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Erratum. 勘误。
IF 3.5 3区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2024-01-22 DOI: 10.1159/000536266
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引用次数: 0
Targeting Cartilage miR-195/497 Cluster for Osteoarthritis Treatment Regulates the Circadian Clock. 用于骨关节炎治疗的靶向软骨miR-195/497簇调节昼夜节律。
IF 3.1 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-01 Epub Date: 2023-10-12 DOI: 10.1159/000534292
Shi Shi, Lele Zhang, Qi Wang, Qian Wang, Dejian Li, Wei Sun, Chengqing Yi

Introduction: Osteoarthritis (OA) is the most prevalent and debilitating joint disease without an effective therapeutic option. Multiple risk factors for OA have been identified, including abnormal chondrocyte miRNA secretion and circadian rhythms disruption, both of which have been found to cause progressive damage and loss of articular cartilage. Environmental disruption of circadian rhythms in mice predisposes animals to cartilage injury and OA.

Methods: The role of miR-195/497 cluster during OA progression was verified by mouse OA model with intra-articular injection of Agomir and Antagomir. We performed micro-CT analysis, Osteoarthritis Research Society International scores, and histological analysis in mouse knee joints. RNA sequencing was performed on the mouse cartilage cell line to explore the molecular mechanism of the miR-195/497 cluster and proteins in signaling pathway were evaluated using Western blot. Senescence-associated phenotypes were detected by Western blot, senescence β-galactosidase staining, and immunofluorescence.

Results: This study demonstrated that miR-195/497-5p expression is disrupted in OA with senescent chondrocytes. In addition, miR-195/497-5p influenced the circadian rhythm of mice chondrocytes by modulating the expression of the Per2 protein, resulting in the gradual degradation of articular cartilage. We found that the miR-195/497 cluster targets DUSP3 expression. The deletion of the miR-195/497 cluster increased the level of DUSP3 expression and decreased the levels of phosphorylated ERK 1/2 and CREB. Per2 transcription is upregulated by stimulating CREB and ERK 1/2 phosphorylation.

Conclusion: Our findings identify a regulatory mechanism connecting chondrocyte miR-195/497-5p to cartilage maintenance and repair and imply that circadian rhythm disturbances affected by miR-195/497-5p are risk factors for age-related joint diseases such as OA.

简介:骨关节炎(OA)是最常见的、使人衰弱的关节疾病,没有有效的治疗选择。OA的多种风险因素已经被确定,包括软骨细胞miRNA分泌异常和昼夜节律紊乱,这两种因素都会导致关节软骨的进行性损伤和损失。环境对小鼠昼夜节律的破坏使动物易患软骨损伤和OA。方法:通过关节内注射阿戈米和安他戈米的小鼠OA模型验证miR-195/497簇在OA进展中的作用。我们对小鼠膝关节进行了显微CT分析、骨关节炎研究学会国际评分和组织学分析。对小鼠软骨细胞系进行RNA测序,以探索miR-195/497簇的分子机制,并使用蛋白质印迹评估信号通路中的蛋白质。通过蛋白质印迹、衰老β-半乳糖苷酶染色和免疫荧光检测衰老相关表型。结果:这项研究表明,miR-195/497-5p在衰老软骨细胞的OA中的表达被破坏。此外,miR-195/497-5p通过调节Per2蛋白的表达来影响小鼠软骨细胞的昼夜节律,导致关节软骨的逐渐降解。我们发现miR-195/497簇靶向DUSP3的表达。miR-195/497簇的缺失增加了DUSP3的表达水平,并降低了磷酸化ERK1/2和CREB的水平。Per2转录通过刺激CREB和ERK1/2磷酸化而上调。结论:我们的研究结果确定了软骨细胞miR-195/497-5p与软骨维持和修复之间的调节机制,并表明miR-195/495-5p影响的昼夜节律紊乱是OA等年龄相关关节疾病的危险因素。
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引用次数: 0
Sitagliptin Extends Lifespan of Caenorhabditis elegans by Inhibiting Insulin/Insulin-Like Signaling and Activating Dietary Restriction-Like Signaling Pathways. 西格列汀通过抑制IIS和激活dr样信号通路延长秀丽隐杆线虫的寿命。
IF 3.1 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-01 Epub Date: 2023-11-10 DOI: 10.1159/000534863
Qunshan Ye, Yimin Li, Cheng Wang, Jingming Zheng, Jing Qiao, Jing Yang, Qin-Li Wan

