Vincent Weng-Jy Cheung,Michaël Libotte,Patrick Viet-Quoc Nguyen,Thien-Tuong Minh Vu,Jean-Philippe Émond,Ariel Mundo Ortiz,Philippe Desmarais,Quoc Dinh Nguyen
BACKGROUNDMobility is a critical component of health status in hospitalized older adults. Adoption of routine mobility tracking in acute and subacute settings is hampered by lack of automated and standardized measurements. Advances in smartwatch technology and machine learning provide the opportunity to use heart rate (HR) and HR variability data to quantify mobility and activity.METHODSIn this pilot study, we recruited 30 older adults aged 65 years and older in a tertiary care geriatric ward to develop (n = 8) and validate (n = 30) the automated Mobility and Activity Scale (MAS). Twelve features based on smartwatch HR data were used in a random forest model to predict 5 activity levels (0 = sleep to 4 = walking with at least a moderate effort or > 20 minutes). We examined concurrent validity with Hierarchical Assessment of Balance and Mobility (HABAM), gait speed, and functional status, as well as discriminant validity with frailty and multimorbidity. We assessed acceptability of watch wearing for patients and care staff.RESULTSParticipants' mean (SD) age was 86 years (8), 18 (60%) were female, and mean follow-up was 8.3 (5.2) days. Mean (SD) HABAM score was 36 (18) and gait speed was 0.53 (0.26) m/s. Across the cohort, mean (SD) MAS score was 1.2 (1.0) overall and 2.1 (0.7) for 10 most active hours of the day. MAS scores were moderately correlated with HABAM (r = 0.43 [95%CI = 0.07,0.69]) and functional status (r=-0.31 [95%CI=-0.60,0.06]), but not with gait speed (r = 0.02 [95%CI=-0.39,0.42]). MAS scores had no association with frailty or multimorbidity. Smartwatch wearing was acceptable.CONCLUSIONSSmartwatch-derived HR data may quantity hourly mobility and activity of hospitalized older adults and facilitate automated and real-time monitoring.
{"title":"Preliminary Feasibility and Development of a Heart Rate-Based Mobility and Activity Scale for Hospitalized Older Adults (MAS).","authors":"Vincent Weng-Jy Cheung,Michaël Libotte,Patrick Viet-Quoc Nguyen,Thien-Tuong Minh Vu,Jean-Philippe Émond,Ariel Mundo Ortiz,Philippe Desmarais,Quoc Dinh Nguyen","doi":"10.1093/gerona/glaf212","DOIUrl":"https://doi.org/10.1093/gerona/glaf212","url":null,"abstract":"BACKGROUNDMobility is a critical component of health status in hospitalized older adults. Adoption of routine mobility tracking in acute and subacute settings is hampered by lack of automated and standardized measurements. Advances in smartwatch technology and machine learning provide the opportunity to use heart rate (HR) and HR variability data to quantify mobility and activity.METHODSIn this pilot study, we recruited 30 older adults aged 65 years and older in a tertiary care geriatric ward to develop (n = 8) and validate (n = 30) the automated Mobility and Activity Scale (MAS). Twelve features based on smartwatch HR data were used in a random forest model to predict 5 activity levels (0 = sleep to 4 = walking with at least a moderate effort or > 20 minutes). We examined concurrent validity with Hierarchical Assessment of Balance and Mobility (HABAM), gait speed, and functional status, as well as discriminant validity with frailty and multimorbidity. We assessed acceptability of watch wearing for patients and care staff.RESULTSParticipants' mean (SD) age was 86 years (8), 18 (60%) were female, and mean follow-up was 8.3 (5.2) days. Mean (SD) HABAM score was 36 (18) and gait speed was 0.53 (0.26) m/s. Across the cohort, mean (SD) MAS score was 1.2 (1.0) overall and 2.1 (0.7) for 10 most active hours of the day. MAS scores were moderately correlated with HABAM (r = 0.43 [95%CI = 0.07,0.69]) and functional status (r=-0.31 [95%CI=-0.60,0.06]), but not with gait speed (r = 0.02 [95%CI=-0.39,0.42]). MAS scores had no association with frailty or multimorbidity. Smartwatch wearing was acceptable.CONCLUSIONSSmartwatch-derived HR data may quantity hourly mobility and activity of hospitalized older adults and facilitate automated and real-time monitoring.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195006","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}
BACKGROUNDDepression among older adults is a growing concern globally, influenced by both environmental stressors and individual health conditions. This study examines the impact of heatwave exposure and multimorbidity on depressive symptom trajectories among older Chinese adults.METHODSData from 3,819 adults aged 60 and above across five waves of the China Health and Retirement Longitudinal Study (CHARLS) were analyzed. Latent growth curve modeling (LGCM) identified depressive trajectories, and machine learning algorithms (Random Forest, Decision Tree, XGBoost, and SVM) were applied to predict trajectory categories. Multinomial logistic regression further explored the moderating effects of multimorbidity on the heatwave-depression relationship.RESULTSFive distinct depressive symptom trajectories were identified: consistently high, high but decreasing, consistently low, high and increasing, and low but increasing. Heatwave exposure was associated with a higher likelihood of persistent or worsening depressive symptoms, particularly among individuals with multimorbidity. Machine learning analysis highlighted maximum temperature as one of the most influential predictors, and further demonstrated that multimorbidity amplified the effect of heatwave exposure on depression trajectories. Multinomial logistic regression confirmed that individuals with multimorbidity were significantly more likely to exhibit worsening depressive symptoms when exposed to elevated temperatures.CONCLUSIONSThis study highlights the vulnerability of older adults with multimorbidity to worsened depression under heatwave exposure, emphasizing the need for tailored mental health interventions. Integrating climate adaptation and multimorbidity care is crucial for mitigating mental health impacts in this population. Policymakers should prioritize targeted interventions, incorporating climate adaptation and heatwave preparedness into mental health protocols to reduce adverse outcomes.
