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}
Kyle J Bourassa,Kirsten H Dillon,Rachel L Rodriguez,Melanie E Garrett,Livia Anderson,Paul A Dennis,Terrie E Moffitt,Avshalom Caspi,Harvey Jay Cohen,Katherine S Hall,Gregory A Taylor,Jennifer C Naylor,Allison E Ashley-Koch,Jean C Beckham,Nathan A Kimbrel,
Injuries characterizing recent military service, such as traumatic brain injury and posttraumatic stress disorder, are linked to accelerated biological aging. If recent veterans have accelerated aging, they might also show early onset of aging-related phenotypes, such as frailty. In this study, we examined the prevalence of frailty and associations with biological aging using data from 1,654 post-9/11 veterans, who were followed for an average of 12.6 years. Biological aging was assessed using DunedinPACE and frailty was assessed using 11 years of Jen Frailty Index scores from electronic health records. We found a high proportion of frailty-25.5% of the post-9/11 veterans met criteria for frailty during the study. This is roughly double the prevalence among community-dwelling older adults, despite the cohort's average age of 50.2 years at study end. Veterans with faster aging had higher initial frailty scores (β, 0.21; 95% CI, 0.15-0.27), higher peak frailty scores (β, 0.24; 95% CI, 0.18-0.30), and larger increases in frailty scores over time (β, 0.15; 95% CI, 0.09-0.21, all ps < .001). Faster aging was associated with a 62% (95% CI, 44%-82%) greater rate of incident frailty over the follow up while accounting for demographics, baseline health, and smoking. These results suggest post-9/11 veterans are at risk of early onset frailty and this increased risk could be explained by accelerated rates of biological aging. Future research should replicate these results in nationally representative samples of post-9/11 veterans and explore whether screening for frailty should be implemented at younger ages for veterans.
{"title":"Accelerated Biological Aging and Midlife Frailty among U.S. Military Veterans.","authors":"Kyle J Bourassa,Kirsten H Dillon,Rachel L Rodriguez,Melanie E Garrett,Livia Anderson,Paul A Dennis,Terrie E Moffitt,Avshalom Caspi,Harvey Jay Cohen,Katherine S Hall,Gregory A Taylor,Jennifer C Naylor,Allison E Ashley-Koch,Jean C Beckham,Nathan A Kimbrel, ","doi":"10.1093/gerona/glaf255","DOIUrl":"https://doi.org/10.1093/gerona/glaf255","url":null,"abstract":"Injuries characterizing recent military service, such as traumatic brain injury and posttraumatic stress disorder, are linked to accelerated biological aging. If recent veterans have accelerated aging, they might also show early onset of aging-related phenotypes, such as frailty. In this study, we examined the prevalence of frailty and associations with biological aging using data from 1,654 post-9/11 veterans, who were followed for an average of 12.6 years. Biological aging was assessed using DunedinPACE and frailty was assessed using 11 years of Jen Frailty Index scores from electronic health records. We found a high proportion of frailty-25.5% of the post-9/11 veterans met criteria for frailty during the study. This is roughly double the prevalence among community-dwelling older adults, despite the cohort's average age of 50.2 years at study end. Veterans with faster aging had higher initial frailty scores (β, 0.21; 95% CI, 0.15-0.27), higher peak frailty scores (β, 0.24; 95% CI, 0.18-0.30), and larger increases in frailty scores over time (β, 0.15; 95% CI, 0.09-0.21, all ps < .001). Faster aging was associated with a 62% (95% CI, 44%-82%) greater rate of incident frailty over the follow up while accounting for demographics, baseline health, and smoking. These results suggest post-9/11 veterans are at risk of early onset frailty and this increased risk could be explained by accelerated rates of biological aging. Future research should replicate these results in nationally representative samples of post-9/11 veterans and explore whether screening for frailty should be implemented at younger ages for veterans.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477695","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}
Nahed El Kassar,Amy E DeZern,Janis Abkowitz,Andrew Artz,Isabel Beerman,Kelly Bolton,Maria M Brooks,Uma Borate,William B Ershler,Tomas Ganz,Theodosia A Kalfa,Alice Kuaban,Sean Leng,Daisuke Nakada,Aziz Nazha,Claudia Grossmann,Michael Pfeilstöcker,Chengxuan Qiu,Jennifer St Sauver,Mikkael A Sekeres,Eleanor M Simonsick,Kenneth E White,Dachuan Zhang,Luigi Ferrucci,George A Kuchel
