Xiangbin Zhong, Ziqi Huang, Baoqing Huang, Honglin Cai, Yao Yao, Keyang Liu, Yuting Li
Background The study aimed to investigate the association between changes in sarcopenia and the risk of dementia, and whether cumulative levels of physical activity (PA) mediate the association of changes in sarcopenia with dementia. Methods Our data are from the English Longitudinal Study of Aging (ELSA) (2004-2019). Robust, probable sarcopenia and sarcopenia were assessed according to EWGSOP2 criteria. Kaplan–Meier cumulative risk curves were used to explore the association between change in sarcopenia and the risk of dementia. Cox proportional hazard models were used to calculate the hazard ratios (HR) and 95% confidence intervals (95% CI). Causal mediation analysis (CMA) was used to assess the mediating effects of cumulative levels of PA. Results A total of 3610 participants were included in the analysis. At a median follow-up time of 9.83 years, 296 participants developed dementia. Compared to participants with stable robust, participants with robust to probable sarcopenia/sarcopenia had a increased risk of dementia (HR = 1.49, 95%CI : 1.05-2.10), conversely, compared to participants with stable sarcopenia, participants with sarcopenia to probable sarcopenia/robust did not have a reduced risk of dementia (HR = 0.79, 95%CI: 0.51-1.52). The cumulative levels of PA mediate the association with robust to probable sarcopenia/sarcopenia and the risk of dementia with a natural indirect effect (NIE) HR (95%CI) of 1.06 (1.01-1.13), proportion mediated (PM) = 15.4%. Conclusions Different changes in sarcopenia were associated with different dementia risks, with continued progression of sarcopenia, increased dementia risk, and cumulative levels of PA mediated the association between the progression of sarcopenia and the risk of dementia.
{"title":"Change in sarcopenia and the risk of dementia: Evidence from the English Longitudinal Study of Ageing with a 10-year follow-up","authors":"Xiangbin Zhong, Ziqi Huang, Baoqing Huang, Honglin Cai, Yao Yao, Keyang Liu, Yuting Li","doi":"10.1093/gerona/glaf290","DOIUrl":"https://doi.org/10.1093/gerona/glaf290","url":null,"abstract":"Background The study aimed to investigate the association between changes in sarcopenia and the risk of dementia, and whether cumulative levels of physical activity (PA) mediate the association of changes in sarcopenia with dementia. Methods Our data are from the English Longitudinal Study of Aging (ELSA) (2004-2019). Robust, probable sarcopenia and sarcopenia were assessed according to EWGSOP2 criteria. Kaplan–Meier cumulative risk curves were used to explore the association between change in sarcopenia and the risk of dementia. Cox proportional hazard models were used to calculate the hazard ratios (HR) and 95% confidence intervals (95% CI). Causal mediation analysis (CMA) was used to assess the mediating effects of cumulative levels of PA. Results A total of 3610 participants were included in the analysis. At a median follow-up time of 9.83 years, 296 participants developed dementia. Compared to participants with stable robust, participants with robust to probable sarcopenia/sarcopenia had a increased risk of dementia (HR = 1.49, 95%CI : 1.05-2.10), conversely, compared to participants with stable sarcopenia, participants with sarcopenia to probable sarcopenia/robust did not have a reduced risk of dementia (HR = 0.79, 95%CI: 0.51-1.52). The cumulative levels of PA mediate the association with robust to probable sarcopenia/sarcopenia and the risk of dementia with a natural indirect effect (NIE) HR (95%CI) of 1.06 (1.01-1.13), proportion mediated (PM) = 15.4%. Conclusions Different changes in sarcopenia were associated with different dementia risks, with continued progression of sarcopenia, increased dementia risk, and cumulative levels of PA mediated the association between the progression of sarcopenia and the risk of dementia.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Serena Iuorio, Antonio De Vincentis, Diana Lelli, Stefania Bandinelli, Luigi Ferrucci, Raffaele Antonelli Incalzi, Claudio Pedone
Background Chronological age inadequately captures inter-individual variability in aging-related functional decline. Biological age metrics such as PhenoAge and PhenoAgeAccel, based on clinical biomarkers, have shown associations with frailty and mortality in clinical populations, but their utility in predicting physical performance decline in community-dwelling older adults remains uncertain. Methods We used data from 979 participants aged ≥65 years in the InCHIANTI study, with complete baseline biomarker and physical performance data. Associations of standardized (z-scores) chronological age, PhenoAge, and PhenoAgeAccel with longitudinal changes in physical function (rescaled SPPB) and 10-year all-cause mortality were analyzed using linear mixed and Cox models respectively. A secondary analysis in 504 participants with normal baseline physical performance (SPPB ≥10) assessed the predictive value of each rescaled metric for the onset of compromised function (SPPB ≤9) at 6 years. Model performance was evaluated using AIC and AUC. Results All three metrics showed statistically significant positive associations with physical function decline and mortality. Chronological age showed the strongest associations with rSPPB decline (β = -0.41, AIC = 3793) and mortality (HR = 2.78). PhenoAge (β = -0. 32, AIC 4338, HR = 2.57) and PhenoAgeAccel (β = -0.14, AIC 4642, HR = 1.71) showed weaker effects. Chronological age also outperformed PhenoAge and PhenoAgeAccel in predicting SPPB decline (AUC = 0.71 vs. 0.69 and 0.55, respectively). Conclusion While PhenoAge and PhenoAgeAccel are associated with adverse functional outcomes, they do not add predictive value over chronological age in a general older population.
