Geriatrics & Gerontology International最新文献

英文中文

Impact of Delayed Recovery of Independent Ambulation and Sarcopenia Progression on Long-Term Outcomes Following Endovascular Aortic Aneurysm Repair 独立活动的延迟恢复和肌少症进展对血管内动脉瘤修复术后长期预后的影响。

IF 2.5 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2026-01-21 DOI: 10.1111/ggi.70355

Hirokazu Sugiura, Tsuyoshi Shibata, Yutaka Iba, Shingo Tsushima, Kenta Yoshikawa, Shun Hayasaka, Tomohiro Nakajima, Junji Nakazawa, Ayaka Arihara, Kenichi Kato, Shigeki Komatsu, Masato Yonemori, Hajime Maeda, Masanori Nakamura, Yuki Sugawara, Nobuyoshi Kawaharada

Aim

To evaluate the long-term prognostic impact of delayed recovery of independent ambulation and post-operative sarcopenia progression in patients undergoing endovascular aortic aneurysm repair (EVAR).

Methods

In this multicenter retrospective cohort study, 228 patients (mean age 78.1 ± 6.5 years; 82.5% male) who underwent EVAR for abdominal aortic aneurysm between January 2015 and December 2020 were included. Independent ambulation was defined as walking ≥ 15 m. Sarcopenia was assessed using the psoas muscle index (PMI) at L3 on CT, normalized by height squared. Baseline PMI was measured within 3 months preoperatively; post-operative sarcopenia progression was calculated as ΔPMI/baseline (% change from baseline to 6 months). The primary outcome was all-cause mortality, analyzed using multivariate Cox proportional hazards models.

Results

Over a mean follow-up of 4.6 ± 2.2 years, 52 patients (22.8%) died. Mean time to independent ambulation was 1.4 ± 1.2 days, and mean ΔPMI/baseline decreased by 4.5% ± 8.9%. After adjusting for age, sex, nutritional status, and pre-operative sarcopenia, time to independent ambulation (HR 1.25; 95% CI 1.07–1.46; p = 0.004) and ΔPMI/baseline (HR 1.13; 95% CI 1.09–1.17; p < 0.001) were independent predictors of mortality. ROC analysis identified cut-offs of ≥ 2 days for ambulation and a decrease of ≥ 6.09% in ΔPMI/baseline. Patients meeting both criteria exhibited the poorest survival, representing delayed ambulation and marked sarcopenia progression.

Conclusions

Delayed recovery of independent ambulation and post-operative sarcopenia progression independently predict all-cause mortality after EVAR and may serve as clinically useful indicators for risk stratification and targeted rehabilitation.

目的：评价血管内动脉瘤修复术（EVAR）患者独立活动恢复延迟和术后肌肉减少症进展的长期预后影响。方法：在这项多中心回顾性队列研究中，纳入了2015年1月至2020年12月期间因腹主动脉瘤接受EVAR治疗的228例患者（平均年龄78.1±6.5岁，男性82.5%）。独立行走定义为步行≥15 m。骨骼肌减少症的评估采用腰大肌指数（PMI）在CT上的L3，通过高度的平方归一化。术前3个月内测量基线PMI；术后肌肉减少症进展计算为ΔPMI/基线（从基线到6个月的变化百分比）。主要结局是全因死亡率，使用多变量Cox比例风险模型进行分析。结果：平均随访4.6±2.2年，52例（22.8%）患者死亡。平均独立行走时间为1.4±1.2天，平均ΔPMI/基线下降4.5%±8.9%。在调整了年龄、性别、营养状况和术前肌肉减少后，独立行走时间（HR 1.25; 95% CI 1.07-1.46; p = 0.004）和ΔPMI/基线（HR 1.13; 95% CI 1.09-1.17; p）得出结论：独立行走延迟恢复和术后肌肉减少进展独立预测EVAR后全因死亡率，并可作为临床有用的风险分层和针对性康复指标。

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引用次数: 0

Acute-Phase Interventions and Clinical Implementation Challenges for Hospital-Associated Sarcopenia: A Narrative Review of a Multifaceted Approach to a Preventable Condition 医院相关性骨骼肌减少症的急性期干预和临床实施挑战：对可预防疾病的多方面方法的叙述性回顾。

IF 2.5 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2026-01-21 DOI: 10.1111/ggi.70330