Approximately 17% of people aged 65 years and older are anemic, and 10% of death certificates report anemia as a secondary cause of death in the US. Nonetheless, anemia remains unexplained in 30-50% of older adults. This unexplained anemia of aging (UAA) is a diagnosis of exclusion. The mechanism, impact, and progression of UAA remain unknown. At older ages, anemia adds to pre-existing co-morbidities with significant adverse health consequences, representing a compelling unmet clinical concern. The National Institute on Aging held a workshop in 2024 to discuss current knowledge and research opportunities. Topics included the epidemiology of anemia at older age, its clinical implications; probable mechanism(s) underlying UAA, ie; low grade inflammation's effects on erythropoiesis; the role of microbiota in iron regulation in bone marrow; the importance of ruling out a diagnosis of leukemic clonal hematopoiesis (CH), which is more prevalent in older age; the role of senescence and aging governing hematopoiesis, and effects of sex hormones on hematopoietic stem cell aging. Understanding the roles of these factors could reduce the proportion of the older anemic population whose anemia remains unexplained and offer insights into new potential diagnostic and intervention strategies. Speakers reviewed previous clinical trials in patients with UAA and CH. They discussed lessons learned, and future research priorities ., including efforts to develop new diagnostic algorithms and potential uses of machine learning.
{"title":"A Proposed Path to Explaining the Unexplained Anemia of Aging.","authors":"Nahed El Kassar,Amy E DeZern,Janis Abkowitz,Andrew Artz,Isabel Beerman,Kelly Bolton,Maria M Brooks,Uma Borate,William B Ershler,Tomas Ganz,Theodosia A Kalfa,Alice Kuaban,Sean Leng,Daisuke Nakada,Aziz Nazha,Claudia Grossmann,Michael Pfeilstöcker,Chengxuan Qiu,Jennifer St Sauver,Mikkael A Sekeres,Eleanor M Simonsick,Kenneth E White,Dachuan Zhang,Luigi Ferrucci,George A Kuchel","doi":"10.1093/gerona/glaf251","DOIUrl":"https://doi.org/10.1093/gerona/glaf251","url":null,"abstract":"Approximately 17% of people aged 65 years and older are anemic, and 10% of death certificates report anemia as a secondary cause of death in the US. Nonetheless, anemia remains unexplained in 30-50% of older adults. This unexplained anemia of aging (UAA) is a diagnosis of exclusion. The mechanism, impact, and progression of UAA remain unknown. At older ages, anemia adds to pre-existing co-morbidities with significant adverse health consequences, representing a compelling unmet clinical concern. The National Institute on Aging held a workshop in 2024 to discuss current knowledge and research opportunities. Topics included the epidemiology of anemia at older age, its clinical implications; probable mechanism(s) underlying UAA, ie; low grade inflammation's effects on erythropoiesis; the role of microbiota in iron regulation in bone marrow; the importance of ruling out a diagnosis of leukemic clonal hematopoiesis (CH), which is more prevalent in older age; the role of senescence and aging governing hematopoiesis, and effects of sex hormones on hematopoietic stem cell aging. Understanding the roles of these factors could reduce the proportion of the older anemic population whose anemia remains unexplained and offer insights into new potential diagnostic and intervention strategies. Speakers reviewed previous clinical trials in patients with UAA and CH. They discussed lessons learned, and future research priorities ., including efforts to develop new diagnostic algorithms and potential uses of machine learning.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477694","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 effect of dietary micronutrient adequacy on hearing loss is unknown. The aim of this study was to examine the cross-sectional association between dietary micronutrient adequacy and hearing loss among community-dwelling older adults.METHODSThis study included 1608 adults aged 65 y from the Seniors-ENRICA-2 cohort. Habitual diet was assessed with a validated computerized diet history. The intakes of 10 micronutrients (calcium, magnesium, potassium, zinc, iodine, vitamins A, C, D, E, and folate) were expressed as percentages relative to dietary reference intakes, with higher scores indicating greater adequacy. Dietary micronutrient adequacy was computed as the average of all nutrient scores. Hearing loss was defined as pure-tone average >40 dB-aHL in the better ear for standard frequency (0.5, 1, and 2 kHz), speech frequency (0.5, 1, 2, and 4 kHz), and high frequency pure tone average (PTA) (3, 4, and 8 kHz). Logistic regression models were conducted, after adjusting for sociodemographic factors, lifestyle, comorbidities, cognitive impairment and hearing-related variables.RESULTSOf the 1608 participants, 813 were men (50.6%); mean (SD) age was 73.8 (4.3) years. The prevalence of hearing loss was 13.3% at speech frequency. A high dietary micronutrient adequacy index was associated with hearing loss: OR (95% CI) for tertile 3 vs. 1 was 0.57 (0.35-0.94) for standard frequency, 0.58 (0.38-0.89) for speech frequency, and 0.69 (0.51-0.93) for high frequency PTA. No differences were observed for the association among the subgroups of participants defined by sex, body mass index, physical activity and chronic diseases.CONCLUSIONHigher dietary-based micronutrient adequacy was associated with lower prevalence of hearing loss across all frequency ranges.
