Aging Medicine最新文献_第4页

Cancer Burden in Chinese Older Adults: Insights Into Incidence, Mortality, and Global Comparisons Using GLOBOCAN 2022 中国老年人的癌症负担：使用GLOBOCAN 2022分析发病率、死亡率和全球比较

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2025-06-29 DOI: 10.1002/agm2.70028

Yuanjie Zheng, He Li, Qianru Li, Siyi He, Yi Teng, Mengdi Cao, Nuopei Tan, Jiachen Wang, Tingting Zuo, Tianyi Li, Wanqing Chen

Objective

To summarize the latest cancer burden among Chinese adults aged 60 years and older and compare it with the global average and four regions classified by Human Development Index (HDI).

Methods

Cancer incidence and mortality data were extracted from the GLOBOCAN 2022 database. The estimated numbers of new cases and deaths, age-standardized incidence rates (ASIRs), and age-standardized mortality rates (ASMRs) were analyzed for the top ten cancer types in Chinese older adults, categorized by sex and age groups (60–69, 70–84, and 85+ years). Descriptive analyses were conducted to compare ASIRs and ASMRs for all cancer sites combined and major cancer types among adults aged 60 and older across China, the global average, and four HDI-classified regions.

Results

In 2022, there were an estimated 2884.2 thousand new cancer cases and 1963.9 thousand cancer deaths among Chinese adults aged 60 and older. The ASIR (1211.8 per 100,000) and ASMR (857.2 per 100,000) for all cancers combined were 1.6 and 2.0 times higher in males than in females, respectively. Nearly half of new cancer cases and deaths occurred in the 70–84 age group, accounting for 48.4% of all cases (1395.9 thousand) and 53.3% of all deaths (1046.4 thousand). Lung, colorectal, stomach, liver, esophageal, prostate, and female breast cancers were the most prevalent cancer types. Compared with the global average and four HDI-classified regions, Chinese older adults had higher ASIRs and ASMRs for lung, stomach, liver, and esophageal cancers but lower rates for prostate and female breast cancers. The ASIR and ASMR for prostate cancer were comparable to those in countries with medium HDI. For female breast cancer, the ASIR was similar to that in countries with low and medium HDI, with a lower ASMR. For colorectal cancer, the ASIR and ASMR were close to the global average but lower than those in countries with very high HDI.

Conclusion

Chinese adults aged 60 and older face a heavy burden of lung and digestive cancers, with incidence and mortality patterns reflecting characteristics of both developed and developing regions. Given the rapid population aging and limited healthcare resources, tailored, evidence-based strategies are urgently needed to improve cancer prevention and control in China.

目的总结中国60岁及以上老年人的最新癌症负担情况，并与全球平均水平和人类发展指数（HDI）划分的四个地区进行比较。方法从GLOBOCAN 2022数据库中提取癌症发病率和死亡率数据。根据性别和年龄组（60-69岁、70-84岁和85岁以上），分析了中国老年人十大癌症类型的估计新病例和死亡人数、年龄标准化发病率（asir）和年龄标准化死亡率（ASMRs）。进行描述性分析，比较中国、全球平均水平和四个hdi分类地区的60岁及以上成年人的所有癌症部位和主要癌症类型的asir和asmr。结果2022年，中国60岁及以上的成年人中估计有2884.2万例新发癌症病例和1963.9万例癌症死亡。所有癌症的ASIR（1211.8 / 10万）和ASMR（857.2 / 10万）男性分别是女性的1.6倍和2.0倍。近一半的新发癌症病例和死亡发生在70-84岁年龄组，占所有病例的48.4%（139.59万人），占所有死亡人数的53.3%（104.64万人）。肺癌、结肠直肠癌、胃癌、肝癌、食道癌、前列腺癌和女性乳腺癌是最常见的癌症类型。与全球平均水平和四个hdi分类地区相比，中国老年人肺癌、胃癌、肝癌和食管癌的asir和ASMRs较高，但前列腺癌和女性乳腺癌的发生率较低。前列腺癌的ASIR和ASMR与中等HDI国家相当。对于女性乳腺癌，ASIR与低和中等HDI国家相似，ASMR较低。对于结直肠癌，ASIR和ASMR接近全球平均水平，但低于人类发展指数非常高的国家。结论中国60岁及以上老年人肺癌和消化道肿瘤负担较重，且发病率和死亡率模式反映了发达地区和发展中地区的特点。鉴于人口老龄化迅速，医疗资源有限，迫切需要有针对性的循证策略来改善中国的癌症预防和控制。

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引用次数: 0

Factors Associated With Frailty Clinic Utilization by High-Need High-Risk Older Adult Veterans 高需求高危老年退伍军人衰弱门诊使用相关因素

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2025-06-23 DOI: 10.1002/agm2.70032

Marianne Desir, Fei Tang, Carlos Gomez-Orozco, Stuti Dang

Objectives

Clinical models incorporating multidomain assessment and interventions may be helpful for older adults with frailty and other higher-risk geriatric patients. Patient participation in these clinical programs is variable, however, and there is a need for greater understanding of the factors that influence participation. We aimed to identify patient characteristics associated with participation in an outpatient frailty clinic intervention.