Yoshinori Yamamoto, Masato Ogawa, Takayuki Okamoto, Marika Tsuboi, Ryo Momosaki

Hospital-associated sarcopenia (HAS) is a preventable and reversible condition characterized by rapid muscle loss during hospitalization. Although its prevalence is higher than that of age-related sarcopenia, the clinical recognition and structured management of this condition remain limited. In this narrative review, the pathophysiology of HAS is synthesized, the effectiveness of acute-phase interventions is evaluated, and the implementation challenges are examined to propose multifaceted strategies for optimizing treatment outcomes. The development of HAS involves a vicious cycle of activity limitation, inflammation, malnutrition, and iatrogenic stress. Initiating interventions within 48 h may aid in preserving muscle function and improving the patients' quality of life. However, protocol variability, inadequate patient stratification, fragile transitional care systems, and other challenges persist. The proposed solutions include modular protocols, electronic medical record-integrated adaptive algorithms, and strengthened team coordination. To prevent HAS progression and improve patient-centered outcomes, timely, structured multidisciplinary interventions in the acute phase are imperative. Standardized evaluations, scalable protocols, and sustainable post-discharge systems are key to advancing the clinical implementation of HAS management strategies.

医院相关性肌肉减少症（HAS）是一种可预防和可逆的疾病，其特征是住院期间肌肉迅速减少。尽管其患病率高于与年龄相关的肌肉减少症，但对这种疾病的临床认识和结构化管理仍然有限。在这篇叙述性综述中，综合了HAS的病理生理学，评估了急性期干预措施的有效性，并研究了实施挑战，提出了优化治疗结果的多方面策略。HAS的发展涉及活动受限、炎症、营养不良和医源性应激的恶性循环。在48小时内开始干预可能有助于保持肌肉功能和改善患者的生活质量。然而，方案的可变性、患者分层不足、脆弱的过渡护理系统和其他挑战仍然存在。提出的解决方案包括模块化协议、电子病历集成自适应算法和加强团队协调。为了防止HAS进展并改善以患者为中心的结果，在急性期及时、结构化的多学科干预是必要的。标准化的评估、可扩展的方案和可持续的出院后系统是推进HAS管理策略临床实施的关键。

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引用次数: 0

Muscle Quality and Post-THA Falls: Interpreting the Clinical Impact of Gluteus Medius Fatty Infiltration 肌肉质量和髋关节置换术后跌倒：解释臀中肌脂肪浸润的临床影响。

IF 2.5 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2026-01-21 DOI: 10.1111/ggi.70334

Shenghong Chen

引用次数: 0

Characteristics of Probable Respiratory Sarcopenia Based on the Definitions of Four Professional Organizations—The Otassha Study 基于四个专业组织定义的可能的呼吸性肌肉减少症的特征——奥塔沙研究。

IF 2.5 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2026-01-21 DOI: 10.1111/ggi.70329

Takeshi Kera, Hisashi Kawai, Manami Ejiri, Keigo Imamura, Hirohiko Hirano, Yoshinori Fujiwara, Kazushige Ihara, Shuichi Obuchi

<div> <section> <h3> Background</h3> <p>The new position paper on the definition and diagnosis of respiratory sarcopenia defines respiratory sarcopenia as a decrease in respiratory muscle strength and mass. It recommends using a decrease in limb muscle mass as a substitute for respiratory muscle mass, which is difficult to measure, and recommends that such cases be diagnosed as “probable respiratory sarcopenia” with appropriate interventions. This study aimed to determine the physical characteristics of older adults with probable respiratory sarcopenia based on current criteria.</p> </section> <section> <h3> Methods</h3> <p>A total of 496 community-dwelling older adults were enrolled in this study, completing an evaluation of respiratory and physical function in 2023 as part of a comprehensive health check-up program called the Otassha study. The respiratory and physical functions, comorbidities, instrumental activities of daily living, and lifestyles of the participants were measured. “Probable respiratory sarcopenia” was compared to non-respiratory sarcopenia with respect to respiratory and physical functions. Probable respiratory sarcopenia was determined using low maximal mouth pressure (< 80% of predicted value) and low appendicular skeletal muscle mass (ASM)/height<sup>2</sup> (7.0 kg/m<sup>2</sup> for men and 5.7 kg/m<sup>2</sup> for women). The association between probable respiratory sarcopenia (as the independent variable) and physical and peak expiratory flow rate (PEFR) (as dependent variables), adjusted for covariates, was evaluated using a multivariate linear regression model. A 2:1 matched pair of individuals with non-respiratory sarcopenia and probable respiratory sarcopenia was compared using propensity score matching (PSM) to account for confounders.</p> </section> <section> <h3> Results</h3> <p>The prevalence of probable respiratory sarcopenia was 33 out of 185 (17.8%) in men and 65 out of 311 (20.9%) in women. Grip strength, knee extension strength, and PEFR were significantly associated with probable respiratory sarcopenia (<i>p</i> = 0.001 to <i>p</i> < 0.01). In the PSM data set, compared to non-respiratory sarcopenia, those with probable respiratory sarcopenia showed significantly lower values for respiratory function, grip strength, and knee extension strength, cognitive function, as well as a higher prevalence of whole-body sarcopenia (<i>p</i> = 0.028 to <i>p</i> < 0.001).</p> </section> <section> <h3> Conclusion</h3> <p>Probable sarcopenia is characterized by low limb muscle strength and impaired respiratory and physical function. Understanding this aspect of suspected respiratory sarcopenia ca

