Geriatrics & Gerontology International最新文献_第3页

Ability of the SMART-COP score to predict the need for intensive care unit admission and mortality in older patients with non–ventilator-associated hospital-acquired pneumonia: A retrospective observational study SMART-COP 评分预测老年非呼吸机相关医院获得性肺炎患者入住重症监护病房的需求和死亡率的能力：一项回顾性观察研究。

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2024-10-02 DOI: 10.1111/ggi.14990

Korhan Kollu, Merve Yilmaz Kars, Mustafa Hakan Dogan, Ilyas Akkar, Ayse Dikmeer, Muhammet Cemal Kizilarslanoglu

Aim

To evaluate the ability of SMART-COP (systolic blood pressure, multilobar infiltrates, albumin, respiratory rate, tachycardia, confusion, oxygen and pH) score to predict the need for intensive care unit (ICU) admission and mortality among patients with non–ventilator-associated hospital-acquired pneumonia (NV-HAP) and to compare ICU-hospitalized patients with those followed-up in the clinic, as well as the patients who survived with those who died in the ICU, in terms of clinical and laboratory parameters.

Methods

A total of 203 patients (aged > 65 years) who were diagnosed with NV-HAP while staying in the geriatric clinic were enrolled in this retrospective observational study. Patient information was retrieved from hospital files.

Results

In a total of 203 patients with NV-HAP, the rate of ICU admission was 77.3% and the rate of mortality was 40.9%. The SMART-COP score was significantly higher in those admitted to the ICU and those died in the ICU (ICU nonsurvivors). The rate of ICU mortality was 52.9%. The SMART-COP score had significantly poor to moderate ability to predict the need for ICU admission (area under the curve [AUC] = 0.583) and both in-hospital mortality (AUC = 0.633) and ICU mortality (AUC = 0.617) with low sensitivity. The regression analysis revealed that a one-unit increase in SMART-COP score resulted in a 1.2-fold increase in both the hospital and ICU mortality (P < 0.05 for both) and 1.1-fold increase in ICU admission (P = 0.154).

Conclusion

The SMART-COP score has poor to moderate ability to predict the need for ICU admission, in-hospital mortality and ICU mortality, and a one-unit increase in the SMART-COP score significantly increases the risk of both hospital and ICU mortality. Geriatr Gerontol Int 2024; 24: 1165–1172.

目的：评估SMART-COP（收缩压、多叶浸润、白蛋白、呼吸频率、心动过速、意识模糊、血氧和pH值）评分预测非呼吸机相关医院获得性肺炎（NV-HAP）患者入住重症监护病房（ICU）的必要性和死亡率的能力，并从临床和实验室参数方面比较入住ICU的患者与在诊所随访的患者，以及存活的患者与死于ICU的患者：这项回顾性观察研究共纳入了 203 名在老年病诊所就诊时被确诊为 NV-HAP 的患者（年龄大于 65 岁）。患者信息来自医院档案：在 203 名 NV-HAP 患者中，入住重症监护室的比例为 77.3%，死亡率为 40.9%。入住重症监护室和在重症监护室死亡的患者（重症监护室非存活者）的 SMART-COP 评分明显较高。ICU 死亡率为 52.9%。SMART-COP评分在预测ICU入院需求（曲线下面积[AUC] = 0.583）、院内死亡率（AUC = 0.633）和ICU死亡率（AUC = 0.617）方面的能力明显处于中下水平，灵敏度较低。回归分析表明，SMART-COP 评分每增加一个单位，住院死亡率和重症监护室死亡率都会增加 1.2 倍（P 结论：SMART-COP 评分具有较高的灵敏度：SMART-COP 评分在预测是否需要入住重症监护病房、院内死亡率和重症监护病房死亡率方面的能力处于中下水平，SMART-COP 评分每增加一个单位，住院和重症监护病房死亡率的风险都会显著增加。Geriatr Gerontol Int 2024; --：-----.