{"title":"Association of Heatwave Exposure and Multimorbidity with Depression Trajectories among Older Adults: Evidence from CHARLS.","authors":"Boye Fang,Youwei Wang,Xubao Li,Yanbi Hong","doi":"10.1093/gerona/glaf209","DOIUrl":"https://doi.org/10.1093/gerona/glaf209","url":null,"abstract":"BACKGROUNDDepression among older adults is a growing concern globally, influenced by both environmental stressors and individual health conditions. This study examines the impact of heatwave exposure and multimorbidity on depressive symptom trajectories among older Chinese adults.METHODSData from 3,819 adults aged 60 and above across five waves of the China Health and Retirement Longitudinal Study (CHARLS) were analyzed. Latent growth curve modeling (LGCM) identified depressive trajectories, and machine learning algorithms (Random Forest, Decision Tree, XGBoost, and SVM) were applied to predict trajectory categories. Multinomial logistic regression further explored the moderating effects of multimorbidity on the heatwave-depression relationship.RESULTSFive distinct depressive symptom trajectories were identified: consistently high, high but decreasing, consistently low, high and increasing, and low but increasing. Heatwave exposure was associated with a higher likelihood of persistent or worsening depressive symptoms, particularly among individuals with multimorbidity. Machine learning analysis highlighted maximum temperature as one of the most influential predictors, and further demonstrated that multimorbidity amplified the effect of heatwave exposure on depression trajectories. Multinomial logistic regression confirmed that individuals with multimorbidity were significantly more likely to exhibit worsening depressive symptoms when exposed to elevated temperatures.CONCLUSIONSThis study highlights the vulnerability of older adults with multimorbidity to worsened depression under heatwave exposure, emphasizing the need for tailored mental health interventions. Integrating climate adaptation and multimorbidity care is crucial for mitigating mental health impacts in this population. Policymakers should prioritize targeted interventions, incorporating climate adaptation and heatwave preparedness into mental health protocols to reduce adverse outcomes.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"115 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189372","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 Tooth loss has been associated with cognitive function in older adults. We aimed to explore the mechanism between tooth loss and cognitive decline in these specific populations, which has been scarcely studied. Methods This study used the Longitudinal data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to build a linear mixed effects model to explore the impact of tooth loss on cognitive function in older adults. The effect of wearing dentures on the above effects was also evaluated. In addition, through mediation analysis, this study studied the mediating role of dietary diversity in the relationship between tooth loss and cognitive function. Results A total of 8283 older adults aged ≥65 years were included in this study. Maintaining ≥20 teeth was associated with better cognitive function (β = 0.338, 95% confidence interval [CI]: 0.229∼0.447), and so was denture wearing (β = 0.449, 95%CI: 0.351∼0.547). However, there was no significant difference in cognitive function between the older adults with < 20 teeth and dentures and those with ≥20 teeth (β = 0.084, 95%CI: -0.035∼0.203). The total effect and direct effect of tooth number on cognitive function were 0.201 (95%CI: 0.096-0.306) and 0.177 (95%CI: 0.072-0.282), respectively. The indirect effect of dietary diversity was 0.023 (95% CI: 0.010∼0.037), accounting for 11.65% of the total effect. Conclusions In Chinese older adults, more teeth were associated with better cognitive function. Denture wearing reduced the risk of cognitive decline caused by tooth loss to a certain extent. Dietary diversity mediated the relationship between tooth number and cognitive function.
