Aging Medicine最新文献_第9页

Global trend of cervical cancer among women aged 55 and older from 2010 to 2019: An analysis by socio-demographic index and geographic regions 2010 至 2019 年全球 55 岁及以上妇女患宫颈癌的趋势：按社会人口指数和地理区域进行的分析

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2024-10-14 DOI: 10.1002/agm2.12366

Fatemeh Rezaei, Afrooz Mazidimoradi, Zahra Pasokh, Farzaneh Mobasheri, Mohammad Taheri, Hamid Salehiniya, Leila Allahqoli, Ibrahim Alkatout

Objective

This study describes the 2010–2019 trend of cervical cancer (CC) in women over 55 by socio-demographic index (SDI) and geographical regions.

Methods

We obtained data on CC annually from 2010 to 2019 from the 2019 Global Burden of Disease Study (GBD) to analyze the incidence, death and prevalence rates, and disability-adjusted life years (DALYs) associated with CC across different parameters such as global trend, age groups, SDI, continents, World Bank Regions, World Health Organization (WHO) regions, GBD regions, and National and territorial division. This analysis covers data from 204 countries and territories from 1990 to 2019.

Results

There were 236,228 CC incidence cases worldwide in 2019, which is a 1.27-fold increase from 2010. Global CC deaths also increased to 169,304 cases in 2019, reflecting a 1.24-fold increase. CC prevalence increased to 769,925 cases in 2019, representing a 1.4-fold rise. The number of CC DALYs globally increased to 3,835,979 cases in 2019, reflecting a 1.24-fold increase. Incidence, death, prevalence, and DALY numbers of CC increased across all age groups females in the 65–69 years age group experienced the highest increase. Middle SDI countries had the highest incidence, death, prevalence, and DALY numbers, while low SDI countries showed increasing trends. Asia exhibited the highest incidence, death, prevalence, and DALY numbers of CC. Upper middle-income countries had the highest incidence, death, prevalence, and DALY numbers, with the highest decreases in these rates except the prevalence rate. The Western Pacific Region showed the highest incidence, death, prevalence, and DALY numbers, with declining rate trends. The Republic of Kiribati showed the highest incidence, death, prevalence, and DALY numbers.

Conclusion

Based on the study results, it is clear that although the global trend of epidemiological indicators of CC is decreasing, the largest proportion of the decreasing trend is related to developing countries. But in regions of Africa and Asia that have a lower level of development, sometimes these indicators show upward trends, which shows the worsening of the problem in these regions and the need for serious policies and plans to implement comprehensive vaccination, screening, and promotion interventions. People's awareness is necessary in the field of better disease control.

目的本研究按社会人口指数（SDI）和地理区域描述了2010-2019年55岁以上女性宫颈癌（CC）的发病趋势。方法我们从《2019年全球疾病负担研究》（GBD）中获取了2010-2019年每年的CC数据，分析了全球趋势、年龄组、SDI、大洲、世界银行地区、世界卫生组织（WHO）地区、GBD地区以及国家和地区划分等不同参数下与CC相关的发病率、死亡率和患病率以及残疾调整生命年（DALYs）。该分析涵盖了 204 个国家和地区从 1990 年到 2019 年的数据。结果 2019年全球共有236228例CC发病病例，比2010年增加了1.27倍。2019年全球CC死亡病例也增至169,304例，增长了1.24倍。2019年，CC患病率增至769,925例，增长了1.4倍。2019年，全球CC残疾调整寿命年数增至3,835,979例，增长了1.24倍。CC的发病率、死亡率、患病率和残疾调整寿命年数在所有年龄组中均有所上升，其中65-69岁年龄组中女性的增幅最大。中等SDI国家的发病率、死亡率、患病率和残疾调整寿命年数最高，而低SDI国家则呈上升趋势。亚洲的CC发病率、死亡率、流行率和残疾调整寿命年数最高。中上收入国家的发病率、死亡率、流行率和残疾调整寿命年数最高，除流行率外，其他比率的下降幅度最大。西太平洋地区的发病率、死亡人数、流行率和残疾调整寿命年数最高，且呈下降趋势。基里巴斯共和国的发病率、死亡人数、患病率和残疾调整寿命年数最高。结论根据研究结果，尽管全球 CC 流行病学指标呈下降趋势，但发展中国家在下降趋势中所占比例最大。但在发展水平较低的非洲和亚洲地区，这些指标有时呈上升趋势，这表明这些地区的问题正在恶化，需要制定严肃的政策和计划来实施全面的疫苗接种、筛查和宣传干预措施。要更好地控制疾病，就必须提高人们的认识。