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引用次数: 0

DASC-21 score and risk of rehospitalization and all-cause mortality after discharge in older patients with heart failure DASC-21 评分与老年心力衰竭患者出院后再次住院和全因死亡的风险。

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2024-10-01 DOI: 10.1111/ggi.14975

Ruri Shimizu, Joji Ishikawa, Chihiro Jyubishi, Ayumi Toba, Shutaro Futami, Ai Morozumi, Yoshihiro Saito, Shunsuke Komatsu, Hajime Fujimoto, Taizo Ishiyama, Shinichi Usui, Yusuke Tuboko, Shuichi Awata, Masahiro Akishita, Kazumasa Harada

Aim

The impact of cognitive dysfunction-associated activities of daily living (ADL) on mortality and rehospitalization for heart failure has not yet been evaluated.

Methods

We retrospectively evaluated DASC-21, the incidence of all-cause mortality, and rehospitalization for heart failure after discharge in 329 older patients with heart failure.

Results

The mean age was 85.1 ± 7.4 years (62.6% women). There were 110 cases of death from any cause (33.4%) during 25.5 ± 16.1 months of follow-up and 166 cases of rehospitalization from heart failure (50.5%) during 16.1 ± 15.2 months of follow-up. The DASC-21 score was not significantly associated with an increased risk of all-cause mortality or rehospitalization. For each item of the DASC-21 questionnaire, defective route-finding (item 6) (HR = 2.631, P = 0.003), common sense and capacity for judgement (item 9) (HR = 1.717, P = 0.040), instrumental ADL (IADL) for shopping (item 10) (HR = 1.771, P = 0.020), and IADL for meal preparation (item 14) (HR = 1.790, P = 0.019) were significantly associated with an increased risk of all-cause mortality. Disabilities in route finding (HR = 2.257, P = 0.005), IADL for shopping (HR = 1.632, P = 0.016), and IADL for transportation (HR = 1.537, P = 0.033) were significant risk factors for rehospitalization due to heart failure. Even in the multivariate-adjusted model, disability in defective route-finding was significantly associated with an increased risk of all-cause mortality (hazard ratio [HR] = 2.148, 95% confidence interval [CI] 1.090–4.236; P = 0.027) and of rehospitalization for heart failure (HR = 2.138, 95% CI 1.153–3.963, P = 0.016).

Conclusions

In older patients hospitalized for heart failure, route disability was associated with all-cause mortality and rehospitalization for heart failure after discharge. Geriatr Gerontol Int 2024; 24: 1130–1136.

目的：认知功能障碍相关的日常生活活动（ADL）对心力衰竭死亡率和再住院率的影响尚未得到评估：我们对329名老年心衰患者的DASC-21、全因死亡率和出院后因心衰再次住院的情况进行了回顾性评估：平均年龄为 85.1 ± 7.4 岁（女性占 62.6%）。在 25.5 ± 16.1 个月的随访期间，有 110 例因任何原因死亡（33.4%），在 16.1 ± 15.2 个月的随访期间，有 166 例因心衰再次住院（50.5%）。DASC-21评分与全因死亡率或再住院风险的增加无明显关联。在 DASC-21 问卷的每个项目中，路线寻找缺陷（第 6 项）（HR = 2.631，P = 0.003）、常识和判断能力（第 9 项）（HR = 1.717，P = 0.040）、购物的工具性日常生活能力（IADL）（第 10 项）（HR = 1.771，P = 0.020）和准备膳食的 IADL（第 14 项）（HR = 1.790，P = 0.019）与全因死亡风险增加显著相关。寻找路线（HR = 2.257，P = 0.005）、购物（HR = 1.632，P = 0.016）和交通（HR = 1.537，P = 0.033）方面的残疾是心衰再住院的重要危险因素。即使在多变量调整模型中，路径选择缺陷也与全因死亡风险增加（危险比 [HR] = 2.148，95% 置信区间 [CI] 1.090-4.236；P = 0.027）和心衰再住院风险增加（HR = 2.138，95% CI 1.153-3.963，P = 0.016）显著相关：结论：在因心力衰竭住院的老年患者中，路线残疾与全因死亡率和出院后因心力衰竭再次住院有关。Geriatr Gerontol Int 2024; --：-----.

