Geriatrics & Gerontology International最新文献

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; 25: 307–315.

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; 25: 206–212.

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; 25: 260–266.

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; 25: 190–205.

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; 25: 232–242.

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; 25: 226–231.

Aim

Based on the Job Demands–Resources model, this study aimed to assess the predictive effect of workload on emotional exhaustion and test the buffering effect of three types of work resources (workplace cohesion, work control, and workplace support) on the relationship between workload and emotional exhaustion among older Japanese assistant care workers.

Methods

We analyzed data from a national survey on the work features and work-related outcomes of 1601 older assistant care workers working in geriatric health services facilities in Japan. Demographic characteristics, workload, work resources, and emotional exhaustion were analyzed. A hierarchical multiple regression analysis and simple slope test were conducted.

Results

Workload had a significant main effect in predicting emotional exhaustion (β = 0.337, P < 0.001). Workplace cohesion buffered the negative effect of workload on emotional exhaustion (interaction between workload and workplace cohesion: β = −0.097, P = 0.002). Work control (interaction between workload and work control: β = −0.015, P = 0.585) and workplace support (interaction between workload and workplace support: β = 0.025, P = 0.391) had no buffering effect on the negative impact of workload on emotional exhaustion.

Conclusions

Regulating workload and promoting workplace cohesion might be effective strategies for preventing burnout among elderly workers. Investigations into the occupational stress of elderly workers from diverse cultures and work contexts are needed. Geriatr Gerontol Int 2025; 25: 273–278.

Aim

The aim of this study was to identify opportunities for more effective measures. We analyzed sex-, age- and season-specific trends in unintentional accidental deaths from stumbling falls, bathtub drowning, food choking and traffic injuries among older adults in Japan.

Methods

Death rates from major unintentional accidents were analyzed by sex, month and 5-year age groups (aged ≥50 years) based on a custom-made aggregation of data from the Vital Statistics survey (2008–2022) in compliance with the Statistics Act.

Results

From 2008 to 2022, death rates from the 4 major unintentional accidental causes (11 354 and 11 374 deaths in 19 408 000 men and 24 272 000 women aged ≥60 in 2022) were obviously higher among older men than older women, except for notably high death rates from bathtub drowning among women aged 75–84 years. Significant increases in death rates from stumbling falls were observed in men and women aged ≥85 years, with significant decreases among men aged 60–74 years and women aged 65–74 years. Significant increases in bathtub drowning death rates were observed among men aged 90–94 and ≥100 years, as well as among women aged 90–99 years. Bathtub drowning death rates rose with age but peaked in women aged 85–89 years. Both bathtub drowning and food choking deaths were more frequent during the winter season.

Conclusions

Accidental deaths from stumbling falls and bathtub drowning continue to rise among older Japanese adults in some age groups. Notably, deaths from bathtub drowning were distinctively higher among women aged in their 70s and 80s, possibly including apparently healthy women, during the winter season. Geriatr Gerontol Int 2025; 25: 287–293.