{"title":"Phenoage and Phenoageaccel Do Not Outperform Chronological Age in Predicting Physical Performance Decline or Mortality in Community-Dwelling Older Adults","authors":"Maria Serena Iuorio, Antonio De Vincentis, Diana Lelli, Stefania Bandinelli, Luigi Ferrucci, Raffaele Antonelli Incalzi, Claudio Pedone","doi":"10.1093/gerona/glaf285","DOIUrl":"https://doi.org/10.1093/gerona/glaf285","url":null,"abstract":"Background Chronological age inadequately captures inter-individual variability in aging-related functional decline. Biological age metrics such as PhenoAge and PhenoAgeAccel, based on clinical biomarkers, have shown associations with frailty and mortality in clinical populations, but their utility in predicting physical performance decline in community-dwelling older adults remains uncertain. Methods We used data from 979 participants aged ≥65 years in the InCHIANTI study, with complete baseline biomarker and physical performance data. Associations of standardized (z-scores) chronological age, PhenoAge, and PhenoAgeAccel with longitudinal changes in physical function (rescaled SPPB) and 10-year all-cause mortality were analyzed using linear mixed and Cox models respectively. A secondary analysis in 504 participants with normal baseline physical performance (SPPB ≥10) assessed the predictive value of each rescaled metric for the onset of compromised function (SPPB ≤9) at 6 years. Model performance was evaluated using AIC and AUC. Results All three metrics showed statistically significant positive associations with physical function decline and mortality. Chronological age showed the strongest associations with rSPPB decline (β = -0.41, AIC = 3793) and mortality (HR = 2.78). PhenoAge (β = -0. 32, AIC 4338, HR = 2.57) and PhenoAgeAccel (β = -0.14, AIC 4642, HR = 1.71) showed weaker effects. Chronological age also outperformed PhenoAge and PhenoAgeAccel in predicting SPPB decline (AUC = 0.71 vs. 0.69 and 0.55, respectively). Conclusion While PhenoAge and PhenoAgeAccel are associated with adverse functional outcomes, they do not add predictive value over chronological age in a general older population.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145845019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Insomnia has been identified as a plausible modifiable risk factor for dementia. Quantifying its population-level impact may inform strategies to reduce dementia risk among older adults in the United States. Methods We used data from the 2022 National Health and Aging Trends Study (NHATS) to classify insomnia as sleep-onset insomnia, sleep-maintenance insomnia, or both, and to identify probable dementia using established algorithms. We obtained relative risks from a published meta-analysis. Using these relative risks and NHATS prevalence estimates, we estimated the population attributable fraction (PAF) of dementia cases attributable to insomnia overall and stratified by age and sex. Results Among 5,899 participants (44.7% aged ≥ 80 years; 57.9% females; 77.9% non-Hispanic White), 28.7% (95% CI: 26.9%, 30.5%) reported insomnia symptoms and 6.6% (95% CI: 5.9%, 7.3%) had probable dementia. The estimated PAF of probable dementia due to any insomnia was 12.5% (95% CI: 1.0%, 25.0%), and it was slightly higher among females (13.1%, 95% CI: 1.0%, 26.1%) than males (11.6%, 95% CI: 0.9%, 23.3%). The highest PAF was observed in the 65–69 age group (14.4%, 95% CI: 1.1%, 27.8%) among females and in the 70–74 age group (12.8%, 95% CI: 0.9%, 25.8%) among males. An estimated 449,069 (95% CI: 35,049, 923,082) dementia cases in 2022 could have been prevented if insomnia were eliminated. Conclusions Approximately 13% of dementia cases, almost half a million cases, among U.S. older adults may be attributable to insomnia. Addressing insomnia could be a promising target for dementia prevention efforts in aging populations.
{"title":"Quantifying the Population-Level Impact of Insomnia on Dementia Among Older Adults in the United States","authors":"Yuqian Lin, Fei Wu, Yuhan Wu, Wanru Liu, Goodarz Danaei, Ruijia Chen","doi":"10.1093/gerona/glaf289","DOIUrl":"https://doi.org/10.1093/gerona/glaf289","url":null,"abstract":"Background Insomnia has been identified as a plausible modifiable risk factor for dementia. Quantifying its population-level impact may inform strategies to reduce dementia risk among older adults in the United States. Methods We used data from the 2022 National Health and Aging Trends Study (NHATS) to classify insomnia as sleep-onset insomnia, sleep-maintenance insomnia, or both, and to identify probable dementia using established algorithms. We obtained relative risks from a published meta-analysis. Using these relative risks and NHATS prevalence estimates, we estimated the population attributable fraction (PAF) of dementia cases attributable to insomnia overall and stratified by age and sex. Results Among 5,899 participants (44.7% aged ≥ 80 years; 57.9% females; 77.9% non-Hispanic White), 28.7% (95% CI: 26.9%, 30.5%) reported insomnia symptoms and 6.6% (95% CI: 5.9%, 7.3%) had probable dementia. The estimated PAF of probable dementia due to any insomnia was 12.5% (95% CI: 1.0%, 25.0%), and it was slightly higher among females (13.1%, 95% CI: 1.0%, 26.1%) than males (11.6%, 95% CI: 0.9%, 23.3%). The highest PAF was observed in the 65–69 age group (14.4%, 95% CI: 1.1%, 27.8%) among females and in the 70–74 age group (12.8%, 95% CI: 0.9%, 25.8%) among males. An estimated 449,069 (95% CI: 35,049, 923,082) dementia cases in 2022 could have been prevented if insomnia were eliminated. Conclusions Approximately 13% of dementia cases, almost half a million cases, among U.S. older adults may be attributable to insomnia. Addressing insomnia could be a promising target for dementia prevention efforts in aging populations.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145845018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vivien Bahr, Hannah Schmid, Valentin Max Vetter, Dominik Spira, Johanna Drewelies, Vera Regitz-Zagrosek, Denis Gerstorf, Sandra Düzel, Knut Mai, Ilja Demuth
Background Age-related declines in gonadal and cognitive function are commonly observed, but their relationship is still not completely understood. Methods 615 men and 607 women from the Berlin Aging Study II aged ≥60 years were analyzed at baseline, of which 308 men and 297 women were re-assessed on average 7.2 years later. Total testosterone (TT) was measured, and free testosterone estimated using the Vermeulen (FTV), Sartorius (FTS), and Free Androgen Index (FAI) equations. Cognitive performance was assessed using the Digit Symbol Substitution Test (DSST) and latent factor scores established from the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD)-Plus test battery representing four cognitive domains (verbal memory, visuo-construction, executive functions and processing speed, verbal fluency). Associations between testosterone measures and cognitive function were analyzed using linear regression. Results Cross-sectional analyses showed negative associations in women between visuo-construction and TT (β=-0.215, p = 0.010) and FTS (β=-0.013, p = 0.03) as well as between verbal fluency and TT (β=-0.189, p = 0.006), FAI (β=-0.062, p = 0.03), FTS (β=-0.013, p = 0.008) and FTV (β=-0.012, p = 0.01). In men, FAI was positively associated with DSST performance (β = 0.103, p = 0.003). Longitudinally, higher FAI and FTV at baseline were associated with a less steep decline in DSST performance in men (β = 0.066, and β = 0.007, all p = 0.03). In women, declines in FAI and DSST scores were positively associated (β = 1.794, p = 0.03). Conclusions Our findings suggest sex-specific associations between testosterone levels and cognitive function in older adults. Higher testosterone levels were predominantly associated with better DSST performance in men, but with poorer visuo-construction and verbal fluency in women.