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引用次数: 0

Unwanted cardiopulmonary resuscitation against patients’ “Do Not Attempt Resuscitation” orders in community settings in Japan: A narrative review 日本社区环境中违背患者 "不要尝试复苏 "指令的意外心肺复苏：叙述性综述。

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2024-10-01 DOI: 10.1111/ggi.14993

Kaku Kuroda, Kaori Ito, Takeshi Uemura

We aimed to synthesize existing research to elucidate the underlying factors and causes responsible for the high prevalence of unwanted cardiopulmonary resuscitation (CPR) occurring outside a hospital setting in Japan despite patients' Do Not Attempt Resuscitation (DNAR) orders. We conducted a narrative review by searching PubMed, EMBASE, and Scopus for English literature, and Google Scholar for Japanese literature. The key factors we identified included lack of documentation of resuscitation preferences, variation in the perception of other life-sustaining measures associated with DNAR, non-inclusion of the patient in discussions of goals of care, unlegislated and unstandardized DNAR orders, emergency medical service activation by the family or facility, the Fire Service Act that mandates life-saving measures irrespective of the presence of advance directives, fire department protocols and CPR decision-making, and death pronouncement authorization limited to physicians. This study identified the multifaceted factors and the potential triggers for unwanted CPR despite DNAR orders. These findings underscore the urgent need for comprehensive interventions encompassing educational initiatives, ethical considerations, systemic reforms, and legal adjustments to prevent future unwanted CPRs in Japan. Geriatr Gerontol Int 2024; 24: 1093–1098.

我们的目的是综合现有的研究，以阐明在日本，尽管患者下达了 "不要尝试人工呼吸"（DNAR）的命令，但在医院以外的环境中仍发生大量不必要的心肺复苏（CPR）的潜在因素和原因。我们通过检索 PubMed、EMBASE 和 Scopus（英文文献）以及 Google Scholar（日文文献）进行了叙述性综述。我们发现的关键因素包括：缺乏复苏偏好记录、对与 DNAR 相关的其他维持生命措施的认识存在差异、未将患者纳入护理目标的讨论中、DNAR 命令未经立法且未标准化、家属或医疗机构启动了紧急医疗服务、《消防法》规定无论是否存在预先指示都必须采取挽救生命的措施、消防部门协议和心肺复苏决策，以及仅限于医生的死亡宣告授权。本研究确定了尽管有 DNAR 命令，但仍不希望进行心肺复苏的多方面因素和潜在触发因素。这些研究结果突出表明，日本急需采取包括教育措施、伦理考虑、系统改革和法律调整在内的综合干预措施，以防止未来发生不必要的心肺复苏。Geriatr Gerontol Int 2024; --：-----.

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引用次数: 0

Developing a brief older adults' physical activity questionnaire 编制老年人体育活动简明问卷。

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2024-09-30 DOI: 10.1111/ggi.14986

Koutatsu Nagai, Ryota Matsuzawa, Hiroyuki Sasai, Kayoko Tamaki, Hiroshi Kusunoki, Yosuke Wada, Shotaro Tsuji, Kana Hashimoto, Takara Mori, Ken Shinmura

Aim

This study aimed to develop and evaluate the Brief Older Adults' Physical Activity Questionnaire (BOPAQ), which was designed to quickly assess moderate-to-vigorous physical activity (MVPA) in community-dwelling older adults.

Methods

We used a cross-sectional study design involving 165 older participants. The BOPAQ calculated weekly MVPA duration based on two questions regarding the number of days per week engaged in MVPA and the daily duration of activity. Validity was assessed by correlating the MVPA durations derived from the BOPAQ with those obtained from the ActiGraph and International Physical Activity Questionnaire short form. Reliability was evaluated using the intraclass correlation coefficient, and measurement errors were analyzed using Bland–Altman plots.