{"title":"Influence of the number of teeth on the cognitive function of older adults: an intermediary analysis based on dietary diversity","authors":"Shiyi Liao, Sailong Shi, Zhujun Chong, Chuiran Kong, Xuerui Chen, Peiyuan Qiu","doi":"10.1093/gerona/glaf213","DOIUrl":"https://doi.org/10.1093/gerona/glaf213","url":null,"abstract":"Background Tooth loss has been associated with cognitive function in older adults. We aimed to explore the mechanism between tooth loss and cognitive decline in these specific populations, which has been scarcely studied. Methods This study used the Longitudinal data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to build a linear mixed effects model to explore the impact of tooth loss on cognitive function in older adults. The effect of wearing dentures on the above effects was also evaluated. In addition, through mediation analysis, this study studied the mediating role of dietary diversity in the relationship between tooth loss and cognitive function. Results A total of 8283 older adults aged ≥65 years were included in this study. Maintaining ≥20 teeth was associated with better cognitive function (β = 0.338, 95% confidence interval [CI]: 0.229∼0.447), and so was denture wearing (β = 0.449, 95%CI: 0.351∼0.547). However, there was no significant difference in cognitive function between the older adults with &lt; 20 teeth and dentures and those with ≥20 teeth (β = 0.084, 95%CI: -0.035∼0.203). The total effect and direct effect of tooth number on cognitive function were 0.201 (95%CI: 0.096-0.306) and 0.177 (95%CI: 0.072-0.282), respectively. The indirect effect of dietary diversity was 0.023 (95% CI: 0.010∼0.037), accounting for 11.65% of the total effect. Conclusions In Chinese older adults, more teeth were associated with better cognitive function. Denture wearing reduced the risk of cognitive decline caused by tooth loss to a certain extent. Dietary diversity mediated the relationship between tooth number and cognitive function.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188468","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 Cross-sectional studies have suggested that patients with Parkinson’s disease (PD) have significantly lower heart rate variability (HRV) than healthy controls. However, the role of ultra-short HRV (usHRV) as an early biomarker for PD remains unclear. The objective of this study was to investigate the association between usHRV and PD risk and its underlying mechanisms. Methods In a prospective cohort study based on the UK Biobank, participants without PD and dementia at baseline who had available 15-second resting electrocardiogram data (n = 48,202) were included. The participants were followed up for an average of 12.24 years and some were diagnosed with PD (n = 307). Cox proportional hazards models were used to examine the association between usHRV parameters and PD risk. A nested case-control study was conducted within the cohort to further investigate temporal trends in HRV. Mediation analysis was used to explore the underlying mechanisms driven by brain structure, peripheral inflammation and proteomic biomarkers. Results We found that lower usHRV parameters were significantly associated with an increased PD risk. Notably, an L-shaped association was observed between corrected root mean square of successive differences and PD risk. Temporal trend analysis suggested usHRV levels of patients with PD started to decline approximately 10 years before diagnosis. Mediation analysis revealed that thalamus-related fiber tracts, plasma inflammatory and neuroendocrine markers mediated the association between usHRV and PD risk. Conclusions Our findings provide evidence supporting that usHRV may serve as an early, convenient, and noninvasive biomarker of PD risk up to a decade before diagnosis.
{"title":"Association between ultra-short heart rate variability and risk of Parkinson's disease: A prospective cohort study","authors":"Ruihan Wang, Kai Zhou, Nannan Li, Yingying Tang, Hui Gao, Linyuan Qin, Hanlin Cai, Feng Yang, Caimei Luo, Shiyu Feng, Mengyao Guo, Yongping Chen, Qing Gao, Qin Chen","doi":"10.1093/gerona/glaf204","DOIUrl":"https://doi.org/10.1093/gerona/glaf204","url":null,"abstract":"Background Cross-sectional studies have suggested that patients with Parkinson’s disease (PD) have significantly lower heart rate variability (HRV) than healthy controls. However, the role of ultra-short HRV (usHRV) as an early biomarker for PD remains unclear. The objective of this study was to investigate the association between usHRV and PD risk and its underlying mechanisms. Methods In a prospective cohort study based on the UK Biobank, participants without PD and dementia at baseline who had available 15-second resting electrocardiogram data (n = 48,202) were included. The participants were followed up for an average of 12.24 years and some were diagnosed with PD (n = 307). Cox proportional hazards models were used to examine the association between usHRV parameters and PD risk. A nested case-control study was conducted within the cohort to further investigate temporal trends in HRV. Mediation analysis was used to explore the underlying mechanisms driven by brain structure, peripheral inflammation and proteomic biomarkers. Results We found that lower usHRV parameters were significantly associated with an increased PD risk. Notably, an L-shaped association was observed between corrected root mean square of successive differences and PD risk. Temporal trend analysis suggested usHRV levels of patients with PD started to decline approximately 10 years before diagnosis. Mediation analysis revealed that thalamus-related fiber tracts, plasma inflammatory and neuroendocrine markers mediated the association between usHRV and PD risk. Conclusions Our findings provide evidence supporting that usHRV may serve as an early, convenient, and noninvasive biomarker of PD risk up to a decade before diagnosis.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188502","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}
Eric T Hyde,Gretchen E Bandoli,Jingjing Zou,Noe C Crespo,Humberto Parada,Kelly R Evenson,Annie Green Howard,Michael J LaMonte,Marcia L Stefanick,Lesley F Tinker,Bernhard Haring,JoAnn E Manson,I-Min Lee,Andrea Z LaCroix
BACKGROUNDThe influence of physical activity (PA) and sedentary behavior (SB) on survival to late age with intact mobility is unclear. This study investigated associations between accelerometer-measured daily PA, SB, and survival to age 90 birthyear with and without intact mobility in the Women's Health Accelerometry Collaboration (WHAC).METHODSPostmenopausal U.S. women aged 78-89 years without mobility disability were followed for an average of 6.1 years. At age 90 birthyear, participants were categorized as: (1) surviving with intact mobility, (2) surviving with mobility disability, or (3) deceased. Participants wore an accelerometer on the hip for up to 7 days at baseline from 2011-2015. Covariate-adjusted multinomial logistic regression models estimated odds ratios (ORs) of PA (light, moderate-to-vigorous [MVPA], total, steps) and SB (sitting time, mean sitting bout duration) with survival outcomes relative to dying.RESULTSAmong 2,656 women (mean baseline age 83.1 years), 62.8% survived with intact mobility, 22.3% with mobility disability, and 15.0% died. Compared to dying before age 90, the OR (95% confidence intervals [CI]) for every 1-SD increment in accelerometer variables and survival with intact mobility were 1.36 (1.20, 1.54) for light PA, 1.69 (1.47, 1.96) for MVPA, 1.51 (1.33, 1.71) for total PA, 1.75 (1.51, 2.03) for steps, 0.70 (0.61, 0.80) for sitting time, and 0.79 (0.70, 0.89) for sitting bouts. Similar, weaker trends were present for mobility disability.CONCLUSIONSThese findings corroborate the potential role of increasing physical activity in preserving physical functioning as an important element of healthy longevity.
