Gerontology最新文献

Introduction: This is a cross-sectional design to evaluate high-density lipoprotein cholesterol (HDL-C) and fasting blood glucose (FBG) as novel biomarkers for assessing the risk of geriatric comorbidities. Based on data from 316 patients with geriatric comorbidities, participants were selected through hospital records according to predefined inclusion and exclusion criteria. The primary outcome measures include the impact of HDL-C and FBG levels on the severity of comorbidities and the calibration and decision utility of the nomogram prediction model. The study also explores the clinical value of the nomogram model in managing the risk of geriatric comorbidities amidst the aging population.

Methods: Multiple statistical methods, including logistic regression, Lasso regression, and calibration analysis, were used to assess the associations of the above factors and evaluate the performance of the nomogram prediction model. The model demonstrated high predictive accuracy in internal and external validation, with nearly perfect calibration performance observed in the external validation. Decision curve analysis further confirmed the model's high clinical utility and benefit.

Results: HDL-C was significantly negatively associated with the risk of geriatric comorbidities (odds ratio [OR] = 0.387, 95% confidence interval [CI]: 0.286-0.547, p < 0.05), while FBG was positively associated with comorbidity risk (OR = 1.050, 95% CI: 1.129-2.136, p < 0.05). The nomogram model demonstrated high predictive accuracy in internal and external validation, with nearly perfect calibration performance observed in the external validation. Decision curve analysis further confirmed the model's high clinical utility and benefit.

Conclusion: This study underscores the importance of HDL-C and FBG as critical biomarkers for assessing comorbidity risk in the elderly and reveals the potential application of the nomogram prediction model in the risk prediction and management of elderly comorbidities. These findings support using these indicators in predicting and intervening comorbidities in the elderly, providing substantial evidence for further research and clinical practice.

Introduction: Individuals' construals of aging capture how they think of aging, and what aging well means to them. Assessing such construals is important for understanding attitudes toward aging and, ultimately, how to tailor personalized aging well interventions to an individual.

Methods: We analyzed 100 younger adults (YAs)' and 92 older adults (OAs)' spoken narratives of what aging well means to them using two language analysis approaches, closed-vocabulary, word count analysis via Linguistic Inquiry and Word Count (LIWC) and open-vocabulary, word co-occurrence analysis via topic modeling.

Results: YAs' and OAs' spoken narratives differed in both word and topic use. YAs used more words related to physical aspects, more tentative language, and expressed themselves via higher status language (clout), while OAs used authentic language, i-talk, and words related to work, home, family, and religion. Topic modeling complemented the LIWC analyses and showed that YAs primarily discussed topics of bodily and cognitive decline and strategies of preventing aging, conveying concerns about, and negative stereotypes of aging. OAs topicalized family reflections, openness to new experiences, and their social engagement, signaling a more positive outlook on (continued) aging.

Conclusion: Our complimentary word count and word co-occurrence language analyses of aging well construals revealed stark differences between YAs' and OAs' perceptions of aging well, which raise important questions about intergenerational exchanges and communications about aging more broadly. Further, we found that aging construals of OAs are useful for estimating their future outlook, an important aspect of resilience against cognitive decline and possible entry point for targeted precision aging interventions.

Introduction: The idea that older adults should contribute to the common good has become a social normative belief (i.e., social activation). Younger and - even more so - older adults prescribe social activation to the group of older adults. Older adults are assumed to behave in line with what is socially expected of them. However, previous studies did not establish a link between the old-age norm of social activation and older adults' social engagement. Following the reasoning of stereotype embodiment theory, we investigated the role of self-endorsement of social activation for older adults' social engagement (i.e., formal volunteering).

Methods: We conducted two preregistered experiments in which older participants (60-90 years, N = 1,463) reflected on agreeing or disagreeing with the norm of social activation. We then assessed endorsement of social activation and intention to engage in formal volunteering.

Results: Replicating our previous studies, participants who reflected on agreement with the norm of social activation reported higher endorsement of this norm compared to participants who reflected on disagreement. Endorsing the norm of social activation for (other) older adults translated into endorsing social activation for oneself (internalization). Furthermore, reflecting on agreement with social activation was indirectly related to volunteering intention via endorsement of self-related social activation (embodiment).