与年龄相关的性腺功能和认知功能下降是常见的，但它们之间的关系仍未完全了解。方法对柏林老龄化研究II中年龄≥60岁的615名男性和607名女性进行基线分析，其中308名男性和297名女性在平均7.2年后重新评估。测量总睾酮（TT），并使用Vermeulen （FTV）、Sartorius （FTS）和游离雄激素指数（FAI）方程估计游离睾酮。认知表现采用数字符号替代测试（DSST）和由建立阿尔茨海默病注册协会（CERAD）建立的潜在因素评分进行评估-Plus测试，代表四个认知领域（言语记忆，视觉构建，执行功能和处理速度，语言流畅性）。使用线性回归分析睾酮测量与认知功能之间的关系。结果横断面分析显示，女性视觉建构与TT （β=-0.215, p = 0.010）、FTS （β=-0.013, p = 0.03）呈负相关，言语流畅性与TT （β=-0.189, p = 0.006）、FAI （β=-0.062, p = 0.03）、FTS （β=-0.013, p = 0.008）、FTV （β=-0.012, p = 0.01）呈负相关。在男性中，FAI与DSST表现呈正相关（β = 0.103, p = 0.003）。纵向上，基线时较高的FAI和FTV与男性DSST表现下降幅度较小相关（β = 0.066, β = 0.007，均p = 0.03）。在女性中，FAI和DSST评分的下降呈正相关（β = 1.794, p = 0.03）。结论：我们的研究结果表明，睾酮水平与老年人认知功能之间存在性别特异性关联。较高的睾丸激素水平主要与男性较好的DSST表现有关，但与女性较差的视觉结构和语言流畅性有关。
{"title":"Cross-sectional and Longitudinal Associations between Testosterone and Cognitive Performance in Older People: Results of the Berlin Aging Study II (BASE-II)","authors":"Vivien Bahr, Hannah Schmid, Valentin Max Vetter, Dominik Spira, Johanna Drewelies, Vera Regitz-Zagrosek, Denis Gerstorf, Sandra Düzel, Knut Mai, Ilja Demuth","doi":"10.1093/gerona/glaf286","DOIUrl":"https://doi.org/10.1093/gerona/glaf286","url":null,"abstract":"Background Age-related declines in gonadal and cognitive function are commonly observed, but their relationship is still not completely understood. Methods 615 men and 607 women from the Berlin Aging Study II aged ≥60 years were analyzed at baseline, of which 308 men and 297 women were re-assessed on average 7.2 years later. Total testosterone (TT) was measured, and free testosterone estimated using the Vermeulen (FTV), Sartorius (FTS), and Free Androgen Index (FAI) equations. Cognitive performance was assessed using the Digit Symbol Substitution Test (DSST) and latent factor scores established from the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD)-Plus test battery representing four cognitive domains (verbal memory, visuo-construction, executive functions and processing speed, verbal fluency). Associations between testosterone measures and cognitive function were analyzed using linear regression. Results Cross-sectional analyses showed negative associations in women between visuo-construction and TT (β=-0.215, p = 0.010) and FTS (β=-0.013, p = 0.03) as well as between verbal fluency and TT (β=-0.189, p = 0.006), FAI (β=-0.062, p = 0.03), FTS (β=-0.013, p = 0.008) and FTV (β=-0.012, p = 0.01). In men, FAI was positively associated with DSST performance (β = 0.103, p = 0.003). Longitudinally, higher FAI and FTV at baseline were associated with a less steep decline in DSST performance in men (β = 0.066, and β = 0.007, all p = 0.03). In women, declines in FAI and DSST scores were positively associated (β = 1.794, p = 0.03). Conclusions Our findings suggest sex-specific associations between testosterone levels and cognitive function in older adults. Higher testosterone levels were predominantly associated with better DSST performance in men, but with poorer visuo-construction and verbal fluency in women.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ines Sturmlechner, Sarah A Ashiqueali, Hélène Martini, Karla Valdivieso, Ana Catarina Franco, Prashanth Guthikonda, Andrew J Dosch, Luis I Prieto, Niels C Asmussen, Amanda S Latham, James T Redden, Ethan A Leitschuh, Douglas G Mashek, João F Passos, Jhonny Rodriguez-Lopez, T Blake Monroe, David A Bernlohr, Paul D Robbins, Bailey A Knopf, Dudley W Lamming, Matthew J Johnston, Holly M Brown-Borg, Spencer A Tye, Timothy W Rhoads, David M Gate, Bennett G Childs, Darren J Baker, Xinna Li, In Hwa Jang, Christina D Camell, Zachary Miller, Hemali Phatnani, Adam R Konopka, Andrew J Haak, Natalia Vanegas-Avendano, Ramya N Akula, Ajinkya R Limkar, William A Ricke, Scott F Leiser, Jacinta Correia, Hua Bai, Szczepan Olszewski, Kenneth L Seldeen, G R Scott Budinger, Luisa C Morales-Nebreda, Deborah R Winter, Shelly K Mccrady-Spitzer, Rozalyn M Anderson, Maria M Mihaylova, Mauricio Rojas, Ana L Mora, Nathan K Lebrasseur, Marissa J Schafer
Geroscience research benefits from interdisciplinary approaches, team science, and collaborations, which collectively facilitate the discovery of aging mechanisms and their translation into tangible, clinical interventions. Since its inception in 2019, the Midwest Aging Consortium (MAC) has provided an engaging platform for aging researchers in the United States’ Midwest to connect, collaborate, and exchange ideas. The Sixth Annual Research Symposium of the MAC held at the Mayo Clinic in Rochester, Minnesota in April 2025 highlighted the continued impact of the MAC in bringing together aging researchers, including many trainees and early career investigators, into a collaborative environment. This record-setting event featured interdisciplinary research on key aging mechanisms, including lipid metabolism, mitochondrial dysfunction, stress response, cellular senescence, and immune adaptations across organ systems. New therapeutic concepts and clinical trial approaches were presented. Cutting-edge methodologies including single-cell and spatial transcriptomics, metabolomics, and organoid cultures, to dissect aging process in tissue-specific and systemic contexts also were presented. Overall, the MAC symposium underscored the translational potential of geroscience and reinforced the MAC’s mission to accelerate aging research through regional collaborations and innovation.