{"title":"Prospective associations between accelerometer-measured physical activity, sedentary behavior, and healthy longevity: the Women's Health Accelerometry Collaboration.","authors":"Eric T Hyde,Gretchen E Bandoli,Jingjing Zou,Noe C Crespo,Humberto Parada,Kelly R Evenson,Annie Green Howard,Michael J LaMonte,Marcia L Stefanick,Lesley F Tinker,Bernhard Haring,JoAnn E Manson,I-Min Lee,Andrea Z LaCroix","doi":"10.1093/gerona/glaf206","DOIUrl":"https://doi.org/10.1093/gerona/glaf206","url":null,"abstract":"BACKGROUNDThe influence of physical activity (PA) and sedentary behavior (SB) on survival to late age with intact mobility is unclear. This study investigated associations between accelerometer-measured daily PA, SB, and survival to age 90 birthyear with and without intact mobility in the Women's Health Accelerometry Collaboration (WHAC).METHODSPostmenopausal U.S. women aged 78-89 years without mobility disability were followed for an average of 6.1 years. At age 90 birthyear, participants were categorized as: (1) surviving with intact mobility, (2) surviving with mobility disability, or (3) deceased. Participants wore an accelerometer on the hip for up to 7 days at baseline from 2011-2015. Covariate-adjusted multinomial logistic regression models estimated odds ratios (ORs) of PA (light, moderate-to-vigorous [MVPA], total, steps) and SB (sitting time, mean sitting bout duration) with survival outcomes relative to dying.RESULTSAmong 2,656 women (mean baseline age 83.1 years), 62.8% survived with intact mobility, 22.3% with mobility disability, and 15.0% died. Compared to dying before age 90, the OR (95% confidence intervals [CI]) for every 1-SD increment in accelerometer variables and survival with intact mobility were 1.36 (1.20, 1.54) for light PA, 1.69 (1.47, 1.96) for MVPA, 1.51 (1.33, 1.71) for total PA, 1.75 (1.51, 2.03) for steps, 0.70 (0.61, 0.80) for sitting time, and 0.79 (0.70, 0.89) for sitting bouts. Similar, weaker trends were present for mobility disability.CONCLUSIONSThese findings corroborate the potential role of increasing physical activity in preserving physical functioning as an important element of healthy longevity.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182633","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}
Danielle S Taylor, Albert A Allotey, Rachel E Fanelli, Sushumna B Satyanarayana, Sharanya S Bettadapura, Cole R Wyatt, Jason G Landen, Adam C Nelson, Emily E Schmitt, Danielle R Bruns, Nicole L Bedford
Nocturia, defined as waking one or more times per night to urinate, is a prevalent and burdensome condition with few effective treatments. While the primary risk factor for nocturia is advanced age, few preclinical studies have addressed the pathophysiological mechanisms of nocturia in older subjects. Here, we develop a translational model of nocturia using aging mice and a behavioral paradigm that enables circadian assessment of voluntary urination in group-housed animals. We discovered dampened diurnal regulation of urinary behavior in aged mice compared to adult controls. Molecular analyses revealed disrupted diurnal expression of canonical circadian genes in aged mouse kidney and bladder tissues. Notably, we identified age-related loss of diurnal regulation of the bladder mechanosensory ion channel, Piezo1, suggesting a potential mechanism linking circadian disruption to altered bladder sensitivity. Our results reveal a role for circadian dysfunction in age-related nocturia and identify Piezo1 as a promising therapeutic target for chronobiological intervention.
