Background Accurate diagnosis and assessment of mild cognitive impairment (MCI) are essential. The efficacy of saccades in the detection of MCI lacks validation through large-scale clinical trials. Methods All eligible participants underwent saccadic assessment in four tasks and cognitive assessment. MCI diagnoses were made on the basis of clinical indicators and MRI by experienced physicians. The physicians were blinded to the saccade experiments and the operators of saccade experiments were blind to the diagnosis of physicians. The classification models based on machine learning was constructed for assessing the diagnostic accuracy of MCI based on saccadic parameters. Results Of the 559 residents who consented to participate, 383 (153 with MCI and 230 controls) were completely assessed. The classification model trained by saccadic parameters achieved high accuracy in dissociating MCI and control with AUROC of 0.945 (95% CI, 0.924-0.964), sensitivity of 0.824 (95% CI, 0.769-0.886) and specificity of 0.904 (95% CI, 0.867-0.935). The parameters of the memory-guided and antisaccade tasks demonstrated better diagnostic efficacy. The saccade model also exhibited a good diagnostic value in patients with borderline cognition being defined by the score of MoCA. When the borderline cognition was defined as 23-27 of MoCA score, the diagnosing accuracy of MCI based on saccadic parameters resulted with AUROC of 0.911 (95% CI: 0.836-0.972), sensitivity of 0.929 (95% CI, 0.762-1.000) and specificity of 0.796 (95% CI, 0.718-0.863). Conclusions Saccades can distinguish MCI from controls with great accuracy, offering a sensitive and objective diagnostic aid of MCI, especially in participants with borderline cognition.
{"title":"Diagnostic value of saccades in mild cognitive impairment (MCI): a community-based study","authors":"Leihao Sha, Hua Li, Anjiao Peng, Huajun Yang, Xin Liu, Hongjian Zhao, Wenbo Ma, Qiulei Hong, Yusha Tang, Mingsha Zhang, Lei Chen","doi":"10.1093/gerona/glaf264","DOIUrl":"https://doi.org/10.1093/gerona/glaf264","url":null,"abstract":"Background Accurate diagnosis and assessment of mild cognitive impairment (MCI) are essential. The efficacy of saccades in the detection of MCI lacks validation through large-scale clinical trials. Methods All eligible participants underwent saccadic assessment in four tasks and cognitive assessment. MCI diagnoses were made on the basis of clinical indicators and MRI by experienced physicians. The physicians were blinded to the saccade experiments and the operators of saccade experiments were blind to the diagnosis of physicians. The classification models based on machine learning was constructed for assessing the diagnostic accuracy of MCI based on saccadic parameters. Results Of the 559 residents who consented to participate, 383 (153 with MCI and 230 controls) were completely assessed. The classification model trained by saccadic parameters achieved high accuracy in dissociating MCI and control with AUROC of 0.945 (95% CI, 0.924-0.964), sensitivity of 0.824 (95% CI, 0.769-0.886) and specificity of 0.904 (95% CI, 0.867-0.935). The parameters of the memory-guided and antisaccade tasks demonstrated better diagnostic efficacy. The saccade model also exhibited a good diagnostic value in patients with borderline cognition being defined by the score of MoCA. When the borderline cognition was defined as 23-27 of MoCA score, the diagnosing accuracy of MCI based on saccadic parameters resulted with AUROC of 0.911 (95% CI: 0.836-0.972), sensitivity of 0.929 (95% CI, 0.762-1.000) and specificity of 0.796 (95% CI, 0.718-0.863). Conclusions Saccades can distinguish MCI from controls with great accuracy, offering a sensitive and objective diagnostic aid of MCI, especially in participants with borderline cognition.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145730637","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}
Johannes C Michaelian,Kira Trares,Joshua Stevenson-Hoare,Bernd Holleczek,Ben Schöttker,Hermann Brenner
BACKGROUNDWhile previous research has demonstrated that frailty is associated with increased dementia risk over time, large multi-decade prospective population-based cohort studies remain limited. Furthermore, the association between lower grip strength and blood-based biomarkers of neuropathology and global cognitive function remains under-investigated.METHODSWe investigated the relationship between varying levels of baseline frailty (measured using a deficit accumulation Frailty Index) and dementia incidence over 17 years, as well as associations of grip strength (hand, pinch and key, assessed at 8- and 14-year follow-up) with blood-based biomarkers of neuropathology (year 8) and with global cognitive function (year 14) in a population-representative cohort of 9,940 mid-to-late life (50-75 years) individuals.RESULTSIn a subsample of 6,357 participants with available dementia information at 17-year follow-up (mean age at baseline [SD], 61.7 [6.6] years; female, 54.3%), 516 received an all-cause dementia diagnosis. Over this time, individuals in the highest frailty index quintile demonstrated a significantly higher risk of all-cause dementia (HR, 1.75; 95% CI, 1.18-2.60) and a vascular dementia diagnosis (HR, 2.44; 95% CI, 1.22-4.91). Cross-sectionally, lower handgrip strength was associated with elevated blood levels of NfL (β=-0.01, p=0.007) and pTau181 (β=-0.004, p=0.017) at 8-year follow-up, as well as poorer cognitive function on the Montreal Cognitive Assessment (MoCA) (β = 0.02, p=0.037) at 14-year follow-up.CONCLUSIONSThis study strengthens evidence that frailty is a risk factor for dementia in mid-to-late life. It also suggests that it is of considerable importance to assess frailty and grip strength in individuals 'at risk' of cognitive decline.