{"title":"The Sixth Annual Symposium of the Midwest Aging Consortium","authors":"Ines Sturmlechner, Sarah A Ashiqueali, Hélène Martini, Karla Valdivieso, Ana Catarina Franco, Prashanth Guthikonda, Andrew J Dosch, Luis I Prieto, Niels C Asmussen, Amanda S Latham, James T Redden, Ethan A Leitschuh, Douglas G Mashek, João F Passos, Jhonny Rodriguez-Lopez, T Blake Monroe, David A Bernlohr, Paul D Robbins, Bailey A Knopf, Dudley W Lamming, Matthew J Johnston, Holly M Brown-Borg, Spencer A Tye, Timothy W Rhoads, David M Gate, Bennett G Childs, Darren J Baker, Xinna Li, In Hwa Jang, Christina D Camell, Zachary Miller, Hemali Phatnani, Adam R Konopka, Andrew J Haak, Natalia Vanegas-Avendano, Ramya N Akula, Ajinkya R Limkar, William A Ricke, Scott F Leiser, Jacinta Correia, Hua Bai, Szczepan Olszewski, Kenneth L Seldeen, G R Scott Budinger, Luisa C Morales-Nebreda, Deborah R Winter, Shelly K Mccrady-Spitzer, Rozalyn M Anderson, Maria M Mihaylova, Mauricio Rojas, Ana L Mora, Nathan K Lebrasseur, Marissa J Schafer","doi":"10.1093/gerona/glaf280","DOIUrl":"https://doi.org/10.1093/gerona/glaf280","url":null,"abstract":"Geroscience research benefits from interdisciplinary approaches, team science, and collaborations, which collectively facilitate the discovery of aging mechanisms and their translation into tangible, clinical interventions. Since its inception in 2019, the Midwest Aging Consortium (MAC) has provided an engaging platform for aging researchers in the United States’ Midwest to connect, collaborate, and exchange ideas. The Sixth Annual Research Symposium of the MAC held at the Mayo Clinic in Rochester, Minnesota in April 2025 highlighted the continued impact of the MAC in bringing together aging researchers, including many trainees and early career investigators, into a collaborative environment. This record-setting event featured interdisciplinary research on key aging mechanisms, including lipid metabolism, mitochondrial dysfunction, stress response, cellular senescence, and immune adaptations across organ systems. New therapeutic concepts and clinical trial approaches were presented. Cutting-edge methodologies including single-cell and spatial transcriptomics, metabolomics, and organoid cultures, to dissect aging process in tissue-specific and systemic contexts also were presented. Overall, the MAC symposium underscored the translational potential of geroscience and reinforced the MAC’s mission to accelerate aging research through regional collaborations and innovation.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jack F V Hunt,Erik J Buchholz,Carol E Franz,Chandra A Reynolds,Matthew S Panizzon,McKenna E Williams,Tyler R Bell,Rongxiang Tang,Donald J Hagler,Nathan Gillespie,Jeremy A Elman,Michael C Neale,Stephen Dorros,Anders M Dale,William S Kremen,Christine Fennema-Notestine,
BACKGROUNDCumulative deficit frailty (CDF) is a syndrome characterized by the accumulation of negative physical, functional and psychosocial insults. Accumulation of CDF and changes in brain structure both occur during the transition to older age and are associated with the development of Alzheimer's disease (AD) and related dementias. However, how these phenomena are temporally related to each other during the aging process is not well understood.METHODSWe examined bidirectional relationships between CDF and brain structure using structural MRI-based brain-predicted age difference and an AD brain signature. Longitudinal MRI and questionnaire-based data were collected from men in the Vietnam Era Twin Study of Aging at three study waves (average ages 56, 62 and 68).RESULTSBest-fitting longitudinal random intercepts cross-lagged panel models support the strong overall association between CDF and brain structural integrity with significant covariance between random intercepts for CDF and brain-predicted age difference (r = 0.36, p < 0.001) and between CDF and AD brain signature (r=-0.16, p = 0.005) after controlling for chronological age, smoking, race/ethnicity and education. Significant bidirectional negative cross-lagged associations suggested attenuation over time of the association between CDF and non-specific brain aging (β's=-0.33 to -0.23, p < =0.012) but not between CDF and AD brain signature.CONCLUSIONSCDF was associated with age-related brain structure via strong time-invariant common variance as well as weaker across-time factors. By contrast, the association between CDF and AD-related brain structure was via moderate common variance and was not temporally dynamic. Together, this suggests that CDF is differentially associated with age-related and AD-related brain changes and may be a clinically relevant risk factor for pathological brain aging.