{"title":"Association between a dietary-based micronutrient adequacy index and hearing loss in community-dwelling older adults.","authors":"Humberto Yévenes-Briones,Erika Tapia-Portilla,Veronica Vega-Cabello,Jorge Rey-Martinez,Alberto Lana,Francisco Félix Caballero,Esther Lopez-Garcia","doi":"10.1093/gerona/glaf252","DOIUrl":"https://doi.org/10.1093/gerona/glaf252","url":null,"abstract":"BACKGROUNDThe effect of dietary micronutrient adequacy on hearing loss is unknown. The aim of this study was to examine the cross-sectional association between dietary micronutrient adequacy and hearing loss among community-dwelling older adults.METHODSThis study included 1608 adults aged 65 y from the Seniors-ENRICA-2 cohort. Habitual diet was assessed with a validated computerized diet history. The intakes of 10 micronutrients (calcium, magnesium, potassium, zinc, iodine, vitamins A, C, D, E, and folate) were expressed as percentages relative to dietary reference intakes, with higher scores indicating greater adequacy. Dietary micronutrient adequacy was computed as the average of all nutrient scores. Hearing loss was defined as pure-tone average >40 dB-aHL in the better ear for standard frequency (0.5, 1, and 2 kHz), speech frequency (0.5, 1, 2, and 4 kHz), and high frequency pure tone average (PTA) (3, 4, and 8 kHz). Logistic regression models were conducted, after adjusting for sociodemographic factors, lifestyle, comorbidities, cognitive impairment and hearing-related variables.RESULTSOf the 1608 participants, 813 were men (50.6%); mean (SD) age was 73.8 (4.3) years. The prevalence of hearing loss was 13.3% at speech frequency. A high dietary micronutrient adequacy index was associated with hearing loss: OR (95% CI) for tertile 3 vs. 1 was 0.57 (0.35-0.94) for standard frequency, 0.58 (0.38-0.89) for speech frequency, and 0.69 (0.51-0.93) for high frequency PTA. No differences were observed for the association among the subgroups of participants defined by sex, body mass index, physical activity and chronic diseases.CONCLUSIONHigher dietary-based micronutrient adequacy was associated with lower prevalence of hearing loss across all frequency ranges.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477699","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}
Malcolm P Forbes, Mark W Cox, Katharine Brewster, Mojtaba Lotfaliany, Mohammadreza Mohebbi, Gary Rance, Robyn L Woods, Carlene Britt, John J Mcneil, Michael Berk
Background Hearing loss (HL) is common in older adults and is associated with several adverse health outcomes. Although previous research has demonstrated a link between hearing impairment and depression, most studies have been cross-sectional or relied on a single baseline measure of hearing. Aims To investigate the association between longitudinal, time-varying audiometric measures of hearing and incident depression in older adults. A secondary aim was to assess whether hearing aid use modifies this association over time in those with moderate to severe HL. Methods We included 1,260 participants who underwent pure-tone audiometry at baseline, 18 months, and 36 months. Depression was defined using the CES-D-10 scale, with a cut-score of ≥ 8. Cox proportional hazards analyses were used to examine the link between hearing status (normal, mild HL, moderate/severe HL) and depression, adjusted for demographic, lifestyle, and clinical variables. Results Over a median follow-up of 7.3 years, participants with moderate to severe HL had a higher risk of incident depression (adjusted HR [aHR] 1.24; 95% CI 1.08–1.43, p < 0.01) compared with participants with normal hearing. Hearing aid use (≥ 6 hours self-reported use per day on average) in those with moderate to severe HL was associated with significantly reduced risk of incident depression (aHR 0.65; 95% CI 0.49–0.87, p < 0.01). Conclusion Moderate to severe HL is a significant risk factor for incident depression among older adults. Hearing aid use attenuated this risk. Future research should investigate mechanistic pathways linking HL and mood disturbances.
