Gerontology最新文献

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: Parkinson's disease (PD) is a progressive neurological disorder caused by a reduction in dopamine in the substantia nigra and striatum of the basal ganglia. Patients with mild to moderate PD have poor hand dexterity, reduced grip strength, and lower self-perceived hand function ability. The aim of the study was to explore the correlation between hand function and balance function in patients with PD.

Methods: Overall, 196 patients with PD who visited the Department of Rehabilitation Medicine and the Department of Neurology of Huashan Hospital affiliated to Fudan University from June 2022 to December 2024 were selected, with Hohn-Yahr stages II-III. The hand function and balance function of the patients were evaluated. The correlation between the hand function and balance function of the patients was observed through the Simple Test for Evaluating Hand Function (STEF), Berg Balance Scale (BBS), and Timed Up and Go Test (TUGT).

Results: The hand function of the patients was positively correlated with the balance function. The right hand STEF test was negatively correlated with the total Berg score at the opening period (r = -0.563, p < 0.01) and was positively correlated with the duration of TUGT (r = 0.527, p < 0.01). The results obtained with the left hand were similar to those of the right hand.

Conclusion: Improved hand function correlates with better balance and shorter completion times on the Timed Up and Go Test (TUGT). Hand function assessments may therefore predict balance performance in patients. Future research should determine whether these functions are interdependent or operate independently.

Introduction: Age-related functional decline is assumed to be a complex process in which declines in one domain may trigger decline in others. Yet research empirically identifying the temporal ordering of age-related decline across emotional, cognitive, physical, and social functioning as well as health-behavioral factors is still scarce.

Methods: We analyzed up to 10 waves of the Longitudinal Aging Study Amsterdam (LASA) cohort over 30 years (n = 1,560), covering fifteen indicators of physical, cognitive, emotional and social functioning, and health-behavioral factors. We used directed dynamic time warping to quantify the temporal ordering of within-person changes in these indicators. Average temporal relationships were visualized as a network graph and by rank-ordering indicators according to their tendency to precede (high out-strength) or follow (high in-strength) changes in other indicators.

Results: Participants were on average 62.3 ± 5.50 years old at baseline, 53.8% female, with 14.8 ± 4.74 years of follow-up. Physical and cognitive declines (e.g., physical performance and episodic memory) tended to precede decline in other domains, while changes in social functioning (e.g., social participation) tended to follow. No clear temporal ordering was found between emotional functioning (e.g., depression and anxiety) and other domains.

Conclusion: The study offers insights into early detection and prevention strategies for healthy aging. Assuming that physical and cognitive domains are primarily driven by age-related biological changes, our findings support theories proposing that biological changes precede functional decline and theories emphasizing the importance of psychosocial resilience. Moreover, this study highlights the potential of adopting a complex systems approach and innovative within-person analytical methods in gerontology.

Introduction: The age-associated loss of muscle mass is partly accounted for by a reduction in muscle fascicle length (FL). Studies on rodents have confirmed this reduced FL is driven by a loss of sarcomeres aligned in series (serial sarcomere number; SSN) along a muscle. However, studies on rodents have focused primarily on rat plantar flexor SSN at two aging timepoints, leaving an incomplete view of age-related changes in SSN. Hence, this study investigated SSN as a contributor to the age-related loss of muscle mass in five hindlimb muscles across four aging timepoints in rats.

Methods: The soleus, medial gastrocnemius (MG), plantaris, tibialis anterior (TA), and vastus lateralis (VL) were obtained from 5 young (8 months), 5 middle-aged (20 months), 5 old (32 months), and 5 very old (36 months) male F344BN rats. After fixation of muscles in formalin and digestion in nitric acid, fascicles were teased out end-to-end to measure FL. SSN was determined by dividing FL by sarcomere length measured via laser diffraction. Muscle wet weight, anatomical cross-sectional area (ACSA), and physiological cross-sectional area (PCSA) were also determined for insight on age-related losses of whole-muscle mass and in-parallel muscle morphology.

