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Associations of Apathy and Depressive Symptoms With Frailty Domains in Individuals Aged 75 Years Old: A Cross-Sectional Study. 75岁老年人冷漠和抑郁症状与衰弱域的关联:一项横断面研究
IF 2.5 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2026-02-01 DOI: 10.1111/ggi.70394
Yoko Kuroda, Takafumi Abe, Takehiko Tsujimoto, Masayuki Yamasaki, Minoru Isomura, Atsushi Nagai

Aim: Preventing and mitigating frailty across physical, cognitive, social, and oral domains is vital for extending healthy life expectancy in older adults. Although apathy and depressive symptoms are reportedly associated with frailty domains, their domain-specific relationships remain unclear. This study aimed to compare the associations of apathy and depressive symptoms with frailty domains in older adults.

Methods: This cross-sectional study included 465 community-dwelling adults aged ≥ 75 years (median age, 78 years; interquartile range, 76.0-82.0; 49.7% women) from the 2024 Shimane CoHRE Study. Apathy and depressive symptoms were defined as scores of ≥ 16 on the Japanese version of the Starkstein Apathy Scale and ≥ 40 on the Self-rating Depression Scale, respectively. Frailty domains across physical, cognitive, social, and oral domains were assessed using the Questionnaire for Medical Checkup of the Old-Old. Logistic regression analyses adjusted for age, sex, and body mass index.

Results: The prevalence of apathy, depressive symptoms, and their coexistence was 30.8%, 29.9%, and 14.6%, respectively. Both apathy and depressive symptoms were significantly associated with a higher prevalence of physical frailty (lack of exercise), cognitive frailty (memory impairment), and social frailty (lack of interaction with others). Their coexistence was additionally associated with oral, physical, cognitive, and social frailty.

Conclusions: Apathy and depressive symptoms share some frailty domains but also exhibit domain-specific associations. Their coexistence may be associated with multidimensional frailty. These findings highlight the importance of assessing emotional function and tailoring frailty prevention to individual emotional profiles.

目的:预防和减轻身体、认知、社会和口腔领域的脆弱性对于延长老年人的健康预期寿命至关重要。尽管冷漠和抑郁症状据报道与脆弱域有关,但它们的特定域关系尚不清楚。本研究旨在比较老年人冷漠和抑郁症状与脆弱域的关联。方法:本横断面研究纳入了来自2024年岛根CoHRE研究的465名年龄≥75岁的社区居民(中位年龄为78岁,四分位数范围为76.0-82.0,女性49.7%)。冷漠和抑郁症状的定义分别为日本版斯塔克斯坦冷漠量表得分≥16分和抑郁自评量表得分≥40分。使用老年人体检问卷对身体、认知、社会和口腔领域的脆弱领域进行评估。Logistic回归分析调整了年龄、性别和体重指数。结果:冷漠、抑郁症状及其共存的患病率分别为30.8%、29.9%和14.6%。冷漠和抑郁症状都与身体虚弱(缺乏锻炼)、认知虚弱(记忆障碍)和社交虚弱(缺乏与他人互动)的较高患病率显著相关。他们的共存还与口腔、身体、认知和社会脆弱有关。结论:冷漠和抑郁症状有一些共同的脆弱域,但也表现出特定域的关联。它们的共存可能与多方面的脆弱有关。这些发现强调了评估情绪功能和针对个人情绪状况量身定制脆弱预防的重要性。
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引用次数: 0
Noise Pareidolia Test for Delirium Prediction: Considering the Role of Dopaminergic Basal Ganglia Circuitry. 噪声幻觉试验预测谵妄:考虑多巴胺能基底神经节回路的作用。
IF 2.5 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2026-02-01 DOI: 10.1111/ggi.70406
Takahiko Nagamine
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引用次数: 0
Role of Posterior Occlusal Support in the Development of Frailty Among Japanese Adults: A Longitudinal Cohort Study. 后咬合支持在日本成年人虚弱发展中的作用:一项纵向队列研究。
IF 2.5 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2026-02-01 DOI: 10.1111/ggi.70405
Takashi Miyano, Taro Kusama, Yudai Tamada, Ken Osaka, Kenji Takeuchi

Aim: Recent studies have suggested that masticatory function may influence frailty progression. However, the relationship between posterior occlusal support and frailty remains underexplored. We aimed to evaluate the association between the loss of posterior occlusal support and frailty in a large cohort of Japanese adults.

Methods: This retrospective cohort study used data from the JMDC Claims Database. We included 386 270 individuals aged ≥ 40 years who underwent both specific health checkups and dental visits in 2016, with follow-up data available through 2020. We categorized posterior occlusal support using the Eichner classification (A, all support zones intact; B, partial support zones; C, no functional support zones). We assessed frailty annually using the claims-based frailty index (CFI) (a deficit accumulation-type frailty measure). We used generalized estimating equations to evaluate the association between occlusal support and frailty after adjusting for potential confounders.