背景：累积缺陷虚弱（CDF）是一种以身体、功能和心理上的负面侮辱积累为特征的综合征。CDF的积累和大脑结构的变化都发生在向老年过渡的过程中，并与阿尔茨海默病（AD）和相关痴呆的发展有关。然而，在老化过程中，这些现象是如何在时间上相互联系的，还没有得到很好的理解。方法：我们使用基于结构mri的脑预测年龄差异和AD脑特征来研究CDF与脑结构之间的双向关系。纵向MRI和基于问卷的数据收集自越南时代双胞胎衰老研究中三个研究阶段的男性（平均年龄56岁、62岁和68岁）。结果最拟合的纵向随机截距交叉滞后面板模型支持CDF与大脑结构完整性之间的强整体关联，在控制了实足年龄、吸烟、种族/民族和教育之后，CDF与大脑预测年龄差异（r= 0.36, p < 0.001）和CDF与AD大脑特征之间（r=-0.16, p = 0.005）的随机截距之间存在显著的协方差。显著的双向负交叉滞后关联表明，CDF与非特异性脑衰老之间的关联随着时间的推移而减弱（β s=-0.33至-0.23,p < =0.012），但CDF与AD脑特征之间没有关联。结论scdf与年龄相关的脑结构存在较强的时不变共同方差和较弱的跨时间因素。相比之下，CDF与ad相关的大脑结构之间的关联是通过中等共同方差，而不是时间动态的。总之，这表明CDF与年龄相关和ad相关的大脑变化存在差异，可能是病理性脑衰老的临床相关危险因素。
{"title":"Association of cumulative deficit frailty with brain age and Alzheimer's disease-related brain structure starting in late middle age.","authors":"Jack F V Hunt,Erik J Buchholz,Carol E Franz,Chandra A Reynolds,Matthew S Panizzon,McKenna E Williams,Tyler R Bell,Rongxiang Tang,Donald J Hagler,Nathan Gillespie,Jeremy A Elman,Michael C Neale,Stephen Dorros,Anders M Dale,William S Kremen,Christine Fennema-Notestine, ","doi":"10.1093/gerona/glaf283","DOIUrl":"https://doi.org/10.1093/gerona/glaf283","url":null,"abstract":"BACKGROUNDCumulative deficit frailty (CDF) is a syndrome characterized by the accumulation of negative physical, functional and psychosocial insults. Accumulation of CDF and changes in brain structure both occur during the transition to older age and are associated with the development of Alzheimer's disease (AD) and related dementias. However, how these phenomena are temporally related to each other during the aging process is not well understood.METHODSWe examined bidirectional relationships between CDF and brain structure using structural MRI-based brain-predicted age difference and an AD brain signature. Longitudinal MRI and questionnaire-based data were collected from men in the Vietnam Era Twin Study of Aging at three study waves (average ages 56, 62 and 68).RESULTSBest-fitting longitudinal random intercepts cross-lagged panel models support the strong overall association between CDF and brain structural integrity with significant covariance between random intercepts for CDF and brain-predicted age difference (r = 0.36, p < 0.001) and between CDF and AD brain signature (r=-0.16, p = 0.005) after controlling for chronological age, smoking, race/ethnicity and education. Significant bidirectional negative cross-lagged associations suggested attenuation over time of the association between CDF and non-specific brain aging (β's=-0.33 to -0.23, p < =0.012) but not between CDF and AD brain signature.CONCLUSIONSCDF was associated with age-related brain structure via strong time-invariant common variance as well as weaker across-time factors. By contrast, the association between CDF and AD-related brain structure was via moderate common variance and was not temporally dynamic. Together, this suggests that CDF is differentially associated with age-related and AD-related brain changes and may be a clinically relevant risk factor for pathological brain aging.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica E Rast,Andrea L Rosso,Bryan D James,Jack F G Underwood,Jacob Bergstedt,Viktor H Ahlqvist,Jakob Grove,Fang Fang,Neal D Goldstein,Giacomo Vivanti,Stephen Z Levine,Anna Nordström,Diana Schendel,Kristen Lyall,Peter Nordström,Marcel Ballin,Jean Stafford,Adam C Naj,Brian K Lee,
BACKGROUNDNeurodevelopmental conditions (NDC), including attention deficit/hyperactivity disorder (ADHD) and autism, are associated with increased rates of neurodegenerative diseases, including Alzheimer's disease and related dementias (ADRD) and Parkinson's disease. Such associations are unstudied in diverse populations and while controlling for a range of important covariates. The purpose of this study was to examine the association of ADRD and Parkinson's disease with NDCs in a diverse sample of adults.METHODSThis case-control study used data from the U.S. All of Us Research Program 2018-2023 from approximately 600,000 adults in the U.S. We matched on ADRD and Parkinson's disease status in order to examine the association of these conditions with NDCs.RESULTSNDC was more prevalent in ADRD cases than in non-ADRD controls (7.8% versus 2.4%) and among Parkinson's disease cases than non-Parkinson's disease controls (4.5% versus 1.8%). After adjustment for sex, age, education level, body mass index, cardiometabolic conditions, and psychiatric conditions, individuals with ADRD had significantly higher odds of having an NDC compared with controls (adjusted odds ratio, 2.68; 95% CI, 2.40-2.99). Similarly, Parkinson's disease cases had 2.09 times the odds of having an NDC as non-Parkinson's disease controls (95% CI 1.66, 2.59) in adjusted models.CONCLUSIONSAs the population of individuals with NDCs ages, and more older adults find themselves in the care of clinicians with experetise in ADRD and Parkinson's disease, it is imperative to understand the support needs of this population, and to provide targets for reducing ADRD prevalence in younger or middle adulthood.