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引用次数: 0

The impact of education as a proxy for lifestyle habits on reducing the association with dementia prevalence in the Southern Region of Brazil 教育作为生活习惯的替代物对降低巴西南部地区痴呆症发病率的影响

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2024-10-14 DOI: 10.1002/agm2.12362

Marcos Antonio Lopes, Alberto Stoppe Junior, Ylmar Correa Neto, Eleonora D'Orsi

Objectives

This study aimed to investigate the prevalence of dementia among older adults from Florianópolis, in the Southern Region of Brazil.

Methods

Data were originally drawn from the Epifloripa Aging Cohort Study, a representative and community-based survey designed to evaluate older people's health. This cross-sectional study was conducted in two phases: the community-screening phase, in which the Mini-Mental State Examination and a multifunctional scale were administered to older subjects and close informants, respectively; and the hospital-diagnosis phase, when the Cambridge Examination and the National Institute on Aging criteria were used. Adjustment for screening accuracy was made in order to estimate dementia prevalence.

Results

Of 1184 subjects evaluated in the community, 243 were screened for the diagnosis phase, in which 47 were identified with dementia, resulting in a crude prevalence of 4.5% (95% CI: 3.241–5.758) and an estimated prevalence of 9.2% (95% CI: 7.446–10.954). Dementia was associated with older ages, lower education levels, and the presence of stroke. Mild alcohol use (in comparison with no alcohol use), community-group practice, internet use and a higher level of physical activity, rather than education, decreased the odds ratio for dementia. Education was directly associated with these lifestyle habits.

Conclusions

Prevalence was lower than that in previous studies in the country, and multivariate analysis reinforced the importance of lifestyle in preventing cognitive disorders in the older population.

目的本研究旨在调查巴西南部弗洛里亚诺波利斯老年人痴呆症的发病率。方法数据最初来自埃皮弗洛里帕老龄化队列研究（Epifloripa Aging Cohort Study），这是一项具有代表性的社区调查，旨在评估老年人的健康状况。这项横断面研究分两个阶段进行：社区筛查阶段，分别对老年受试者和线人进行小型精神状态检查和多功能量表；医院诊断阶段，采用剑桥检查和国家老龄化研究所的标准。为了估算痴呆症的患病率，对筛查的准确性进行了调整。结果在社区接受评估的 1184 名受试者中，有 243 人接受了诊断阶段的筛查，其中 47 人被确认患有痴呆症，粗略患病率为 4.5%（95% CI：3.241-5.758），估计患病率为 9.2%（95% CI：7.446-10.954）。痴呆症与年龄较大、教育水平较低和中风有关。轻度饮酒（与不饮酒相比）、社区团体活动、互联网使用和较高水平的体育锻炼（而非受教育程度）降低了痴呆症的几率比例。教育程度与这些生活习惯直接相关。结论该国的患病率低于以往的研究，多变量分析加强了生活方式在预防老年人认知障碍方面的重要性。

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引用次数: 0

Curcumin inhibits oxidative stress and autophagy in C17.2 neural stem cell through ERK1/2 signaling pathways 姜黄素通过ERK1/2信号通路抑制C17.2神经干细胞的氧化应激和自噬作用

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2024-10-13 DOI: 10.1002/agm2.12361

Yuting Ruan, Haoyu Luo, Jingyi Tang, Mengyao Ji, Dapeng Yu, Qun Yu, Zhiyu Cao, Yingren Mai, Bei Zhang, Yan Chen, Jun Liu, Wang Liao

Objectives

This study investigates curcumin's neuroprotective role and its potential in promoting neurogenesis in progenitor cells within the brain. Notably, curcumin's antioxidant properties have been implicated in Alzheimer's disease treatment. However, the association between curcumin's antioxidative effects and its impact on neural stem cells (NSCs) remains to be elucidated.

Methods

C17.2 neural stem cells were utilized as a model to simulate oxidative stress, induced by hydrogen peroxide (H₂O₂). We quantified the levels of superoxide dismutase (SOD), malondialdehyde (MDA), and intracellular reactive oxygen species (ROS), alongside the gene expression of SOD1 and SOD2, to assess intracellular oxidative stress. Additionally, Western blot analysis was conducted to measure the expressions of LC3-II, Beclin-1, and phosphorylated ERK (p-ERK), thereby evaluating autophagy and ERK signaling pathway activation.