Results: At baseline, the mean age was 49.6 (standard deviation, 7.2) years, and 47.4% of the participants were women. The prevalence of frailty was 4.9%, 9.5%, and 12.1% in the Eichner A, B, and C groups, respectively. Compared to Eichner A, the adjusted odds ratios (ORs) for frailty were 1.21 (95% confidence interval [CI], 1.13-1.30) for Eichner B and 1.39 (95% CI, 1.21-1.59) for Eichner C. This relationship was stronger among women than men.

Conclusions: Reduced posterior occlusal support is independently associated with an increased risk of frailty. These findings underscore the importance of oral health in preventing physical debilitation and suggest incorporating early dental interventions into health strategies for older populations.

目的:最近的研究表明,咀嚼功能可能影响虚弱的进展。然而,后咬合支持与脆性之间的关系仍未得到充分探讨。我们的目的是在一大批日本成年人中评估后牙合支持的丧失与虚弱之间的关系。方法:这项回顾性队列研究使用来自JMDC索赔数据库的数据。我们纳入了386 270名年龄≥40岁的个体,他们在2016年接受了特定的健康检查和牙科就诊,并在2020年之前获得了随访数据。我们使用Eichner分类法对后咬合支持进行分类(A,所有支持区完整;B,部分支持区;C,无功能支持区)。我们每年使用基于索赔的脆弱性指数(CFI)(一种赤字累积型脆弱性指标)评估脆弱性。在调整了潜在的混杂因素后,我们使用广义估计方程来评估咬合支持和虚弱之间的关系。结果:基线时,平均年龄为49.6岁(标准差为7.2),47.4%的参与者为女性。Eichner A、B和C组的虚弱患病率分别为4.9%、9.5%和12.1%。与艾希纳A相比,艾希纳B和艾希纳c的脆弱性校正比值比分别为1.21(95%可信区间[CI], 1.13-1.30)和1.39 (95% CI, 1.21-1.59)。这种关系在女性中强于男性。结论:后牙合支持减少与虚弱风险增加独立相关。这些发现强调了口腔健康在预防身体衰弱中的重要性,并建议将早期牙科干预纳入老年人的健康策略。
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引用次数: 0
Intrinsic Capacity and "Healthy Longevity": Outcome Definition, Censoring, and Clinical Utility of Prediction Models. 内在能力和“健康长寿”:预测模型的结果定义、审查和临床应用。
IF 2.5 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2026-02-01 DOI: 10.1111/ggi.70397
Fanchang Wang, Hongyang Qiao, Xiaoming He
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引用次数: 0
Refining the Interpretation of Cognitive Domain-Specific Neuropsychiatric Symptoms in Alzheimer's Disease. 细化阿尔茨海默病认知领域特异性神经精神症状的解释。
IF 2.5 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2026-02-01 DOI: 10.1111/ggi.70392
Siru Wang, Hao Liu
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引用次数: 0
Comment on: “Increased Risk of Postoperative Complications in Elderly Hip Fracture Patients With Cognitive Impairment: Evidence From a Japanese Nationwide Database” 评论:“老年髋部骨折合并认知障碍患者术后并发症风险增加:来自日本全国数据库的证据”。
IF 2.5 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-30 DOI: 10.1111/ggi.70379
Huiyun Deng, Xinyu Wu, Jin Wu
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引用次数: 0
Do JST-IC Trajectories Truly Capture Aging Processes? A Need to Reconsider What the Trajectories Represent JST-IC轨迹真的能捕捉到老化过程吗?需要重新考虑轨迹所代表的东西。
IF 2.5 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-30 DOI: 10.1111/ggi.70380
Schawanya K. Rattanapitoon, Chutharat Thanchonnang, Natnapa H. Padchasuwan, Nathkapach K. Rattanapitoon

This Letter questions whether JST-IC-based trajectories primarily reflect aging-related decline or enduring life-course capacities and contextual adaptation. We argue that trajectory patterns may represent mixed trait-change constructs shaped by cognitive reserve, digital literacy, and cohort-specific exposures, with important implications for interpretation and intervention.

这封信质疑基于jst - ic的轨迹是否主要反映了与年龄相关的衰退或持久的生命过程能力和环境适应。我们认为,轨迹模式可能代表了由认知储备、数字素养和群体特定暴露形成的混合特质变化结构,对解释和干预具有重要意义。
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引用次数: 0
The Development Trajectories of Media Exposure and Cognitive Function in Older Adults: An Analysis Based on Latent Growth Models 基于潜在成长模型的老年人媒介暴露与认知功能发展轨迹分析。
IF 2.5 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-30 DOI: 10.1111/ggi.70381
Maomin Jiang, Yangyi Chen, Zhu Guo

Objective

This study explores the developmental trajectories and influencing factors of media exposure and cognitive function among older Chinese adults, aiming to provide evidence for promoting healthy aging.

