Merve Yilmaz Kars, Mustafa Hakan Dogan, Ilyas Akkar, Zeynep Iclal Turgut, Orhan Cicek, Muhammet Cemal Kizilarslanoglu
{"title":"Comment on: Association of sleep duration with obesity in older adults: A systematic review and meta-analysis","authors":"Merve Yilmaz Kars, Mustafa Hakan Dogan, Ilyas Akkar, Zeynep Iclal Turgut, Orhan Cicek, Muhammet Cemal Kizilarslanoglu","doi":"10.1111/ggi.15044","DOIUrl":"10.1111/ggi.15044","url":null,"abstract":"","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"25 1","pages":"133-134"},"PeriodicalIF":2.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is a growing body of evidence suggesting a correlation between sarcopenia (SP) and cognitive impairment (CI), but with conflict. This study employed a bidirectional Mendelian randomization (MR) approach to ascertain the causality between SP and CI.
Method
This study looked at whether there might be causality between SP and CI by using a bidirectional MR analysis on the GWAS summary datasets, which anyone can publicly access. The primary analysis employed inverse variance weighting (IVW), with MR-Egger, weighted median, and mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) serving as supplements. Multiple sensitivity analyses were performed to enhance the stability of the results, which encompassed heterogeneity tests and pleiotropy tests.
Results
Appendicular lean mass (ALM), walking pace (WP), and grip strength (GS) were found to be causally connected to cognitive performance in forward MR analysis. In the reverse MR study, cognitive performance also had a causal impact on ALM and WP. Additionally, we discovered comparable outcomes in the replication samples, which strengthens the validity of our findings.
Conclusions
The results of our MR investigation revealed a definitive cause-and-effect association between SP and CI. Our findings provide additional supporting evidence for the muscle–brain axis, which may suggest that muscle strengthening has a significant impact on the management and avoidance of CI. Geriatr Gerontol Int 2025; 25: 116–122.
目的：越来越多的证据表明肌肉减少症（SP）和认知障碍（CI）之间存在相关性，但两者之间存在冲突。本研究采用双向孟德尔随机化（MR）方法来确定SP和CI之间的因果关系。方法：本研究通过对任何人都可以公开访问的GWAS汇总数据集进行双向MR分析，研究SP和CI之间是否存在因果关系。主要分析采用逆方差加权法（IVW），以MR-Egger、加权中位数、孟德尔随机化多效残差和异常值（MR-PRESSO）作为补充。为了提高结果的稳定性，我们进行了多重敏感性分析，包括异质性试验和多效性试验。结果：在正向磁共振分析中发现阑尾瘦质量（ALM）、步行速度（WP）和握力（GS）与认知表现有因果关系。在反向MR研究中，认知表现对ALM和WP也有因果影响。此外，我们在复制样本中发现了可比较的结果，这加强了我们研究结果的有效性。结论：我们的MR调查结果揭示了SP和CI之间明确的因果关系。我们的研究结果为肌肉-脑轴提供了额外的支持证据，这可能表明肌肉强化对CI的管理和避免有重大影响。Geriatr Gerontol Int 2024；••: ••-••.
{"title":"Causal association between sarcopenia and cognitive impairment contributes to the muscle–brain axis: A bidirectional Mendelian randomization study","authors":"Lincheng Duan, Haoming Li, Shiyin Li, Yue Shi, Yue Feng","doi":"10.1111/ggi.15045","DOIUrl":"10.1111/ggi.15045","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>There is a growing body of evidence suggesting a correlation between sarcopenia (SP) and cognitive impairment (CI), but with conflict. This study employed a bidirectional Mendelian randomization (MR) approach to ascertain the causality between SP and CI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This study looked at whether there might be causality between SP and CI by using a bidirectional MR analysis on the GWAS summary datasets, which anyone can publicly access. The primary analysis employed inverse variance weighting (IVW), with MR-Egger, weighted median, and mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) serving as supplements. Multiple sensitivity analyses were performed to enhance the stability of the results, which encompassed heterogeneity tests and pleiotropy tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Appendicular lean mass (ALM), walking pace (WP), and grip strength (GS) were found to be causally connected to cognitive performance in forward MR analysis. In the reverse MR study, cognitive performance also had a causal impact on ALM and WP. Additionally, we discovered comparable outcomes in the replication samples, which strengthens the validity of our findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results of our MR investigation revealed a definitive cause-and-effect association between SP and CI. Our findings provide additional supporting evidence for the muscle–brain axis, which may suggest that muscle strengthening has a significant impact on the management and avoidance of CI. <b>Geriatr Gerontol Int 2025; 25: 116–122</b>.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"25 1","pages":"116-122"},"PeriodicalIF":2.4,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The study investigates end-of-life trajectories, focusing on the degree of oral intake function in older individuals with frailty aged over 90 years.