Conclusion: Our findings elucidate the role of societal normative beliefs for older adults' behavior and offer insights into the discourse on the continued social participation of older adults.

Introduction: Sarcopenia is highly prevalent in older inpatients. However, it is unclear if sarcopenia is documented routinely in geriatric rehabilitation. This study aimed to investigate the documentation of sarcopenia in medical records among geriatric rehabilitation patients.

Methods: Geriatric rehabilitation inpatients in a statewide hospital in VIC, Australia, were included. Patient characteristics, muscle measurements, and medical records at admission and discharge were collected. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Patient characteristics were compared between the groups with documented and non-documented sarcopenia using the Wilcoxon rank-sum or chi-square test.

Results: Of 1,890 geriatric rehabilitation inpatients (aged 83.4 [interquartile range: 77.6-88.4] years, 56.3% female), muscle measurements were available in 1,334 patients at admission. The prevalence of sarcopenia was 20.8% (n = 278). Sarcopenia was documented in 68 out of 1,890 patients; 23 of them did not have muscle mass or muscle strength measured. Forty-five patients with muscle measurements available were documented with sarcopenia either at discharge from acute admissions (n = 9), on rehabilitation admission (n = 25), or at discharge from rehabilitation (n = 26). Of these 45 patients, 8 patients had sarcopenia following the EWGSOP2 criteria. Compared with patients without sarcopenia documented, patients documented with sarcopenia had lower body mass index and sarcopenia screening (Strength, Assistance in Walking, Rise from a Chair, Climb Stairs, Falls History [SARC-F]) scores and higher Clinical Frailty Scale (CFS) scores and were likely to come from nursing homes.

Conclusions: Documentation of sarcopenia was lower than the prevalence of sarcopenia in geriatric rehabilitation inpatients. Sarcopenia was incorrectly documented as data on muscle measurement were missing to define sarcopenia. Practitioners likely used clinical impressions to document sarcopenia, rather than the formal diagnostic criteria.

Background: Osteoporosis is the most common metabolic bone disease with a high prevalence in the elderly population. The diagnosis is straightforward when a fragility fracture at major skeletal sites (hip, vertebrae, humerus, distal radius) occurs. However, the diagnosis may be challenging in the absence of fractures or when, even with a fracture (morphometric vertebral), no symptoms are reported by the patient.

Summary: In recent years, there has been a huge advancement in diagnostic imaging modalities with particular interest in measuring skeletal resistance. Each technique has inherent advantages and disadvantages. In this narrative review, we discuss all diagnostic modalities from bone mineral density to more sophisticated techniques.

Key messages: It is hoped that a greater utilization of opportunistic CT will increase patient screening with consequent advantages for patient care and future fraction prevention.

Introduction: Frailty, characterized by a reduction in intrinsic capacity across multiple physiological systems, is a key concern in healthy aging. Insight in the trajectory of an individual's functional ability and intrinsic reserve capacity in a relatively younger population of older adults is lacking. This study aims to investigate the early stages of frailty by tracking trajectories of physical indicators of intrinsic capacity before frailty becomes clinically evident.

Methods: The AMersfoort COhort study on functional decline, Healthy aging and Frailty (AMCOHF) is a unique 10-year prospective cohort study evaluating the predictive value of longitudinal trajectories of physical parameters for frailty onset or robustness maintenance. An a-select community-dwelling robust population of Amersfoort (55-75 years) in the Netherlands will undergo baseline assessments for inclusion criteria and will be followed longitudinally every 2.5 years. Frailty status is assessed using the Fried phenotype, Rockwood frailty index, and Groningen frailty indicator. Testing procedures and questionnaire completion include physical performance tests in the domains: (1) musculoskeletal system, (2) articular system, (3) cardiorespiratory system, (4) sensory system, (5) immune system, and 6) uro-gynecological system. Study outcomes focus on intrinsic capacity, functional ability, explanatory data, and frailty. Statistical analyses evaluating the predictive capacity include logistic regression, confirmatory factor or latent class analysis, and structural equation modeling. Nonprobability convenience sampling recruits 2,078 robust participants, estimating a 1-year frailty incidence of 1.5%-6.0%. Ethical approval was obtained, and the trial is prospectively registered on Open Science Framework (DOI: 10.17605/OSF.IO/RMBQV).

