Geriatrics & Gerontology International最新文献

Aim: Cerebral small vessel disease (CSVD)-related MRI findings, including white matter hyperintensities (WMHs), are not rare in general elderly populations. The aim of this study was to elucidate the contribution of hereditary CSVD-related genes to CSVD-related MRI findings in a general Japanese population.

Methods: We analyzed datasets from 324 individuals aged ≥ 50 years in Tohoku Medical Megabank (TMM), focusing on MRI markers and variants of NOTCH3, ABCC6, COL4A1, COL4A2, GLA, HTRA1, and TREX1 genes. Background factors included age, sex, hypertension, diabetes, dyslipidemia, hyperuricemia, alcohol drinking, and smoking.

Results: Pathogenic variant carriers were identified within ABCC6 (n = 20), but not other genes. To compare with previous studies including rare NOTCH3 variants regardless of pathogenicity, we included 24 rare functional variants of NOTCH3. We performed a gene-based analysis using the burden test and sequence kernel association test (SKAT) adjusted for background factors, between WMH/lacune and ABCC6/NOTCH3. The only significant finding was the correlation between WMH volume and rare NOTCH3 variants by SKAT, both with the basic model, adjusted for age, sex, and hypertension (p = 0.045), and full model, adjusted for all background factors (p = 0.027). We also analyzed the association between intracranial major artery stenosis/occlusion (ICASO) and RNF213 p.Arg4810Lys, the East Asian-specific variant susceptible to ICASO; however, we failed to identify a significant correlation.

Conclusions: This study suggests that NOTCH3 may contribute to WMH volume in a general Japanese population.

Aim: During the COVID-19 pandemic, some patients experienced difficulty attending regular in-hospital cardiac rehabilitation (CR) after discharge. This study investigated the impact of CR in older patients with cardiovascular disease (CVD) by comparing outcomes before, during, and after the COVID-19 pandemic.

Methods: In this post hoc analysis of a single-center registry, 505 patients aged ≥ 65 years (mean age 82) were included. Outcomes were compared between participants in a 4-month outpatient CR program after discharge and non-participants. Patients were categorized into three periods: before the COVID-19 pandemic (n = 173), during the COVID-19 pandemic (n = 217), and after the COVID-19 pandemic (n = 105). Cardiovascular (CV) events and non-CV events were followed.

Results: As the primary endpoint, cumulative hospitalization for worsening HF was significantly lower in the CR group across all time periods (p < 0.001, p < 0.001, and p = 0.019, respectively). Cumulative non-CV event-free survival was significantly higher in the CR group before and after the COVID-19 pandemic (p < 0.001, p = 0.030, respectively) but showed no significant differences during the pandemic. Before the pandemic, participation in CR was significantly associated with hospitalization for worsening HF (hazard ratio [HR], 0.538; 95% confidence interval [CI], 0.294-0.982; p = 0.043). During and after the pandemic, this association was not.

Conclusion: CR appears to have a protective effect against CV events in older patients with CVD. Although the COVID-19 pandemic disrupted this positive trend, the findings support CR as a cornerstone of recovery in this population.

Objective: To develop and validate a risk prediction model for digestive tract diseases in depressed individuals, facilitating early identification of high-risk populations and guiding personalized preventive interventions.

Methods: This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) for the years 2011 and 2015. Depressed patients from the 2011 dataset were randomly split into a training group (70%) and a validation group (30%). Independent prognostic factors were identified via eXtreme Gradient Boosting (XGBoost), Least absolute shrinkage and selection operator (LASSO) regression, and multivariate logistic regression. A nomogram model was constructed based on the contribution of these predictive factors and subsequently evaluated using the receiver operating characteristic (ROC) curve, calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC). External validation was conducted using data from depressed patients in 2015.