Methods

We conducted a retrospective study of high-need high-risk older adult patients who were offered a frailty clinic intervention designed to assess and address their medical, functional, psychological, and social needs (FIT clinic). Consistent with the Andersen Behavioral Model of Healthcare Utilization, we identified variables in the “predisposing,” “need,” and “enabling” domains that might relate to patient participation in the clinic. Bivariate analyses were employed to explore the potential roles of the identified variables in the observed levels of patient participation.

Results

In the analyses of “predisposing” factors, being married and being of African American race were positively associated with FIT clinic participation (p = 0.021 and 0.036, respectively). With controlling for chronic conditions, however, African American race was no longer associated with clinic participation. In the analyses of “need” factors, patients with essential hypertension, type II diabetes mellitus, and/or overweight/obesity were more likely to attend the frailty clinic (p = 0.002, 0.012, and 0.013, respectively). There was less availability of data regarding potential “enabling” factors, and no statistically significant differences were found in the “enabling” domain.

Conclusion

The application of the Andersen Behavioral Model can provide insights into the participation patterns of high-risk older Veterans in clinical interventions involving comprehensive geriatric assessments and multidomain interventions, including frailty clinics.

目的结合多领域评估和干预的临床模型可能有助于老年人虚弱和其他高风险老年患者。然而，患者对这些临床项目的参与是可变的，因此需要对影响参与的因素有更深入的了解。我们的目的是确定与参加门诊虚弱诊所干预相关的患者特征。方法我们对高需求高危老年患者进行了回顾性研究，这些患者接受了虚弱诊所干预，旨在评估和解决他们的医疗、功能、心理和社会需求（FIT诊所）。与Andersen医疗保健利用行为模型一致，我们确定了“倾向”、“需要”和“使能”领域中的变量，这些变量可能与患者参与诊所有关。采用双变量分析来探讨确定的变量在观察到的患者参与水平中的潜在作用。结果在“诱发因素”分析中，已婚和非裔美国人与FIT临床参与呈正相关（p分别为0.021和0.036）。然而，在控制慢性病的情况下，非裔美国人的种族与临床参与不再相关。在“需要”因素分析中，原发性高血压、II型糖尿病和/或超重/肥胖患者更有可能到虚弱门诊就诊（p分别= 0.002、0.012和0.013）。关于潜在的“使能”因素的可用性数据较少，并且在“使能”领域中没有发现统计学上显著的差异。结论应用Andersen行为模型可以深入了解高风险退伍军人在老年综合评估和多领域临床干预（包括衰弱诊所）中的参与模式。

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引用次数: 0

Exploring Potentially Inappropriate Medication Use on Elderly Patients in a General Medicine Ward Using 2023 AGS Beers Criteria 利用2023 AGS Beers标准探讨普通内科病房老年患者潜在不适当用药

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2025-06-15 DOI: 10.1002/agm2.70025

Subash Karki, Rahi Bikram Thapa, Rajeev Shrestha

Objectives

Potentially inappropriate medication (PIM) use is a significant concern among the elderly, a vulnerable population, due to physiological changes, and the risk of multiple comorbidities and polypharmacy. This study aimed to assess the use of PIM among elderly inpatients in tertiary care hospital in eastern Nepal.

Methods

A three-month prospective observational study was conducted, involving 200 eligible elderly patients admitted to general medicine ward. Relevant data were collected from patient case sheets, nursing and doctor cardex, discharge summaries, and via patient interviews. PIMs were identified based on the latest 2023 AGS Beers Criteria.

Results

Among the 200 eligible patients, 108 (54.0%) were prescribed at least one PIM. Medications that should be avoided in older patients accounted for 32.2%, where prazosin and hyoscine were the most common. Additionally, 52.8% of the medications required cautious use, with diuretics being the most frequent one. Multivariate analysis revealed that patients with chronic kidney disease (CKD) and the number of prescribed medicines significantly influenced the likelihood of PIMs with an adjusted odd ratio of 6.730 (2.111–21.456) and 2.764 (1.448–5.276), respectively, at p < 0.05.

Conclusion

PIMs are more common among the elderly, with CKD and polypharmacy contributing significantly to their prevalence. To reduce PIM use, healthcare professionals, including clinical pharmacists, should implement targeted interventions, particularly for older adults with CKD who are managing with multiple medications.