Conclusion: The AMCOHF study will contribute to knowledge about markers to predict an accelerated decline in intrinsic capacity in an early stage. This knowledge is important to deploy prevention strategies at an earlier stage in life then those currently undertaken, ultimately reducing healthcare costs and contributing to a healthy aging population.

Introduction: Cognitive frailty, characterized by the coexistence of cognitive impairment and physical frailty, is a significant predictor of cognitive decline. However, few studies integrate both cognitive and physical assessments alongside hormonal markers, such as cortisol, that may influence frailty and cognitive function. To address this gap, our study combines noninvasive physical, cognitive, and cortisol markers to assess frailty in aging adults.

Methods: Data were collected from four sites as part of the Healthy Minds for Life (HML) longitudinal cohort, a project within the Precision Aging Network. Baseline data included cognitive evaluation using the Montreal Cognitive Assessment (MoCA); frailty assessment using a validated 20-s elbow flexion-extension test analyzed by AI under single-task (ST) and dual-task (DT) conditions; cortisol measurement in eccrine sweat samples via direct analysis in real-time mass spectrometry (DART-MS); and demographic information.

Results: Of 202 participants completing all assessments, 60 were identified with mild cognitive impairment (MCI). The dual-task frailty index (FI) derived from the 20-s test significantly differentiated individuals with MCI from cognitively robust participants and correlated strongly with MoCA scores (p = 0.015). The dual-task FI showed superior model fit compared to the single-task FI when predicting cognitive function. A significant correlation between the dual-task FI and cortisol by age interaction was observed (p = 0.0042) highlighting the potential impact of cortisol to moderate the relationship between frailty and age in an otherwise healthy aging population. By contrast, no significant correlation was found between dual-task FI and aging outside of the presence of cortisol (p = 0.116) in this study.

Conclusions: This study highlights practical and efficient methods for assessing frailty emphasizing the value of DT testing and cortisol measures in identifying individuals at higher risk for cognitive and physical decline. The findings underscore the importance of integrating hormonal markers with cognitive and physical assessments to enhance risk stratification and intervention planning in aging populations.

Introduction: Ageism, defined as stereotype, prejudice, and discrimination against people based on their age, has been shown to have unfavorable impacts on health. While discrimination has often been shown to negatively impact health, whether ageism might accelerate biological aging itself is unclear.

Methods: We conducted secondary analyses of the Health and Retirement Study (HRS, 2008, 2012, and 2016 waves). Ageism was estimated using self-perception of aging (SPA) and perceived age discrimination (PAD). Other types of discrimination (e.g., racism, sexism) were also considered. The Everyday Discrimination Scale was used to assess PAD and other types of discrimination. Biological aging was measured through homeostatic dysregulation (HD, n = 3,443, 2016 wave, six measures), epigenetic age (n = 1,484, 2016 wave, five measures), and telomere length (n = 1,981, 2008 wave). Biological aging measures were modeled as a function of ageism within and across waves.

Results: Within waves, SPA score was associated with some elevated HD (e.g., β = 0.11, p < 0.001, quantified by 44 biomarkers) and epigenetic age indices (e.g., β = 0.61, p < 0.001, Hannum Epi Age). After controlling for comorbidities and social participation, these variables were no longer associated. Effects were similar but weaker in predicting 2016 biological aging from SPA in 2008 and 2012. PAD was not associated with biological aging measures, in contrast to other types of discrimination, which were.

Conclusions: We found no consistent evidence linking ageism to biological aging status. Further research should investigate why; potentially, ageism has less time to become biologically embedded, compared to racism and sexism, which might be experienced throughout one's life, but measurement challenges could also be present.