{"title":"TITLE: Frailty, grip strength, blood-based biomarkers of neuropathology and incident dementia: a 17-year longitudinal population study.","authors":"Johannes C Michaelian,Kira Trares,Joshua Stevenson-Hoare,Bernd Holleczek,Ben Schöttker,Hermann Brenner","doi":"10.1093/gerona/glaf268","DOIUrl":"https://doi.org/10.1093/gerona/glaf268","url":null,"abstract":"BACKGROUNDWhile previous research has demonstrated that frailty is associated with increased dementia risk over time, large multi-decade prospective population-based cohort studies remain limited. Furthermore, the association between lower grip strength and blood-based biomarkers of neuropathology and global cognitive function remains under-investigated.METHODSWe investigated the relationship between varying levels of baseline frailty (measured using a deficit accumulation Frailty Index) and dementia incidence over 17 years, as well as associations of grip strength (hand, pinch and key, assessed at 8- and 14-year follow-up) with blood-based biomarkers of neuropathology (year 8) and with global cognitive function (year 14) in a population-representative cohort of 9,940 mid-to-late life (50-75 years) individuals.RESULTSIn a subsample of 6,357 participants with available dementia information at 17-year follow-up (mean age at baseline [SD], 61.7 [6.6] years; female, 54.3%), 516 received an all-cause dementia diagnosis. Over this time, individuals in the highest frailty index quintile demonstrated a significantly higher risk of all-cause dementia (HR, 1.75; 95% CI, 1.18-2.60) and a vascular dementia diagnosis (HR, 2.44; 95% CI, 1.22-4.91). Cross-sectionally, lower handgrip strength was associated with elevated blood levels of NfL (β=-0.01, p=0.007) and pTau181 (β=-0.004, p=0.017) at 8-year follow-up, as well as poorer cognitive function on the Montreal Cognitive Assessment (MoCA) (β = 0.02, p=0.037) at 14-year follow-up.CONCLUSIONSThis study strengthens evidence that frailty is a risk factor for dementia in mid-to-late life. It also suggests that it is of considerable importance to assess frailty and grip strength in individuals 'at risk' of cognitive decline.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"138 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688982","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}
BACKGROUNDThe aim of this study was to explore the developmental trajectories of social participation and cognitive function, as well as their interaction.METHODSThe study enrolled 6,242 participants from the China Health and Retirement Longitudinal Study, with a mean age (SD) of 58.81 (7.94) years and 45.3% being female. Linear mixed models (LMM) were used in the research to examine the association between social participation and cognitive function. Then, we performed latent growth curve models (LGCM) and cross-lagged panel models (CLPM) to explore the 5-year bidirectional causal relationship from 2015 to 2020.RESULTSDuring the five-year follow-up (2015, 2018, & 2020), baseline social participation was related to subsequent cognitive function (β = 0.190, 95% CI: 0.138-0.244, P < 0.001), mental intactness (β = 0.092, 95% CI: 0.056-0.128, P < 0.001) and episodic memory (β = 0.099, 95% CI: 0.068-0.129, P < 0.001). Baseline cognitive function (β = 0.033, 95% CI: 0.021-0.045, P < 0.001), mental intactness (β = 0.035, 95% CI: 0.017-0.052, P < 0.001) and episodic memory (β = 0.050, 95% CI: 0.029-0.070, P < 0.001) were significantly related to subsequent social participation. LGCM showed that the level of social participation increases, while cognitive function remains stable, with the initial levels of both factors mutually influencing each other. The rate of change in social participation significantly predicts the rate of change in cognitive function, and vice versa. CLPM results further support the bidirectional causal relationship.CONCLUSIONOur study reveals the intricate dynamic association between social participation and cognitive function. The findings support the positive effects of social participation on healthy cognitive aging, while robust cognitive function enhances social participation in late midlife and older adulthood.