Results

Treatment with curcumin resulted in a reduction of MDA and ROS levels, suggesting a protective effect on NSCs against oxidative damage induced by H₂O₂. Furthermore, a decrease in the relative expressions of LC3-II, Beclin-1, and p-ERK was observed post-curcumin treatment.

Conclusions

The findings suggest that curcumin may confer protection against oxidative stress by attenuating autophagy and deactivating the ERK1/2 signaling pathways, which could contribute to therapeutic strategies for Alzheimer's disease.

目的本研究探讨姜黄素的神经保护作用及其在促进脑内祖细胞神经发生方面的潜力。值得注意的是，姜黄素的抗氧化特性已被用于阿尔茨海默病的治疗。然而，姜黄素的抗氧化作用与其对神经干细胞（NSCs）的影响之间的关联仍有待阐明。方法以C17.2神经干细胞为模型，模拟过氧化氢（H2O2）诱导的氧化应激。我们量化了超氧化物歧化酶（SOD）、丙二醛（MDA）和细胞内活性氧（ROS）的水平，以及SOD1和SOD2的基因表达，以评估细胞内氧化应激。此外，还进行了 Western 印迹分析，以测定 LC3-II、Beclin-1 和磷酸化 ERK（p-ERK）的表达，从而评估自噬和 ERK 信号通路的激活情况。结果姜黄素能降低 MDA 和 ROS 水平，表明姜黄素能保护 NSCs 免受 H2O2 诱导的氧化损伤。此外，姜黄素处理后还观察到 LC3-II、Beclin-1 和 p-ERK 的相对表达量减少。结论研究结果表明，姜黄素可以通过抑制自噬和使ERK1/2信号通路失活来抵御氧化应激，这可能有助于阿尔茨海默病的治疗策略。

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引用次数: 0

Factors associated with diabesity in older women: A cross-sectional investigation 老年妇女肥胖症的相关因素：横断面调查

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2024-10-13 DOI: 10.1002/agm2.12368

Karol Kaina Moraes Brum, Lucas dos Santos, Gabriel Alves Godinho, José Ailton Oliveira Carneiro, Thaís Alves Brito, Marcos Henrique Fernandes, Raildo da Silva Coqueiro, Camille Giehl Martins Miranda

Objective

To investigate the factors associated with diabesity in older women.

Methods

This epidemiological study used a cross-sectional design and included 196 older women (72.70 ± 7.20 years) from Jequié, Bahia, Brazil. Diabesity was defined as having both an elevated abdominal circumference (≥88 cm) and diabetes mellitus. For the inferential analyses, we constructed crude models followed by a multiple hierarchical explanatory model, with the following levels: Level 1 (socioeconomic variables), Level 2 (behavioral aspects), and Level 3 (health conditions). Poisson regression with a robust estimator was employed, and we calculated Prevalence Ratios (PR) with 95% Confidence Intervals (CI).

Results

The prevalence of abdominal obesity, diabetes mellitus, and diabesity were 79.60%, 27.80%, and 22.40%, respectively. Women who were insufficiently active had a higher likelihood of diabesity (PR: 2.04; 95% CI: 1.22–3.41), as did those who spent more time in sedentary behavior (PR: 1.81; 95% CI: 1.04–3.16), used three or more continuous medications (PR: 2.51; 95% CI: 1.29–4.89), or reported a negative self-perception of health (PR: 2.57; 95% CI: 1.03–5.80).

Conclusion

The study identified several factors associated with diabesity in older women: insufficient physical activity, prolonged sedentary behavior, polypharmacy, and negative self-perception of health.