Methods
This retrospective observational study examined individuals aged 90 years and older who passed away at a long-term chronic care hospital and related facilities in Japan. We assessed their Clinical Frailty Scale (CFS) and Function Oral Intake Scale (FOIS), categorizing them into two groups—“preserved CFS” (CFS score ≤7) and “poor CFS” (CFS score ≥8)—considering evaluations conducted 6 months before death. We examined the transitional progression of their CFS and FOIS scores, along with a time-course assessment of low FOIS scores (≤3) in each group at various intervals.
Results
Among 66 cases, 38 were in the preserved CFS group, and 28 were in the poor CFS group. The CFS and FOIS scores of the preserved CFS group declined rapidly towards the end-of-life, with approximately half experiencing significant declines within 3 months. In contrast, both the CFS and the FOIS scores of the poor CFS group declined gradually within 6 months. The percentage of low FOIS score (≤3) was lower at 12 and 6 months than at 1 month prior to death in the preserved CFS group.
Conclusions
The end-of-life trajectories in older individuals with frailty aged over 90 years were heterogeneous. Clinicians should carefully monitor the degree of frailty and changes in food intake as crucial indications of the end-of-life phase, providing optimal support to manage potential vicious cycles. Geriatr Gerontol Int 2025; 25: 96–101.
目的：该研究调查了生命终结的轨迹，重点关注90岁以上老年人的口腔摄入功能程度。方法：本回顾性观察性研究调查了在日本一家长期慢性护理医院及相关机构去世的90岁及以上的个体。我们评估了他们的临床虚弱量表（CFS）和功能口服摄入量表（FOIS），将他们分为两组-“保存CFS”（CFS评分≤7）和“不良CFS”（CFS评分≥8）-考虑到死亡前6个月的评估。我们检查了他们的CFS和FOIS评分的过渡进展，以及每组在不同时间间隔的低FOIS评分（≤3）的时间过程评估。结果：66例患者中，CFS保存组38例，CFS差组28例。保留CFS组的CFS和FOIS评分在生命末期迅速下降，大约一半的患者在3个月内出现显著下降。相比之下，CFS较差组的CFS和FOIS评分在6个月内逐渐下降。保留CFS组在死亡前12个月和6个月FOIS评分低（≤3）的百分比低于死亡前1个月。结论：90岁以上老年衰弱患者的生命终结轨迹具有异质性。临床医生应该仔细监测虚弱的程度和食物摄入的变化，作为生命末期的关键指标，为管理潜在的恶性循环提供最佳支持。Geriatr Gerontol Int 2024；••: ••-••.
{"title":"Time-course assessment of oral intake function and its impact on end-of-life in older individuals over 90 years with frailty","authors":"Hidetada Yamada, Masahiro Nakamori, Masaya Oda, Megumi Toko, Hideaki Sakahara, Yuichiro Tagane, Yu Yamazaki, Yuishin Izumi, Hirofumi Maruyama","doi":"10.1111/ggi.15048","DOIUrl":"10.1111/ggi.15048","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The study investigates end-of-life trajectories, focusing on the degree of oral intake function in older individuals with frailty aged over 90 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study examined individuals aged 90 years and older who passed away at a long-term chronic care hospital and related facilities in Japan. We assessed their Clinical Frailty Scale (CFS) and Function Oral Intake Scale (FOIS), categorizing them into two groups—“preserved CFS” (CFS score ≤7) and “poor CFS” (CFS score ≥8)—considering evaluations conducted 6 months before death. We examined the transitional progression of their CFS and FOIS scores, along with a time-course assessment of low FOIS scores (≤3) in each group at various intervals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 66 cases, 38 were in the preserved CFS group, and 28 were in the poor CFS group. The CFS and FOIS scores of the preserved CFS group declined rapidly towards the end-of-life, with approximately half experiencing significant declines within 3 months. In contrast, both the CFS and the FOIS scores of the poor CFS group declined gradually within 6 months. The percentage of low FOIS score (≤3) was lower at 12 and 6 months than at 1 month prior to death in the preserved CFS group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The end-of-life trajectories in older individuals with frailty aged over 90 years were heterogeneous. Clinicians should carefully monitor the degree of frailty and changes in food intake as crucial indications of the end-of-life phase, providing optimal support to manage potential vicious cycles. <b>Geriatr Gerontol Int 2025; 25: 96–101</b>.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"25 1","pages":"96-101"},"PeriodicalIF":2.4,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In recent years, the majority of patients eligible for endoscopic retrograde cholangiopancreatography (ERCP) have been aged ≥75 years. We investigated ERCP safety in very elderly patients (aged ≥90 years).