本研究旨在探讨社会参与与认知功能的发展轨迹及其相互作用。方法从中国健康与退休纵向研究中招募6242名参与者，平均年龄（SD）为58.81（7.94）岁，其中45.3%为女性。采用线性混合模型（LMM）研究社会参与与认知功能之间的关系。利用潜在增长曲线模型（LGCM）和交叉滞后面板模型（CLPM）分析了2015 - 2020年的5年双向因果关系。结果在5年随访期间（2015年、2018年和2020年），基线社会参与与随后的认知功能（β = 0.190, 95% CI: 0.138-0.244, P < 0.001）、精神完整性（β = 0.092, 95% CI: 0.056-0.128, P < 0.001）和情景记忆（β = 0.099, 95% CI: 0.068-0.129, P < 0.001）相关。基线认知功能（β = 0.033, 95% CI: 0.021-0.045, P < 0.001）、精神完整性（β = 0.035, 95% CI: 0.017-0.052, P < 0.001）和情景记忆（β = 0.050, 95% CI: 0.029-0.070, P < 0.001）与随后的社会参与显著相关。LGCM表明，社会参与水平提高，认知功能保持稳定，两者的初始水平相互影响。社会参与的变化率显著地预测了认知功能的变化率，反之亦然。CLPM结果进一步支持双向因果关系。结论本研究揭示了社会参与与认知功能之间复杂的动态关联。研究结果支持社会参与对健康认知衰老的积极影响，而强健的认知功能可以促进中年晚期和老年的社会参与。
{"title":"The Dynamic Trends and Causal Effects of Social Participation and Cognitive Function Among Middle-Aged and Older Adults: A Longitudinal Study in China.","authors":"Lin Sun,Jingru Wang,Yuting Kang,Pengjun Zhang","doi":"10.1093/gerona/glaf266","DOIUrl":"https://doi.org/10.1093/gerona/glaf266","url":null,"abstract":"BACKGROUNDThe aim of this study was to explore the developmental trajectories of social participation and cognitive function, as well as their interaction.METHODSThe study enrolled 6,242 participants from the China Health and Retirement Longitudinal Study, with a mean age (SD) of 58.81 (7.94) years and 45.3% being female. Linear mixed models (LMM) were used in the research to examine the association between social participation and cognitive function. Then, we performed latent growth curve models (LGCM) and cross-lagged panel models (CLPM) to explore the 5-year bidirectional causal relationship from 2015 to 2020.RESULTSDuring the five-year follow-up (2015, 2018, & 2020), baseline social participation was related to subsequent cognitive function (β = 0.190, 95% CI: 0.138-0.244, P < 0.001), mental intactness (β = 0.092, 95% CI: 0.056-0.128, P < 0.001) and episodic memory (β = 0.099, 95% CI: 0.068-0.129, P < 0.001). Baseline cognitive function (β = 0.033, 95% CI: 0.021-0.045, P < 0.001), mental intactness (β = 0.035, 95% CI: 0.017-0.052, P < 0.001) and episodic memory (β = 0.050, 95% CI: 0.029-0.070, P < 0.001) were significantly related to subsequent social participation. LGCM showed that the level of social participation increases, while cognitive function remains stable, with the initial levels of both factors mutually influencing each other. The rate of change in social participation significantly predicts the rate of change in cognitive function, and vice versa. CLPM results further support the bidirectional causal relationship.CONCLUSIONOur study reveals the intricate dynamic association between social participation and cognitive function. The findings support the positive effects of social participation on healthy cognitive aging, while robust cognitive function enhances social participation in late midlife and older adulthood.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688979","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}
Federico Bellelli, Maria Cristina Ferrara, Alice Margherita Ornago, Elena Pinardi, Alberto Finazzi, Ernesto Consorti, Davide Angioni, Chukwuma Okoye, Giuseppe Bellelli
Background Benzodiazepines (BZDs) are commonly used in older populations despite their association with multiple adverse outcomes. However, the impact of continuing versus deprescribing BZDs during hospitalization on short-term mortality after discharge remains uncertain. This study aims to evaluate the association of BZD-use at hospital discharge with 6-month mortality and explore whether in-hospital deprescribing modifies mortality risk. Methods This is a retrospective analysis of prospectively collected data from patients (aged 66–101 years) consecutively admitted to an Acute Geriatric Unit (AGU). Upon admission, all patients underwent a Comprehensive Geriatric Assessment (CGA), including functional status, comorbidities, and medications review. A multivariable Cox-regression model was used to evaluate the relationship between 6-month mortality and BZD prescription at hospital discharge (BZD non-users, BZD at discharge, and BZD deprescribed). Results Overall, 1375 patients (median age: 85.5 [IQR: 48-77, 55% females]) were included. Following therapeutic reconciliation, the BZD at discharge group was younger (p = 0.029), had lower frailty (p = 0.031), cognitive decline (p = 0.043) and in-hospital delirium (p < 0.001) prevalence than the BZD non-users and BZD deprescribed groups. The BZD at discharge group (n = 130) showed a higher risk of all-cause 6-month mortality compared to BZD non-users (n = 1066) (HR: 1.64; 95%CI: 1.14-2.37). Conversely, patients in whom BZDs were deprescribed during hospitalization (n = 179) exhibited a similar mortality risk as non-users (HR: 0.97; 95%CI: 0.68–1.39). Conclusions BZDs prescription on hospital discharge was associated with an increased risk of 6-month mortality, whereas deprescription may mitigate this excess risk. Our data suggest that hospitalization may represent an opportunity to safely deprescribe BZDs in a controlled setting.
