Gerontology最新文献

Background: The hemoglobin-to-red cell distribution width ratio (HRR), which has demonstrated better predictive ability than the red blood cell distribution width (RDW) and hemoglobin (Hb) level, has not been used to predict orthopedic surgical outcomes and may be a novel prognostic parameter for mortality.

Methods: In this single-center cohort study, data of 363 patients (aged ≥60 years) who underwent surgery for fragility hip fracture at our institution between January 2016 and December 2018 were retrospectively analyzed. Multivariable Cox proportional hazards and Kaplan-Meier survival curve analyses were performed to compare the high and low HRR and RDW groups, divided based on cutoff values. The power of mortality prediction over time was assessed by comparing Harrell's concordance index using the bootstrapping method.

Results: Among 363 patients, the overall mortality was 48.48% (176/363), with a mean±standard deviation of 4.31±2.09 (0.02-7.44) years. HRR was significantly associated with all-cause mortality after hip fracture surgery (hazard ratio: 0.989; 95% confidence interval: 0.978-0.999; p=0.044). Moreover, during the follow-up period after 1 year, HRR demonstrated the second-highest predictive ability for mortality among all laboratory parameters and indicators reflecting general condition, and it remained unaffected by anemia status for up to 4 years.

Conclusions: HRR is proposed as a novel prognostic indicator for mid- to long-term survival after hip fracture surgery in older patients.

Objective: This study aimed to evaluate the effects of a 12-week dual-task resistance training (RT) program on inflammatory and metabolic biomarkers in institutionalized older adults and assess the impact of detraining.

Methods: The study followed a crossover experimental design. Participants were 11 older adults (mean age: 81.9 ± 3.0 years) completed baseline (week 1), post-control (weeks 14-15), post-training (week 28), and post-detraining (week 42) assessments over 42 weeks. Immunometabolic markers, including IL-10, IL-18, IL-17, TGF-β, sestrin-2, klotho, adiponectin, leptin, and irisin, were measured using ELISA kits. A 12-week dual-task resistance training program (weeks 16 to 27) carried out progressively, incorporating cognitive tasks during lower limb exercises. Cognitive complexity increased monthly, and detraining followed in weeks 29-41.

Results: Results demonstrated a significant post-training increase in IL-10 (p=0.011) and a decrease in IL-18 (p<0.001), indicating improved inflammatory status. Metabolic markers such as sestrin-2 (p=0.016), klotho (p<0.001), adiponectin (p=0.019), and irisin (p = 0.009) also increased post-training. Notably, klotho and irisin levels remained elevated post-detraining, suggesting sustained benefits.

Conclusion: Dual-task RT enhanced inflammatory and metabolic profiles, partially retaining benefits after detraining. This intervention presents a viable strategy to mitigate aging-related systemic health decline in vulnerable populations.

Background: Physical frailty in older adults is frequently associated with adverse outcomes, yet most assessment tools rely on subjective or time-consuming measures. This study explores ultrasound-derived anterior thigh muscle thickness (ATMT) as an objective marker for frailty.

Methods: This cross-sectional study included 641 patients aged 65 years and older. Comprehensive geriatric evaluations and anterior thigh muscle thickness (ATMT) measurements by ultrasound were performed. Frailty was diagnosed using the Fried Frailty Phenotype (FFP). The association between ATMT and frailty was examined using multivariate logistic regression analysis.

Results: Participants' mean age was 75±6.4 years; 62.9% were women, and 12% were frail. Frail individuals had significantly lower ATMT compared to non-frail counterparts (p<0.001). ATMT remained independently associated with frailty after adjusting for confounders (β=0.94, 95% CI: 0.90-0.99, p=0.033). The area under the ROC curve for ATMT predicting frailty was 0.660 (95% CI: 0.62-0.69; p<0.001). Sex-stratified analyses revealed higher accuracy in men (AUC=0.757) than in women (AUC=0.599). The optimal ATMT cut-off was ≤30.5 mm, with a negative predictive value of 90.3%.

Conclusions: Ultrasound-derived ATMT offers a simple, radiation-free, and objective method for frailty screening, showing stronger discriminative ability in men and moderate accuracy in women. It may be used as a practical screening measure in combination with other geriatric assessment tools in outpatient settings.

Introduction: Recently, there has been a clear trend towards a wider use of herbal preparations in medical practice, the advantage of which lies in their harmlessness and effectiveness of therapeutic action.

Objective: Objective of the study: To study the contractile activity of isolated lymph nodes in old animals, as well as under the influence of a new method of phytotherapy.