Results: Age-related SSN loss was apparent after middle age for all muscles, with the plantaris showing the smallest (8%) and the VL the greatest (21%) differences between age groups. The MG and VL appeared to plateau in their SSN loss by 32 months, while the soleus and TA demonstrated continued decline from 32 to 36 months. In all muscles, an age-related lower SSN evidently contributed in part to the smaller muscle mass, alongside less contractile tissue in parallel (indicated by ACSA and PCSA).

Conclusion: As SSN is closely tied to biomechanical function, these findings present SSN as a distinct target for improving muscle performance in older adults.

Sarcopenia and osteoporosis are common, interconnected conditions, in aging populations that lead to increased frailty, disability and a heightened risk of falls and fractures. Sarcopenia is the progressive loss of muscle mass, strength and function, that often coexists with osteoporosis, which is characterized by reduced bone strenght for a decreased bone mineral density (BMD) and altered bone quality. Together, these conditions form a clinical syndrome known as osteosarcopenia. Both disorders share common risk factors, including chronic inflammation, oxidative stress, and hormonal changes, which accelerate the deterioration of musculoskeletal health. This chapter discusses the overlapping pathophysiology and highlights the importance of early diagnosis and integrated therapeutic strategies. Nutritional approaches, such as ensuring adequate protein, vitamin D, and calcium intake, combined with resistance training, are essential to preserving muscle and bone health. Pharmacological treatments, including bisphosphonates for osteoporosis and emerging therapies like selective androgen receptor modulators (SARMs) and myostatin inhibitors for sarcopenia, offer promising avenues for comprehensive management. A multifaceted approach targeting both conditions can reduce the risk of falls and fractures, ultimately improving quality of life in older adults.

Introduction: The purpose of this systematic review is to examine the effects of virtual reality training (VRT) on the muscle strength of the elderly.

Methods: Primary sources were obtained from 4 databases including PubMed, SCOPUS, CENTRAL, and Web of Science. The search period covered years from inception to February 1th, 2025. Standardized mean differences (SMDs), weighted mean differences, and 95% CIs were calculated using random or fixed-effect models for outcomes.

Results: Following the screening process, 38 studies involving a total of 1280 participants were included in the systematic review. The results of the meta-analysis showed that VRT increased upper-body muscle strength (1.89 [95% CI: 0.65-3.13], p=0.003), lower-body muscle strength (0.68 [95% CI: 0.46-0.91], p=0.001) and handgrip (0.45 [95% CI: 0.26-0.63], p=0.001). Additionally, the results of the meta-analysis demonstrated that there was no significant difference between VRT and traditional training (TT) on lower-body muscle strength (0.04 [95% CI: -0.26-0.36), p=0.75) and handgrip (0.06 [95% CI: -0.11-0.24], p=0.48).

Conclusion: The results meta-analysis demonstrated that VRT has a positive effect on the muscle strength of all three parts of the lower limb, upper limb, and HG. Also, comparing VRT with TT, no significant difference was observed between these two types of training.

Introduction: The use of reporting guidelines and clinical trial registration policies by academic journals reduces bias and improves transparency in clinical research. It is unknown whether geriatric and gerontology journals mention, recommend, or require their use for the studies they may potentially publish. The purpose of this study is to assess the submission guidelines of the top geriatric and gerontology journals for their editorial recommendation or requirement of predetermined reporting guidelines and clinical trial registration.

Methods: Using the 2021 Scopus CiteScore tool, we identified the top 100 journals in the "Geriatrics and Gerontology" subcategory. We reviewed each journal's "Instructions to Authors" for references to reporting guidelines commonly used for various study designs, categorizing them as "Not Mentioned," "Recommended," "Does Not Require," or "Required." Additionally, we assessed how each journal addressed clinical trial registration using the same classification system.

Results: Among the 100 journals reviewed, none referenced the QUOROM statement. In contrast, the CONSORT statement was the most frequently mentioned, with 44 journals (44%) recommending or requiring its use. PRISMA guidelines were omitted by 57 journals (57%), while study registration was recommended or required by 92 journals (92%).