Methods

Data were drawn from the Chinese Longitudinal Aging Social Survey (CLASS) across 2016, 2018, and 2020, including 7625 participants who completed all cognitive assessments. Descriptive analyses and Pearson correlations examined relationships between cognitive function and media exposure. Unconditional least squares estimation identified trajectory patterns, and latent growth models (LGMs) were applied using Mplus 8.0 to assess developmental trends and interrelations.

Results

Significant variations were found in initial levels and growth rates of both media exposure and cognitive function (p < 0.001). LGMs revealed negative correlations between intercepts and slopes for both cognitive function (β = −0.530) and media exposure (β = −0.324). Age, gender, and education significantly influenced baseline cognitive levels, while age and education also affected cognitive decline (p < 0.001). The intercept of media exposure positively influenced both the intercept (β1 = 0.229) and slope (β2 = −0.070) of cognition, and its slope significantly affected cognitive change (β = 0.184, p < 0.001).

Conclusions

Media exposure and cognitive function in older adults decline over time. Policies should prioritize women and those with lower education, expand their access to positive media content, and encourage balanced information engagement to mitigate cognitive decline and promote healthy aging.

目的:探讨中国老年人媒介暴露与认知功能的发展轨迹及其影响因素,为促进健康老龄化提供依据。方法:数据来自2016年、2018年和2020年的中国纵向老龄化社会调查(CLASS),包括7625名完成所有认知评估的参与者。描述性分析和Pearson相关性检验了认知功能与媒体接触之间的关系。无条件最小二乘估计确定了发展轨迹模式,并利用Mplus 8.0应用潜在增长模型(LGMs)评估发展趋势和相互关系。结果:媒介暴露与认知功能的初始水平和增长率(p = 0.229)、认知斜率(β2 = -0.070)均存在显著差异,其斜率显著影响认知变化(β = 0.184, p)。政策应优先考虑妇女和受教育程度较低的人,扩大她们接触正面媒体内容的机会,并鼓励平衡的信息参与,以减轻认知能力下降,促进健康老龄化。
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引用次数: 0
Analysis of the Current Status and Associated Factors of Premature Frailty in Adults Aged 18–59 Years Based on the NHANES Database 基于NHANES数据库的18-59岁成人早衰现状及相关因素分析
IF 2.5 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-29 DOI: 10.1111/ggi.70328
Kaiwusaierjiang Keremu, Decheng Liu, Yingying Gu, Chaozhu He

Purpose

This study aims to determine the prevalence of premature frailty in adults aged 18–59 years, and identify modifiable factors associated with its occurrence. The findings will facilitate targeted screening for high-risk individuals and inform primary prevention strategies to mitigate development of premature frailty.

Methods

This study analyzed data from the National Health and Nutrition Examination Survey (NHANES, 2005–2018), including adults aged 18–59 years. Premature frailty was defined using a 49 item frailty index (FI) based on the deficit accumulation model. We assessed nutritional status, depressive symptoms, and physical activity (PA), respectively. Multivariable logistic regression identified factors associated with premature frailty, with covariates selected via univariate screening (p < 0.05). Random forest modeling ranked variable importance, and restricted cubic splines examined nonlinear associations between continuous predictors and frailty risk.

Results

A total of 4173 participants were included in this study, with 49.2% male and 50.8% female. The highest prevalence of premature frailty was observed in the 40–59 age group, accounting for 67.3% of cases. Logistic regression results showed that depression score, sleep condition, and age were associated factors for premature frailty, while education level, marital status, ratio of family income to poverty (PIR), alcohol intake, Healthy Eating Index (HEI) score, and PA were protective factors. Based on the random forest model, depression scores, sleep condition, and PA were identified as the top three associated factors for premature frailty. Restricted cubic spline analysis revealed potential nonlinear relationships between premature frailty and depression scores, PA, PIR, and alcohol intake, while suggesting a possible linear relationship with HEI score.

Conclusion

Multiple factors are associated with the occurrence of premature frailty, among which depression, PA, and sleep condition are the three most prominent. In clinical practice, healthcare professionals should prioritize high-risk populations by implementing effective interventions such as psychological care, health education, and targeted treatments.