{"title":"Diurnal Regulation of Urinary Behavior and Gene Expression in Aged Mice","authors":"Danielle S Taylor, Albert A Allotey, Rachel E Fanelli, Sushumna B Satyanarayana, Sharanya S Bettadapura, Cole R Wyatt, Jason G Landen, Adam C Nelson, Emily E Schmitt, Danielle R Bruns, Nicole L Bedford","doi":"10.1093/gerona/glaf208","DOIUrl":"https://doi.org/10.1093/gerona/glaf208","url":null,"abstract":"Nocturia, defined as waking one or more times per night to urinate, is a prevalent and burdensome condition with few effective treatments. While the primary risk factor for nocturia is advanced age, few preclinical studies have addressed the pathophysiological mechanisms of nocturia in older subjects. Here, we develop a translational model of nocturia using aging mice and a behavioral paradigm that enables circadian assessment of voluntary urination in group-housed animals. We discovered dampened diurnal regulation of urinary behavior in aged mice compared to adult controls. Molecular analyses revealed disrupted diurnal expression of canonical circadian genes in aged mouse kidney and bladder tissues. Notably, we identified age-related loss of diurnal regulation of the bladder mechanosensory ion channel, Piezo1, suggesting a potential mechanism linking circadian disruption to altered bladder sensitivity. Our results reveal a role for circadian dysfunction in age-related nocturia and identify Piezo1 as a promising therapeutic target for chronobiological intervention.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188501","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}
Luis Polo-Ferrero, Alfonso J Cruz-Jentoft, Javier Vallejo-Martín, Ana Silvia Puente-González, María Carmen Sánchez-Sánchez, Fausto J Barbero-Iglesias, Roberto Méndez-Sánchez
Background Low muscle strength and sarcopenia are strong predictors of disability. Although multicomponent training (MT) is commonly recommended, its long-term effects remain unclear, and evidence on High-Speed Resistance Training (H-RT) in older women is limited. Methods This double-blind randomized trial evaluated the effects of a 32-week intervention, with RT (weeks 1–11) progressing to H-RT (weeks 12–32) vs MT, on muscle strength, body composition, and functional performance. A total of 120 women aged ≥65 years (mean age: 77.0 ± 6.8 years) with low muscle strength (diagnosed with probable sarcopenia according to EWGSOP2) were randomized into H-RT, MT, or a non-exercise control group (CG). Results Both exercise modalities improved lower-limb physical performance, as assessed by the Five Times Sit-to-Stand Test, compared to women who did not exercise (p < 0.001), with no significant differences between H-RT and MT (p = 0.127) (H-RT: -3.2 ± 2.5 s; MT: -2.6 ± 2.5 s vs CG: -0.8 ± 2.1 s). Functional and body composition improvements were seen in both groups. H-RT led to greater improvements in the Timed Up & Go Test (-0.9 ± 1.9 s; p = 0.007) and waist circumference (-4.5 ± 5.1 cm; p = 0.010), while MT showed better results in aerobic capacity (Two-minute step test: +19.9 ± 17.2 steps; p = 0.044). Conclusions H-RT is an effective alternative to MT for improving strength, performance, and body composition in older women, with specific benefits. Further studies should confirm its role in preserving intrinsic capacity and preventing sarcopenic obesity.
背景：低肌力和肌肉减少症是残疾的有力预测因子。虽然多组分训练（MT）通常被推荐，但其长期效果尚不清楚，并且老年妇女的高速阻力训练（H-RT）的证据有限。该双盲随机试验评估了32周干预的效果，从RT（1-11周）进展到H-RT（12-32周）vs MT，对肌肉力量、身体成分和功能表现的影响。共有120名年龄≥65岁（平均年龄：77.0±6.8岁）、肌肉力量低（根据EWGSOP2诊断为可能的肌肉减少症）的女性被随机分为H-RT、MT或非运动对照组（CG）。结果：与不运动的女性相比，两种运动方式都能改善下肢身体机能（p < 0.001）， H-RT和MT之间无显著差异（p = 0.127） （H-RT: -3.2±2.5 s; MT: -2.6±2.5 s vs CG: -0.8±2.1 s）。两组患者的功能和身体成分均有所改善。H-RT在Timed Up &； Go Test（-0.9±1.9 s, p = 0.007）和腰围（-4.5±5.1 cm, p = 0.010）方面有较大改善，而MT在有氧能力方面有较好的效果（两分钟步数测试：+19.9±17.2步，p = 0.044）。结论：H-RT是MT的有效替代方案，可改善老年妇女的力量、表现和身体成分，并具有特定的益处。进一步的研究应证实其在保持内在能力和预防肌肉减少性肥胖方面的作用。
{"title":"Long-Term effects of Progressive High-Speed Resistance Exercise in Older Women with Low Muscle Strength. A Randomized Clinical Trial","authors":"Luis Polo-Ferrero, Alfonso J Cruz-Jentoft, Javier Vallejo-Martín, Ana Silvia Puente-González, María Carmen Sánchez-Sánchez, Fausto J Barbero-Iglesias, Roberto Méndez-Sánchez","doi":"10.1093/gerona/glaf211","DOIUrl":"https://doi.org/10.1093/gerona/glaf211","url":null,"abstract":"Background Low muscle strength and sarcopenia are strong predictors of disability. Although multicomponent training (MT) is commonly recommended, its long-term effects remain unclear, and evidence on High-Speed Resistance Training (H-RT) in older women is limited. Methods This double-blind randomized trial evaluated the effects of a 32-week intervention, with RT (weeks 1–11) progressing to H-RT (weeks 12–32) vs MT, on muscle strength, body composition, and functional performance. A total of 120 women aged ≥65 years (mean age: 77.0 ± 6.8 years) with low muscle strength (diagnosed with probable sarcopenia according to EWGSOP2) were randomized into H-RT, MT, or a non-exercise control group (CG). Results Both exercise modalities improved lower-limb physical performance, as assessed by the Five Times Sit-to-Stand Test, compared to women who did not exercise (p &lt; 0.001), with no significant differences between H-RT and MT (p = 0.127) (H-RT: -3.2 ± 2.5 s; MT: -2.6 ± 2.5 s vs CG: -0.8 ± 2.1 s). Functional and body composition improvements were seen in both groups. H-RT led to greater improvements in the Timed Up & Go Test (-0.9 ± 1.9 s; p = 0.007) and waist circumference (-4.5 ± 5.1 cm; p = 0.010), while MT showed better results in aerobic capacity (Two-minute step test: +19.9 ± 17.2 steps; p = 0.044). Conclusions H-RT is an effective alternative to MT for improving strength, performance, and body composition in older women, with specific benefits. Further studies should confirm its role in preserving intrinsic capacity and preventing sarcopenic obesity.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188504","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}