Methods
We included patients aged ≥75 years who underwent ERCP between January 2015 and December 2020. We compared background factors, comorbidities, ERCP indications, complications, and outcomes and identified risk factors for complications using binary logistic regression and inverse probability of treatment weighting with propensity scores.
Results
The study included 1344 patients aged ≥75 years (137 and 1207 very elderly and elderly patients, respectively). The very elderly group had more women, less frequent diabetes, fewer antithrombotic medications, more frequent parapapillary diverticulum, less frequent post-cholecystectomy, and worse performance status. No significant differences were observed in the ERCP indications. Experienced endoscopists were likely to perform the procedure, and the procedure time was shorter for the very elderly. Complications occurred in 21 (15%) very elderly patients and 120 (10%) elderly patients, with no significant differences. The very elderly did not have an increased risk of complications but were less likely to be discharged home and had a significantly worse performance status at discharge.
Conclusions
ERCP could be safely performed in the very elderly, and age did not increase the risk of complications. Geriatr Gerontol Int 2025; 25: 54–60.
目的：近年来，大多数符合内镜逆行胆管胰胆管造影（ERCP）条件的患者年龄≥75岁。我们研究了ERCP在高龄患者（年龄≥90岁）中的安全性。方法：我们纳入了2015年1月至2020年12月期间接受ERCP的年龄≥75岁的患者。我们比较了背景因素、合并症、ERCP适应症、并发症和结果，并使用二元逻辑回归和倾向评分的治疗加权逆概率确定了并发症的危险因素。结果：研究纳入1344例年龄≥75岁的患者（137例高龄患者和1207例高龄患者）。老年组有更多的女性，更少的糖尿病，更少的抗血栓药物，更频繁的乳头旁憩室，更少的胆囊切除术后，和更差的表现状态。在ERCP适应症方面没有观察到显著差异。经验丰富的内窥镜医生可能会执行该手术，并且对于老年人来说，手术时间更短。极高龄患者发生并发症21例（15%），老年患者发生并发症120例（10%），差异无统计学意义。老年人出现并发症的风险没有增加，但出院回家的可能性较低，出院时的表现也明显较差。结论：ERCP在高龄患者中可以安全进行，年龄不会增加并发症的发生风险。Geriatr Gerontol Int 2024；••: ••-••.
{"title":"Risk factors for post-endoscopic retrograde cholangiopancreatography complications in very elderly patients aged 90 years or older—No additional risk","authors":"Daisuke Manabe, Toshihiko Arizumi, Hitoshi Aoyagi, Koichiro Abe, Shinya Kodashima, Yoshinari Asaoka, Takatsugu Yamamoto, Atsushi Tanaka","doi":"10.1111/ggi.15037","DOIUrl":"10.1111/ggi.15037","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>In recent years, the majority of patients eligible for endoscopic retrograde cholangiopancreatography (ERCP) have been aged ≥75 years. We investigated ERCP safety in very elderly patients (aged ≥90 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included patients aged ≥75 years who underwent ERCP between January 2015 and December 2020. We compared background factors, comorbidities, ERCP indications, complications, and outcomes and identified risk factors for complications using binary logistic regression and inverse probability of treatment weighting with propensity scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 1344 patients aged ≥75 years (137 and 1207 very elderly and elderly patients, respectively). The very elderly group had more women, less frequent diabetes, fewer antithrombotic medications, more frequent parapapillary diverticulum, less frequent post-cholecystectomy, and worse performance status. No significant differences were observed in the ERCP indications. Experienced endoscopists were likely to perform the procedure, and the procedure time was shorter for the very elderly. Complications occurred in 21 (15%) very elderly patients and 120 (10%) elderly patients, with no significant differences. The very elderly did not have an increased risk of complications but were less likely to be discharged home and had a significantly worse performance status at discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ERCP could be safely performed in the very elderly, and age did not increase the risk of complications. <b>Geriatr Gerontol Int 2025; 25: 54–60</b>.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"25 1","pages":"54-60"},"PeriodicalIF":2.4,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Şimşek Çelik, Onur Türkdoğan, Tayfun Erdoğan, Pelin Çelik
Aim
To compare the performance of the Programme of Research on the Integration of Services for the Maintenance of Autonomy (PRISMA-7), which is used to assess the frailty of older patients visiting emergency departments, with the quick Sepsis Related Organ Failure Assessment (qSOFA) and Emergency Severity Index (ESI) in terms of 28-day mortality and intensive care unit (ICU) admission.