在老年人这一弱势群体中，由于生理变化、多种合并症和多种用药的风险，潜在的不适当用药（PIM）使用是一个值得关注的问题。本研究旨在评估尼泊尔东部三级医院老年住院患者PIM的使用情况。方法对200例普通内科住院的老年患者进行为期3个月的前瞻性观察研究。相关数据收集自患者病例表、护理和医生病历、出院总结以及患者访谈。pim是根据最新的2023 AGS Beers标准确定的。结果在200例符合条件的患者中，108例（54.0%）至少服用了一种PIM。老年患者应避免使用的药物占32.2%，其中以普唑嗪和海莨菪碱最为常见。此外，52.8%的药物需要谨慎使用，利尿剂是最常见的药物。多因素分析显示，慢性肾脏疾病（CKD）患者和处方药物数量显著影响pim发生的可能性，调整奇数比分别为6.730（2.111 ~ 21.456）和2.764 (1.448 ~ 5.276),p < 0.05。结论PIMs在老年人中更为常见，CKD和多药是其发病的重要因素。为了减少PIM的使用，包括临床药师在内的医疗保健专业人员应该实施有针对性的干预措施，特别是对于患有慢性肾病的老年人，他们正在使用多种药物进行治疗。

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引用次数: 0

A Phase 3 Multicenter, Double-Blind Study Comparing Efficacy, Safety, Immunogenicity, and Pharmacokinetics of Alkem's Biosimilar Teriparatide Versus Reference Teriparatide in Postmenopausal Osteoporosis 一项3期多中心双盲研究比较Alkem生物仿制药特立帕肽与参比特立帕肽治疗绝经后骨质疏松症的疗效、安全性、免疫原性和药代动力学

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2025-06-13 DOI: 10.1002/agm2.70029

Nitin Kapoor, Thomas Paul, Rajeshwar Nath Srivastava, Saurabh Singh, Sunil Maheshwari, Vishal Patil, Awadhesh Kumar Yadav, Girish Bhatia, Sushil H. Mankar, Joe Joseph Cherian, Surabhi Maheshwari, Sudeepti Srivastava, Dattatray Pawar, Roshan Pawar, Amol Aiwale, Amitrajit Pal, Yogesh Rane, Vinayaka Shahavi, Akhilesh Sharma

<div> <section> <h3> Objective</h3> <p>The primary purpose of this study was to compare the efficacy and safety of proposed biosimilar teriparatide with reference teriparatide in patients of postmenopausal osteoporosis. The secondary objectives were to assess the pharmacodynamic response of study drugs in postmenopausal osteoporosis and to assess the pharmacokinetic profile of biosimilar and reference teriparatide in a subset of subjects (a total of 30 evaluable subjects i.e., 15 subjects in reference arm and 15 subjects in biosimilar arm).</p> </section> <section> <h3> Methods</h3> <p>A prospective, active-controlled, randomized, double-blind, phase III study included postmenopausal women (50–80 years of age) with at least 5 years since menopause diagnosed with osteoporosis (<i>T-SCORE</i> ≤ −2.5 SD at lumbar spine or femoral neck) randomized 2:1 to receive either Alkem's biosimilar teriparatide or reference teriparatide 20 μg once daily subcutaneously for 48 weeks. All subjects received calcium 1000 mg and vitamin D3 500 IU once daily orally. The primary efficacy endpoint was percent change in bone mineral density (BMD) at lumbar spine and femoral neck from baseline to 48 weeks. Safety outcomes, pharmacokinetics, and immunogenicity were also evaluated. Secondary endpoints included change from baseline in pharmacodynamic parameters like serum P1NP, which were analyzed at randomization, at week 12, 24, and 48.</p> </section> <section> <h3> Results</h3> <p>In total, 177 patients (114 in biosimilar group and 63 in reference group) were randomized. The percent change from baseline to 48 weeks in lumbar spine BMD (least square mean [LSM] ± standard error [SE]) was 8.58% ± 0.85 in the biosimilar group and 8.02% ± 1.23 in the reference group. The estimated between-group difference (95% confidence interval [CI]) was −0.56% (−2.43% to 3.54%) within the prespecified noninferiority margin (− 2.43%), which indicates noninferiority of biosimilar teriparatide compared to reference teriparatide. The percent change in femoral neck BMD from baseline to 48 weeks (LSM ± SE) was 3.94% ± 0.83 in the biosimilar group and 2.50% ± 1.20 in the reference group. The estimated between-group difference (95% CI) was 1.44% (−1.44% to 4.32%) within the prespecified noninferiority margin (−1.44%) indicating noninferiority of biosimilar teriparatide compared to reference teriparatide. Changes in P1NP (serum procollagen type 1 N terminal pro-peptide) were also similar between the groups. Safety profiles, including immunogenicity, were comparable.</p> </section> <section> <h3> Conclusion</h3>