目的研究老年妇女肥胖的相关因素。方法该流行病学研究采用横断面设计，纳入了巴西巴伊亚州耶奎市的 196 名老年妇女（72.70 ± 7.20 岁）。腹围增大（≥88 厘米）和患有糖尿病即为肥胖。在推理分析中，我们首先建立了粗略模型，然后建立了一个多重分层解释模型，其层次如下：第 1 层（社会经济变量）、第 2 层（行为方面）和第 3 层（健康状况）。我们采用了带有稳健估计器的泊松回归，并计算了患病率（PR）和 95% 的置信区间（CI）。结果腹部肥胖、糖尿病和肥胖症的患病率分别为 79.60%、27.80% 和 22.40%。活动量不足的女性患糖尿病的可能性更高（PR：2.04；95% CI：1.22-3.41），久坐不动时间较长（PR：1.81；95% CI：1.04-3.16）、连续使用三种或三种以上药物（PR：2.51；95% CI：1.29-4.89）或自我感觉健康状况较差（PR：2.57；95% CI：1.03-5.80）的女性也是如此。结论该研究发现了与老年妇女肥胖症相关的几个因素：体力活动不足、长期久坐不动、多种药物治疗以及对健康的负面自我认知。

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引用次数: 0

Association of handgrip strength weakness and asymmetry with later life pain risk in middle-aged and older individuals: Results from four prospective cohorts 中老年人手握力减弱和不对称与日后疼痛风险的关系：四个前瞻性队列的结果

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2024-10-10 DOI: 10.1002/agm2.12365

Yuanpeng Zhu, Haoran Zhang, Terry Jianguo Zhang, Nan Wu

<div> <section> <h3> Objectives</h3> <p>The burden of pain in middle-aged and older adults is considerable and significantly increases healthcare expenditures. We aimed to investigate the roles of handgrip strength (HGS) weakness and asymmetry in predicting pain across four nationally representative cohorts.</p> </section> <section> <h3> Methods</h3> <p>This longitudinal study utilized data from four major surveys: the Health and Retirement Study (HRS); the English Longitudinal Study of Ageing (ELSA); the Survey of Health, Ageing and Retirement in Europe (SHARE); and the China Health and Retirement Longitudinal Study (CHARLS). Multivariable cubic regression splines were employed to visually explore the nonlinear associations between HGS and pain in each cohort. The Cox proportional hazard model was applied to analyze the independent and combined relationship between HGS weakness and asymmetry and pain risk.</p> </section> <section> <h3> Results</h3> <p>We included 41,171 participants in the final analysis, with a mean follow-up period of 4.68 ± 2.61 years (50.7% female, mean age 64.3 ± 9.3 years). No nonlinear relationship was found between HGS and pain incidence (nonlinear <i>p</i> < 0.05 in ELSA and SHARE; >0.05 in CHARLS and HRS). After adjustment, the highest quartile groups had a significantly reduced risk of pain compared to the lowest quartile groups across all cohorts, with hazard ratios of 0.81 (0.74, 0.89) in CHARLS, 0.86 (0.77, 0.97) in HRS, 0.88 (0.77, 0.98) in ELSA, and 0.78 (0.73, 0.84) in SHARE. Participants with normal HGS had approximately 20% lower risk of pain compared to those with weak HGS. Each 5 kg increase in HGS was associated with decreased hazard ratios for pain: 0.95 (0.93, 0.97) in CHARLS, 0.97 (0.94, 0.99) in HRS, 0.96 (0.94, 0.99) in ELSA, and 0.94 (0.92, 0.95) in SHARE. The association between HGS asymmetry and pain risk was significant only in a few cohorts (HRS at 10%, 1.10 (1.03, 1.18); SHARE at 30%, 1.12 (1.05, 1.21)). No interaction effect between HGS weakness and asymmetry on pain risk was observed (all <i>p</i>-values for interaction >0.05).</p> </section> <section> <h3> Conclusions</h3> <p>Our findings suggest that HGS can be used as an independent predictor of pain in middle-aged and older European, American, and Chinese populations. However, our results do not support the use of HGS asymmetry as an independent predictor of pain risk. It is necessary to establish appropriate criteria for HGS asymmetry across different populations. The use of both weak HGS and asymmetry as predictors of health outcom