背景：关于呼吸性肌肉减少症的定义和诊断的新立场文件将呼吸性肌肉减少症定义为呼吸肌肉力量和质量的减少。它建议用肢体肌肉质量的减少来代替难以测量的呼吸肌质量，并建议将此类病例诊断为“可能的呼吸性肌肉减少症”，并采取适当的干预措施。本研究旨在根据现行标准确定可能患有呼吸性肌肉减少症的老年人的身体特征。方法：共有496名居住在社区的老年人参加了这项研究，他们在2023年完成了呼吸和身体功能的评估，这是一项名为Otassha研究的综合健康检查计划的一部分。测量参与者的呼吸和身体功能、合并症、日常生活工具活动和生活方式。将“可能的呼吸性肌肉减少症”与非呼吸性肌肉减少症在呼吸和身体功能方面进行比较。使用低最大口压(2)（男性7.0 kg/m2，女性5.7 kg/m2）来确定可能的呼吸性肌肉减少症。使用多元线性回归模型评估可能的呼吸性肌肉减少症（作为自变量）与物理和呼气峰流速（PEFR）（作为因变量）之间的关联，并对协变量进行调整。使用倾向评分匹配（PSM）对非呼吸性肌肉减少症和可能的呼吸性肌肉减少症患者进行2:1匹配，以解释混杂因素。结果：185例男性患者中有33例（17.8%），311例女性患者中有65例（20.9%）。握力、膝关节伸展力和PEFR与可能的呼吸性肌肉减少症有显著相关性（p = 0.001 ~ p）。结论：可能的肌肉减少症以下肢肌力低、呼吸和身体功能受损为特征。了解疑似呼吸性肌肉减少症的这一方面有助于早期发现和治疗管理，从而改善未来的健康结果。

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引用次数: 0

Comment on: “Intrinsic Capacity as a Predictor of Healthy Longevity: Insights From Four Cohort Studies” 评论：“内在能力作为健康寿命的预测因子：来自四个队列研究的见解”。

IF 2.5 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2026-01-20 DOI: 10.1111/ggi.70350

Xingjie Shen, Yiheng Yao, Liang Liu

引用次数: 0

Comment on “Association of Unplanned Home Visits, Deaths, Preference for Dying at Home, and Home Deaths With Patient Complexity in a Physician-Led Home Visit Setting: A Secondary Analysis of a Multicenter Prospective Cohort Study” 评论“在医生主导的家访中，意外家访、死亡、在家死亡偏好和家庭死亡与患者复杂性的关系：一项多中心前瞻性队列研究的二次分析”。

IF 2.5 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2026-01-20 DOI: 10.1111/ggi.70362

Kishankumar Mahida, Snehal Rajendra Jagtap

引用次数: 0

Mortality in Oldest-Old ICU Survivors: The Crucial Roles of Cause of Death and Goals of Care 高龄ICU幸存者的死亡率：死亡原因和护理目标的关键作用。

IF 2.5 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2026-01-20 DOI: 10.1111/ggi.70348

Yong Shen, Xiaoqin Fu

引用次数: 0

Comment on: “Clinical Frailty Scale as a Predictor of 2-Year Mortality and Associated Risk Factors in Older Diabetic Patients” 评论：“临床虚弱量表作为老年糖尿病患者2年死亡率和相关危险因素的预测因子”。

IF 2.5 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2026-01-20 DOI: 10.1111/ggi.70333

Jiaxing Ma, Yiheng Yao, Liang Liu

引用次数: 0

Beyond Visual Acuity: Contrast Sensitivity as a Potential Neuro-Visual Dimension of “Eye Frailty” in Mild Cognitive Impairment 超越视觉敏锐度：对比敏感度作为轻度认知障碍中“眼睛脆弱”的潜在神经视觉维度。

IF 2.5 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2026-01-20 DOI: 10.1111/ggi.70349

Yi-Ching Chu, Chao-Chun Huang

We read with great interest the article by Uchida et al. [1], regarding the J-MINT study baseline data. The authors highlighted a compelling dissociation in older adults with Mild Cognitive Impairment (MCI): while clinical visual acuity (LogMAR) was largely preserved, self-reported visual difficulties were significantly associated with physical, social, and cognitive frailty. We commend the authors for establishing “self-reported vision status” (SRVS) as a sensitive marker for frailty, potentially superior to standard acuity charts in this specific population.