Methods
This study was prospective and observational. All patients above the age of 65 who were admitted to the Sivas Republic University Medical Faculty Hospital from March 1 to April 30 in the year 2024 were included in the study. Patients' all-cause mortality values and ICU acceptance rates were evaluated for a 28-day period following their applications.
Results
The area under the receiver operating characteristic curve stood for the 28-day mortality, while the values for PRISMA-7, ESI, and qSOFA were, respectively, 0.81 (95% confidence interval [CI]: 0.78–0.84), 0.78 (95% CI: 0.72–0.83), and 0.71 (95% CI: 0.65–0.77). Our findings have demonstrated PRISMA-7 to be more effective than ESI and qSOFA in terms of hospitalization predictions. However, while it was found to be more effective than qSOFA in mortality predictions, it was determined that, despite PRISMA-7 having a larger AUC than ESI, no meaningful difference existed between PRISMA-7 and ESI.
Conclusions
In conclusion, PRISMA-7, which is thought of as a reliable and valid tool for the determination of frailty in emergency departments, has predictive value for individuals' 28-day mortality risk as well as for their acceptance to the ICU. Geriatr Gerontol Int 2025; 25: 61–66.
{"title":"PRISMA-7 is a predictor of intensive care unit admission and mortality in older patients in an emergency department","authors":"Şimşek Çelik, Onur Türkdoğan, Tayfun Erdoğan, Pelin Çelik","doi":"10.1111/ggi.15039","DOIUrl":"10.1111/ggi.15039","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To compare the performance of the Programme of Research on the Integration of Services for the Maintenance of Autonomy (PRISMA-7), which is used to assess the frailty of older patients visiting emergency departments, with the quick Sepsis Related Organ Failure Assessment (qSOFA) and Emergency Severity Index (ESI) in terms of 28-day mortality and intensive care unit (ICU) admission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was prospective and observational. All patients above the age of 65 who were admitted to the Sivas Republic University Medical Faculty Hospital from March 1 to April 30 in the year 2024 were included in the study. Patients' all-cause mortality values and ICU acceptance rates were evaluated for a 28-day period following their applications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The area under the receiver operating characteristic curve stood for the 28-day mortality, while the values for PRISMA-7, ESI, and qSOFA were, respectively, 0.81 (95% confidence interval [CI]: 0.78–0.84), 0.78 (95% CI: 0.72–0.83), and 0.71 (95% CI: 0.65–0.77). Our findings have demonstrated PRISMA-7 to be more effective than ESI and qSOFA in terms of hospitalization predictions. However, while it was found to be more effective than qSOFA in mortality predictions, it was determined that, despite PRISMA-7 having a larger AUC than ESI, no meaningful difference existed between PRISMA-7 and ESI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In conclusion, PRISMA-7, which is thought of as a reliable and valid tool for the determination of frailty in emergency departments, has predictive value for individuals' 28-day mortality risk as well as for their acceptance to the ICU. <b>Geriatr Gerontol Int 2025; 25: 61–66</b>.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"25 1","pages":"61-66"},"PeriodicalIF":2.4,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to evaluate the effectiveness of oral health assessment tools in facilitating oral health care interventions by dental care providers for acute stroke patients within 48 h of admission, following a reform of the nursing system.
Methods
Data were gathered from a retrospective cohort study conducted at a stroke center, comparing 10 months before and after the implementation of the reformed system, with a 2-month interval. Parameters assessed included stroke type, severity measured using the National Institutes of Health Stroke Scale, stroke history, stroke-related factors, number of teeth, hospitalization cost and duration, occurrence of fever and pneumonia, stroke treatment, days from admission to dental intervention, and intervention frequency.
Results
Implementation of the new system significantly reduced the time before dental intervention (P < 0.001), increased the frequency of interventions (P < 0.001), and allowed for the management of more severe cases (P = 0.007). However, there was a slight increase in the occurrence of fevers and the days of fever (P = 0.039 and P = 0.015, respectively). Multiple regression analysis showed that fever days were positively correlated with stroke severity and the number of days from admission to dental intervention (P < 0.001 and P = 0.013, respectively). Even after propensity score matching adjusting for stroke severity, these associations persisted. Additional multiple regression analysis was performed after this, but fever days were positively correlated with stroke severity and sex (P < 0.001 and P = 0.008, respectively), as well as with the presence of other factors affecting the occurrence of fever.
Conclusions
Although the frequency and duration of fevers increased slightly, this approach, incorporating oral health assessment tools, made it possible to provide early dental intervention, particularly for patients with severe strokes. Geriatr Gerontol Int 2025; 25: 48–53.