Results: This study included 4006 patients with depression from the 2011 CHARLS, with a prevalence of gastrointestinal diseases of 31.4%. The final model included UA, HCT, sleep quality, difficulty running or jogging 1 km, hypertension, chest pain, chronic lung diseases, heart diseases, kidney diseases, and arthritis or rheumatism. The area under the curve (AUC) was 0.678 (95% CI: 0.657-0.699) in the training set, 0.651 (95% CI: 0.619-0.686) in internal validation, and 0.693 (95% CI: 0.674-0.713) in external validation. The ROC curve indicates that the model has good predictive accuracy, and the calibration curve shows a high consistency between the predicted and actual results. DCA and CIC confirm that the model has a high net clinical benefit.

Conclusion: The model developed in this study is effective in predicting the occurrence of gastrointestinal diseases in people with depression and can be used for early identification and targeted preventive measures in high-risk populations to reduce the risk of gastrointestinal diseases.

Aim: Evidence regarding the association between heart failure and sarcopenia in middle-aged and older community-dwelling adults is scarce. This study aimed to examine the association between NT-proBNP levels and sarcopenia among community-dwelling adults aged 40-74 years.

Methods: This cross-sectional study was conducted based on the Circulatory Risk in Communities Study, which involved 1675 Japanese residents aged 40-74 years. Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, physical function, and lifestyle information were measured. Participants were categorized according to their NT-proBNP levels (< 55, 55-124, and ≥ 125 pg/mL). Multivariate-adjusted logistic regression models were used to calculate the odds ratios for low skeletal muscle mass, muscle strength, walking speed, maximal walking speed, and sarcopenia according to serum NT-proBNP levels.

Results: Among the analyzed participants, the prevalence was 22.6% for low skeletal muscle mass, 4.3% for low handgrip strength, 14.3% for low walking speed, 24.1% for low maximal walking speed, and 5.9% for sarcopenia. The multivariable odds ratios (95% confidence interval, p for trend) comparing the highest versus lowest groups of serum NT-proBNP levels were 1.63 (1.07-2.49, p < 0.01) for low skeletal muscle mass, 3.38 (1.70-6.73, p < 0.01) for low handgrip strength, 1.81 (0.96-3.40, p = 0.06) for low walking speed, 1.75 (1.03-2.97, p = 0.06) for low maximal walking speed, and 2.56 (1.07-6.14, p = 0.03) for sarcopenia.

Conclusions: High serum NT-proBNP levels, which are a surrogate marker for heart failure, were associated with low physical function and sarcopenia.

The FR-IC index demonstrated good concurrent validity for baseline disability and significant predictive validity for 1-year deterioration in disability among older outpatients. This tool may enable effective risk stratification and seamless monitoring of physical and mental capacities across the aging trajectory in clinical settings.

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.

Purpose: This study aimed to examine the influence of leisure-time physical activity habits and willingness to engage in physical activity on the onset of depressive symptoms among older adults over a 3-year period.

Methods: This study included 3341 participants without depressive symptoms who participated in the National Center for Geriatrics and Gerontology Study of Geriatric Syndromes. Leisure-time physical activity habits and willingness to engage in leisure-time physical activity were elicited using a questionnaire, and the participants were classified into (1) habitual, (2) no habit but willing (willing), and (3) no habit and unwilling (unwilling). Outcome was defined as a score of 6 or more on the Geriatrics Depression Scale in a follow-up survey conducted 3 years after the onset of depressive symptoms. Logistic regression analysis was used to examine the effects of habit and willingness on the onset of depressive symptoms.

Results: Of the participants (median age 70 years [interquartile range: 66-76 years]; 56.0% were women), 275 (14.1%) developed depressive symptoms. The habitual, willing, and unwilling groups comprised 2879 (87.2%), 246 (7.5%), and 176 (5.3%), respectively. Logistic regression analysis showed that compared to the habit group, the willing group was significantly associated with the onset of depressive symptoms (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.10-2.78), while the unwilling group was not significantly associated with the onset of depressive symptoms (OR 0.99, 95% CI 0.54-1.82).

Conclusion: The gap between the willingness to exercise and the lack of a daily habit can increase the risk of depression in older adults.