Results

The BOPAQ reasonably correlated with accelerometer-based MVPA (rho = 0.297) and showed good test–retest reliability (intraclass correlation coefficient of 0.78, 95% CI 0.64–0.87). In contrast, the correlation between the International Physical Activity Questionnaire short form and accelerometer-based MVPA was poor (rho = 0.139). The cut-off value for the BOPAQ was set to identify participants engaging in <150 min of objectively measured physical activity per week, corresponding to the 150-min threshold. However, the area under the curve in the receiver operating characteristic analyses was not significantly high (0.601, 95% CI 0.514–0.688). The Bland–Altman plots showed an underestimation bias of 51.72 min/week (95% CI 1.61–101.84) and showed heteroscedasticity.

Conclusion

Despite some measurement errors, the BOPAQ is an available tool for assessing MVPA in community-dwelling older adults. Geriatr Gerontol Int 2024; 24: 1150–1155.

目的：本研究旨在开发和评估 "简明老年人体力活动问卷"（BOPAQ），该问卷旨在快速评估社区老年人的中强度体力活动（MVPA）：我们采用横断面研究设计，共有 165 名老年人参与。BOPAQ 根据每周进行 MVPA 的天数和每天活动的持续时间这两个问题计算每周 MVPA 的持续时间。通过将 BOPAQ 得出的 MVPA 持续时间与 ActiGraph 和国际体力活动问卷简表得出的 MVPA 持续时间相关联，对其有效性进行了评估。可靠性采用类内相关系数进行评估，测量误差采用 Bland-Altman 图进行分析：结果：BOPAQ 与基于加速度计的 MVPA 有合理的相关性（rho = 0.297），并显示出良好的测试-再测试可靠性（类内相关系数为 0.78，95% CI 为 0.64-0.87）。相比之下，国际体力活动问卷简表与加速度计 MVPA 之间的相关性较差（rho = 0.139）。设定 BOPAQ 的临界值是为了识别参与结论的参与者：尽管存在一些测量误差，但 BOPAQ 是评估社区老年人 MVPA 的可用工具。Geriatr Gerontol Int 2024; --：-----.

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引用次数: 0

Effect of standardized hypnotic bundles on insomnia during hospitalization and reducing fall rate: A single-center retrospective cohort study 标准化催眠药束对住院期间失眠和降低跌倒率的影响：单中心回顾性队列研究。

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2024-09-30 DOI: 10.1111/ggi.14985

Yuta Yoshino, Naoko Fudaka, Yumiko Shibasaki, Miyuki Ogawa, Yoshimasa Watanabe

Aim

Although the use of benzodiazepine receptor agonists is a risk factor for falls and fractures, whether benzodiazepine-avoiding hypnotic bundles are beneficial in clinical settings remains unclear.

Methods

A new hospital-wide standardized hypnotic bundle for insomnia, with suvorexant as the first choice, was created for clinical purposes. This single-center retrospective cohort study involved a pre-post design and adult inpatients who had had falls. The primary outcome was the total fall rate in the pre-post groups. Additionally, the level change in the fall-rate trend for each month at standardization of the new hypnotic bundle was analyzed. The numbers of hypnotic-related falls and injuries requiring treatment were evaluated.

Results

There were no differences in baseline characteristics between the two groups, except for patients with COVID-19. Overall, 31 736 patients were included in this study. The total number of falls was 924 (3.42‰) in the pre-standardization group and 837 (3.31‰) in the post-standardization group, with no significant difference. An interrupted time-series analysis of the level change in the fall rate revealed that the gap in trend at standardization was –11%, with no significance. Hypnotic-related falls were 300 (1.11‰) versus 213 (0.84‰), and the injury incidences were 251 (0.93‰) versus 181 (0.71‰) in the pre and post groups, respectively, showing a significant reduction.

Conclusions

The standardization of the new hypnotic bundle for insomnia did not help achieve a significant reduction in total falls. However, our findings suggest that this bundle has the potential to reduce hypnotic-related falls and injuries in inpatients who have had falls. Geriatr Gerontol Int 2024; 24: 1144–1149.