目的：本研究旨在评估口腔健康评估工具在促进牙科保健提供者对急性脑卒中患者入院48小时内进行口腔保健干预方面的有效性，随后进行护理制度改革。方法：在某脑卒中中心进行回顾性队列研究，比较改革前后10个月，间隔2个月。评估的参数包括中风类型、使用美国国立卫生研究院中风量表测量的严重程度、中风史、中风相关因素、牙齿数量、住院费用和持续时间、发烧和肺炎的发生、中风治疗、入院到牙科干预的天数和干预频率。结论：虽然发热的频率和持续时间略有增加，但这种结合口腔健康评估工具的方法，使早期牙科干预成为可能，特别是对严重中风患者。Geriatr Gerontol Int 2024；••: ••-••.
{"title":"Effectiveness of oral health care intervention for stroke patients following the introduction of Oral Health Assessment Tool","authors":"Kazuyuki Matsunaga, Ayaka Yoshida-Tsuboi, Ken Inohara, Yasuko Yoshida, Kanako Nakahama, Kazuki Sasaki, Fumie Souda, Yuka Terasawa, Yutaka Shimoe, Kazu Takeuchi-Hatanaka, Tadashi Yamamoto, Kazuhiro Omori, Tatsuo Kohriyama, Shogo Takashiba","doi":"10.1111/ggi.15035","DOIUrl":"10.1111/ggi.15035","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to evaluate the effectiveness of oral health assessment tools in facilitating oral health care interventions by dental care providers for acute stroke patients within 48 h of admission, following a reform of the nursing system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were gathered from a retrospective cohort study conducted at a stroke center, comparing 10 months before and after the implementation of the reformed system, with a 2-month interval. Parameters assessed included stroke type, severity measured using the National Institutes of Health Stroke Scale, stroke history, stroke-related factors, number of teeth, hospitalization cost and duration, occurrence of fever and pneumonia, stroke treatment, days from admission to dental intervention, and intervention frequency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Implementation of the new system significantly reduced the time before dental intervention (<i>P</i> < 0.001), increased the frequency of interventions (<i>P</i> < 0.001), and allowed for the management of more severe cases (<i>P</i> = 0.007). However, there was a slight increase in the occurrence of fevers and the days of fever (<i>P</i> = 0.039 and <i>P</i> = 0.015, respectively). Multiple regression analysis showed that fever days were positively correlated with stroke severity and the number of days from admission to dental intervention (<i>P</i> < 0.001 and <i>P</i> = 0.013, respectively). Even after propensity score matching adjusting for stroke severity, these associations persisted. Additional multiple regression analysis was performed after this, but fever days were positively correlated with stroke severity and sex (<i>P</i> < 0.001 and <i>P</i> = 0.008, respectively), as well as with the presence of other factors affecting the occurrence of fever.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although the frequency and duration of fevers increased slightly, this approach, incorporating oral health assessment tools, made it possible to provide early dental intervention, particularly for patients with severe strokes. <b>Geriatr Gerontol Int 2025; 25: 48–53</b>.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"25 1","pages":"48-53"},"PeriodicalIF":2.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Falls are a major global public health concern, requiring early screening and prevention. Cardiovascular disease (CVD) is associated with physical impairments and increased fall risk. Despite the link between CVD and sleep parameters, research on falls and sleep in CVD patients is limited. We aimed to compare the correlation between falls and sleep in populations with and without CVD to develop fall prevention strategies.
Methods
This longitudinal cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS). Baseline data were collected in 2011, with follow-up in 2015. Falls and CVD were assessed based on self-reporting. Sleep parameters, including nighttime and total sleep duration, daytime napping, and sleep disturbance were collected via self-reported questionnaires. Data analysis was conducted using SPSS and R statistical.
Results
A cohort of 4349 individuals with an average age of 68.00 ± 5.97 years was analyzed. From these individuals, 21.5% reported falls during follow-up. Baseline CVD was significantly associated with follow-up falls (P < 0.001). After adjusting for multiple factors, nighttime sleep durations of <6 h (P = 0.004), 8 to 9 h (P = 0.016) and >9 h (P = 0.031) were significantly associated with follow-up falls among the CVD group. Total sleep duration <7 h was significantly associated with follow-up falls in both the total and non-CVD groups (P < 0.05).
Conclusions
Maintaining a moderate sleep duration is crucial for preventing falls among older adults. Both excessively short and long sleep durations are associated with fall risks, particularly for individuals with CVD. Geriatr Gerontol Int 2025; 25: 38–47.