目的本研究的主要目的是比较拟用特立帕肽与参比特立帕肽治疗绝经后骨质疏松症的疗效和安全性。次要目的是评估研究药物在绝经后骨质疏松症中的药效学反应，并评估生物类似药和参比特立帕肽在一部分受试者中的药代动力学特征（共30名可评估受试者，即参比组15名受试者和生物类似药组15名受试者）。方法一项前瞻性、主动对照、随机、双盲、III期研究，纳入绝经后至少5年诊断为骨质疏松症（腰椎或股骨颈T-SCORE≤- 2.5 SD）的绝经后妇女（50-80岁），随机2:1接受Alkem的生物类似药特立帕肽或参比特立帕肽20 μg每日一次皮下注射，持续48周。所有受试者每天口服一次钙1000毫克和维生素D3 500国际单位。主要疗效终点是腰椎和股骨颈骨密度（BMD）从基线到48周的百分比变化。安全性结果、药代动力学和免疫原性也进行了评估。次要终点包括从基线开始的药效学参数的变化，如血清P1NP，在随机分组时，在第12、24和48周进行分析。结果共纳入177例患者，其中生物仿制药组114例，对照组63例。从基线到48周，生物仿制药组腰椎骨密度的百分比变化（最小二乘法平均值[LSM]±标准误差[SE]）为8.58%±0.85，对照组为8.02%±1.23。估计组间差异（95%置信区间[CI]）为- 0.56%(- 2.43%至3.54%)，在预定的非劣效性范围内（- 2.43%），这表明生物仿制药特立帕肽与参比特立帕肽相比非劣效性。从基线到48周，生物仿制药组股骨颈骨密度变化百分比（LSM±SE）为3.94%±0.83，对照组为2.50%±1.20。估计组间差异（95% CI）为1.44%(- 1.44%至4.32%)，在预定的非劣效性范围内（- 1.44%），表明生物仿制药特立帕肽与参比特立帕肽相比非劣效性。血清1型前胶原N末端前肽（P1NP）的变化在两组之间也相似。安全性，包括免疫原性，具有可比性。结论在绝经后骨质疏松患者中，Alkem的生物仿制药特立帕肽与参比特立帕肽具有相当的安全性和免疫原性，且无劣效性。试验报名CTRI号：CTRI/2018/05/014254

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引用次数: 0

Effect of Bazi Bushen Capsule on D-Galactose-Induced Human Endothelial Cell Senescence Through PI3K/Akt/eNOS Signaling Pathway 八子补肾胶囊通过PI3K/Akt/eNOS信号通路对d -半乳糖诱导的人内皮细胞衰老的影响

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2025-06-11 DOI: 10.1002/agm2.70031

Lulu Yao, Fuyao Li, Jingnian Ni, Mingqing Wei, Ting Li, Jing Shi, Jinzhou Tian

Objectives

BaZi BuShen capsule (BZBS) is a Chinese herbal prescription with the function of nourishing the kidney, replenishing essence, and combating aging. This study aims to investigate the effects of BZBS on aging endothelial cells and to elucidate the underlying mechanisms.

Methods

An aging human brain microvascular endothelial cells (HBMECs) model was established using D-galactose (D-gal) for 24 h. The efficacy of the model was evaluated by the positive rate of senescence-associated β-galactosidase (SA-β-Gal) staining. The treatment was administered using drug-containing serum of BZBS. The experimental groups comprised the following: Control, Model, and groups treated with drug-containing serum at low (BZBSL), medium (BZBSM), and high (BZBSH) doses of BZBS, in addition to a pathway inhibitor group (LY294002 [5 μM/L]). Western blotting and immunofluorescence assays were conducted to evaluate the expression levels of proteins. Nitric oxide (NO) levels in the cells were detected using an Assay Kit. The experiments were independently repeated five times.

Results

D-gal significantly elevated the SA-β-Gal positive rate in HBMECs. Intervention with BZBS significantly reduced the percentage of SA-β-Gal positive cells (p < 0.001). Compared to the Model group, drug-containing serum of BZBS significantly increased the expression levels of PI3K, p-Akt, Akt, and eNOS (p < 0.010) and elevated NO levels in the cells (p < 0.010), by which BZBS ameliorated HBMECs aging and enhanced the function of aging HBMECs.

Conclusions

Our findings indicate that BZBS can mitigate D-gal-induced aging in HBMECs by activating the PI3K/Akt/eNOS signaling pathway.