目的：虽然使用苯并二氮杂卓受体激动剂是导致跌倒和骨折的风险因素之一，但避免使用苯并二氮杂卓的催眠药捆绑疗法在临床环境中是否有益仍不清楚：方法：为临床目的，在全院范围内创建了新的失眠症标准化催眠药束，并将舒眠宁作为首选。这项单中心回顾性队列研究采用了前-后设计，研究对象为发生过跌倒的成年住院患者。主要结果是前后组的总跌倒率。此外，还分析了新催眠药捆绑标准化后每月跌倒率趋势的水平变化。此外，还评估了与催眠药相关的跌倒和需要治疗的受伤人数：除 COVID-19 患者外，两组患者的基线特征无差异。本研究共纳入 31 736 名患者。标准化前组的跌倒总次数为 924 次（3.42‰），标准化后组的跌倒总次数为 837 次（3.31‰），差异无显著性。对跌倒率水平变化的间断时间序列分析显示，标准化时的趋势差距为-11%，差异不显著。催眠药相关跌倒率为 300（1.11‰）对 213（0.84‰），受伤发生率为 251（0.93‰）对 181（0.71‰），前后两组分别有显著下降：针对失眠症的新催眠药束的标准化无助于显著减少跌倒总数。然而，我们的研究结果表明，这种捆绑疗法有可能减少曾发生过跌倒的住院病人因催眠药导致的跌倒和伤害。Geriatr Gerontol Int 2024; --：-----.

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引用次数: 0

Prevalence, correlates, and health indicators associated with meal-skipping among middle-aged and older adults in Thailand: A national longitudinal study 泰国中老年人不吃正餐的流行率、相关因素和健康指标：一项全国纵向研究。

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2024-09-25 DOI: 10.1111/ggi.14966

Supa Pengpid, Karl Peltzer, Dararatt Anantanasuwong

Aim

The purpose of this longitudinal study was to evaluate the prevalence and correlates of and the factors contributing to meal-skipping in middle-aged and older adults in Thailand.

Methods

We examined prospective cohort data from three consecutive waves of the Health, Aging and Retirement in Thailand (HART) study (analytic sample size = 2863) for participants 45 years of age and older. Meal-skipping was assessed with a one- and two-day recall of breakfast, lunch, and dinner. We used generalized estimating equations analysis to evaluate the longitudinal relationships between sociodemographic, lifestyle, and health indicators and meal-skipping between 2015 (wave 1), 2017 (wave 2), and 2020 (wave 3). Furthermore, binary logistic regression was used to establish the longitudinal association between meal-skipping and the incidence of multiple chronic conditions.

Results

The prevalence of meal-skipping was 6.2% in 2015, 16.2% in 2017, and 13.6% in 2020, and across study years the highest proportion of meal skipping was for lunch (6.0%), followed by breakfast (4.6%), and dinner (2.8%). In the final model, sociodemographic factors (higher education, urban residence, and lower subjective economic status), lifestyle factors (high alcohol use, current smoking, and obesity class II), and health indicators (probable depression and wearing dentures) were positively associated with meal-skipping. In the adjusted logistic regression models, compared with no meal-skipping, meal-skipping in 2–3 study waves was associated with incident obesity and incident probable depression.

Conclusion

Skipping meals was linked to a number of lifestyle variables and indicators of physical and mental illness. Geriatr Gerontol Int 2024; 24: 1196–1202.

目的：这项纵向研究的目的是评估泰国中老年人逃餐的发生率、相关性以及导致逃餐的因素：我们研究了泰国健康、老龄化和退休（HART）研究连续三波的前瞻性队列数据（分析样本量 = 2863），研究对象为 45 岁及以上的参与者。通过对早餐、午餐和晚餐进行一天和两天的回忆来评估漏餐情况。我们使用广义估计方程分析法评估了 2015 年（第 1 次调查）、2017 年（第 2 次调查）和 2020 年（第 3 次调查）之间社会人口学、生活方式和健康指标与弃餐之间的纵向关系。此外，还采用二元逻辑回归法来确定逃餐与多种慢性病发病率之间的纵向关系：2015年的漏餐率为6.2%，2017年为16.2%，2020年为13.6%，在各研究年份中，漏餐比例最高的是午餐（6.0%），其次是早餐（4.6%）和晚餐（2.8%）。在最终模型中，社会人口学因素（高等教育、城市居住和主观经济地位较低）、生活方式因素（大量饮酒、目前吸烟和肥胖等级 II）和健康指标（可能患有抑郁症和佩戴假牙）与不吃正餐呈正相关。在调整后的逻辑回归模型中，与不逃餐相比，在2-3次研究中逃餐与肥胖症和抑郁症的发生有关：结论：不吃饭与许多生活方式变量以及身体和精神疾病指标有关。Geriatr Gerontol Int 2024; --：-----.