Introduction: The discovery of longevity molecules that delay aging and prolong lifespan has always been a dream of humanity. Sitagliptin phosphate (SIT), an oral dipeptidyl peptidase-4 (DPP-4) inhibitor, is an oral drug commonly used in the treatment of type 2 diabetes (T2D). In addition to being antidiabetic, previous studies have reported that SIT has shown potential to improve health. However, whether SIT plays a role in the amelioration of aging and the underlying molecular mechanism remain undetermined.

Methods: Caenorhabditis elegans (C. elegans) was used as a model of aging. Lifespan assays were performed with adult-stage worms on nematode growth medium plates containing FUdR with or without the specific concentration of SIT. The period of fast body movement, body bending rates, and pharyngeal pumping rates were recorded to assess the healthspan of C. elegans. Gene expression was confirmed by GFP fluorescence signal of transgenic worms and qPCR. In addition, the intracellular reactive oxygen species levels were measured using a free radical sensor H2DCF-DA.

Results: We found that SIT significantly extended lifespan and healthspan of C. elegans. Mechanistically, we found that several age-related pathways and genes were involved in SIT-induced lifespan extension. The transcription factors DAF-16/FOXO, SKN-1/NRF2, and HSF-1 played important roles in SIT-induced longevity. Moreover, our findings illustrated that SIT-induced survival benefits by inhibiting the insulin/insulin-like signaling pathway and activating the dietary restriction-related and mitochondrial function-related signaling pathways.

Conclusion: Our work may provide a theoretical basis for the development of anti-T2D drugs as antiaging drugs, especially for the treatment of age-related disease in diabetic patients.

发现延缓衰老、延长寿命的长寿分子一直是人类的梦想。磷酸西格列汀(SIT)是一种口服二肽基肽酶-4 (DPP-4)抑制剂,是一种常用的治疗2型糖尿病(T2D)的口服药物。除了抗糖尿病之外,先前的研究报告表明,SIT还显示出改善健康的潜力。然而,SIT是否在延缓衰老中起作用及其潜在的分子机制仍未确定。方法:以秀丽隐杆线虫(C. elegans)为衰老模型。在含有或不含特定浓度SIT的FUDR的NGM板上对成虫进行寿命测定。记录线虫的快速身体运动周期、身体弯曲率和咽泵率,以评估线虫的健康跨度。通过转基因虫的GFP荧光信号和qPCR证实了基因的表达。此外,使用自由基传感器H2DCF-DA测量细胞内ROS水平。结果:我们发现SIT能显著延长秀丽隐杆线虫的寿命和健康寿命。在机制上,我们发现一些与年龄相关的途径和基因参与了sit诱导的寿命延长。转录因子DAF-16/FOXO、SKN-1/NRF2和HSF-1在sit诱导的长寿中发挥重要作用。此外,我们的研究结果表明,SIT通过抑制胰岛素/胰岛素样信号通路(IIS)和激活饮食限制(DR)相关和线粒体功能相关的信号通路来诱导生存。结论:本研究可为开发抗t2d药物作为抗衰老药物,特别是治疗糖尿病患者的老年性疾病提供理论依据。
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引用次数: 0
Testing a Conceptual Model of Physiologic Reserve, Intrinsic Capacity, and Physical Resilience in Hospitalized Older Patients: A Structural Equation Modelling. 检验住院老年患者生理储备、内在能力和身体恢复力的概念模型:结构方程模型。
IF 3.1 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-01 Epub Date: 2023-11-23 DOI: 10.1159/000535413
Fang-Wen Hu, Fang-Ru Yueh, Tzu-Jung Fang, Chia-Ming Chang, Chung-Ying Lin

Introduction: The relationship among physiologic reserve, intrinsic capacity, and physical resilience has not been examined, and a conceptual model that includes these key determinants of healthy ageing is needed. This study aimed to test a conceptual model using real-world data to determine the relationships among physiologic reserve, intrinsic capacity, physical resilience, and clinical outcomes.