神经发育疾病（NDC），包括注意缺陷/多动障碍（ADHD）和自闭症，与神经退行性疾病（包括阿尔茨海默病和相关痴呆（ADRD）和帕金森病）的发病率增加有关。在控制一系列重要协变量的情况下，这种关联在不同人群中尚未得到研究。本研究的目的是在不同的成人样本中检查ADRD和帕金森病与ndc的关系。方法：本病例对照研究使用了美国2018-2023年All of Us研究计划中来自美国约60万成年人的数据，我们匹配了ADRD和帕金森病状态，以检查这些疾病与ndc的关系。结果sndc在ADRD患者中比在非ADRD对照组中更普遍（7.8%比2.4%），在帕金森病患者中比在非帕金森病对照组中更普遍（4.5%比1.8%）。在对性别、年龄、教育水平、体重指数、心脏代谢状况和精神状况进行校正后，ADRD患者发生NDC的几率明显高于对照组（校正优势比2.68;95% CI 2.40-2.99）。同样，在调整后的模型中，帕金森病患者发生NDC的几率是非帕金森病患者的2.09倍（95% CI 1.66, 2.59）。结论随着ndc患者年龄的增长，越来越多的老年人发现自己需要由具有ADRD和帕金森病专业知识的临床医生护理，了解这一人群的支持需求，并为降低年轻或中年ADRD患病率提供目标是势在必行的。
{"title":"Association of neurodevelopmental conditions with Alzheimer's disease and related dementias and Parkinson's disease.","authors":"Jessica E Rast,Andrea L Rosso,Bryan D James,Jack F G Underwood,Jacob Bergstedt,Viktor H Ahlqvist,Jakob Grove,Fang Fang,Neal D Goldstein,Giacomo Vivanti,Stephen Z Levine,Anna Nordström,Diana Schendel,Kristen Lyall,Peter Nordström,Marcel Ballin,Jean Stafford,Adam C Naj,Brian K Lee, ","doi":"10.1093/gerona/glaf281","DOIUrl":"https://doi.org/10.1093/gerona/glaf281","url":null,"abstract":"BACKGROUNDNeurodevelopmental conditions (NDC), including attention deficit/hyperactivity disorder (ADHD) and autism, are associated with increased rates of neurodegenerative diseases, including Alzheimer's disease and related dementias (ADRD) and Parkinson's disease. Such associations are unstudied in diverse populations and while controlling for a range of important covariates. The purpose of this study was to examine the association of ADRD and Parkinson's disease with NDCs in a diverse sample of adults.METHODSThis case-control study used data from the U.S. All of Us Research Program 2018-2023 from approximately 600,000 adults in the U.S. We matched on ADRD and Parkinson's disease status in order to examine the association of these conditions with NDCs.RESULTSNDC was more prevalent in ADRD cases than in non-ADRD controls (7.8% versus 2.4%) and among Parkinson's disease cases than non-Parkinson's disease controls (4.5% versus 1.8%). After adjustment for sex, age, education level, body mass index, cardiometabolic conditions, and psychiatric conditions, individuals with ADRD had significantly higher odds of having an NDC compared with controls (adjusted odds ratio, 2.68; 95% CI, 2.40-2.99). Similarly, Parkinson's disease cases had 2.09 times the odds of having an NDC as non-Parkinson's disease controls (95% CI 1.66, 2.59) in adjusted models.CONCLUSIONSAs the population of individuals with NDCs ages, and more older adults find themselves in the care of clinicians with experetise in ADRD and Parkinson's disease, it is imperative to understand the support needs of this population, and to provide targets for reducing ADRD prevalence in younger or middle adulthood.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"369 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yaolin Pei, Xiang Qi, Zexi Zhou, Yifan Lou, Jing Wang, Yang Li, Bei Wu
Background Effective pain management is essential for enhancing quality of life at the end of life. However, challenges persist globally, particularly in China, where palliative care remains underdeveloped. This study investigates pain prevalence and the associations between pain severity, place of death, and the quality of pain management among older adults in China, with a focus on regional and urban-rural disparities. Methods We used data from the 2014, 2016, 2018, and 2020 waves of the China Longitudinal Aging Social Survey. The final sample included 1,525 older adults who deceased during the study period. We conducted OLS regression analyses to examine the regional and rural-urban disparities in the associations between pain severity, place of death, and the quality of pain management. Results Severe pain at the end of life was reported for 42.6% of decedents. Severe pain and hospital death were associated with better quality of pain management. The association between hospital death and pain management quality was stronger in the Eastern region than in the Middle and Western regions. The associations between severe pain symptoms, place of death, and pain management quality were stronger in urban areas than in rural areas. The urban-rural disparities in pain management quality were stronger in the Eastern region than in the Middle and Western regions. Conclusions The regional and urban-rural disparities in end-of-life pain management in China highlight the urgent need to strengthen palliative care capacity in under-resourced and rural areas through equitable expansion of home- and community-based services and integrated medical insurance reforms.