目的八子补肾胶囊是一种具有补肾、益精、抗衰老作用的中草药方剂。本研究旨在探讨BZBS对衰老内皮细胞的影响，并阐明其作用机制。方法采用d -半乳糖（D-gal）培养24 h的老化人脑微血管内皮细胞（HBMECs）模型。采用衰老相关β-半乳糖苷酶（SA-β-Gal）染色阳性率评价模型的疗效。治疗采用含药物的BZBS血清。实验组包括：对照组、模型组和BZBS低剂量（BZBSL）、中剂量（BZBSM）和高剂量（BZBSH）含药血清处理组，以及途径抑制剂组（LY294002 [5 μM/L]）。Western blotting和免疫荧光法检测蛋白表达水平。使用Assay Kit检测细胞中的一氧化氮（NO）水平。这些实验独立地重复了五次。结果D-gal可显著提高HBMECs中SA-β-Gal的阳性率。BZBS干预显著降低了SA-β-Gal阳性细胞的百分比（p < 0.001）。与模型组相比，BZBS含药血清中PI3K、p-Akt、Akt和eNOS的表达水平显著升高（p < 0.010），细胞中NO水平显著升高（p < 0.010）， BZBS通过此途径改善HBMECs衰老，增强老化HBMECs功能。结论BZBS可通过激活PI3K/Akt/eNOS信号通路，缓解d - galg诱导的hbmec衰老。

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引用次数: 0

Genetically Predicted 1400 Blood Metabolites in Relation to Risk of Prostate Cancer: A Mendelian Randomization Study 基因预测1400种血液代谢物与前列腺癌风险相关：一项孟德尔随机研究

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2025-06-11 DOI: 10.1002/agm2.70016

Xiaojin Lu, Yongming Chen, Yuxiao Jiang, Jiaxin Ning, Shengjie Liu, Zhengtong Lv, Miao Wang, Huiming Hou, Ming Liu

Objectives

Metabolic dysregulation is common in cancer, yet evidence linking circulating metabolites to causal relationships in prostate cancer (PCa) is lacking. We performed a Mendelian randomization analysis utilizing 1400 blood metabolites to evaluate their roles in PCa.

Methods

Exposure data from genome-wide association studies (GWAS) was extracted from metabolite level GWAS involving 462,933 individuals of European descent. GWAS data for PCa were obtained from the UK Biobank (UKB) database (79,148 cases, 61,106 controls) for a two-sample Mendelian randomization (MR) preliminary analysis, where we investigated potential causal relationships between 1400 metabolites and PCa. Inverse variance weighting (IVW) was the primary method for causal analysis, with MR-Egger and weighted median as supplementary analyses to enhance robustness. Sensitivity analyses including Cochran Q test, MR-Egger intercept test, MR-PRESSO, and leave-one-out analysis were employed to evaluate the robustness of MR results. For significant associations, an additional independent PCa dataset was utilized for validation analysis and meta-analysis.

Results

Our findings revealed significant associations between two metabolites and prostate cancer: Cysteinylglycine disulfide levels (OR: 0.999, 95% CI: 0.998–0.999, p = 0.004). Validation analyses showed a similar trend, and sensitivity analyses supported the robustness of MR estimates.

Conclusions

Our results suggest that Cysteinylglycine disulfide levels may have a causal relationship with increased PCa risk.

代谢失调在癌症中很常见，但循环代谢物与前列腺癌（PCa）因果关系的证据尚缺乏。我们利用1400种血液代谢物进行了孟德尔随机分析，以评估它们在PCa中的作用。方法从全基因组关联研究（GWAS）的代谢物水平中提取暴露数据，涉及462,933名欧洲血统个体。PCa的GWAS数据来自UK Biobank （UKB）数据库（79,148例，61,106例对照），用于两样本孟德尔随机化（MR）初步分析，我们调查了1400种代谢物与PCa之间的潜在因果关系。反方差加权（IVW）是因果分析的主要方法，MR-Egger和加权中位数作为补充分析，以增强稳健性。采用Cochran Q检验、MR- egger截距检验、MR- presso和留一分析等敏感性分析来评价MR结果的稳健性。对于显著关联，使用另外一个独立PCa数据集进行验证分析和元分析。结果两种代谢物：半胱氨酸二硫氨酸水平与前列腺癌有显著相关性（OR: 0.999, 95% CI: 0.998-0.999, p = 0.004）。验证分析显示了类似的趋势，敏感性分析支持MR估计的稳健性。结论：我们的研究结果表明，半胱氨酸二硫水平可能与前列腺癌风险增加有因果关系。

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引用次数: 0

Chinese Expert Consensus on Standardized Outpatient Management of Sarcopenia in the Elderly (2024) 老年人骨骼肌减少症门诊规范化管理专家共识（2024）

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2025-05-29 DOI: 10.1002/agm2.70010

Zhang Qin, Kang Lin, Wang Jianye, Xi Huan, Yu Pulin, Zhang Cuntai, Hidenori Arai, Tuo Xiping, Yang Yunmei, Liu Xiaohong

Sarcopenia is an age-related disorder that influences the daily living ability of older adults and interacts with various chronic diseases. Older adults with sarcopenia typically experience a deterioration in their quality of life and healthy lifespan. The number of Chinese persons with sarcopenia is considerable, and the burden of sarcopenia is substantial; however, the specific sarcopenia clinics available for outpatients are insufficient. The promotion of sarcopenia clinics is beneficial for the early identification, standardized diagnosis, and treatment of older adults with sarcopenia, thereby helping to enhance their physical function and quality of life. This consensus incorporates the professional recommendations of Chinese geriatrics experts, synthesizes existing Chinese experiences in establishing sarcopenia clinics, offers guidance for managing sarcopenia clinics, and advocates for early identification, diagnosis, and intervention of sarcopenia in older adults.