Methods: This longitudinal study was conducted at a 1,343-bed tertiary-care medical centre. Patients were eligible for inclusion if they were 65 years of age or older and able to communicate independently. Demographic factors, cumulative illness rating scale for geriatrics [CIRS-G] (assessing physiologic reserve), intrinsic capacity, physical resilience instrument for older adults [PRIFOR] (assessing physical resilience), and clinical frailty scale [CFS] were collected at admission. The CFS and EuroQoL 5-dimension 3-level questionnaire [EQ5D] were administered at discharge.

Results: The mean age of the 413 patients was 76.34 ± 6.72 (52.5% female). Two conceptual models were identified and supported. Specifically, the path coefficients in the two models showed that the CIRS-G had diverse associations with each intrinsic capacity domain, and that all intrinsic capacity domains (except vitality) were significantly associated with PRIFOR. Moreover, PRIFOR was significantly associated with follow-up CFS, baseline control, and EQ5D scores.

Conclusion: Physiologic reserve positively correlated with the cognitive and locomotive domains of intrinsic capacity. Moreover, older patients with better intrinsic capacity may have improved physical resilience, which may lead to better clinical outcomes. Efforts to improve the intrinsic capacity and physical resilience of older patients are necessary to promote healthy ageing.

生理储备、内在能力和身体恢复力之间的关系尚未得到检验,需要一个包括这些健康老龄化关键决定因素的概念模型。本研究旨在利用真实世界的数据检验一个概念模型,以确定生理储备、内在能力、身体恢复力和临床结果之间的关系。方法:本纵向研究在一家拥有1,343张床位的三级医疗中心进行。如果患者年龄在65岁或以上并且能够独立交流,则符合纳入条件。入院时收集人口学因素、老年累积疾病评定量表(CIRS-G)(评估生理储备)、内在能力、老年人身体弹性量表(PRIFOR)(评估身体弹性)和临床虚弱量表(CFS)。出院时进行CFS和EuroQoL五维三水平问卷[EQ5D]。结果:413例患者平均年龄76.34±6.72岁,其中女性52.5%。确定并支持了两个概念模型。具体而言,两种模型的路径系数表明,CIRS-G与每个内在容量域存在不同的关联,并且除活力外,所有内在容量域都与PRIFOR显著相关。此外,PRIFOR与随访CFS、基线对照和EQ5D评分显著相关。结论:生理储备与内在能力的认知和运动领域呈正相关。此外,具有更好内在能力的老年患者可能具有更好的身体恢复能力,这可能导致更好的临床结果。努力提高老年患者的内在能力和身体恢复能力是促进健康老龄化的必要条件。
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引用次数: 0
Estimation of Average and Maximum Daily-Life Mobility Performance Using the Timed Up-and-Go: Exploring the Added Value of an Instrumented Timed Up-and-Go. 使用定时起立行走(TUG)估算平均和最大日常生活行动能力:探索带仪器的 TUG 的附加值。
IF 3.1 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-01 Epub Date: 2023-12-18 DOI: 10.1159/000535846
Patrick Heldmann, Alexander Elser, Franziska Kramer-Gmeiner, Carl-Philipp Jansen, Sabato Mellone, Michael Schwenk

Introduction: The association between specific motor capacity variables obtained in a laboratory and parameters of daily-life mobility performance (MP) obtained via wearables is still unclear. The Timed Up-and-Go (TUG) test is a widely used motor capacity tests available either as traditional hand-stopped TUG or as instrumented TUG (iTUG), providing specific information about its subphases. This study aimed to: (1) estimate the association between the TUG and specific parameters reflecting average and maximum daily-life MP, (2) estimate the benefits of the iTUG in terms of explaining MP in daily life compared to the TUG.

Methods: The present study was a cross-sectional analysis using baseline data of 294 older persons (mean age: 76.7 ± 5.3 years). Univariate linear regression analysis was performed to delineate the coefficient of determination between TUG time and participants' MP. MP variables containing mean cadence (MCA) to represent average performance and the 95th percentile of mean cadence of walks with more than three steps (p95>3stepsMCA) to represent maximum performance. To determine whether the iTUG variables give more information about MP, a stepwise multivariate regression analysis between iTUG variables and the p95>3stepsMCA variable to represent maximum performance was conducted.