目的：跌倒是一个主要的全球公共卫生问题，需要早期筛查和预防。心血管疾病（CVD）与身体损伤和跌倒风险增加有关。尽管心血管疾病与睡眠参数之间存在联系，但对心血管疾病患者跌倒和睡眠的研究有限。我们的目的是比较有和没有心血管疾病的人群中跌倒和睡眠之间的相关性，以制定预防跌倒的策略。方法：本纵向队列研究采用中国健康与退休纵向研究（CHARLS）的数据。基线数据于2011年收集，并于2015年进行随访。根据自我报告对跌倒和心血管疾病进行评估。通过自我报告问卷收集睡眠参数，包括夜间和总睡眠时间、白天午睡和睡眠障碍。数据分析采用SPSS和R统计软件。结果：共纳入4349例个体，平均年龄68.00±5.97岁。在这些人中，21.5%的人报告在随访期间跌倒。基线CVD与随访跌倒显著相关（p9 h (P = 0.031)） CVD组与随访跌倒显著相关。结论：保持适度的睡眠时间对于预防老年人跌倒至关重要。睡眠时间过短和过长都与跌倒风险有关，特别是对于患有心血管疾病的人。Geriatr Gerontol Int 2024；••: ••-••.
{"title":"Associations between sleep parameters and falls among older adults with and without cardiovascular disease: Evidence from the China Health and Retirement Longitudinal Study (CHARLS)","authors":"Xinze Wu, Satoru Ebihara","doi":"10.1111/ggi.15034","DOIUrl":"10.1111/ggi.15034","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Falls are a major global public health concern, requiring early screening and prevention. Cardiovascular disease (CVD) is associated with physical impairments and increased fall risk. Despite the link between CVD and sleep parameters, research on falls and sleep in CVD patients is limited. We aimed to compare the correlation between falls and sleep in populations with and without CVD to develop fall prevention strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This longitudinal cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS). Baseline data were collected in 2011, with follow-up in 2015. Falls and CVD were assessed based on self-reporting. Sleep parameters, including nighttime and total sleep duration, daytime napping, and sleep disturbance were collected via self-reported questionnaires. Data analysis was conducted using SPSS and R statistical.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A cohort of 4349 individuals with an average age of 68.00 ± 5.97 years was analyzed. From these individuals, 21.5% reported falls during follow-up. Baseline CVD was significantly associated with follow-up falls (<i>P</i> < 0.001). After adjusting for multiple factors, nighttime sleep durations of <6 h (<i>P</i> = 0.004), 8 to 9 h (<i>P</i> = 0.016) and >9 h (<i>P</i> = 0.031) were significantly associated with follow-up falls among the CVD group. Total sleep duration <7 h was significantly associated with follow-up falls in both the total and non-CVD groups (<i>P</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Maintaining a moderate sleep duration is crucial for preventing falls among older adults. Both excessively short and long sleep durations are associated with fall risks, particularly for individuals with CVD. <b>Geriatr Gerontol Int 2025; 25: 38–47</b>.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"25 1","pages":"38-47"},"PeriodicalIF":2.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evidence is lacking regarding associations between smoking/drinking and falls. This study aimed to determine longitudinal associations between smoking, alcohol consumption, and fall risk in middle-aged and older people.
Methods
Participants of this cohort study were 7542 community-dwelling Japanese people aged 40–74 years. The baseline self-administered questionnaire survey was conducted in 2011–2013, and the second survey was conducted 5 years later. Predictors were smoking level and alcohol consumption. The outcome was the occurrence of recurrent falls. Information on self-reported falls in the previous year was obtained. Covariates were demographics, lifestyle factors, body mass index, general health status, and disease history.
Results
The mean age of participants was 60.3 years. Higher smoking levels were associated with a higher recurrent fall risk (adjusted P for trend = 0.0386), with the ≥20 cigarettes/day group having a higher risk (adjusted odds ratio [OR] = 1.93, 95% confidence interval [CI]: 1.20–3.10) than lifetime non-smokers. The association between smoking and recurrent fall risk tended to be stronger in drinkers than in non-drinkers (adjusted OR = 2.75, 95% CI: 1.57–4.81), suggesting a potential interaction (P for interaction = 0.1035). Although there were no dose-dependent associations between alcohol consumption and recurrent fall risk overall, moderate alcohol consumption (150–299 g ethanol/week) was associated with a lower risk (adjusted OR = 0.57, 95% CI: 0.33–0.98) compared with no consumption in men.
Conclusions
Smoking, but not alcohol consumption, is dose-dependently associated with high fall risk. However, moderate alcohol consumption may be associated with a decreased fall risk. Moreover, there may be a potential interaction between smoking and alcohol consumption on fall risk. Geriatr Gerontol Int 2025; 25: 67–74.