Sunyang Fu,Min Ji Kwak,Jaerong Ahn,Zhiyi Yue,Shreyas Ranganath,Joseph R Applegate,Andrew Wen,Liwei Wang,Chenyu Li,Michele Morris,Kelly M Toth,Timothy D Girard,John D Osborne,Richard E Kennedy,Nelly-Estefanie Garduno-Rapp,Phillip Reeder,Justin F Rousseau,Chao Yan,You Chen,Mayur B Patel,Tyler J Murphy,Bradley A Malin,Chan Mi Park,Jia Heling,Sandeep Pagali,Allyson K Palmer,Jennifer St Sauver,Sunghwan Sohn,Elmer V Bernstam,Shyam Visweswaran,Yanshan Wang,Hongfang Liu
BACKGROUNDDelirium is often underdiagnosed in clinical practice and is not routinely coded for billing. While manual chart review can identify delirium, it is labor-intensive and impractical for large-scale studies. Natural language processing (NLP) can analyze unstructured text in electronic health records (EHRs) to extract meaningful clinical information.METHODSTo support national integration of NLP for EHR-based delirium identification across different institutions, we launched the Delirium Interest Group within the national Evolve to Next-Gen Accrual to Clinical Trials (ENACT) NLP Working Group. This paper outlines our initial efforts to standardize, evaluate, and translate an NLP-based delirium detection model into the i2b2/ENACT platform.RESULTSMultisite contextual inquiry identified several key challenges, including variations in local screening practices (e.g., tools used, documentation frequency, and quality control), the need for harmonized definitions in the context of EHRs, and the complexity of modeling temporal logic. Multisite NLP evaluation revealed variable performance degradation driven by differences in delirium screening practices, clinical documentation patterns and semantics, and note syntactic structures.CONCLUSIONOur work represents an important first step toward enabling scalable and standardized NLP-based delirium detection across institutions. By engaging diverse institutions through the ENACT NLP Working Group, we identified shared challenges and site-specific variations that impact model implementation and performance. Our collaborative approach enabled the development of a more robust framework for delirium identification across heterogeneous EHR systems. Future efforts will build on this foundation to enhance the validity, usability, and translational impact of delirium detection.
{"title":"Advancing Delirium Detection through the Open Health Natural Language Processing Consortium and ENACT Network.","authors":"Sunyang Fu,Min Ji Kwak,Jaerong Ahn,Zhiyi Yue,Shreyas Ranganath,Joseph R Applegate,Andrew Wen,Liwei Wang,Chenyu Li,Michele Morris,Kelly M Toth,Timothy D Girard,John D Osborne,Richard E Kennedy,Nelly-Estefanie Garduno-Rapp,Phillip Reeder,Justin F Rousseau,Chao Yan,You Chen,Mayur B Patel,Tyler J Murphy,Bradley A Malin,Chan Mi Park,Jia Heling,Sandeep Pagali,Allyson K Palmer,Jennifer St Sauver,Sunghwan Sohn,Elmer V Bernstam,Shyam Visweswaran,Yanshan Wang,Hongfang Liu","doi":"10.1093/gerona/glaf207","DOIUrl":"https://doi.org/10.1093/gerona/glaf207","url":null,"abstract":"BACKGROUNDDelirium is often underdiagnosed in clinical practice and is not routinely coded for billing. While manual chart review can identify delirium, it is labor-intensive and impractical for large-scale studies. Natural language processing (NLP) can analyze unstructured text in electronic health records (EHRs) to extract meaningful clinical information.METHODSTo support national integration of NLP for EHR-based delirium identification across different institutions, we launched the Delirium Interest Group within the national Evolve to Next-Gen Accrual to Clinical Trials (ENACT) NLP Working Group. This paper outlines our initial efforts to standardize, evaluate, and translate an NLP-based delirium detection model into the i2b2/ENACT platform.RESULTSMultisite contextual inquiry identified several key challenges, including variations in local screening practices (e.g., tools used, documentation frequency, and quality control), the need for harmonized definitions in the context of EHRs, and the complexity of modeling temporal logic. Multisite NLP evaluation revealed variable performance degradation driven by differences in delirium screening practices, clinical documentation patterns and semantics, and note syntactic structures.CONCLUSIONOur work represents an important first step toward enabling scalable and standardized NLP-based delirium detection across institutions. By engaging diverse institutions through the ENACT NLP Working Group, we identified shared challenges and site-specific variations that impact model implementation and performance. Our collaborative approach enabled the development of a more robust framework for delirium identification across heterogeneous EHR systems. Future efforts will build on this foundation to enhance the validity, usability, and translational impact of delirium detection.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182709","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}
Yong-Hao Pua, Laura Tay, Ross Allan Clark, Julian Thumboo, Ee-Ling Tay, Shi-Min Mah, Wang Min Xian, Lim Jin Jin, Gary Kwok Kum Hoe, Yee-Sien Ng