Results: The univariate regression models revealed associations of the TUG with MCA (adjusted R2 = 0.078, p < 0.001) and p95>3stepsMCA (adjusted R2 = 0.199, p < 0.001). The multivariate stepwise regression models revealed a total explanation of maximum daily-life MP (p95>3stepsMCA) of the TUG (adjusted R2 = 0.199, p < 0.001) versus iTUG (adjusted R2 = 0.278, p < 0.010).

Discussion/conclusion: This study shows that the TUG better reflects maximum daily-life MP than average daily-life MP. Moreover, we demonstrate the added value of the iTUG for a more accurate estimation of daily MP compared to the traditional TUG. The iTUG is recommended to estimate maximum daily-life MP in fall-prone older adults. The study is a step toward a specific assessment paradigm using capacity variables from the iTUG to estimate maximum daily-life MP.

导言:在实验室中获得的特定运动能力变量与通过可穿戴设备获得的日常生活行动能力参数之间的关联尚不明确。定时上-下(TUG)测试是一种广泛使用的运动能力测试,既可以是传统的手停TUG,也可以是仪器TUG(iTUG),提供有关其子阶段的具体信息。本研究旨在1)估计 TUG 与反映平均和最大日常生活移动能力(MP)的特定参数之间的关联;2)估计 iTUG 与 TUG 相比在解释日常生活移动能力方面的优势:本研究使用 294 名老年人(平均年龄:76.7 ± 5.3 岁)的基线数据进行横断面分析。通过单变量线性回归分析,确定了 TUG 时间与参与者 MP 之间的决定系数。MP 变量包括代表平均成绩的平均步频(MCA)和代表最高成绩的三步以上步行平均步频第 95 百分位数(p95>3stepsMCA)。为了确定 iTUG 变量是否能提供有关 MP 的更多信息,我们对 iTUG 变量和代表最高成绩的 p95>3stepsMCA 变量进行了逐步多元回归分析:单变量回归模型显示,TUG 与 MCA(调整后 R² = .078,p3stepsMCA 调整后 R² = .199,p3stepsMCA
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引用次数: 0
Serum Proteomic Signatures of Common Health Outcomes among Older Adults. 老年人常见健康后果的血清蛋白质组特征。
IF 3.1 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-01 Epub Date: 2024-01-12 DOI: 10.1159/000534753
Jackson A Roberts, Sayantani Basu-Roy, Jong Shin, Vijay R Varma, Andrew Williamson, Chad Blackshear, Michael E Griswold, Julián Candia, Palchamy Elango, Ajoy C Karikkineth, Toshiko Tanaka, Luigi Ferrucci, Madhav Thambisetty

Introduction: In aging populations, the coexistence of multiple health comorbidities represents a significant challenge for clinicians and researchers. Leveraging advances in omics techniques to characterize these health conditions may provide insight into disease pathogenesis as well as reveal biomarkers for monitoring, prognostication, and diagnosis. Researchers have previously established the utility of big data approaches with respect to comprehensive health outcome measurements in younger populations, identifying protein markers that may provide significant health information with a single blood sample.

Methods: Here, we employed a similar approach in two cohorts of older adults, the Baltimore Longitudinal Study of Aging (mean age = 76.12 years) and InCHIANTI Study (mean age = 66.05 years), examining the relationship between levels of serum proteins and 5 key health outcomes: kidney function, fasting glucose, physical activity, lean body mass, and percent body fat.

Results: Correlations between proteins and health outcomes were primarily shared across both older adult cohorts. We further identified that most proteins associated with health outcomes in the older adult cohorts were not associated with the same outcomes in a prior study of a younger population. A subset of proteins, adiponectin, MIC-1, and NCAM-120, were associated with at least three health outcomes in both older adult cohorts but not in the previously published younger cohort, suggesting that they may represent plausible markers of general health in older adult populations.

Conclusion: Taken together, these findings suggest that comprehensive protein health markers have utility in aging populations and are distinct from those identified in younger adults, indicating unique mechanisms of disease with aging.