{"title":"Benzodiazepine Exposure and 6-Month Mortality in Older Adults Post-Hospitalization: Time to Consider Deprescribing?","authors":"Federico Bellelli, Maria Cristina Ferrara, Alice Margherita Ornago, Elena Pinardi, Alberto Finazzi, Ernesto Consorti, Davide Angioni, Chukwuma Okoye, Giuseppe Bellelli","doi":"10.1093/gerona/glaf260","DOIUrl":"https://doi.org/10.1093/gerona/glaf260","url":null,"abstract":"Background Benzodiazepines (BZDs) are commonly used in older populations despite their association with multiple adverse outcomes. However, the impact of continuing versus deprescribing BZDs during hospitalization on short-term mortality after discharge remains uncertain. This study aims to evaluate the association of BZD-use at hospital discharge with 6-month mortality and explore whether in-hospital deprescribing modifies mortality risk. Methods This is a retrospective analysis of prospectively collected data from patients (aged 66–101 years) consecutively admitted to an Acute Geriatric Unit (AGU). Upon admission, all patients underwent a Comprehensive Geriatric Assessment (CGA), including functional status, comorbidities, and medications review. A multivariable Cox-regression model was used to evaluate the relationship between 6-month mortality and BZD prescription at hospital discharge (BZD non-users, BZD at discharge, and BZD deprescribed). Results Overall, 1375 patients (median age: 85.5 [IQR: 48-77, 55% females]) were included. Following therapeutic reconciliation, the BZD at discharge group was younger (p = 0.029), had lower frailty (p = 0.031), cognitive decline (p = 0.043) and in-hospital delirium (p &lt; 0.001) prevalence than the BZD non-users and BZD deprescribed groups. The BZD at discharge group (n = 130) showed a higher risk of all-cause 6-month mortality compared to BZD non-users (n = 1066) (HR: 1.64; 95%CI: 1.14-2.37). Conversely, patients in whom BZDs were deprescribed during hospitalization (n = 179) exhibited a similar mortality risk as non-users (HR: 0.97; 95%CI: 0.68–1.39). Conclusions BZDs prescription on hospital discharge was associated with an increased risk of 6-month mortality, whereas deprescription may mitigate this excess risk. Our data suggest that hospitalization may represent an opportunity to safely deprescribe BZDs in a controlled setting.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"165 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145593723","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}
BACKGROUNDPreclinical Mobility Limitations (PCML) represent an early transitional stage in which individuals compensate for functional decline, yet do not exhibit overt disability. Recognition of PCML may identify individuals at elevated risk for future disability. Despite its importance, PCML has been understudied using nationally representative datasets. The purpose of this study is to operationalize and validate PCML using the National Health and Aging Trends Study (NHATS) and to examine its prevalence among community dwelling older adults.METHODSWe analyzed 4,566 participants from NHATS 2022/2023. PCML was operationalized based on expert consensus, incorporating task modifications and reduction in frequency of tasks without overt difficulty. We examined the prevalence of PCML and its association with sociodemographic and health factors. Concurrent validity was assessed using the Short Physical Performance Battery (SPPB) measure and an assessment of participation restrictions. We evaluated whether PCML predicts incident manifest limitations one year later using logistic multivariate regression models.RESULTSPCML was identified in 46.8% of older adults and was more prevalent among those that were between the ages of 75-84 years and women. The mean SPPB composite score for those with PCML was 9.7 out of 12 and 30.6% reported participation restrictions. Those with PCML had 1.8 times increased odds of developing manifest limitations within one year, compared to those without PCML.CONCLUSIONSThis PCML measure has strong criterion validity, highlighting its utility as an early marker of functional decline. Screening for PCML in primary care may provide opportunities to prevent mobility disability and improve quality of life among older adults.