From a neuro-ophthalmic perspective, we suggest that this discrepancy—good acuity yet poor subjective vision—is not merely a psychological phenomenon but likely reflects specific pathophysiological changes in the early stages of neurodegeneration. Standard high-contrast visual acuity testing primarily assesses the parvocellular pathway, which is often resilient in early MCI [2]. Conversely, the magnocellular pathway and the dorsal visual stream, which process low-contrast information, motion, and depth, are known to be selectively vulnerable to early amyloid and tau pathology [3].

Therefore, the “poor vision” reported by participants, despite their 20/20 acuity, may represent a functional deficit in contrast sensitivity (CS). This “hidden” deficit explains the study's observation that poor SRVS correlates with the Fall Risk Index (FRI) [1]. Postural stability relies heavily on detecting low-contrast edges (like carpet borders) and processing optic flow, functions governed by the dorsal stream rather than the foveal acuity measured by LogMAR [4].

We propose that Uchida et al.'s findings support a paradigm shift in defining “Eye Frailty.” We suggest conceptualizing subjective vision not just as a proxy for acuity, but as a distinct neuro-visual dimension of frailty. This dimension likely captures the “cognitive cost” of processing visual information through a compromised neural network.

Moving forward, incorporating rapid contrast sensitivity assessments (e.g., Pelli-Robson charts or frequency-doubling technology) in geriatric research frameworks could objectively quantify this dimension. This would bridge the gap between the patient's lived experience and clinical metrics, ultimately refining fall prevention strategies for the growing MCI population.

The authors have nothing to report.

The authors declare no conflicts of interest.

Data sharing is not applicable to this article as no new data were created or analyzed in this study.

我们饶有兴趣地阅读了由Uchida等人撰写的关于J-MINT研究基线数据的文章。作者强调了轻度认知障碍（MCI）老年人中令人信服的分离：虽然临床视力（LogMAR）在很大程度上保持不变，但自我报告的视觉困难与身体、社交和认知脆弱显著相关。我们赞扬作者建立了“自我报告视力状态”（SRVS）作为脆弱的敏感标记，在这一特定人群中可能优于标准视力表。从神经眼科的角度来看，我们认为这种差异——良好的敏锐度和较差的主观视力——不仅仅是一种心理现象，而且可能反映了神经退行性变早期阶段的特定病理生理变化。标准的高对比度视力测试主要评估细小细胞通路，该通路在早期轻度认知损伤中通常具有弹性。相反，处理低对比度信息、运动和深度的大细胞通路和背侧视觉流被认为是选择性地易受早期淀粉样蛋白和tau病理[3]的影响。因此，尽管参与者的视力为20/20，但他们报告的“视力差”可能代表了对比敏感度（CS）的功能性缺陷。这种“隐藏的”缺陷解释了该研究的观察结果，即较差的SRVS与跌倒风险指数（FRI）相关。姿势稳定性在很大程度上依赖于检测低对比度边缘（如地毯边缘）和处理光流，这些功能由背侧流控制，而不是由LogMAR[4]测量的中央凹锐度。我们认为Uchida等人的发现支持了定义“眼虚弱”的范式转变。我们建议将主观视觉概念化，不只是作为敏锐的代理，而是作为脆弱的独特神经视觉维度。这个维度很可能捕获了通过受损的神经网络处理视觉信息的“认知成本”。展望未来，在老年研究框架中纳入快速对比敏感性评估（例如，Pelli-Robson图表或倍频技术）可以客观地量化这一维度。这将弥合患者生活经验和临床指标之间的差距，最终为不断增长的MCI人群制定预防跌倒的策略。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，因为本研究没有创建或分析新的数据。

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引用次数: 0

Response to the Letter by Chen et al. on “From Prognostic Marker to Therapeutic Target—Appetite in Swallowing Rehabilitation” 对Chen等人关于“从预后标志物到治疗靶点——吞咽康复中的食欲”的回复。

IF 2.5 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International

Pub Date : 2026-01-20 DOI: 10.1111/ggi.70352

Akio Shimizu, Xiaojing Sharon Wu, Shinsuke Nagami, Katsuya Nakamura, Jun Kayashita, Akiko Nomoto, Ichiro Fujishima, Ryo Momosaki

引用次数: 0

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