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.

Introduction: 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), who 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 interleukin (IL)-10, IL-18, IL-17, transforming growth factor-beta, sestrin-2, klotho, adiponectin, leptin, and irisin, were measured using enzyme-linked immunosorbent assay kits. A 12-week dual-task RT program (weeks 16-27) was 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.

Introduction: 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 ATMT measurements by ultrasound were performed. Frailty was diagnosed using the fried frailty phenotype. 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% confidence interval [CI]: 0.90-0.99, p = 0.033). The area under the receiver operating characteristic 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 aging 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 modeling approach, and sequential multiple regression.

Results: A total of 1,211 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 toward 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, and 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 that implementation of monitoring technologies addresses, first and foremost, the needs of the older care recipient.

Introduction: 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.

Methods: 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, naive Bayes, random forest, gradient boosting decision tree, and eXtreme Gradient Boosting. Model performance was assessed using accuracy, precision, recall, and F1 score. Feature importance and Shapley Additive Explanations were used for feature analysis.

Results: 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.

Conclusion: The findings suggest that the CatBoost model is a highly effective tool for predicting sarcopenia, offering potential for early detection and intervention.

Introduction: This study aimed to assess the within- and between-states inequality in hypertension management and cardiovascular disease (CVD) risk across sociodemographic groups in India and the correlation between states/UTs expenditure on health, hypertension management, and CVD risk.

Methods: This study utilized cross-sectional data from 2017/2018 Longitudinal Aging Study in India (LASI), with a total sample of 58,848 respondents aged ≥45 years. Hypertension management was assessed based on hypertension awareness, treatment, and control, while 10-year CVD risk was measured using the 2019 WHO CVD risk. We used multilevel logistic regression models to estimate the socioeconomic inequality in hypertension management and 10-year CVD risk, measured by the relative index of inequality (RII).

Results: Rural areas had a substantially poorer coverage of hypertension awareness, treatment, and control compared with urban areas. Richest socioeconomic groups were more likely to be aware of their hypertensive status (RII 1.28, 95% CI: 1.16-1.42), receive antihypertensive treatment (RII 1.47, 95% CI: 1.28-1.69), have their blood pressure controlled (RII 1.60, 95% CI: 1.34-1.90), and have 10-year CVD risk <10% (1.06, 95% CI: 1.01-1.12) compared to the poorest. The variance partition coefficient ranged from 1.5% for 10-year CVD risk to 9.9% for hypertension control. There was no significant correlation between socioeconomic inequality in hypertension management, 10-year CVD risk, and the per capita public health expenditure of states/UTs.

Conclusion: Differences in state-level health system capacity may disproportionately affect socioeconomically disadvantaged populations, underscoring the need for more equitable hypertension management and cardiovascular health strategies across India.

Introduction: Understanding why bilateral sensorineural hearing loss (BHL) is associated with balance dysfunction can guide balance rehabilitation programs. We investigated whether adults with BHL demonstrated impaired standing balance and increased postural visual and somatosensory dependence as compared to those with normal hearing.

Methods: This cross-sectional study assessed postural sway in 31 adults with BHL (mean age = 72.97) and 28 controls (mean age = 59.14), using the instrumented modified Clinical Test of Sensory Integration (mCTSIB). The mCTSIB has 4 tasks, each 30-s long: standing with eyes open/closed on floor/foam. Outcome measures, calculated from inertial measurement units, included overall stability (root-mean-square [RMS] sway, ms2) and smoothness of sway (anterior-posterior and mediolateral jerk, m2s5). Participants also self-reported whether they exercised on a regular basis.

Results: Adjusting for age, both groups increased RMS and jerk significantly with task, with no significant differences between groups. Greater BHL severity moderately correlated with higher anterior-posterior jerk and RMS in foam eyes closed condition. Age showed no more than weak correlations with BHL severity, jerk, or RMS. As a post hoc analysis, we observed that people who reported exercising regularly exerted less effort to maintain stance and were significantly more stable on the most challenging tasks.

Conclusions: Individuals with BHL did not show increased visual or somatosensory reliance and overall as a group showed similar balance performance to adults with normal hearing. Greater severity of hearing loss was associated with worse performance regardless of age. This study supports the role of regular exercise as protective against balance dysfunction in aging with or without hearing loss.

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.

Introduction: Balance on the Brain is a balance-focused multi-modal community-based exercise intervention aimed at reducing falls and improving health outcomes for people living with mild cognitive impairment (MCI). This study completed an important step when conducting randomised controlled trials (RCTs) by evaluating the barriers and facilitators of the program from the perspective of the intervention participants and the exercise providers delivering the intervention. This study also explored the perspective of the main informal support people (MISP) of intervention participants living with MCI.

Methods: This was a qualitative study using face-to-face semi-structured interviews. Interviews were audio-recorded to enable verbatim transcriptions. Braun and Clarke's 6-step thematic analysis process was used to analyse the data.

Results: A total of 26 RCT intervention participants, 4 physiotherapists, and 14 MISPs were interviewed at the end of the 6-month intervention. There was moderate diversity in the overall experiences; for example, what may have been a barrier for some was a facilitator for others. Overall, lack of motivation and other health issues were the most identified barriers across the Balance on the Brain intervention. Key facilitators for the intervention participant were the guidance provided by the physiotherapists delivering the program and the ease of adding the intervention into their daily routine. The MISPs had varying levels of involvement and support throughout the intervention; some completed the intervention exercises with the intervention participant, others were supportive and encouraged participation, and some had no input into the intervention participant's involvement in the Balance on the Brain intervention.

Conclusion: The Balance on the Brain RCT was largely accepted by intervention participants, physiotherapists delivering the intervention, and the MISPs. Exercise interventions that can be tailored to each participant's needs are likely to be viewed more favourably. Future interventions for this population may be improved by adding opportunities for the MISPs to be more involved.