Conclusion: The recommendation or requirement of reporting guidelines and clinical trial registration in the top 100 geriatric and gerontology journals is inconsistent. Journal editors should strongly recommend that authors follow reporting guidelines to reduce potential bias and improve transparency in the articles they publish.

Introduction: Older adults can reduce the risk of falls after participation in a Perturbation-Based Balance Training (PBBT). We aimed to compare two perturbation motor learning paradigms: random vs block practice.

Methods: Twenty community-dwelling older adults were recruited and randomly allocated to a random PBBT group (n=8), participants were exposed to unannounced perturbations in multiple directions during each training session, or a block PBBT group (n=12) participants experienced perturbations from a single during every training session during treadmill walking. Both groups received eight training sessions over a four-weeks period that included a concurrent cognitive task during training. Primary outcome measures were parameters of reactive stepping i.e., step-thresholds in walking and kinematics of reactive stepping during walking; and secondary outcome measures were proactive balance, i.e. voluntary step test and cognitive performance. All outcomes were measured before and after PBBT.

Results: Both PBBT groups improved their ability to cope with higher perturbations post training and a reduction in Center of Mass path displacement during the recovery after the perturbation in walking. No improvement was found in voluntary stepping post training, both groups, however, showed improvement in cognitive performance post-training.

Discussion: Results show some improvements in reactive stepping performance but not in proactive voluntary stepping in both random and block PBBT methods, with no superiority of one training method over the other. Some improvements in cognitive performance in both groups suggest a transfer effect post training, regardless of training method. Given the small sample size, results are preliminary and should be interpreted with caution.

Introduction: Residing at moderate altitudes has been associated with various health benefits also affecting mortality risk. This study investigates life expectancy and disease-specific mortality rates among populations in the Italian Alps and in northern Italian lowland regions. Additionally, cardiometabolic health and serum metabolite concentrations of residents in an Alpine province across three distinct elevation zones (<1,000 m, 1,000-1,500 m, and >1,500 m above sea level) are studied.

Methods: Data on life expectancy and mortality rate (per ten thousand) were retrieved from the ISTAT database for 6 provinces located in the Italian Alps and 6 provinces at sea level near the Alps. Using cross-sectional data from a sub-sample of the Cooperative Health Research in South Tyrol (CHRIS) study (n=6,292), we fitted multivariable adjusted logistic regression models to investigate associations between altitude and cardiometabolic health, determined by the Cumulative Illness Rating Scale. Moreover, associations between altitude and 175 serum metabolites were evaluated through linear regression models (n=1,447).

Results: Population size and sex distribution were similar between provinces (p>0.485). Life expectancy at 65 years differed between areas (20.8±0.4 vs 20.1±0.3, for Alps vs sea-level, respectively, p=0.026). Mortality rate for diseases of the circulatory system was lower in the Alps than at sea-level (35.3±5.7 vs. 44.5±6.8, respectively, p=0.026). No statistically significant differences were found for mortality (Alps vs. sea-level) from all causes (108.1±15.7 vs. 126.1±15.5, p=0.065), cerebrovascular diseases (8.4±2.5 vs. 12.6±3.1, p=0.065), endocrine, nutritional and metabolic diseases (3.6±1.0 vs. 5.0±1.0, p=0.065), neoplasms (31.1±4.7 vs. 34.3±2.4 p=0.394) and diseases of the respiratory system (8.3±1.7 vs. 8.8±1.7, p=0.589). In the CHRIS study sample, living at moderate vs. low altitude level was associated with lower odds of mild to severe conditions in the hypertension (OR:0.77; 95%CI: 0.62-0.96) and endocrine-metabolic domain (OR:0.77, 95%CI: 0.61-0.97). No differences in blood serum metabolic profiles were observed between people living at different altitude levels.

Conclusions: Living in the Italian Alps seems to have a positive effect on life expectancy and mortality from certain diseases compared to living at sea level in northern Italy. Furthermore, living at moderate altitude conferred some cardiometabolic health benefits in the CHRIS study population, even after corrections for confounding factors. The metabolite profile in a sub-sample did, however, not reveal any significant differences between altitude levels.