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引用次数: 0

Acute exacerbation of combined pulmonary fibrosis and emphysema due to suspected loxoprofen-induced lung injury 疑似洛索洛芬诱发的肺损伤导致肺纤维化和肺气肿合并症急性加重。

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2024-09-25 DOI: 10.1111/ggi.14974

Masaru Ando, Honoka Nagase, Yoshio Satonaga, Izumi Yamatani, Michitoshi Yabe, Takamasa Kan, Erika Omote, Shuya Miyazaki, Kosaku Komiya, Kazufumi Hiramatsu

引用次数: 0

Geraniol intake improves age-related malnutrition in mice 摄入香叶醇可改善小鼠与年龄有关的营养不良。

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2024-09-24 DOI: 10.1111/ggi.14982

Shuichi Shibuya, Kenji Watanabe, Daiki Sakuraba, Takeshi Nagata, Yoshimasa Yamaguchi, Yasuyuki Suzuki, Takahiko Shimizu

Aim

Geraniol is an acyclic monoterpenoid that is abundant in many plants, including rose, lemongrass, and lavender. As geraniol has various beneficial functions, rose oil rich in geraniol is not only used for aromatherapy but also as a supplement to promote health benefits. However, the beneficial effects of geraniol on age-related pathologies are unknown. In this study, we aimed to clarify the effects of geraniol intake on age-related pathologies.

Methods

We orally administered geraniol to aged mice (age: 24–29 months) five times a week for 4 weeks and sampled their blood and various organs. We investigated age-related changes in the blood and organ samples. Furthermore, we treated HepG2 cells with geraniol and examined the expression level of the ALB gene and the amount of secreted albumin in vitro.

Results

Geraniol significantly increased blood albumin, total cholesterol, and red blood cell counts, indicating an improvement in nutritional markers in aged mice. Geraniol also transcriptionally increased the Alb gene expression in the liver of aged mice. Furthermore, treatment with geraniol significantly upregulated the ALB gene expression and the secretion of albumin in the conditioned medium of HepG2 cells.

Conclusion

Geraniol increases serum albumin levels at the transcriptional level. Geraniol intake can be an effective strategy for age-related malnutrition. Geriatr Gerontol Int 2024; 24: 1233–1240.

目的：香叶醇是一种无环单萜类化合物，在许多植物（包括玫瑰、柠檬草和薰衣草）中含量丰富。由于香叶醇具有多种有益功能，富含香叶醇的玫瑰精油不仅被用于芳香疗法，还被用作促进健康的补充剂。然而，香叶醇对老年相关病症的有益作用尚不清楚。本研究旨在阐明摄入香叶醇对老年相关病症的影响：方法：我们给老年小鼠（年龄：24-29 个月）口服香叶醇，每周 5 次，连续 4 周，并对小鼠的血液和各种器官进行采样。我们研究了血液和器官样本中与年龄相关的变化。此外，我们还用香叶醇处理了 HepG2 细胞，并在体外检测了 ALB 基因的表达水平和分泌的白蛋白量：结果：香叶醇能明显增加血液中的白蛋白、总胆固醇和红细胞数量，这表明老年小鼠的营养指标有所改善。香叶醇还能转录增加老龄小鼠肝脏中 Alb 基因的表达。此外，香叶醇还能显著提高 ALB 基因的表达和 HepG2 细胞条件培养基中白蛋白的分泌：结论：香叶醇能在转录水平上提高血清白蛋白水平。结论：香叶醇能在转录水平上提高血清白蛋白水平，摄入香叶醇是治疗老年营养不良的有效策略。Geriatr Gerontol Int 2024; --：-----.