{"title":"Preclinical Mobility Limitations Amongst Community Dwelling Older Adults Using the National Health and Aging Trends Study.","authors":"Pallavi Tyagi,Luisa Franzini,Jie Chen","doi":"10.1093/gerona/glaf257","DOIUrl":"https://doi.org/10.1093/gerona/glaf257","url":null,"abstract":"BACKGROUNDPreclinical Mobility Limitations (PCML) represent an early transitional stage in which individuals compensate for functional decline, yet do not exhibit overt disability. Recognition of PCML may identify individuals at elevated risk for future disability. Despite its importance, PCML has been understudied using nationally representative datasets. The purpose of this study is to operationalize and validate PCML using the National Health and Aging Trends Study (NHATS) and to examine its prevalence among community dwelling older adults.METHODSWe analyzed 4,566 participants from NHATS 2022/2023. PCML was operationalized based on expert consensus, incorporating task modifications and reduction in frequency of tasks without overt difficulty. We examined the prevalence of PCML and its association with sociodemographic and health factors. Concurrent validity was assessed using the Short Physical Performance Battery (SPPB) measure and an assessment of participation restrictions. We evaluated whether PCML predicts incident manifest limitations one year later using logistic multivariate regression models.RESULTSPCML was identified in 46.8% of older adults and was more prevalent among those that were between the ages of 75-84 years and women. The mean SPPB composite score for those with PCML was 9.7 out of 12 and 30.6% reported participation restrictions. Those with PCML had 1.8 times increased odds of developing manifest limitations within one year, compared to those without PCML.CONCLUSIONSThis PCML measure has strong criterion validity, highlighting its utility as an early marker of functional decline. Screening for PCML in primary care may provide opportunities to prevent mobility disability and improve quality of life among older adults.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145559223","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}
Jennifer S Albrecht,Jay S Magaziner,Jason R Falvey
BACKGROUNDTraumatic brain injury (TBI) is a serious full-related injury that could occur simultaneously during the fall that resulted in hip fracture. The objective of the current study was to estimate the impact of TBI on days at home (DAH) among older adults hospitalized with hip fracture.METHODSWe identified community-dwelling Medicare beneficiaries aged 65 and older and hospitalized with hip fracture hospitalized with hip fracture 2010-2017 from Medicare administrative claims data. TBI was identified during the hospitalization episode. DAH was calculated by subtracting the number of days spent in an inpatient, skilled nursing facility, nursing home, emergency department observation, or outpatient observation setting, and the number of days spent deceased, from the total follow-up available for each of the twelve follow-up months (ie 365 days). We modelled the sum of DAH as a function of TBI using overlap weighting in a Poisson regression model.RESULTSAmong 101,196 Medicare beneficiaries hospitalized with hip fracture between 2010-2017, average age was 83.5 (SD 8.1), 72.7% were female, and and 3,121 (3.1%) met our criteria for concurrent TBI. Beneficiaries with TBI were older with a higher burden of comorbidities and more likely to die during the 12-month follow-up. Beneficiaries with TBI had fewer DAH after hip fracture (199.7 (SD 140.9) vs. 229.7 (SD 133.9), p<.001). Following overlap weighting, TBI was associated with significantly reduced DAH (rate ratio 0.90; 95% confidence interval 0.90, 0.91).CONCLUSIONSResults suggest that any head injury in the setting of hip fracture may confer meaningful morbidity beyond the already well-documented increases in mortality. Future studies should examine whether improved management of TBI would optimize recovery following hip fracture.
{"title":"Impact of Traumatic Brain Injury on Recovery over the Year Following Hip Fracture among Older Medicare Beneficiaries.","authors":"Jennifer S Albrecht,Jay S Magaziner,Jason R Falvey","doi":"10.1093/gerona/glaf256","DOIUrl":"https://doi.org/10.1093/gerona/glaf256","url":null,"abstract":"BACKGROUNDTraumatic brain injury (TBI) is a serious full-related injury that could occur simultaneously during the fall that resulted in hip fracture. The objective of the current study was to estimate the impact of TBI on days at home (DAH) among older adults hospitalized with hip fracture.METHODSWe identified community-dwelling Medicare beneficiaries aged 65 and older and hospitalized with hip fracture hospitalized with hip fracture 2010-2017 from Medicare administrative claims data. TBI was identified during the hospitalization episode. DAH was calculated by subtracting the number of days spent in an inpatient, skilled nursing facility, nursing home, emergency department observation, or outpatient observation setting, and the number of days spent deceased, from the total follow-up available for each of the twelve follow-up months (ie 365 days). We modelled the sum of DAH as a function of TBI using overlap weighting in a Poisson regression model.RESULTSAmong 101,196 Medicare beneficiaries hospitalized with hip fracture between 2010-2017, average age was 83.5 (SD 8.1), 72.7% were female, and and 3,121 (3.1%) met our criteria for concurrent TBI. Beneficiaries with TBI were older with a higher burden of comorbidities and more likely to die during the 12-month follow-up. Beneficiaries with TBI had fewer DAH after hip fracture (199.7 (SD 140.9) vs. 229.7 (SD 133.9), p<.001). Following overlap weighting, TBI was associated with significantly reduced DAH (rate ratio 0.90; 95% confidence interval 0.90, 0.91).CONCLUSIONSResults suggest that any head injury in the setting of hip fracture may confer meaningful morbidity beyond the already well-documented increases in mortality. Future studies should examine whether improved management of TBI would optimize recovery following hip fracture.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145559219","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}
Qifan Li,Zhiqiang Shao,Cheng Chen,Zonghan Xu,Jiaqian Wang
Aging cells in the bone marrow contribute to bone aging and related diseases. By combining single-cell and bulk RNA analysis, we aim to better understand the changes in the bone marrow micro-environment caused by aging. We established single-cell profiles of bone marrow from young and aging mice to identify cell types that exhibited significant aging-related changes. And differential gene enrichment analysis and cell-cell communication analysis were conducted on cells with significant changes. Then, we validated the enrichment analysis results using bulk RNA sequencing. Based on sequencing data and machine learning, we identified key genes involved in cellular aging. And the best anti-aging drugs were screened through molecular docking. Finally, the communication between cells, effectiveness of drugs and key genes were validated through experiments. In the aged bone marrow, the content of mesenchymal stem cells (BMSCs) and macrophages (BMMs) significantly increases. The aging of bone marrow is related to cellular fibrosis, immune inflammatory response, resulting in reduced ossification and enhanced osteoclast differentiation. Aging BMSCs secrete various cytokines to promote the aging of BMMs, such as adiponectin, annexin, and galectin. The effect of aging BMMs on BMSCs is relatively small. CADM1 and FAP may be key targets for BMSCs and BMMs aging. Rapamycin has the highest binding affinity with target gene and can to some extent reverse the aging of bone marrow cells. Aged bone marrow cells can further spread aging, and the interaction between bone marrow cells helps us better understand bone aging.