BACKGROUND To address the lack of a composite intrinsic capacity (IC) score based on the World Health Organization (WHO) Integrated Care for Older People (ICOPE) Screening tool, we propose a model-based approach to computing the composite score by developing and validating a model that uses the ICOPE screening items to predict the presence of impaired IC in community-dwelling older adults. METHODS In this cross-sectional study, a sample of 1,235 participants (mean[SD], 68[7]years) completed a multi-domain geriatric and fitness assessment, from which we (i) operationalized the ICOPE Steps 1-2 screening/assessment and (ii) derived a 5-point count-based Step 1 composite IC score and an 8-point Step 2 composite IC score. Proportional-odds regression analysis, leveraging on ICOPE screening items, was used to predict, for a given person, the probability that the Step 2 score was ≤6points (impaired IC) and the corresponding mean score (model-based composite IC score). RESULTS The model c-statistic for impaired IC was 0.81 (95%CI, 0.79 to 0.86) and calibration was excellent. The model-based IC scores showed stronger discriminative validity than did the count-based scores for the prefrailty/frailty, sarcopenia, and restricted life-space-mobility outcomes (AUC differences, 0.05-0.12; P-values < 0.001). At a decision threshold of 20%, the model-based approach yielded greater net benefit (0.016), and it allowed a greater proportion of participants to potentially delay Step 2 assessment (n = 633 vs 317) without compromising positive and negative predictive values. CONCLUSIONS If externally validated, composite IC scores derived from the proposed model-based approach have the potential to facilitate more granular risk stratification and IC monitoring.
{"title":"Development, validity, and utility of a model-based intrinsic capacity composite score in community-dwelling older persons","authors":"Yong-Hao Pua, Laura Tay, Ross Allan Clark, Julian Thumboo, Ee-Ling Tay, Shi-Min Mah, Wang Min Xian, Lim Jin Jin, Gary Kwok Kum Hoe, Yee-Sien Ng","doi":"10.1093/gerona/glaf210","DOIUrl":"https://doi.org/10.1093/gerona/glaf210","url":null,"abstract":"BACKGROUND To address the lack of a composite intrinsic capacity (IC) score based on the World Health Organization (WHO) Integrated Care for Older People (ICOPE) Screening tool, we propose a model-based approach to computing the composite score by developing and validating a model that uses the ICOPE screening items to predict the presence of impaired IC in community-dwelling older adults. METHODS In this cross-sectional study, a sample of 1,235 participants (mean[SD], 68[7]years) completed a multi-domain geriatric and fitness assessment, from which we (i) operationalized the ICOPE Steps 1-2 screening/assessment and (ii) derived a 5-point count-based Step 1 composite IC score and an 8-point Step 2 composite IC score. Proportional-odds regression analysis, leveraging on ICOPE screening items, was used to predict, for a given person, the probability that the Step 2 score was ≤6points (impaired IC) and the corresponding mean score (model-based composite IC score). RESULTS The model c-statistic for impaired IC was 0.81 (95%CI, 0.79 to 0.86) and calibration was excellent. The model-based IC scores showed stronger discriminative validity than did the count-based scores for the prefrailty/frailty, sarcopenia, and restricted life-space-mobility outcomes (AUC differences, 0.05-0.12; P-values &lt; 0.001). At a decision threshold of 20%, the model-based approach yielded greater net benefit (0.016), and it allowed a greater proportion of participants to potentially delay Step 2 assessment (n = 633 vs 317) without compromising positive and negative predictive values. CONCLUSIONS If externally validated, composite IC scores derived from the proposed model-based approach have the potential to facilitate more granular risk stratification and IC monitoring.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188649","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}
Roee Hayek,Carrie A Karvonen-Gutierrez,Jonathan F Bean,Jack M Guralnik,Kenneth Covinsky,Jay R Hoffman,Michal Azmon,Galit Yogev-Seligmann,Gregory Krautner,Odelyah Saad,Yaniv Nudelman,Rebecca T Brown,Shmuel Springer
BACKGROUNDMobility decline often begins in midlife and early identification of individuals at risk of accelerated deterioration can enable timely prevention. However, there is no validated self-report instrument that specifically assesses mobility in the middle-aged population.METHODSThe Mobility in Middle-Age Questionnaire (MMQ) was developed through a seven-step Delphi process, consisting of 10 experts, involving item selection and content validation in both English and Hebrew, comprising two factors: (1) Current Mobility Ability and (2) One-Year Mobility Change. Psychometric properties were assessed in 610 U.S. and 594 Israeli middle-aged adults. Analyses included internal consistency, test-retest reliability, structural and construct validity (using the 10-item Physical Functioning scale (PF-10) from SF-36), and floor/ceiling effect assessments. A 'Potential Mobility Risk Zone' was defined as the lowest 20% of MMQ scores.RESULTSThe MMQ showed excellent internal consistency (Cronbach's α = 0.94 English; 0.92 Hebrew) and strong test-retest reliability (ICC = 0.89-0.90). Exploratory factor analysis explained 66% of variance; confirmatory factor analysis showed good fit (CFI = 0.99, TLI = 0.99, SRMR = 0.05). Construct validity was supported, with all pre-defined hypotheses confirmed. MMQ showed significantly lower ceiling effects than PF-10 (3.9% vs. 34.5% in U.S.; 0.17% vs. 25.25% in Israel, p < .001, large effect sizes). A score of 50 (20th percentile) was proposed as a preliminary "Potential Mobility Risk" Threshold.CONCLUSIONSThe MMQ is a reliable and valid tool for detecting early mobility decline in midlife. Longitudinal studies are needed to confirm its predictive value and responsiveness to change.