介绍:在老龄人口中,多种健康合并症并存是临床医生和研究人员面临的一项重大挑战。利用全息技术的进步来描述这些健康状况,可以深入了解疾病的发病机制,并揭示用于监测、预后和诊断的生物标志物。研究人员之前已经确定了大数据方法在年轻群体综合健康结果测量方面的实用性,并确定了蛋白质标记物,这些标记物可通过单次血液样本提供重要的健康信息。方法:在此,我们在巴尔的摩老龄化纵向研究(平均年龄为 76.12 岁)和 InCHIANTI 研究(平均年龄为 66.05 岁)这两个老年人队列中采用了类似的方法,研究了血清蛋白水平与肾功能、空腹血糖、体力活动、瘦体重和体脂百分比这 5 项关键健康指标之间的关系:结果:蛋白质与健康结果之间的相关性主要体现在两个老年人组群中。我们进一步发现,与老年人组群健康结果相关的大多数蛋白质,在之前对年轻人群的研究中都与相同的结果无关。在两个老年人队列中,脂肪连通素、MIC-1 和 NCAM-120 等蛋白质与至少三种健康结果相关,但在之前发表的年轻队列中却不相关,这表明它们可能代表了老年人群总体健康状况的合理标志物:综上所述,这些研究结果表明,综合蛋白质健康标志物在老年人群中具有实用性,并且与在年轻人群中发现的标志物不同,这表明随着年龄的增长,疾病的发生有其独特的机制。
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引用次数: 0
The Role of Subjective Age in Predicting Post-Hospitalization Outcomes of Older Adults. 主观年龄在预测老年人住院后结果中的作用。
IF 3.1 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-01 Epub Date: 2024-01-22 DOI: 10.1159/000536364
Anna Zisberg, Nurit Gur-Yaish, Efrat Shadmi, Ksenya Shulyaev, Juliana Smichenko, Amos Rogozinski, Yuval Palgi

Introduction: Studies of community-dwelling older adults find subjective age affects health and functional outcomes. This study explored whether younger subjective age serves as a protective factor against hospital-associated physical, cognitive, and emotional decline, well-known consequences of hospitalization among the elderly.

Methods: This study is a secondary data analysis of a subsample (N = 262; age: 77.5 ± 6.6 years) from the Hospitalization Process Effects on Mobility Outcomes and Recovery (HoPE-MOR) study. Psychological and physical subjective age, measured as participants' reports on the degree to which they felt older or younger than their chronological age, was assessed at the time of hospital admission. Independence in activities of daily living, life-space mobility, cognitive function, and depressive symptoms were assessed at hospital admission and 1 month post-discharge.

Results: The odds of decline in cognitive status, functional status, and community mobility and the exacerbation of depressive symptoms were significantly lower in those reporting younger vs. older psychological subjective age (odds ratio [OR] = 0.68, 95% CI = 0.46-0.98; OR = 0.59, 95% CI = 0.36-0.98; OR = 0.64, 95% CI = 0.44-0.93; OR = 0.64, 95% CI = 0.43-0.96, respectively). Findings were significant after controlling for demographic, functional, cognitive, emotional, chronic, and acute health predictors. Physical subjective age was not significantly related to post-hospitalization outcomes.

Conclusion: Psychological subjective age can identify older adults at risk for poor hospitalization outcomes and should be considered for preventive interventions.

介绍:对居住在社区的老年人进行的研究发现,主观年龄会影响健康和功能结果。本研究探讨了较年轻的主观年龄是否是防止老年人因住院而导致的身体、认知和情绪衰退的保护因素:本文是对 HoPE-MOR(住院过程对行动能力结果和恢复的影响研究)的子样本(N=262;年龄 77.5±6.6)进行的二次数据分析。入院时对心理和生理主观年龄进行了评估,即参与者对自己感觉比实际年龄大或小的程度的报告。在入院时和出院后一个月对日常生活活动的独立性、生活空间的活动能力、认知功能和抑郁症状进行评估:报告心理主观年龄较小的患者认知状况、功能状况和社区活动能力下降的几率以及抑郁症状加重的几率显著低于报告心理主观年龄较大的患者(OR=.68,95%CI=.46-.98;OR=.59,95%CI=.36-.98;OR=.64,95%CI=.44-.93;OR=.64,95%CI=.43-.96)。在控制了人口统计学、功能、认知、情绪、慢性和急性健康预测因素后,研究结果仍有意义。生理主观年龄与住院后的结果无明显关系:结论:心理主观年龄可识别出有不良住院后果风险的老年人,并应考虑采取预防性干预措施。
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引用次数: 0
Examining a Healthy Lifestyle as a Moderator of the Relationship between Psychological Distress and Cognitive Decline among Older Adults in the NuAge Study. 在 NuAge 研究中探讨健康生活方式对老年人心理困扰和认知能力下降之间关系的调节作用。
IF 3.1 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-01 Epub Date: 2024-02-14 DOI: 10.1159/000535978
Danielle D'Amico, Udi Alter, Danielle Laurin, Guylaine Ferland, Alexandra J Fiocco

Introduction: The objective of this study was to examine whether a healthy lifestyle composite score of social engagement, physical activity, and Mediterranean diet adherence moderates the association between psychological distress and global cognitive decline among cognitively healthy older adults (67+ years of age at baseline).