{"title":"Single-cell RNA sequencing analysis combined with bulk RNA sequencing revealed changes in the micro-environment of bone marrow aging.","authors":"Qifan Li,Zhiqiang Shao,Cheng Chen,Zonghan Xu,Jiaqian Wang","doi":"10.1093/gerona/glaf261","DOIUrl":"https://doi.org/10.1093/gerona/glaf261","url":null,"abstract":"Aging cells in the bone marrow contribute to bone aging and related diseases. By combining single-cell and bulk RNA analysis, we aim to better understand the changes in the bone marrow micro-environment caused by aging. We established single-cell profiles of bone marrow from young and aging mice to identify cell types that exhibited significant aging-related changes. And differential gene enrichment analysis and cell-cell communication analysis were conducted on cells with significant changes. Then, we validated the enrichment analysis results using bulk RNA sequencing. Based on sequencing data and machine learning, we identified key genes involved in cellular aging. And the best anti-aging drugs were screened through molecular docking. Finally, the communication between cells, effectiveness of drugs and key genes were validated through experiments. In the aged bone marrow, the content of mesenchymal stem cells (BMSCs) and macrophages (BMMs) significantly increases. The aging of bone marrow is related to cellular fibrosis, immune inflammatory response, resulting in reduced ossification and enhanced osteoclast differentiation. Aging BMSCs secrete various cytokines to promote the aging of BMMs, such as adiponectin, annexin, and galectin. The effect of aging BMMs on BMSCs is relatively small. CADM1 and FAP may be key targets for BMSCs and BMMs aging. Rapamycin has the highest binding affinity with target gene and can to some extent reverse the aging of bone marrow cells. Aged bone marrow cells can further spread aging, and the interaction between bone marrow cells helps us better understand bone aging.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145559220","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}
Ramkrishna K Singh,Semere Bekena,Yiqi Zhu,Paris B Adkins-Jackson,Beau M Ances,Ganesh M Babulal
BACKGROUNDPlasma biomarkers, such as neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), phosphorylated tau (pTau217), and total tau (tTau), are associated with cognitive decline. However, the role of sleep quality in modifying these associations remains unclear. This study examines whether subjective sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), modifies the associations between plasma biomarkers and cognitive performance.METHODSWe analyzed cross-sectional data from 491 adults aged 36 years or older in the Aging Adult Brain Connectome study. Plasma levels of NfL, GFAP, pTau217, and total tTau were measured. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) and the Preclinical Alzheimer's Cognitive Composite (PACC). Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Generalized linear models were used to test main and moderation effects while adjusting for demographics. Sensitivity analyses included APOE ε4 status and body mass index.RESULTSHigher plasma levels of NfL, GFAP, and pTau217 were associated with lower cognitive performance on both MoCA and PACC (all P < 0.05). Poorer sleep quality was independently associated with worse PACC outcomes. Critically, significant moderation effects were observed: PSQI moderated the negative associations between GFAP and both PACC (β = 0.0003, P = 0.039) and MoCA (β = 0.0019, P = 0.021), and between pTau217 and MoCA (β = 0.0299, P = 0.004), indicating a synergistic relationship between sleep quality and glial/amyloid-related pathology in cognitive aging.CONCLUSIONSleep quality modifies biomarker-cognition associations, highlighting its potential as a behavioral target to support brain health.