Methods: In the experiments, lymph nodes were taken from old animals. And on these isolated nodes, their contractile activity was studied before and after exposure to the bioactive composition. For this, a highly sensitive installation with a recording device was used.

Results: The use of our bioactive phytocomposition on the cervical and tracheobronchial lymph nodes increased their contractile activity - a decrease in the frequency and an increase in the amplitude of contractions were observed. An activating effect of the contractile activity of the lymph nodes on biologically active substances under the influence of phytopreparations was observed. The study revealed a predominant effect on the tracheobronchial lymph nodes than on the cervical ones.

Conclusion: Phytocorrection proved to be effective in stabilizing the structural components of the lymph nodes, which maintained their contractile function at an adequate level. The composition is a geroprotector, and the biologically active substances in the phytocomposition correct and stimulate the lymph nodes' own transport function. Activation of the contractile activity of the lymph nodes is an important link in the body's anti-aging. This phytocorrection may have a wider application.

Introduction: The ageing of the population calls for closer evaluations of gerontechnologies as potential resources to aid in the care of older persons. Despite the wealth of theoretical and empirical works in this area, there exists a dearth of quantitative studies to address this population trend. This paper uses a large weighted sample in Switzerland to understand the factors associated with the acceptance of smart monitoring technologies to care for older persons.

Methods: We designed a telephone survey to address the purposes of this study, collecting data on self-rated acceptance of monitoring technologies (wearables and ambient sensors with and without camera), their care situations, perceived relief of caregiving stress through technology use, and the perceived impact of external factors in technology adoption. Statistical analyses included descriptive analysis, multilevel modelling approach, and sequential multiple regression.

Results: A total of 1211 valid responses were obtained for this cross-sectional survey study. Over 80% of participants were willing to accept wearables for locating older persons with dementia as well as for fall detection purposes. Among the respondents, almost 60% were open to using sensors at home to detect changes in the older person, and roughly 35% accepted the use of cameras to recognize fall or pain. Acceptance towards cameras increased significantly with risk of falling, and even in relatively private areas of the home when fall risk was perceived. The care situation and technologies' perceived usefulness in addressing caregiver stress explained the most variance related to acceptance of the smart monitoring technologies.

Conclusions: Higher acceptance was found for smart wearable devices for elder care purposes compared to the sensors and cameras at home. Presence of actual need such as risk of falling, practical care situations, as well as an overall emphasis on ensuring the safety of older persons, were observed to positively impact the acceptance of technologies. Our findings also impart significance of the role of caregiving stress as a driver to incorporating technical tools in elder care. Further research is necessary to ensure implementation of monitoring technologies address, first and foremost, the needs of the older care recipient.

As the global population ages, sarcopenia is increasingly recognized for its severe consequences, including disability, falls, injuries, hospitalization, and even death. Despite its significance, research on predicting sarcopenia using machine learning is limited. This study aims to develop an effective machine learning model for sarcopenia prediction. Data from 1,441 participants were retrospectively reviewed from Kaohsiung Medical University-affiliated hospitals between 2022 and 2024. The dataset included demographics, lifestyle habits, medical history, and other relevant factors, with sarcopenia assessment based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Six machine learning models were evaluated: CatBoost, K Nearest Neighbor (KNN), Naive Bayes (NB), Random Forest (RF), Gradient Boosting Decision Tree (GBDT), and Extreme Gradient Boosting (XGBoost). Model performance was assessed using accuracy, precision, recall, and F1-Score. Feature importance and SHAP (Shapley Additive Explanations) were used for feature analysis. CatBoost outperformed the other models, achieving an accuracy of 96.62%, with similarly high precision, recall, and F1-Score. Feature importance analysis using SHAP revealed that age, gender, pulse rate, pulmonary disease, blood pressure, dizziness, and missing teeth were key predictors in the model for sarcopenia prediction. The findings suggest that the CatBoost model is a highly effective tool for predicting sarcopenia, offering potential for early detection and intervention.

Introduction: Alterations in gut microbiota have been linked to various neurological diseases, including Parkinson's disease (PD). Modifying the microbiota through probiotics, prebiotics, or synbiotics may help improve symptoms in PD patients. This study aimed to evaluate the efficacy and safety of these supplements in treating PD.

Methods: A systematic search was conducted in several databases, including PubMed, EMBASE, Scopus, Cochrane Library, Web of Science, and Google Scholar, until September 2023. No restrictions were placed on language or publication date. Study quality was assessed, and data were analyzed using meta-analysis techniques and narrative synthesis tables. The certainty of evidence was evaluated using GRADE, and trial sequential analysis was performed for primary outcomes.