Methods: A total of 1,272 cognitively intact older adults (Mage = 74.1 ± 4.1 years, 51.9% female) in the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge) completed a series of self-reported questionnaires to measure psychological distress and lifestyle behaviors, and the Modified Mini-Mental Examination (3MS) to assess cognitive performance at baseline and annually over 3 years.

Results: Controlling for sociodemographic and health-related characteristics, greater psychological distress was associated with steeper cognitive decline over time among males (B = -0.07, 95% CI: [-0.12, -0.02]), but not females (B = 0.008, 95% CI: [0.03, 0.04]). Although a healthy lifestyle composite score did not statistically significantly moderate the distress-cognition relationship (B = -0.005, 95% CI: [-0.02, 0.01]), there was an association between higher psychological distress and greater cognitive decline at low levels of social engagement (B = -0.05, 95% CI: [-0.09, -0.006]), but not at high levels of social engagement (B = 0.02, 95% CI: [-0.03, 0.07]).

Conclusion: This study suggests that the potentially harmful impact of stress on cognitive function may be malleable through specific healthy lifestyle behaviors and emphasizes the importance of taking a sex-based approach to cognitive aging research.

简介本研究旨在探讨健康生活方式综合评分(包括社会参与、体育锻炼和地中海饮食)是否能调节认知健康的老年人(基线年龄为 67 岁以上)的心理压力与整体认知能力下降之间的关系:在魁北克营养与成功老龄化纵向研究(NuAge)中,共有1272名认知能力健全的老年人(年龄=74.1±4.1岁,51.9%为女性)完成了一系列自我报告问卷,以测量心理困扰和生活方式行为,并完成了改良版迷你智力测验(3MS),以评估基线时和3年内每年的认知表现:在控制了社会人口学特征和健康相关特征后,男性(B = -0.07,95% CI [-0.12, -0.02])和女性(B = 0.008,95% CI [-0.03, 0.04])的心理压力越大,认知能力下降越快。虽然健康生活方式的综合得分在统计学上并未显著缓和心理困扰与认知之间的关系(B = -0.005,95% CI [-0.02,0.01]),但在社会参与度较低时,较高的心理困扰与较严重的认知能力下降之间存在关联(B = -0.05,95% CI [-0.09,-0.006]),而在社会参与度较高时则不存在关联(B = 0.02,95% CI [-0.03,0.07]):这项研究表明,压力对认知功能的潜在有害影响可以通过特定的健康生活方式行为加以改变,并强调了在认知老化研究中采取基于性别的方法的重要性。
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引用次数: 0
Mortality of Peritoneal Dialysis versus Hemodialysis in Older Adults: An Updated Systematic Review and Meta-Analysis. 老年人腹膜透析与血液透析的死亡率对比:最新系统回顾与元分析》。
IF 3.1 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-01 Epub Date: 2024-02-07 DOI: 10.1159/000536648
Linan Cheng, Nan Hu, Di Song, Yuqing Chen

Introduction: The optimal choice of dialysis modality remains contentious in older adults threatened by advanced age and high risk of comorbidities.

Methods: We conducted a systematic review and meta-analysis of cohort and case-control studies to assess mortality risk between peritoneal dialysis (PD) and hemodialysis (HD) in older adults using PubMed, Embase, and the Cochrane Library database from inception to June 1, 2022. The outcome of interest is all-cause mortality.

Results: Thirty-one eligible studies with >774,000 older patients were included. Pooled analysis showed that PD had a higher mortality rate than HD in older dialysis population (HR 1.17, 95% CI: 1.10-1.25). When stratified by co-variables, our study showed an increased mortality risk of PD versus HD in older patients with diabetes mellitus or comorbidity who underwent longer dialysis duration (more than 3 years) or who started dialysis before 2010. However, definitive conclusions were constrained by significant heterogeneity.