骨骼肌减少症是一种影响老年人日常生活能力并与多种慢性疾病相互作用的年龄相关性疾病。患有肌肉减少症的老年人通常会经历生活质量和健康寿命的恶化。中国骨骼肌减少症患者数量可观，骨骼肌减少症患者负担沉重；然而，为门诊患者提供的专门的肌肉减少症诊所是不够的。推广骨骼肌减少症门诊，有利于老年人骨骼肌减少症的早期发现、规范诊断和治疗，从而有助于提高老年人的身体功能和生活质量。该共识吸纳了中国老年医学专家的专业建议，综合了中国现有的建立骨骼肌减少症诊所的经验，为骨骼肌减少症诊所的管理提供指导，倡导老年人骨骼肌减少症的早期识别、诊断和干预。

{"title":"Chinese Expert Consensus on Standardized Outpatient Management of Sarcopenia in the Elderly (2024)","authors":"Zhang Qin, Kang Lin, Wang Jianye, Xi Huan, Yu Pulin, Zhang Cuntai, Hidenori Arai, Tuo Xiping, Yang Yunmei, Liu Xiaohong","doi":"10.1002/agm2.70010","DOIUrl":"https://doi.org/10.1002/agm2.70010","url":null,"abstract":"<p>Sarcopenia is an age-related disorder that influences the daily living ability of older adults and interacts with various chronic diseases. Older adults with sarcopenia typically experience a deterioration in their quality of life and healthy lifespan. The number of Chinese persons with sarcopenia is considerable, and the burden of sarcopenia is substantial; however, the specific sarcopenia clinics available for outpatients are insufficient. The promotion of sarcopenia clinics is beneficial for the early identification, standardized diagnosis, and treatment of older adults with sarcopenia, thereby helping to enhance their physical function and quality of life. This consensus incorporates the professional recommendations of Chinese geriatrics experts, synthesizes existing Chinese experiences in establishing sarcopenia clinics, offers guidance for managing sarcopenia clinics, and advocates for early identification, diagnosis, and intervention of sarcopenia in older adults.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 3","pages":"183-191"},"PeriodicalIF":2.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical Intervention and Prognosis of Intraductal Papillary Mucinous Adenoma in Elderly Patients: A Single Center Retrospective Study 老年患者导管内乳头状粘液腺瘤的手术干预与预后：单中心回顾性研究

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2025-05-13 DOI: 10.1002/agm2.70022

Tianhan Sun, Meilan Liu, Qing Wang, Boyue Jiang, Tong Li, Jianfu Cao, Jinghai Song, Jingyong Xu, Hongyuan Cui

Objective

The incidence of intraductal papillary mucinous neoplasm (IPMN) is rising among elderly patients. This study aims to investigate the clinical features of IPMN in elderly patients (≥ 60 years), analyze risk factors for high-grade dysplasia (HGD) and invasive cancer (IC), and provide treatment recommendations for elderly patients with IPMN.

Methods

In this single-center retrospective case–control study, 58 consecutive elderly patients (≥ 60 years) who underwent IPMN surgery at Beijing Hospital between January 2014 and November 2023 were included. Clinical characteristics across IPMN subtypes were compared, risk factors were analyzed, and the predictive values of the 2017 Fukuoka and 2023 Kyoto guidelines were evaluated. Follow-up and survival outcomes were also examined.

Results

The proportion of patients with main-duct IPMN (MD-IPMN) and mixed-type IPMN (MT-IPMN) who had diabetes was significantly higher than among those with branch-duct IPMN (BD-IPMN) (p < 0.05). The average postoperative hospital stay for patients with low-grade dysplasia (LGD) was 17.7 days (range, 6–53 days), while for patients with HGD/IC, it was 25.5 days (range, 9–90 days), with a statistically significant difference (p < 0.05). Jaundice, elevated CA19-9, elevated CEA, main duct (MD) > 10 mm, and IPMN subtype were significant predictors of HGD/IC (p < 0.05), with elevated CA19-9 and IPMN subtype identified as independent risk factors (p < 0.05). The 2023 Kyoto guidelines showed higher sensitivity but lower specificity than the 2017 Fukuoka guidelines for detecting HGD/IC (p < 0.05 for both). There was a statistically significant difference in overall survival between patients with LGD and those with HGD/IC following surgery (p < 0.05), while no significant difference in postoperative survival was observed between HGD/IC patients with and without lymph node metastasis (p > 0.05).