{"title":"Pain prevalence and pain management at the end of life: Regional and urban-rural differences from a national-representative survey of chinese older adults","authors":"Yaolin Pei, Xiang Qi, Zexi Zhou, Yifan Lou, Jing Wang, Yang Li, Bei Wu","doi":"10.1093/gerona/glaf282","DOIUrl":"https://doi.org/10.1093/gerona/glaf282","url":null,"abstract":"Background Effective pain management is essential for enhancing quality of life at the end of life. However, challenges persist globally, particularly in China, where palliative care remains underdeveloped. This study investigates pain prevalence and the associations between pain severity, place of death, and the quality of pain management among older adults in China, with a focus on regional and urban-rural disparities. Methods We used data from the 2014, 2016, 2018, and 2020 waves of the China Longitudinal Aging Social Survey. The final sample included 1,525 older adults who deceased during the study period. We conducted OLS regression analyses to examine the regional and rural-urban disparities in the associations between pain severity, place of death, and the quality of pain management. Results Severe pain at the end of life was reported for 42.6% of decedents. Severe pain and hospital death were associated with better quality of pain management. The association between hospital death and pain management quality was stronger in the Eastern region than in the Middle and Western regions. The associations between severe pain symptoms, place of death, and pain management quality were stronger in urban areas than in rural areas. The urban-rural disparities in pain management quality were stronger in the Eastern region than in the Middle and Western regions. Conclusions The regional and urban-rural disparities in end-of-life pain management in China highlight the urgent need to strengthen palliative care capacity in under-resourced and rural areas through equitable expansion of home- and community-based services and integrated medical insurance reforms.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heike A Bischoff-Ferrari,Dai-Hua Tsai,Melanie Kistler-Fischbacher,E John Orav,Patricia Lanz,Katharina Geiling,Cathrine Klaghofer,Patrick Sidler,Uenal Can,Romano Steiner,Markus Minder,Bettina von Rickenbach,Ali Yildirim-Aman,Heinz Bruppacher,Michael Dietrich,Andreas Egli,Michael Gagesch,Gregor Freystaetter
BACKGROUNDThe ICEBERG tool was initially validated in two small pilot studies to address the lack of a comprehensive geriatric screening tool in emergency settings. The present study builds on the second pilot study and extends it to a larger, multicentre sample.METHODSWe report results from a large ICBERG tool validation study across three emergency rooms (ERs) including 1,664 patients aged 70 years and older. The tool targets 9 domains and is administered by ER physicians or specialized nurses. To assess criterion validity-the extent to which ICEBERG scores are associated with relevant clinical outcomes-we compared patients who scored below versus above the median (< 10; ≥10) ICEBERG score for six key clinical outcomes: length of stay in acute care, nursing care in minutes, one-on-one nursing care, in-hospital mortality, discharge to nursing home, and re-admission within 30 days. Negative binomial regression was used for the outcomes length of stay and nursing care in minutes. Logistic regression was used for the other outcomes. All analyses were adjusted for age and sex.RESULTSPatients with ICEBERG scores of 10 or higher had significantly longer stays in acute care (8.9 vs. 6.6 days), required more nursing care (56.4 vs. 32.8 hours), had higher odds of one-on-one nursing care (Odds Ratio, OR = 2.85), in-hospital mortality (OR = 1.89), discharge to a nursing home (OR = 3.20) or being readmitted within 30 days (OR = 1.81).CONCLUSIONSBased on our findings the ICEBERG tool identifies older patients with a geriatric risk profile at ER on all key clinical outcomes tested.
{"title":"ICEBERG emergency room screening tool for early adverse outcome prediction in older patients admitted to acute care: a multi-center study.","authors":"Heike A Bischoff-Ferrari,Dai-Hua Tsai,Melanie Kistler-Fischbacher,E John Orav,Patricia Lanz,Katharina Geiling,Cathrine Klaghofer,Patrick Sidler,Uenal Can,Romano Steiner,Markus Minder,Bettina von Rickenbach,Ali Yildirim-Aman,Heinz Bruppacher,Michael Dietrich,Andreas Egli,Michael Gagesch,Gregor Freystaetter","doi":"10.1093/gerona/glaf270","DOIUrl":"https://doi.org/10.1093/gerona/glaf270","url":null,"abstract":"BACKGROUNDThe ICEBERG tool was initially validated in two small pilot studies to address the lack of a comprehensive geriatric screening tool in emergency settings. The present study builds on the second pilot study and extends it to a larger, multicentre sample.METHODSWe report results from a large ICBERG tool validation study across three emergency rooms (ERs) including 1,664 patients aged 70 years and older. The tool targets 9 domains and is administered by ER physicians or specialized nurses. To assess criterion validity-the extent to which ICEBERG scores are associated with relevant clinical outcomes-we compared patients who scored below versus above the median (< 10; ≥10) ICEBERG score for six key clinical outcomes: length of stay in acute care, nursing care in minutes, one-on-one nursing care, in-hospital mortality, discharge to nursing home, and re-admission within 30 days. Negative binomial regression was used for the outcomes length of stay and nursing care in minutes. Logistic regression was used for the other outcomes. All analyses were adjusted for age and sex.RESULTSPatients with ICEBERG scores of 10 or higher had significantly longer stays in acute care (8.9 vs. 6.6 days), required more nursing care (56.4 vs. 32.8 hours), had higher odds of one-on-one nursing care (Odds Ratio, OR = 2.85), in-hospital mortality (OR = 1.89), discharge to a nursing home (OR = 3.20) or being readmitted within 30 days (OR = 1.81).CONCLUSIONSBased on our findings the ICEBERG tool identifies older patients with a geriatric risk profile at ER on all key clinical outcomes tested.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145759999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jillian S Baker,Michelle M Hood,Leslie M Swanson,Christopher E Kline,Kelly R Ylitalo,Jane A Cauley,Robin R Green,Carrie A Karvonen-Gutierrez