血浆生物标志物，如神经丝轻链（NfL）、胶质纤维酸性蛋白（GFAP）、磷酸化tau蛋白（pTau217）和总tau蛋白（tTau），与认知能力下降有关。然而，睡眠质量在调节这些关联中的作用仍不清楚。这项研究考察了匹兹堡睡眠质量指数（PSQI）测量的主观睡眠质量是否会改变血浆生物标志物与认知表现之间的关系。方法：我们分析了491名年龄在36岁及以上的成人脑连接组研究的横断面数据。测定血浆中NfL、GFAP、pTau217和总tTau水平。认知表现采用蒙特利尔认知评估（MoCA）和临床前阿尔茨海默氏症认知复合（PACC）进行评估。使用匹兹堡睡眠质量指数（PSQI）测量睡眠质量。在调整人口统计数据时，使用广义线性模型来检验主效应和适度效应。敏感性分析包括APOE ε4状态和体重指数。结果血浆中NfL、GFAP和pTau217水平升高与MoCA和PACC认知能力下降相关（均P < 0.05）。较差的睡眠质量与较差的PACC结果独立相关。重要的是，观察到显著的调节效应：PSQI调节了GFAP与PACC （β = 0.0003, P = 0.039）和MoCA （β = 0.0019, P = 0.021）以及pTau217与MoCA （β = 0.0299, P = 0.004）之间的负相关，表明睡眠质量与认知衰老中胶质/淀粉样蛋白相关病理之间存在协同关系。结论：睡眠质量可以改变生物标志物与认知之间的关联，强调其作为支持大脑健康的行为靶点的潜力。
{"title":"Sleep Quality as a Modifier of Plasma pTau217 and GFAP Associations with Cognitive Function.","authors":"Ramkrishna K Singh,Semere Bekena,Yiqi Zhu,Paris B Adkins-Jackson,Beau M Ances,Ganesh M Babulal","doi":"10.1093/gerona/glaf259","DOIUrl":"https://doi.org/10.1093/gerona/glaf259","url":null,"abstract":"BACKGROUNDPlasma biomarkers, such as neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), phosphorylated tau (pTau217), and total tau (tTau), are associated with cognitive decline. However, the role of sleep quality in modifying these associations remains unclear. This study examines whether subjective sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), modifies the associations between plasma biomarkers and cognitive performance.METHODSWe analyzed cross-sectional data from 491 adults aged 36 years or older in the Aging Adult Brain Connectome study. Plasma levels of NfL, GFAP, pTau217, and total tTau were measured. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) and the Preclinical Alzheimer's Cognitive Composite (PACC). Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Generalized linear models were used to test main and moderation effects while adjusting for demographics. Sensitivity analyses included APOE ε4 status and body mass index.RESULTSHigher plasma levels of NfL, GFAP, and pTau217 were associated with lower cognitive performance on both MoCA and PACC (all P < 0.05). Poorer sleep quality was independently associated with worse PACC outcomes. Critically, significant moderation effects were observed: PSQI moderated the negative associations between GFAP and both PACC (β = 0.0003, P = 0.039) and MoCA (β = 0.0019, P = 0.021), and between pTau217 and MoCA (β = 0.0299, P = 0.004), indicating a synergistic relationship between sleep quality and glial/amyloid-related pathology in cognitive aging.CONCLUSIONSleep quality modifies biomarker-cognition associations, highlighting its potential as a behavioral target to support brain health.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145559215","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}
Lisa R Larowe,Heily Chavez Granados,Lisa L Philpotts,Ana-Maria Vranceanu,Christine S Ritchie
BACKGROUNDPain and alcohol use are highly prevalent and frequently co-occur among older adults. An established reciprocal model suggests that pain and alcohol use interact in the manner of a positive feedback loop. However, older adults have been underrepresented in this work.METHODSWe conducted a scoping review to answer the following research questions: (a) What is known regarding the effects of alcohol use on pain among older adults? and (b) What is known regarding the effects of pain on alcohol use among older adults?RESULTSA total of 15 studies describing interrelationships between pain and alcohol use among older adults were identified and described in this review.CONCLUSIONSFindings provided convergent evidence that pain can motivate alcohol use in older adults. The effects of alcohol use on longer-term pain outcomes are less clear in this population. Major gaps and directions for future research are described.