Conclusion: From the survival point of view, caution is needed to employ PD for long-term use in older populations with diabetes mellitus or comorbid conditions. However, a tailored treatment choice needs to take account of what matters to older adults at an individual level, especially in the context of limited survival improvements and loss of quality of life. Further research is still awaited to conclude this topic.

导言:对于受到高龄和高合并症风险威胁的老年人来说,透析方式的最佳选择仍然存在争议:我们使用 PubMed、Embase 和 Cochrane Library 数据库对从开始到 2022 年 6 月 1 日的队列研究和病例对照研究进行了系统回顾和荟萃分析,以评估老年人腹膜透析 (PD) 和血液透析 (HD) 之间的死亡率风险。研究结果为全因死亡率:结果:共纳入了 31 项符合条件的研究,涉及超过 77.4 万名老年患者。汇总分析显示,在老年透析人群中,PD的死亡率高于HD(HR 1.17,95% CI 1.10-1.25)。根据共同变量进行分层后,我们的研究显示,在患有糖尿病或合并症、透析时间较长(超过 3 年)或在 2010 年前开始透析的老年患者中,透析治疗与 HD 相比死亡率风险更高。然而,由于存在显著的异质性,最终结论受到了限制:结论:从生存角度来看,对于患有糖尿病或合并症的老年人群,长期使用腹膜透析需要谨慎。然而,量身定制的治疗选择需要考虑到老年人的个体情况,尤其是在生存率提高有限和生活质量下降的情况下。这一课题还有待于进一步研究。
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引用次数: 0
Cognitive Benefits of Folic Acid, Docosahexaenoic Acid, and a Combination of Both Nutrients in Mild Cognitive Impairment: Possible Alterations through Mitochondrial Function and DNA Damage. 叶酸、二十二碳六烯酸以及这两种营养素的组合对轻度认知障碍患者的认知能力的益处;线粒体功能和 DNA 损伤的可能改变。
IF 3.1 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-01 Epub Date: 2024-07-17 DOI: 10.1159/000540021
Mengyue Li, Tongtong Li, Tong Yang, Ling Huang, Jiangang Zhao, Huan Liu, Yongjie Chen, Wen Li, Yun Zhu, Fei Ma, Jing Yan, Guowei Huang

Introduction: It is uncertain whether folic acid (FA) combined with docosahexaenoic acid (DHA) could improve cognitive performance. This study evaluated the effects of a 12-month FA and DHA supplementation, in combination or alone, on cognitive function, DNA oxidative damage, and mitochondrial function in participants with mild cognitive impairment (MCI).

Methods: This randomized, double-blind, placebo-controlled trial recruited MCI participants aged 60 years and older. Two hundred and eighty participants were randomly divided in equal proportion into four groups: FA + DHA (FA 800 μg/d + DHA 800 mg/d), FA (800 μg/d), DHA (800 mg/d), and placebo groups daily orally for 12 months. The primary outcome was cognitive function evaluated by the Wechsler Adult Intelligence Scale-Revised (WAIS-RC). Cognitive tests and blood mechanism-related biomarkers were determined at baseline and 12 months.

Results: During the 12-month follow-up, scores of full intelligence quotient (βDHA: 1.302, 95% CI: 0.615, 1.990, p < 0.001; βFA: 1.992, 95% CI: 1.304, 2.679, p < 0.001; βFA+DHA: 2.777, 95% CI: 2.090, 3.465, p < 0.001), verbal intelligence quotient, and some subtests of the WAIS-RC were significantly improved in FA + DHA and single intervention groups compared to the placebo group. Moreover, the FA and DHA intervention combination was superior to either intervention alone (p < 0.001). Meanwhile, FA, DHA, and their combined use significantly decreased 8-OHdG level and increased mitochondrial DNA copy number compared to the placebo (p < 0.05).

Conclusions: Supplementation of FA and DHA, alone or combined, for 12 months can improve cognitive function in MCI participants, possibly through mitigating DNA oxidative damage and enhancing mitochondrial function. Combined supplementation may provide more cognitive benefit than supplementation alone.