Conclusions

Surgical resection is recommended for elderly patients with MD-IPMN or MT-IPMN combined with elevated CA19-9. The 2017 Fukuoka guidelines are preferable to the 2023 Kyoto guidelines for managing elderly IPMN patients.

目的导管内乳头状粘液瘤（IPMN）在老年患者中的发病率呈上升趋势。本研究旨在探讨老年（≥60岁）IPMN患者的临床特征，分析高级别发育不良（HGD）和侵袭性癌（IC）的危险因素，为老年IPMN患者提供治疗建议。方法本研究为单中心回顾性病例对照研究，纳入2014年1月至2023年11月在北京医院连续行IPMN手术的58例老年患者（≥60岁）。比较IPMN各亚型的临床特征，分析危险因素，并评估2017年福冈指南和2023年京都指南的预测价值。随访和生存结果也被检查。结果主管IPMN （MD-IPMN）和混合型IPMN （MT-IPMN）合并糖尿病的患者比例显著高于支管IPMN （BD-IPMN）患者（p < 0.05）。低级别发育不良（LGD）患者术后平均住院时间为17.7天（范围6 ~ 53天），高级别发育不良/IC患者术后平均住院时间为25.5天（范围9 ~ 90天），差异有统计学意义（p < 0.05）。黄疸、CA19-9升高、CEA升高、主导管(MD)≥10 mm、IPMN亚型是HGD/IC的显著预测因子（p < 0.05），其中CA19-9升高和IPMN亚型为独立危险因素（p < 0.05）。2023年《京都指南》在检测HGD/IC方面的敏感性高于2017年《福冈指南》（p < 0.05），但特异性较低。LGD患者术后总生存率与HGD/IC患者术后总生存率差异有统计学意义（p < 0.05）， HGD/IC患者术后生存率与无淋巴结转移患者无统计学差异（p > 0.05）。结论老年MD-IPMN或MT-IPMN合并CA19-9升高的患者建议手术切除。2017年福冈指南比2023年京都指南更适用于老年IPMN患者的管理。

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引用次数: 0

Relationship Between Atherogenic Index of Plasma and Hypertension in Chinese Middle-Aged and Older Adults: A Cross-Sectional and Longitudinal Analysis Based on CHARLS 中国中老年人血浆动脉粥样硬化指数与高血压的关系：基于CHARLS的横断面和纵向分析

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2025-04-30 DOI: 10.1002/agm2.70015

Xiao Chen, Lerui Wang, Weicheng Lai, Boda Zhou

Objectives

Atherosclerosis is the underlying pathology of cardiovascular disease (CVD), including hypertension. Unfortunately, the association between the atherogenic index of plasma (AIP) and hypertension has not been reported in a large-scale middle-aged and elderly population. This study aimed to evaluate the association between AIP and hypertension in a representative middle-aged and elderly population in China.

Methods

The present study was a retrospective cohort study. We conducted cross-sectional and longitudinal analysis using data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018. Hypertension was identified by self-report or by taking antihypertensive medications. Participants aged below 45 years, with missing data on AIP, hypertension records, or taking lipid-lowering medication were excluded.

Results

A total of 12,376 participants were included in the cross-sectional analysis; we found that after adjusting for covariates, each unit increment in AIP was associated with a 109.0% increased prevalence of hypertension (OR = 2.090, 95% CI: 1.776–2.459), a 41.2% increased likelihood of systolic blood pressure (SBP) above 140 mmHg (OR = 1.412, 95% CI: 1.199–1.664), and a 43.9% increased likelihood of diastolic blood pressure (DBP) above 90 mmHg (OR = 1.439, 95% CI: 1.153–1.795). A total of 5649 participants were included in the longitudinal analysis; we found that every one-unit increase in AIP was associated with a 57.7% increase in hypertension incidence (OR = 1.577, 95% CI: 1.282–1.941, p < 0.001) during 7 years follow-up.

Conclusions

These results demonstrated a significant positive association between AIP and the prevalence and incidence of hypertension in a nationwide representative middle-aged and elderly population in China.

动脉粥样硬化是包括高血压在内的心血管疾病（CVD）的基础病理。不幸的是，血浆粥样硬化指数（AIP）与高血压之间的关系尚未在大规模中老年人群中报道。本研究旨在评估AIP与高血压在中国具有代表性的中老年人群中的关系。方法采用回顾性队列研究。我们使用2011年至2018年中国健康与退休纵向研究（CHARLS）的数据进行了横断面和纵向分析。高血压是通过自我报告或服用抗高血压药物来确定的。年龄在45岁以下、缺乏AIP数据、高血压记录或服用降脂药物的参与者被排除在外。结果横断面分析共纳入12376名受试者；我们发现，在调整协变量后，AIP每增加一个单位，高血压患病率增加109.0% (OR = 2.090, 95% CI: 1.776-2.459)，收缩压（SBP）高于140 mmHg的可能性增加41.2% (OR = 1.412, 95% CI: 1.199-1.664)，舒张压（DBP）高于90 mmHg的可能性增加43.9% （OR = 1.439, 95% CI: 1.153-1.795）。纵向分析共纳入5649名参与者；我们发现，在7年的随访中，AIP每增加1个单位，高血压发病率增加57.7% （OR = 1.577, 95% CI: 1.282-1.941, p < 0.001）。结论：在中国具有代表性的中老年人群中，AIP与高血压患病率和发病率之间存在显著的正相关关系。