{"title":"Bidirectional Relationships between Pain and Alcohol Use among Older Adults: A Scoping Review.","authors":"Lisa R Larowe,Heily Chavez Granados,Lisa L Philpotts,Ana-Maria Vranceanu,Christine S Ritchie","doi":"10.1093/gerona/glaf258","DOIUrl":"https://doi.org/10.1093/gerona/glaf258","url":null,"abstract":"BACKGROUNDPain and alcohol use are highly prevalent and frequently co-occur among older adults. An established reciprocal model suggests that pain and alcohol use interact in the manner of a positive feedback loop. However, older adults have been underrepresented in this work.METHODSWe conducted a scoping review to answer the following research questions: (a) What is known regarding the effects of alcohol use on pain among older adults? and (b) What is known regarding the effects of pain on alcohol use among older adults?RESULTSA total of 15 studies describing interrelationships between pain and alcohol use among older adults were identified and described in this review.CONCLUSIONSFindings provided convergent evidence that pain can motivate alcohol use in older adults. The effects of alcohol use on longer-term pain outcomes are less clear in this population. Major gaps and directions for future research are described.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145559217","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}
Sun Jae Park, Hyeokjong Lee, Min Chae Kim, Jaewon Kim, Jihun Song, Hye Jun Kim, Sangwoo Park, Hong Yun Jung, Seung Ju Choi, Youn Jae Lee, Hyoung Gil Yoon, Seong Hyok Kim, Sang Min Park
Background Despite growing concerns over the adverse health effects of air pollution, research on the mortality risk associated with exposure to fine particulate matter (PM) in older adults with asthma remains limited. This study aims to investigate the association between short-term exposure to PM2.5 and mortality risk among older adults with asthma. Methods This study utilized the National Health Insurance Service database in South Korea and included 139,189 individuals aged 65 and older with asthma who died between 2015 and 2021. A time-stratified case-crossover design was applied to assess the short-term effects of air pollution exposure on mortality. The daily average PM2.5 concentrations were calculated for case and referent dates. Conditional logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for mortality across quartiles of PM2.5 exposure, adjusting for environmental variables and holidays. Results The highest quartile of PM2.5 exposure (lag 0) was associated with a higher odds ratio for mortality (aOR 1.048, 95% CI 1.021–1.077, p for trend = 0.022) compared to the lowest quartile. Similar trends were observed for lag 1 (aOR 1.032, 95% CI 1.005–1.060, p for trend = 0.015) and lag 0-1 (aOR 1.022, 95% CI 0.994–1.051, p for trend = 0.008). Conclusion This study provides epidemiological evidence of an association between short-term exposure to PM2.5 and an increased mortality risk among older adults with asthma. These findings highlight the need for targeted preventive management strategies to mitigate health risks associated with short-term PM2.5 exposure, particularly for those vulnerable to air pollution.
背景尽管人们越来越关注空气污染对健康的不良影响，但对老年哮喘患者暴露于细颗粒物（PM）相关的死亡风险的研究仍然有限。本研究旨在调查PM2.5短期暴露与老年哮喘患者死亡风险之间的关系。本研究利用韩国国民健康保险服务数据库，纳入了2015年至2021年间死亡的139189名65岁及以上哮喘患者。采用时间分层病例交叉设计来评估空气污染暴露对死亡率的短期影响。计算了案例和参考日期的PM2.5日均浓度。使用条件逻辑回归来估计PM2.5暴露四分位数死亡率的调整优势比（aORs）和95%置信区间（CIs），并对环境变量和节假日进行调整。结果PM2.5暴露的最高四分位数（滞后0）与死亡率的比值比（aOR 1.048, 95% CI 1.021-1.077， p为趋势值= 0.022）高于最低四分位数。滞后期1 （aOR 1.032, 95% CI 1.005-1.060， p为趋势= 0.015）和滞后期0-1 （aOR 1.022, 95% CI 0.994-1.051， p为趋势= 0.008）也观察到类似的趋势。结论：本研究为短期暴露于PM2.5与老年哮喘患者死亡风险增加之间的关联提供了流行病学证据。这些发现突出表明，需要制定有针对性的预防性管理战略，以减轻与PM2.5短期暴露相关的健康风险，特别是那些易受空气污染影响的人。
{"title":"Short-Term PM2.5 Exposure and Mortality in Older Adults with Asthma in South Korea","authors":"Sun Jae Park, Hyeokjong Lee, Min Chae Kim, Jaewon Kim, Jihun Song, Hye Jun Kim, Sangwoo Park, Hong Yun Jung, Seung Ju Choi, Youn Jae Lee, Hyoung Gil Yoon, Seong Hyok Kim, Sang Min Park","doi":"10.1093/gerona/glaf236","DOIUrl":"https://doi.org/10.1093/gerona/glaf236","url":null,"abstract":"Background Despite growing concerns over the adverse health effects of air pollution, research on the mortality risk associated with exposure to fine particulate matter (PM) in older adults with asthma remains limited. This study aims to investigate the association between short-term exposure to PM2.5 and mortality risk among older adults with asthma. Methods This study utilized the National Health Insurance Service database in South Korea and included 139,189 individuals aged 65 and older with asthma who died between 2015 and 2021. A time-stratified case-crossover design was applied to assess the short-term effects of air pollution exposure on mortality. The daily average PM2.5 concentrations were calculated for case and referent dates. Conditional logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for mortality across quartiles of PM2.5 exposure, adjusting for environmental variables and holidays. Results The highest quartile of PM2.5 exposure (lag 0) was associated with a higher odds ratio for mortality (aOR 1.048, 95% CI 1.021–1.077, p for trend = 0.022) compared to the lowest quartile. Similar trends were observed for lag 1 (aOR 1.032, 95% CI 1.005–1.060, p for trend = 0.015) and lag 0-1 (aOR 1.022, 95% CI 0.994–1.051, p for trend = 0.008). Conclusion This study provides epidemiological evidence of an association between short-term exposure to PM2.5 and an increased mortality risk among older adults with asthma. These findings highlight the need for targeted preventive management strategies to mitigate health risks associated with short-term PM2.5 exposure, particularly for those vulnerable to air pollution.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515882","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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