导言:叶酸(FA)与二十二碳六烯酸(DHA)结合是否能改善认知能力尚不确定。本研究评估了叶酸和 DHA 联合或单独补充 12 个月对轻度认知障碍(MCI)患者认知功能、DNA 氧化损伤和线粒体功能的影响:这项随机、双盲、安慰剂对照试验招募了 60 岁及以上的 MCI 患者。280 名参与者被随机等比例分为四组:FA+DHA组(FA 800微克/天+DHA 800毫克/天)、FA组(800微克/天)、DHA组(800毫克/天)和安慰剂组,每天口服,为期12个月。主要结果是通过韦氏成人智力量表-修订版(WAIS-RC)评估认知功能。认知测试和血液机制相关生物标志物在基线和12个月时进行测定:随访 12 个月期间,全智商 (FIQ) 分数(βDHA:1.302,95%CI:0.615,1.990,p < 0.001;βFA:1.992,95%CI:1.304,2.679,p < 0.001;βFA+DHA:2.777,95%CI:2.与安慰剂组相比,FA+DHA干预组和单一干预组的言语智商和WAIS-RC的某些分测验均有显著改善。此外,FA 和 DHA 联合干预优于单独干预(p < 0.001)。同时,与安慰剂相比,FA、DHA及其联合使用可显著降低8-OHdG水平并增加线粒体DNA拷贝数(p < 0.05):连续12个月单独或联合补充FA和DHA可改善MCI患者的认知功能,这可能是通过减轻DNA氧化损伤和增强线粒体功能实现的。与单独补充相比,联合补充可能会带来更多的认知益处:中国临床试验注册中心,ChiCTR2000034351。注册日期:2020年7月3日 - 追溯注册,https://www.chictr.org.cn/showproj.html?proj=53345。
{"title":"Cognitive Benefits of Folic Acid, Docosahexaenoic Acid, and a Combination of Both Nutrients in Mild Cognitive Impairment: Possible Alterations through Mitochondrial Function and DNA Damage.","authors":"Mengyue Li, Tongtong Li, Tong Yang, Ling Huang, Jiangang Zhao, Huan Liu, Yongjie Chen, Wen Li, Yun Zhu, Fei Ma, Jing Yan, Guowei Huang","doi":"10.1159/000540021","DOIUrl":"10.1159/000540021","url":null,"abstract":"<p><strong>Introduction: </strong>It is uncertain whether folic acid (FA) combined with docosahexaenoic acid (DHA) could improve cognitive performance. This study evaluated the effects of a 12-month FA and DHA supplementation, in combination or alone, on cognitive function, DNA oxidative damage, and mitochondrial function in participants with mild cognitive impairment (MCI).</p><p><strong>Methods: </strong>This randomized, double-blind, placebo-controlled trial recruited MCI participants aged 60 years and older. Two hundred and eighty participants were randomly divided in equal proportion into four groups: FA + DHA (FA 800 μg/d + DHA 800 mg/d), FA (800 μg/d), DHA (800 mg/d), and placebo groups daily orally for 12 months. The primary outcome was cognitive function evaluated by the Wechsler Adult Intelligence Scale-Revised (WAIS-RC). Cognitive tests and blood mechanism-related biomarkers were determined at baseline and 12 months.</p><p><strong>Results: </strong>During the 12-month follow-up, scores of full intelligence quotient (βDHA: 1.302, 95% CI: 0.615, 1.990, p &lt; 0.001; βFA: 1.992, 95% CI: 1.304, 2.679, p &lt; 0.001; βFA+DHA: 2.777, 95% CI: 2.090, 3.465, p &lt; 0.001), verbal intelligence quotient, and some subtests of the WAIS-RC were significantly improved in FA + DHA and single intervention groups compared to the placebo group. Moreover, the FA and DHA intervention combination was superior to either intervention alone (p &lt; 0.001). Meanwhile, FA, DHA, and their combined use significantly decreased 8-OHdG level and increased mitochondrial DNA copy number compared to the placebo (p &lt; 0.05).</p><p><strong>Conclusions: </strong>Supplementation of FA and DHA, alone or combined, for 12 months can improve cognitive function in MCI participants, possibly through mitigating DNA oxidative damage and enhancing mitochondrial function. Combined supplementation may provide more cognitive benefit than supplementation alone.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Gerontology
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