy. The correlations between the predictive value and handgrip strength, usual gait speed, and skeletal muscle mass were assessed using Pearson's r.

Results: We identified 10 VOCs (p-xylene, 1-butanol, d-limonene, nonanal, pyrrole, γ-butyrolactone, texanol isomer, octanoic acid, nonanoic acid, and diisobutyl phthalate) as candidate biomarkers in urine. The ROC curve analysis showed high diagnostic accuracy of the predictive values of the 10 VOCs for sarcopenia (area under the curve = 0.866, 95% confidence interval: 0.829-0.942; sensitivity, 80.9%; specificity, 81.7%). Additionally, the predictive values significantly correlated with handgrip strength (male: r = -0.505, P < 0.0001; female: r = -0.568, P < 0.0001).

Conclusions: This study identified 10 urinary VOCs as possible non-invasive biomarkers for sarcopenia, offering insights into its onset mechanism and potential therapeutic targets. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: Frailty is a mediator between robustness and functional disability. This study examined the association between remission of frailty and incident disability.

Methods: The present study analyzed longitudinal data from 2601 community-dwelling older adults who were aged ≥65 years (mean age 70.8 ± 4.5 years, 1307 women [50.2%]) using the Cardiovascular Health Study criteria. Next, examining changes in status from wave 1 (2011) to wave 2 (2015), participants were categorized into a frailty group (those who remained or became frail), a remission of frailty group (those who were frail and became robust) and a robust group (those who remained robust). Cox proportional hazard modeling was used to determine the change of frailty status from wave 1 to wave 2, as well as incident disability at wave 2 (median duration 35 months).

Results: Of those participants who started in the frailty or prefrailty groups at wave 1, 15.8% had an improved frailty status at the 47-month follow up. After adjusting for covariates at baseline, the Cox proportional hazard regression models showed that the hazard ratio of disability among participants who remained robust was significantly less than for those who were in the frailty group (hazard ratio 0.515; 95% confidence interval 0.333-0.796).

Conclusion: Our data confirm that among those whose frailty status improved, the risk of disability was lower than for those who remained frail. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: The aim of the study was to assess the occurrence of sleep disorders and the value of body mass index in seniors, taking into account their quality of aging and participation in classes at Universities of the Third Age (UTAs).

Methods: The study involved 631 (100%) seniors from the Silesian Voivodeship, aged 60 to 96 years (𝑥̅ = 70.28 ± 6.09 years). An original survey questionnaire was used, supplemented by the Successful Aging Scale and the Athens Insomnia Scale questionnaires.

Results: The median of successful aging index (SAI) points obtained by UTAs "+" seniors was 11.71, while the median of SAI points obtained by UTAs "-" seniors was 11.18. Sleep disorders were more common in women than in men as well as among people aged 71-80 years compared to other groups. There were statistically significant weak negative correlations between the points obtained in Successful Aging Scale questionaire domains and the number of points in the Athens Insomnia Scale as well as body mass index value.

Conclusions: The occurrence of sleep disorders and abnormally increased body weight were associated with a deterioration in the quality of aging in the studied seniors. Seniors participating in UTAs activities had a better quality of aging than people who denied participating in the mentioned activity. Actions should be constantly taken to improve the quality of the aging process of seniors, including providing them with access to contacts with other people, treating sleep disorders and educating them on the benefits of a healthy lifestyle and maintaining a proper body weight. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: In the Japanese health checkup system for older adults aged ≥75 years, the Questionnaire for Medical Checkup of Old-Old (QMCOO) was adopted after 2020. However, the prognostic significance of this questionnaire for the incidence of functional disability is uncertain. The current study aimed to validate the prognostic significance of the QMCOO, and to develop a simple risk score for functional disability by analyzing health insurance claims data including annual health checkup data.

Methods: This study included 111 282 older adults aged 75-90 years who did not receive long-term care services at baseline. The study period was between the earliest day of participation in the health checkup after April 2020 and September 2022. The participants who were certified as care level 2 and higher during this period were considered as incident cases of functional disability.

Results: Within a mean follow-up duration of 1.7 years (191 085 person-years), 4578 functional disability cases were identified. In addition to the basic covariates, among the 15 items in the QMCOO, nine were identified as independent determinants. The probability of developing functional disability that was calculated using the model was associated with older age, male sex, underweight and poor responses to the QMCOO items. According to the weighted score based on the model, the participants was classified as functional disability probability of <1% to >45%.