Results: Out of 3,608 studies identified, 69 were selected for review, with 16 analyzed qualitatively. Among these, 12 were randomized controlled trials, and 9 were included in the meta-analysis. Compared with the placebo group, the intervention group would improve non-motor symptoms related to constipation (weekly stools [MD]: 1.04; 95% CI: 0.83, 1.25; Bristol scale [MD]: 0.54; 95% CI: 0.38, 0.70; frequency of laxative use [MD]: -0.63; 95% CI: -0.94, -0.33) and could improve motor symptoms (UPDRS-III [MD]: -2.23; 95% CI: -5.00; 0.53), with very low certainty both due to indirectness and significant risk of bias.

Conclusion: With very low to moderate certainty, probiotics, prebiotics, and synbiotics may improve constipation and motor symptoms in PD compared to placebo. These findings suggest a potential benefit, but more high-quality research is needed to confirm these effects and establish stronger evidence.

Introduction: Heterogeneity of patients with late-life depression (LLD) makes it difficult to predict their responses to treatment.

Methods: Hundred patients with LLD were stratified into clusters based on ten blood biochemical and immunological parameters measured at baseline. The treatment responses and clinical characteristics of the patients in the resulting clusters were compared.

Results: The resulting 4 clusters of patients significantly differed in treatment responses and in a number of clinical traits.

Conclusion: The study confirms the link between the activities of enzymes involved in energy, glutamate metabolism, and antioxidant and immune systems in patients with LLD and their response to therapy as well as their certain clinical characteristics.

Background: It is anticipated that demographic trends will result in a notable increase in the number of elderly and geriatric patients globally. Concurrently, atrial fibrillation exhibits a pronounced age-dependent prevalence, thereby anticipating a substantial increase in the number of elderly atrial fibrillation patients. In this context, we have examined the recently published European Society of Cardiology (ESC) guidelines on the management of atrial fibrillation from 2024, analyzing their recommendations and implications for atrial fibrillation management in elderly patients, and critically summarized the recent recommendations.

Summary: In summary, it can be stated that the guideline makes age-dependent recommendations in some areas. Such recommendations can be found in particular for the indication for anticoagulation and for switching anticoagulation therapy from VKA to DOAC, or for atrial fibrillation screening. When it comes to rhythm control and catheter ablation, however, there are few age-specific recommendations and the particularities and heterogeneities of this patient group tend to be underrepresented in the guidelines.

Key messages: Tailored recommendations for elderly patients can be found in the ESC guidelines on the management of atrial fibrillation for atrial fibrillation screening and anticoagulation. In particular, the recommendations on rhythm control and catheter ablation lack specific recommendations for older patients.

Introduction: Progress in spine surgery has significantly improved the safety of procedures for older patients with disabling spine disease. However, postoperative cognitive dysfunction (POCD) remains a concern due to their link with poorer outcomes and higher long-term care risk. This study aimed to determine if pro-neuroinflammatory states accelerate neurodegeneration, contributing to POCD development, and explore whether specific biomarkers could predict POCD risk.

Methods: Patients (aged ≥ 60 years) scheduled for elective spine surgery between February 2018 and March 2020 were enrolled. Biomarkers tested included IL-6, C-reactive protein, S100 calcium-binding protein β, brain-derived neurotrophic factor, serum neurofilament light chain protein (sNFL), gasdermin D, and soluble ectodomain of triggering receptor expressed on myeloid cells 2 (sTREM2), measured preoperatively and postoperatively. Cognitive outcomes were assessed using the CERAD test battery at baseline and 3 months postoperatively.

Results: Postoperative levels of sTREM2 and gasdermin D were significantly associated with cognitive performance changes 3 months after surgery, particularly in memory function. Higher sTREM2 levels were associated with greater cognitive decline, with six out of twelve CERAD items showing an inverse association (e.g., overall β = -0.010, p = 0.0003). Similarly, higher postoperative gasdermin D levels were linked to worse performance, particularly in recognition memory (e.g., word list recognition β = -0.615, p = 0.032). Additionally, higher preoperative sNFL levels were associated with poorer cognitive outcomes across multiple domains.

Conclusions: This study highlights potential associations between neuroinflammation and cognitive decline following spine surgery. Targeting neuroinflammatory pathways could be crucial in mitigating POCD in older patients. Biomarkers may help identify high-risk patients and guide the development of targeted interventions.