目的:本研究旨在确定18-59岁成人过早虚弱的患病率,并确定与其发生相关的可改变因素。这些发现将有助于对高危人群进行有针对性的筛查,并为初级预防策略提供信息,以减轻过早虚弱的发展。方法:本研究分析了国家健康与营养检查调查(NHANES, 2005-2018)的数据,包括18-59岁的成年人。使用基于赤字积累模型的49项脆弱性指数(FI)来定义过早脆弱性。我们分别评估了营养状况、抑郁症状和身体活动(PA)。多变量logistic回归确定了与过早虚弱相关的因素,并通过单变量筛选选择了协变量(p)。结果:本研究共纳入4173名参与者,其中49.2%为男性,50.8%为女性。早衰患病率最高的是40-59岁年龄组,占67.3%的病例。Logistic回归结果显示,抑郁评分、睡眠状况和年龄是发生早衰的相关因素,而教育程度、婚姻状况、家庭收入与贫困比(PIR)、酒精摄入量、健康饮食指数(HEI)评分和PA是保护因素。基于随机森林模型,抑郁评分、睡眠状况和PA被确定为导致过早虚弱的三大相关因素。限制性三次样条分析显示,过早虚弱与抑郁评分、PA、PIR和酒精摄入量之间存在潜在的非线性关系,而与HEI评分之间可能存在线性关系。结论:早衰的发生与多种因素有关,其中抑郁、PA和睡眠状况是最突出的三个因素。在临床实践中,卫生保健专业人员应优先考虑高危人群,实施有效的干预措施,如心理护理、健康教育和有针对性的治疗。
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引用次数: 0
Visual Dependence and Fall Risk in Dementia: Implications for Sensory Re-Weighting Strategies 痴呆的视觉依赖和跌倒风险:感官重加权策略的意义。
IF 2.5 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-29 DOI: 10.1111/ggi.70378
Yi-Ching Chu, Chao-Chun Huang

We read with great interest the article by Nakai et al. [1], which elucidated the significance of visual correction of balance—quantified by the Romberg quotient—in care planning for fall prevention in dementia. As the authors highlighted, fall risk in dementia with Lewy bodies (DLB) is multifaceted. We would like to offer a complementary perspective from the standpoint of physical rehabilitation and sensory integration.

While the study effectively demonstrated that visual dysfunction correlates with postural instability, it raises a critical question regarding the mechanism of “sensory re-weighting.” In clinical practice, we often observe that patients with cognitive impairment struggle to switch between visual, vestibular, and somatosensory inputs [2]. A high Romberg quotient suggests a maladaptive reliance on visual input to compensate for deficits in other sensory systems. However, in DLB patients, visual processing itself is often fluctuating or impaired [3].

Therefore, simply identifying the reliance on vision is the first step. The logical next step for “care planning,” as proposed by the authors, should involve differentiating whether this visual dependence is a compensatory strategy that should be supported (e.g., by enhancing environmental lighting and visual cues) or a potential distractor that may precipitate falls when visual information is ambiguous.

We suggest that future research could benefit from combining the Romberg quotient with dynamic posturography or dual-task gait analysis. This would help determine if rehabilitation interventions should focus on “visual cueing training” or, conversely, “sensory re-weighting training” to reduce excessive visual dependence. The findings by Nakai et al. [1] provide an excellent foundation for tailoring such precision rehabilitation strategies.

The authors have nothing to report.

The authors have nothing to report.

The authors have nothing to report.

The authors declare no conflicts of interest.

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

我们饶有兴趣地阅读了Nakai等人的文章,该文章阐明了平衡视力矫正(以Romberg商数量化)在痴呆症患者预防跌倒护理计划中的重要性。正如作者所强调的,路易体痴呆(DLB)的跌倒风险是多方面的。我们想从身体康复和感觉统合的角度提供一个互补的观点。虽然这项研究有效地证明了视觉功能障碍与姿势不稳定有关,但它提出了一个关于“感觉重加权”机制的关键问题。在临床实践中,我们经常观察到认知障碍患者很难在视觉、前庭和体感输入之间切换。Romberg商数高表明对视觉输入的不适应依赖弥补了其他感觉系统的缺陷。然而,在DLB患者中,视觉处理本身经常波动或受损。因此,简单地确定对视觉的依赖是第一步。正如作者所提出的,“护理计划”的逻辑下一步应该包括区分这种视觉依赖是一种应该得到支持的补偿策略(例如,通过增强环境照明和视觉提示),还是一种潜在的干扰因素,当视觉信息模糊时,可能会导致跌倒。我们建议将Romberg商数与动态姿势学或双任务步态分析相结合,可以使未来的研究受益。这将有助于确定康复干预是否应该侧重于“视觉提示训练”,或者相反,“感觉重加权训练”,以减少过度的视觉依赖。Nakai等人的研究结果为定制这种精确康复策略提供了良好的基础。作者没有什么可报告的。作者没有什么可报告的。作者没有什么可报告的。作者声明无利益冲突。数据共享不适用于本文,因为在当前研究期间没有生成或分析数据集。
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引用次数: 0
期刊
Geriatrics & Gerontology International
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