{"title":"Smoking, alcohol consumption, and risk of recurrent falls in community-dwelling Japanese people aged 40–74 years: The Murakami cohort study","authors":"Shion Kimura, Choji Suzuki, Kaori Kitamura, Yumi Watanabe, Keiko Kabasawa, Akemi Takahashi, Toshiko Saito, Ryosaku Kobayashi, Rieko Oshiki, Ribeka Takachi, Shoichiro Tsugane, Osamu Yamazaki, Kei Watanabe, Kazutoshi Nakamura","doi":"10.1111/ggi.15040","DOIUrl":"10.1111/ggi.15040","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Evidence is lacking regarding associations between smoking/drinking and falls. This study aimed to determine longitudinal associations between smoking, alcohol consumption, and fall risk in middle-aged and older people.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants of this cohort study were 7542 community-dwelling Japanese people aged 40–74 years. The baseline self-administered questionnaire survey was conducted in 2011–2013, and the second survey was conducted 5 years later. Predictors were smoking level and alcohol consumption. The outcome was the occurrence of recurrent falls. Information on self-reported falls in the previous year was obtained. Covariates were demographics, lifestyle factors, body mass index, general health status, and disease history.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of participants was 60.3 years. Higher smoking levels were associated with a higher recurrent fall risk (adjusted <i>P</i> for trend = 0.0386), with the ≥20 cigarettes/day group having a higher risk (adjusted odds ratio [OR] = 1.93, 95% confidence interval [CI]: 1.20–3.10) than lifetime non-smokers. The association between smoking and recurrent fall risk tended to be stronger in drinkers than in non-drinkers (adjusted OR = 2.75, 95% CI: 1.57–4.81), suggesting a potential interaction (<i>P</i> for interaction = 0.1035). Although there were no dose-dependent associations between alcohol consumption and recurrent fall risk overall, moderate alcohol consumption (150–299 g ethanol/week) was associated with a lower risk (adjusted OR = 0.57, 95% CI: 0.33–0.98) compared with no consumption in men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Smoking, but not alcohol consumption, is dose-dependently associated with high fall risk. However, moderate alcohol consumption may be associated with a decreased fall risk. Moreover, there may be a potential interaction between smoking and alcohol consumption on fall risk. <b>Geriatr Gerontol Int 2025; 25: 67–74</b>.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"25 1","pages":"67-74"},"PeriodicalIF":2.4,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Astragaloside IV (As-IV), a key component of traditional Japanese Hozai tonics, has a steroid skeleton like estrogen. It inhibits vascular calcification via estrogen receptor α, offering cardiovascular benefits. However, its estrogen-like properties promote breast cancer cell proliferation. Targeted research is needed to optimize cardiovascular preventive effects without adverse effects.
黄芪甲苷（Astragaloside IV, As-IV）是日本传统虎仔补药的重要成分，具有类似雌激素的类固醇骨架。它通过雌激素受体α抑制血管钙化，对心血管有益。然而，它的雌激素样特性促进乳腺癌细胞增殖。需要有针对性的研究来优化心血管预防效果而不产生不良反应。
{"title":"Astragaloside IV inhibits vascular calcification through estrogen receptor alpha","authors":"Michiko Nanao-Hamai, Bo-Kyung Son, Sumito Ogawa, Masahiro Akishita","doi":"10.1111/ggi.15032","DOIUrl":"10.1111/ggi.15032","url":null,"abstract":"<p>Astragaloside IV (As-IV), a key component of traditional Japanese <i>Hozai</i> tonics, has a steroid skeleton like estrogen. It inhibits vascular calcification via estrogen receptor α, offering cardiovascular benefits. However, its estrogen-like properties promote breast cancer cell proliferation. Targeted research is needed to optimize cardiovascular preventive effects without adverse effects.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"25 1","pages":"126-128"},"PeriodicalIF":2.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fumihiro Mizokami, Tomohiro Mizuno, Rena Taguchi, Izumi Nasu, Sayaka Arai, Keiichiro Higashi, Ayaka Matsumoto, Miwako Kamei, Taro Kojima, Takayoshi Sakai, Yuuka Shibata, Yasushi Takeya, Masaki Mogi, Shizuo Yamada, Masahiro Akishita, Japanese Society of Geriatric Pharmacy Working Group on Japanese Anticholinergic Risk Scale
Background
Anticholinergic burden, reflecting the cumulative impact of medications with anticholinergic properties, significantly predicts adverse drug reactions and geriatric syndromes in older adults. Although anticholinergic risk scales (ARS) have been developed and validated in various countries, none have been tailored specifically for Japan. The Japanese Anticholinergic Risk Scale (JARS) was developed to adapt the existing ARS frameworks to the Japanese context, considering unique medication profiles and cultural factors.
