Gerontology最新文献

Introduction: Perceived balance confidence may influence stability of gait among older adults and be pronounced in varied environments. This cross-sectional study investigated associations between balance confidence and outdoor walking parameters in various environments as well as differences in these parameters among older adults with varying levels of balance confidence.

Methods: Older adults (N = 39, women 67%, mean age 76) walked outdoors on level, uphill, and downhill with their self-selected normal speed. Walking parameters (stride, stance, and swing durations and cadence) and their variance were assessed using inertial measurement units on the lower back and shanks. Balance confidence was evaluated using the activities-specific balance confidence scale (ABC). Additionally, physical activity, self-rated health, falls in past year, anthropometrics, walking speed on level, short physical performance test (SPPB), and Timed Up and Go (TUG) were recorded.

Results: Balance confidence positively correlated with cadence on level (r_s = 0.439, p = 0.005) and uphill (r_s = 0.336, p = 0.049), negatively with cadence variability downhill (r_s = -0.424, p = 0.007) and stride duration on level (r_s = -0.436, p = 0.006) and uphill (r_s = -0.335, p = 0.049). The high balance confidence group (ABC ≥80, n = 32) had 7-8% higher cadence in all environments, 7-8% shorter stride duration uphill and downhill, walked 0.14 m/s faster on level and showed less variability in walking parameters uphill compared to the lower balance confidence group (ABC <80, n = 7).

Conclusion: In older adults, differences in walking parameters can be seen when using the balance confidence as a differentiating factor. Self-rated balance confidence combined with an uphill walking test may give an indication of varying walking patterns in older adults.

Introduction: This study assessed the association between thyroid-stimulating hormone (TSH) levels and the risk of tooth loss.

Methods: From 2005 to 2013, 56,743 community-dwelling individuals aged ≥65 years underwent biennial physical examinations in Taipei. Dental evaluations documented tooth count and TSH levels were measured using a third-generation assay. Participants averaged 3.4 follow-ups over 4.9 years and were categorized into four groups based on plasma TSH concentrations. A generalized estimating equation model analyzed the longitudinal relationship between tooth loss and TSH levels.

Results: Participants' mean age was 73.1 years (standard deviation, 6.3), being highest in the clinical hypothyroidism group (74.6 years) and lowest in the euthyroid group (73.0 years). Hypertension and diabetes were more prevalent in the clinical hypothyroidism group. Periodontitis rates were consistent across TSH categories, and 81.5% of participants retained ≥20 teeth, 12.0% had 10-19 teeth, and 6.5% had 1-9 teeth. Severe tooth loss (1-9 teeth) was slightly more frequent in the clinical hypothyroidism group (6.7%), suggesting a potential link between thyroid function and tooth retention. Multivariable-adjusted models found no significant association between subclinical hypothyroidism and tooth loss, whereas clinical hypothyroidism reduced risk (odd ratio [OR] = 0.82, 95% confidence interval: 0.74-0.92). Stratified analysis showed this protective effect in those with ≥20 teeth and in individuals aged 65-75 years (OR = 0.79). Conversely, subclinical hypothyroidism increased tooth loss risk in participants aged ≥75 years (OR = 1.12). Sex-stratified analysis revealed 26% lower risk in females with clinical hypothyroidism (OR = 0.74), suggesting age- and sex-specific influences of thyroid function on oral health.

Conclusion: This study suggests a link between clinical hypothyroidism and reduced tooth loss, particularly in women and individuals aged 65-75 years. Conversely, subclinical hypothyroidism in persons ≥75 years correlates with greater risk, underscoring the role of thyroid function in geriatric oral health.

Introduction: Sarcopenia is a growing concern as a geriatric syndrome associated with various adverse health outcomes. Determining its prevalence and identifying risk factors are essential for effective prevention. This systematic review and meta-analysis aimed to estimate the prevalence of sarcopenia and identify the factors associated with sarcopenia in community-dwelling older adults.

Methods: Guided by the PICo framework, we systematically searched six databases for relevant literature. Two reviewers independently assessed the quality of included studies. We performed a meta-analysis to estimate the prevalence of sarcopenia in overall older adults and subgroups. For risk factor analysis, pooled odds ratios (ORs) with 95% CIs were calculated, employing either random or fixed-effects models as appropriate.

Results: A total of 52 eligible studies involving 70,202 older adults were included, among whom 7,488 were male and 9,054 were female. Forty studies were analyzed for both prevalence and related factors, while the remaining 12 were used for prevalence estimation only. The pooled analysis revealed a wide variation in the prevalence of sarcopenia among community-dwelling older adults, ranging from 5.2% to 50.0%, with an overall estimated prevalence of 18.8% (95% CI: 15.6%-22.4%) and substantial heterogeneity (I2 = 99.3%). Subgroup analyses showed that the highest rates were identified in studies using the EWGSOP 2018 definition (25.8%), Europe populations (23.4%), and using the anthropometric equations for muscle mass measurement (23.1%). Moreover, the factors significantly associated with sarcopenia in community-dwelling older adults were older age (OR = 3.3, 95% CI: 2.8-3.8), BMI (OR = 0.7, 95% CI: 0.6-0.9), malnutrition (OR = 3.4, 95% CI: 2.2-5.1), low physical activity (OR = 2.3, 95% CI: 1.8-2.8), current smoking (OR = 1.7, 95% CI: 1.3-2.2), and comorbidities such as osteoporosis (OR = 1.8, 95% CI: 1.3-2.4), osteoarthritis (OR = 1.4, 95% CI: 1.3-1.6), depression (OR = 3.0, 95% CI: 1.9-4.7), diabetes (OR = 2.8, 95% CI: 1.4-5.4), and cognitive impairment (OR = 2.5, 95% CI: 1.9-3.2).

Conclusion: Our findings demonstrate a high prevalence of sarcopenia among community-dwelling older adults, with estimates significantly influenced by geographic region, diagnostic criteria, and muscle mass measurement methods. The findings highlight heterogeneity due to non-standardized diagnostic methods and identify key risk factors including advanced age, low BMI, malnutrition, low physical activity, and comorbidities such as osteoporosis. These results underscore the need for unified diagnostic standards and early community-based interventions targeting modifiable risks.

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: 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.