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引用次数: 0

Predictive validity of the Questionnaire for Medical Checkup of Old-Old for all-cause mortality and disability incidence 老年人体检问卷对全因死亡率和残疾发生率的预测有效性。

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2024-09-24 DOI: 10.1111/ggi.14977

Noriko Hori, Jiaqi Li, Kaori Kinoshita, Kazuhiro Yoshiura, Yosuke Osuka, Shosuke Satake

Aim

The Questionnaire for Medical Checkup of Old-Old (QMCOO) has been used nationwide in Japan as part of the health checkup for latter-stage older adults since the financial year 2020. Although the QMCOO is useful in screening for frailty, its cutoff values for predicting adverse health outcomes have rarely been assessed. Therefore, this study aimed to calculate the cutoff values for predicting all-cause mortality and disability incidence and to evaluate their predictive validity.

Methods

This study included 3837 health checkup recipients aged ≥75 years residing in Higashiura Town, Aichi Prefecture, Japan. The health checkup was conducted from June 1, 2020, to January 31, 2021. Mortality and disability incidence were analyzed separately. For the latter, participants with a disability history were excluded, leaving 3040 available for analysis.

Results

During the follow-up of 11 191 and 8550 person-years, 276 died and 438 developed a disability, respectively. The areas under the receiver operating characteristic curve (95% confidence intervals) for all-cause mortality and disability incidence were 0.68 (0.65–0.71) and 0.66 (0.63–0.68), respectively, with QMCOO cutoff values at 3/4 and 2/3 points. Cox proportional hazard models adjusted for age, sex, body mass index, self-reported diseases, and frequency of alcohol consumption demonstrated the predictive validity of those cutoff values.

Conclusions

The optimal cutoff value of the QMCOO for predicting all-cause mortality was 3/4, while the optimal cutoff value for predicting disability incidence was 2/3 among an older Japanese population. Geriatr Gerontol Int 2024; 24: 1203–1209.

目的：自 2020 财年起，日本在全国范围内使用老年人体检问卷（QMCOO），作为后期老年人健康检查的一部分。虽然 QMCOO 在筛查虚弱方面很有用，但其预测不良健康结果的临界值却很少被评估。因此，本研究旨在计算预测全因死亡率和残疾发生率的临界值，并评估其预测有效性：本研究包括居住在日本爱知县东浦町的 3837 名年龄≥75 岁的健康体检者。体检时间为 2020 年 6 月 1 日至 2021 年 1 月 31 日。死亡率和残疾发生率分别进行分析。对于残疾发生率，排除了有残疾史的参与者，剩下 3040 人可用于分析：结果：在 11 191 人年和 8550 人年的随访期间，分别有 276 人死亡和 438 人致残。全因死亡率和残疾发生率的接收器操作特征曲线下面积（95% 置信区间）分别为 0.68（0.65-0.71）和 0.66（0.63-0.68），QMCOO 临界值分别为 3/4 和 2/3。根据年龄、性别、体重指数、自我报告的疾病和饮酒频率调整后的 Cox 比例危险模型证明了这些临界值的预测有效性：结论：在日本老年人群中，QMCOO 预测全因死亡率的最佳临界值为 3/4，而预测残疾发生率的最佳临界值为 2/3。Geriatr Gerontol Int 2024; --：-----.

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引用次数: 0

Letter to Editor in response to “Sex differences in reduction of trunk muscle mass related to falls and cognitive function during the COVID-19 pandemic in older adults” 致编辑的信，回应 "在 COVID-19 大流行期间，与老年人跌倒和认知功能相关的躯干肌肉质量减少的性别差异"。

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2024-09-23 DOI: 10.1111/ggi.14983

Hinpetch Daungsupawong, Viroj Wiwanitkit

引用次数: 0