Process
First, a systematic review was performed to follow the protocol registered in PROSPERO (CRD42017076510). A PubMed search from October 2017 to March 2023 was conducted to identify ARS publications post-September 2017. Based on two algorithms, average scores from the existing scores were used to develop JARS. The Delphi method, an expert consensus approach, was applied to determine the scores for medications that were not established by the algorithms. Sixteen articles identified in our systematic review contributed to JARS development. JARS categorizes 158 medications into three potency groups: 37 drugs scored as 3 (strong), 27 as 2 (moderate), and 94 as 1 (weak).
Conclusion
JARS, the newly developed ARS, could be a critical tool for anticholinergic burden assessment in older Japanese populations. Developed through a systematic review and Delphi-based expert consensus, it encompasses 158 medications, offering a comprehensive anticholinergic burden assessment. Future studies and updates should be conducted to improve the accuracy and clinical applicability of this scale. Geriatr Gerontol Int 2025; 25: 5–13.
背景：抗胆碱能负荷反映了具有抗胆碱能特性的药物的累积影响，可显著预测老年人的药物不良反应和老年综合征。虽然抗胆碱能风险量表（ARS）已在许多国家开发和验证，但没有一个是专门为日本量身定制的。日本抗胆碱能风险量表（JARS）的开发是为了使现有的ARS框架适应日本的情况，考虑到独特的药物概况和文化因素。过程：首先，按照在PROSPERO （CRD42017076510）注册的方案进行系统评价。对2017年10月至2023年3月的PubMed检索进行了检索，以确定2017年9月之后的ARS出版物。基于两种算法，使用现有分数的平均分数来开发jar。德尔菲法是一种专家共识法，用于确定算法未建立的药物的分数。在我们的系统综述中确定的16篇文章对jar的开发做出了贡献。jar将158种药物分为三个效力组：37种药物被评为3（强），27种药物被评为2（中等），94种药物被评为1（弱）。结论：新开发的ARS可作为评估日本老年人抗胆碱能负荷的重要工具。通过系统评价和基于德尔菲的专家共识，它包括158种药物，提供全面的抗胆碱能负担评估。未来的研究和更新应进行，以提高该量表的准确性和临床适用性。Geriatr Gerontol Int 2024；••: ••-••.
{"title":"Development of the Japanese Anticholinergic Risk Scale: English translation of the Japanese article","authors":"Fumihiro Mizokami, Tomohiro Mizuno, Rena Taguchi, Izumi Nasu, Sayaka Arai, Keiichiro Higashi, Ayaka Matsumoto, Miwako Kamei, Taro Kojima, Takayoshi Sakai, Yuuka Shibata, Yasushi Takeya, Masaki Mogi, Shizuo Yamada, Masahiro Akishita, Japanese Society of Geriatric Pharmacy Working Group on Japanese Anticholinergic Risk Scale","doi":"10.1111/ggi.15001","DOIUrl":"10.1111/ggi.15001","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anticholinergic burden, reflecting the cumulative impact of medications with anticholinergic properties, significantly predicts adverse drug reactions and geriatric syndromes in older adults. Although anticholinergic risk scales (ARS) have been developed and validated in various countries, none have been tailored specifically for Japan. The Japanese Anticholinergic Risk Scale (JARS) was developed to adapt the existing ARS frameworks to the Japanese context, considering unique medication profiles and cultural factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Process</h3>\u0000 \u0000 <p>First, a systematic review was performed to follow the protocol registered in PROSPERO (CRD42017076510). A PubMed search from October 2017 to March 2023 was conducted to identify ARS publications post-September 2017. Based on two algorithms, average scores from the existing scores were used to develop JARS. The Delphi method, an expert consensus approach, was applied to determine the scores for medications that were not established by the algorithms. Sixteen articles identified in our systematic review contributed to JARS development. JARS categorizes 158 medications into three potency groups: 37 drugs scored as 3 (strong), 27 as 2 (moderate), and 94 as 1 (weak).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>JARS, the newly developed ARS, could be a critical tool for anticholinergic burden assessment in older Japanese populations. Developed through a systematic review and Delphi-based expert consensus, it encompasses 158 medications, offering a comprehensive anticholinergic burden assessment. Future studies and updates should be conducted to improve the accuracy and clinical applicability of this scale. <b>Geriatr Gerontol Int 2025; 25: 5–13</b>.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"25 1","pages":"5-13"},"PeriodicalIF":2.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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