背景：听力损失（HL）在老年人中很常见，并与几种不良健康结果相关。虽然以前的研究已经证明听力障碍和抑郁症之间存在联系，但大多数研究都是横向的，或者依赖于单一的听力基线测量。目的探讨老年人纵向时变听力测量与抑郁症的关系。第二个目的是评估在中度至重度HL患者中，助听器的使用是否会随着时间的推移改变这种关联。方法我们纳入了1260名参与者，他们在基线、18个月和36个月时接受了纯音听力测量。采用CES-D-10量表定义抑郁，cut-score≥8。Cox比例风险分析用于检查听力状况（正常、轻度HL、中度/重度HL）与抑郁症之间的联系，并根据人口统计学、生活方式和临床变量进行调整。结果在中位随访7.3年期间，与听力正常的参与者相比，中度至重度HL患者发生抑郁症的风险更高（调整后HR [aHR] 1.24; 95% CI 1.08-1.43, p < 0.01）。中度至重度HL患者使用助听器（平均每天自述使用≥6小时）与抑郁症发生风险显著降低相关（aHR 0.65; 95% CI 0.49-0.87, p < 0.01）。结论中重度HL是老年人发生抑郁的重要危险因素。助听器的使用降低了这种风险。未来的研究应探讨HL与情绪障碍之间的机制途径。
{"title":"The Association Between Hearing Impairment and Incident Depression in Older Adults: A Longitudinal Analysis","authors":"Malcolm P Forbes, Mark W Cox, Katharine Brewster, Mojtaba Lotfaliany, Mohammadreza Mohebbi, Gary Rance, Robyn L Woods, Carlene Britt, John J Mcneil, Michael Berk","doi":"10.1093/gerona/glaf250","DOIUrl":"https://doi.org/10.1093/gerona/glaf250","url":null,"abstract":"Background Hearing loss (HL) is common in older adults and is associated with several adverse health outcomes. Although previous research has demonstrated a link between hearing impairment and depression, most studies have been cross-sectional or relied on a single baseline measure of hearing. Aims To investigate the association between longitudinal, time-varying audiometric measures of hearing and incident depression in older adults. A secondary aim was to assess whether hearing aid use modifies this association over time in those with moderate to severe HL. Methods We included 1,260 participants who underwent pure-tone audiometry at baseline, 18 months, and 36 months. Depression was defined using the CES-D-10 scale, with a cut-score of ≥ 8. Cox proportional hazards analyses were used to examine the link between hearing status (normal, mild HL, moderate/severe HL) and depression, adjusted for demographic, lifestyle, and clinical variables. Results Over a median follow-up of 7.3 years, participants with moderate to severe HL had a higher risk of incident depression (adjusted HR [aHR] 1.24; 95% CI 1.08–1.43, p &lt; 0.01) compared with participants with normal hearing. Hearing aid use (≥ 6 hours self-reported use per day on average) in those with moderate to severe HL was associated with significantly reduced risk of incident depression (aHR 0.65; 95% CI 0.49–0.87, p &lt; 0.01). Conclusion Moderate to severe HL is a significant risk factor for incident depression among older adults. Hearing aid use attenuated this risk. Future research should investigate mechanistic pathways linking HL and mood disturbances.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472708","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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