活动能力下降通常始于中年，早期识别有加速退化风险的个体可以及时预防。然而，目前还没有有效的自我报告工具专门评估中年人口的流动性。方法由10位专家组成的《中年流动能力问卷》（MMQ）采用七步德尔菲法编制，包括英语和希伯来语两种语言的项目选择和内容验证。问卷包含两个因素：(1)当前流动能力和(2)一年流动能力变化。对610名美国儿童的心理测量特性进行了评估594名以色列中年人。分析包括内部一致性、测试重测信度、结构效度和构造效度（使用SF-36的10项身体功能量表（PF-10））以及地板/天花板效应评估。“潜在流动性风险区”被定义为MMQ得分最低的20%。结果MMQ具有良好的内部一致性（英语Cronbach′s α = 0.94；希伯来语Cronbach′s α = 0.92）和较强的重测信度（ICC = 0.89 ~ 0.90）。探索性因子分析解释了66%的方差；验证性因子分析拟合良好（CFI = 0.99, TLI = 0.99, SRMR = 0.05）。结构效度得到支持，所有预先定义的假设都得到证实。MMQ的上限效应明显低于PF-10（美国为3.9% vs. 34.5%；以色列为0.17% vs. 25.25%, p < 0.001，效应量大）。50分（第20百分位）作为初步的“潜在流动风险”阈值。结论MMQ是一种可靠、有效的检测中年早期活动能力下降的工具。需要进行纵向研究来证实其预测价值和对变化的反应性。
{"title":"Development and Validation of the Mobility in Middle-Age Questionnaire (MMQ).","authors":"Roee Hayek,Carrie A Karvonen-Gutierrez,Jonathan F Bean,Jack M Guralnik,Kenneth Covinsky,Jay R Hoffman,Michal Azmon,Galit Yogev-Seligmann,Gregory Krautner,Odelyah Saad,Yaniv Nudelman,Rebecca T Brown,Shmuel Springer","doi":"10.1093/gerona/glaf205","DOIUrl":"https://doi.org/10.1093/gerona/glaf205","url":null,"abstract":"BACKGROUNDMobility decline often begins in midlife and early identification of individuals at risk of accelerated deterioration can enable timely prevention. However, there is no validated self-report instrument that specifically assesses mobility in the middle-aged population.METHODSThe Mobility in Middle-Age Questionnaire (MMQ) was developed through a seven-step Delphi process, consisting of 10 experts, involving item selection and content validation in both English and Hebrew, comprising two factors: (1) Current Mobility Ability and (2) One-Year Mobility Change. Psychometric properties were assessed in 610 U.S. and 594 Israeli middle-aged adults. Analyses included internal consistency, test-retest reliability, structural and construct validity (using the 10-item Physical Functioning scale (PF-10) from SF-36), and floor/ceiling effect assessments. A 'Potential Mobility Risk Zone' was defined as the lowest 20% of MMQ scores.RESULTSThe MMQ showed excellent internal consistency (Cronbach's α = 0.94 English; 0.92 Hebrew) and strong test-retest reliability (ICC = 0.89-0.90). Exploratory factor analysis explained 66% of variance; confirmatory factor analysis showed good fit (CFI = 0.99, TLI = 0.99, SRMR = 0.05). Construct validity was supported, with all pre-defined hypotheses confirmed. MMQ showed significantly lower ceiling effects than PF-10 (3.9% vs. 34.5% in U.S.; 0.17% vs. 25.25% in Israel, p < .001, large effect sizes). A score of 50 (20th percentile) was proposed as a preliminary \"Potential Mobility Risk\" Threshold.CONCLUSIONSThe MMQ is a reliable and valid tool for detecting early mobility decline in midlife. Longitudinal studies are needed to confirm its predictive value and responsiveness to change.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182634","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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