Conclusions: The nine items in the QMCOO were associated with the incidence of functional disability. The weighted scoring system could be helpful for the use of the QMCOO. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: The aim of this study was to investigate the relationship between preoperative patient factors and postoperative half-year health care utilization reflecting recovery, common complications, comorbidities, and significant health concerns, identifying strong risk and protective factors.

Methods: This retrospective cohort study utilized linear, quantile, and ordinal regressions to analyze Osaka National Health Insurance data from 26 606 elderly patients who underwent hip fracture surgery between 2012 and 2018.

Results: The key factors associated with multiple postoperative care utilizations (P < 0.001) included: 1 Compared with men, women were strongly negatively correlated with postoperative length of stay (LOS) at q90, diabetes prescriptions or drip injections, while showing strong positive associations with postoperative antihypertensive, antiosteoporosis, and antidementia prescriptions. 2 Age has a strong negative correlation with antiosteoporosis or diabetes prescriptions but strongly positive associations with indwelling urinary catheters or drip injections. 3 The preoperative 1-year LOS correlated positively with the postoperative LOS or indwelling urinary catheters, and the strongest associations were observed at q25 with the postoperative LOS. It was significantly and negatively associated with antihypertensive or antidementia prescriptions. 4 Many preoperative care utilizations were positive factors, and some were strong factors at q25 of the LOS.

Conclusions: Nuanced relationships between the female sex; preoperative LOS; antidementia, antiosteoporosis, antihypertensive and constipation prescriptions; indwelling catheters, and postoperative LOS were elucidated. These are key risks during shorter postoperative LOS, while male subgroups are at a higher risk during longer LOS duration. Patients with extended preoperative diabetes prescriptions or drip injections are at high risk of multiple postoperative care. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: Pre-injury frailty has been investigated as a tool to predict outcomes of older trauma patients. Using artificial intelligence principles of machine learning, we aimed to identify a "signature" (combination of clinical variables) that could predict which older adults are at risk of fall-related hospital admission. We hypothesized that frailty, measured using the 5-item modified Frailty Index, could be utilized in combination with other factors as a predictor of admission for fall-related injuries.

Methods: The National Readmission Database was mined to identify factors associated with admission of older adults for fall-related injuries. Older adults admitted for trauma-related injuries from 2010 to 2014 were included. Age, sex, number of chronic conditions and past fall-related admission, comorbidities, 5-item modified Frailty Index, and medical insurance status were included in the analysis. Two machine learning models were selected among six tested models (logistic regression and random forest). Using a decision tree as a surrogate model for random forest, we extracted high-risk combinations of factors associated with admission for fall-related injury.

Results: Our approach yielded 18 models. Being a woman was one of the factors most often associated with admission for fall-related injuries. Frailty appeared in four of the 18 combinations. Being a woman, aged 65-74 years and presenting a 5-item modified Frailty Index score >3 predicted admission for fall-related injuries in 80.3% of this population.

Conclusion: Using artificial intelligence principles of machine learning, we were able to develop 18 signatures allowing us to identify older adults at risk of admission for fall-related injuries. Future studies using other databases, such as TQIP, are warranted to validate our high-risk combination models. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: Adequate pelvic floor support for the urethra is crucial for preventing stress urinary incontinence (SUI). Obesity is an established risk factor for SUI. This study aimed to explore the relationship between SUI and body composition, specifically focusing on muscle and fat mass.

Methods: This single-center, prospective, cross-sectional study enrolled women who visited the genitourinary clinic of Taipei City Hospital-Zhongxiao Branch between 1 February 2020 and 31 January 2021. SUI severity was classified according to the type of daily activity in which SUI occurred. Potential risk factors for SUI, including age, labor and history of hysterectomy, were also included. All participants underwent a bioelectric impedance analysis of their body composition. Independent t-tests and Pearson's χ²-tests were used to compare the differences in continuous and categorical parameters between groups. Logistic regression analysis was used to characterize the predictive value of body composition for severe SUI.

Results: Of the 256 included patients, 37 had severe SUI. The participants with severe SUI were older and were more likely to have undergone a hysterectomy. They also had a considerably higher prevalence of sarcopenia. In the univariate analysis, a sarcopenia diagnosis was associated with severe SUI. Furthermore, a history of hysterectomy correlated with severe SUI, although with borderline significance. In the multivariate analysis, a history of hysterectomy and lower trunk muscle mass index were found to be independent predictors of severe SUI.

Conclusions: A history of hysterectomy and a lower trunk muscle mass index are correlated with severe SUI. Geriatr Gerontol Int 2025; ••: ••-••.