BACKGROUNDAs the leading cause of injury and injury-related death for older adults in the United States, falls can be consequential for function and mortality but are preventable. Sleep may be a modifiable risk factor for falls.METHODSData from 1,795 female participants of the multi-ethnic and community-based cohort Study of Women's Health Across the Nation (SWAN) were analyzed to examine whether frequent insomnia symptoms and shorter sleep duration are associated with an increased risk of falls or a greater number of falls. Sleep variables were measured at Visit 12 (2010-2011, analytic baseline). Insomnia symptoms were assessed through self-reported frequency of restless sleep, trouble falling asleep, and waking early and being unable to fall asleep again. Sleep duration was self-reported hours of sleep, dichotomized as fewer than <6 hours/night and ≥6 hours/night. At Visit 15 (2015-2016, analytic follow-up), participants reported the number of falls in the year prior. Log-binomial and multinomial logistic regression models were adjusted for demographic and socioeconomic factors and health conditions.RESULTSWomen who reported frequent (5+ times/week) trouble falling asleep and frequent waking in the middle of the night at baseline had a 30% increased risk (aRR = 1.30, 95% CI = 1.04, 1.62) and 24% increased risk (aRR = 1.24, 95% CI = 1.03, 1.49), respectively, of having fallen in the year prior at follow-up.Frequent trouble falling asleep and short sleep duration (<6 hours) were both associated with higher odds of falling three or more times vs. once or never prior to follow-up (aOR = 2.42, 95% CI = 1.26, 4.63; aOR = 1.77, 95% CI = 1.08, 2.93), respectively.CONCLUSIONSMultiple indicators of poor sleep, including trouble falling asleep, frequent waking, and short sleep duration, were associated with an increased risk of falling and odds of higher fall burden in older adult women. Promoting adequate, high-quality sleep may be an essential component in fall prevention.
背景：作为美国老年人受伤和受伤相关死亡的主要原因，跌倒可能会影响功能和死亡率，但是可以预防的。睡眠可能是一个可改变的跌倒风险因素。方法分析来自全国多民族和社区妇女健康队列研究（SWAN）的1795名女性参与者的数据，以研究频繁的失眠症状和较短的睡眠时间是否与跌倒风险增加或跌倒次数增加有关。在第12次访问时测量睡眠变量（2010-2011，分析基线）。失眠症状通过自我报告的不安睡眠频率、入睡困难、早醒和无法再次入睡来评估。睡眠时间是指自我报告的睡眠时间，分为少于6小时/晚和≥6小时/晚。在第15次访问（2015-2016年，分析随访）中，参与者报告了前一年的跌倒次数。根据人口、社会经济因素和健康状况调整对数二项和多项逻辑回归模型。结果：在基线时报告频繁（5次以上/周）入睡困难和频繁半夜醒来的女性在随访前一年跌倒的风险分别增加30% （aRR = 1.30, 95% CI = 1.04, 1.62）和24% （aRR = 1.24, 95% CI = 1.03, 1.49）。在随访前，频繁入睡困难和睡眠时间短（<6小时）与三次或三次以上跌倒的几率均高于一次或从未跌倒的几率（aOR = 2.42, 95% CI = 1.26, 4.63; aOR = 1.77, 95% CI = 1.08, 2.93）。结论：睡眠质量差的多个指标，包括入睡困难、频繁醒来和睡眠时间短，与老年女性跌倒风险增加和跌倒负担增加的几率有关。促进充足、高质量的睡眠可能是预防跌倒的重要组成部分。
{"title":"Insomnia Symptoms, Sleep Duration and Risk of Falls in Older Adult Women: Findings from the Study of Women's Health Across the Nation.","authors":"Jillian S Baker,Michelle M Hood,Leslie M Swanson,Christopher E Kline,Kelly R Ylitalo,Jane A Cauley,Robin R Green,Carrie A Karvonen-Gutierrez","doi":"10.1093/gerona/glaf249","DOIUrl":"https://doi.org/10.1093/gerona/glaf249","url":null,"abstract":"BACKGROUNDAs the leading cause of injury and injury-related death for older adults in the United States, falls can be consequential for function and mortality but are preventable. Sleep may be a modifiable risk factor for falls.METHODSData from 1,795 female participants of the multi-ethnic and community-based cohort Study of Women's Health Across the Nation (SWAN) were analyzed to examine whether frequent insomnia symptoms and shorter sleep duration are associated with an increased risk of falls or a greater number of falls. Sleep variables were measured at Visit 12 (2010-2011, analytic baseline). Insomnia symptoms were assessed through self-reported frequency of restless sleep, trouble falling asleep, and waking early and being unable to fall asleep again. Sleep duration was self-reported hours of sleep, dichotomized as fewer than <6 hours/night and ≥6 hours/night. At Visit 15 (2015-2016, analytic follow-up), participants reported the number of falls in the year prior. Log-binomial and multinomial logistic regression models were adjusted for demographic and socioeconomic factors and health conditions.RESULTSWomen who reported frequent (5+ times/week) trouble falling asleep and frequent waking in the middle of the night at baseline had a 30% increased risk (aRR = 1.30, 95% CI = 1.04, 1.62) and 24% increased risk (aRR = 1.24, 95% CI = 1.03, 1.49), respectively, of having fallen in the year prior at follow-up.Frequent trouble falling asleep and short sleep duration (<6 hours) were both associated with higher odds of falling three or more times vs. once or never prior to follow-up (aOR = 2.42, 95% CI = 1.26, 4.63; aOR = 1.77, 95% CI = 1.08, 2.93), respectively.CONCLUSIONSMultiple indicators of poor sleep, including trouble falling asleep, frequent waking, and short sleep duration, were associated with an increased risk of falling and odds of higher fall burden in older adult women. Promoting adequate, high-quality sleep may be an essential component in fall prevention.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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