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引用次数: 0

Age-Period-Cohort Analysis and Prediction of Falls Disease Burden Attributable to Low Bone Mineral Density in China, 1990–2019 1990-2019年中国低骨密度导致跌倒疾病负担的年龄-时期队列分析与预测

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2025-04-24 DOI: 10.1002/agm2.70019

Ping Wang, Qingping Liu, Jing Wang, Jing Du, Chao Tong, Zaihua Wei, Jianting Su

Objectives

This study aims to comprehensively describe and analyze the disease burden of falls attributed to low bone mineral density (BMD) in China from 1990 to 2019. Furthermore, we seek to predict the future trends of this burden from 2020 to 2030 to inform evidence-based prevention and control strategies.

Methods

Using data from the 2019 Global Burden of Disease (GBD) study, we conducted an in-depth analysis of mortality and disability-adjusted life year (DALY) trends related to falls attributed to low BMD in China from 1990 to 2019. An age-period-cohort (APC) model was employed to estimate mortality risk, accounting for age, period, and cohort effects. A Bayesian framework was utilized to project mortality and DALY rates for the period 2020–2030.

Results

From 1990 to 2019, there was a significant increase in both crude death rate (224.79%) and DALY rate (196.27%) among the Chinese population affected by falls due to low bone mineral density. The standardized death rate was higher among males compared to females; however, the standardized DALY rate remained lower than that observed among females throughout this period. Importantly, China witnessed a greater surge in deaths and DALYs compared with global figures as well as other socio-demographic index regions during this time frame. The APC model demonstrated a global change of 1.06% (95% confidence interval [CI]: 0.910–1.210) for men and 0.29% (95% CI: 0.147–0.426) for women over time. The death rate increased across all age groups for men, while it specifically increased for women aged 62.5 years and older. The risk of mortality dramatically escalates for individuals over 80 years old. Projections indicate a decline in the standardized mortality rate from falls due to low bone mineral density in both men and women in China during the period of 2020–2030; however, an increase is anticipated in the standardized DALY rate.

Conclusions

The mortality risk associated with falls due to low BMD in China is influenced by age, period, and cohort effects. Strengthening fall prevention and treatment strategies for older adults and younger birth cohorts, as well as addressing fall-related disabilities, is crucial to reducing the substantial burden posed by non-fatal falls. Targeted interventions are needed to mitigate the growing health and economic impacts of this public health issue.

本研究旨在全面描述和分析1990 - 2019年中国低骨密度（BMD）导致跌倒的疾病负担。此外，我们试图预测2020年至2030年这一负担的未来趋势，为循证预防和控制战略提供信息。方法利用2019年全球疾病负担（GBD）研究的数据，我们深入分析了1990年至2019年中国与低骨密度导致的跌倒相关的死亡率和残疾调整生命年（DALY）趋势。采用年龄-时期-队列（APC）模型估计死亡风险，考虑年龄、时期和队列效应。利用贝叶斯框架预测了2020-2030年期间的死亡率和DALY率。结果1990 - 2019年，中国因骨密度低导致跌倒的人群粗死亡率（224.79%）和DALY（196.27%）均显著升高。男性的标准化死亡率高于女性；然而，在此期间，标准化的DALY比率仍然低于在女性中观察到的比率。重要的是，与全球数据以及其他社会人口指数区域相比，中国在这段时间内见证了更大的死亡和DALYs激增。APC模型显示，随着时间的推移，男性的全球变化为1.06%(95%置信区间[CI]: 0.910-1.210)，女性的全球变化为0.29% （95% CI: 0.147-0.426）。所有年龄组的男性死亡率都有所上升，而62.5岁及以上的女性死亡率则有所上升。对于80岁以上的人来说，死亡的风险急剧上升。预测表明，在2020-2030年期间，中国男性和女性因骨密度低而跌倒的标准化死亡率将下降；但是，预期调整生活能力年标准化费率将有所增加。结论中国低骨密度导致跌倒的死亡风险受年龄、时期和队列效应的影响。加强针对老年人和年轻出生人群的跌倒预防和治疗战略，以及解决与跌倒有关的残疾问题，对于减轻非致命性跌倒造成的沉重负担至关重要。需要采取有针对性的干预措施，以减轻这一公共卫生问题日益严重的健康和经济影响。

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引用次数: 0