目标中老年人的疼痛负担相当沉重，大大增加了医疗支出。我们旨在研究手握力（HGS）的弱点和不对称在预测四个具有全国代表性的队列中的疼痛方面所起的作用。方法这项纵向研究利用了四项主要调查的数据：健康与退休研究（HRS）；英国老龄化纵向研究（ELSA）；欧洲健康、老龄化与退休调查（SHARE）；以及中国健康与退休纵向研究（CHARLS）。采用多变量立方回归样条直观地探讨了每个队列中 HGS 与疼痛之间的非线性关系。采用 Cox 比例危险模型分析 HGS 弱性和不对称与疼痛风险之间的独立和组合关系。结果我们在最终分析中纳入了 41 171 名参与者，平均随访时间为 4.68 ± 2.61 年（50.7% 为女性，平均年龄为 64.3 ± 9.3 岁）。HGS 与疼痛发生率之间未发现非线性关系（ELSA 和 SHARE 的非线性 p 为 0.05；CHARLS 和 HRS 的非线性 p 为 0.05）。经调整后，在所有队列中，与最低四分位组相比，最高四分位组的疼痛风险明显降低，危险比分别为：CHARLS：0.81 (0.74, 0.89)；HRS：0.86 (0.77, 0.97)；ELSA：0.88 (0.77, 0.98)；SHARE：0.78 (0.73, 0.84)。HGS 正常的参与者与 HGS 较弱的参与者相比，疼痛风险降低了约 20%。HGS 每增加 5 千克，疼痛的危险比就会降低：CHARLS 为 0.95 (0.93, 0.97)，HRS 为 0.97 (0.94, 0.99)，ELSA 为 0.96 (0.94, 0.99)，SHARE 为 0.94 (0.92, 0.95)。HGS 不对称与疼痛风险之间的关系仅在少数队列中显著（HRS 为 10%，1.10 (1.03, 1.18)；SHARE 为 30%，1.12 (1.05, 1.21)）。没有观察到 HGS 弱化和不对称对疼痛风险的交互作用（所有交互作用的 p 值均为 0.05）。结论我们的研究结果表明，在欧洲、美国和中国的中老年人群中，HGS 可作为疼痛的独立预测指标。然而，我们的结果并不支持将 HGS 不对称作为疼痛风险的独立预测指标。有必要在不同人群中建立适当的 HGS 不对称标准。使用弱 HGS 和不对称作为健康结果的预测指标需要在更多样化的人群中进一步验证。

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引用次数: 0

Intratumoral microbiota as cancer therapeutic target 作为癌症治疗靶点的瘤内微生物群

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2024-10-10 DOI: 10.1002/agm2.12359

Chang Guo, Qi An, Lu-yao Zhang, Xun-dong Wei, Jing Xu, Jiang-yong Yu, Guo-ju Wu, Jie Ma

Intratumoral microbiota, which affects the physiological and pathological processes of the host, has attracted increasing attention from researchers. Microbials have been found in normal as well as tumor tissues that were originally thought to be sterile. Intratumoral microbiota is considered to play a significant role in the development of tumors and the reduction of clinical benefits. In addition, intratumoral microbiota are heterogeneous, which have different distribution in various types of tumors, and can influence tumor development through different mechanisms, including genome mutations, inflammatory responses, activated cancer pathways, and immunosuppressive microenvironments. Therefore, eliminating the intratumoral microbiota is considered one of the most promising ways to slow down the tumor progression and improve therapeutic outcomes. In this review, we systematically categorized the intratumoral microbiota and elucidated its role in the pathogenesis and therapeutic response of cancer. We have also described the novel strategies to mitigate the impact of tumor progression. We hope this review will provide new insights for the anti-tumor treatment, particularly for the elderly population, where such insights could significantly enhance treatment outcomes.

影响宿主生理和病理过程的瘤内微生物群越来越受到研究人员的关注。在正常组织和肿瘤组织中都发现了微生物，而这些组织原本被认为是无菌的。瘤内微生物群被认为在肿瘤的发展和减少临床获益方面发挥着重要作用。此外，瘤内微生物群具有异质性，在各类肿瘤中分布不同，可通过基因组突变、炎症反应、激活癌症通路、免疫抑制微环境等不同机制影响肿瘤发生发展。因此，消除瘤内微生物群被认为是减缓肿瘤进展和改善治疗效果的最有希望的方法之一。在这篇综述中，我们对腔内微生物群进行了系统分类，并阐明了其在癌症发病机制和治疗反应中的作用。我们还介绍了减轻肿瘤进展影响的新策略。我们希望这篇综述能为抗肿瘤治疗提供新的见解，尤其是针对老年人群，因为这些见解能显著提高治疗效果。

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引用次数: 0

Excess dietary salt is associated with an altered bone strain index, degraded bone microarchitecture, vertebral fractures, and increased prevalence of osteoporosis in postmenopausal women—A study from a teaching hospital in southern India 膳食盐过量与绝经后妇女骨应变指数改变、骨微结构退化、脊椎骨折和骨质疏松症患病率增加有关--印度南部一家教学医院的研究结果

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2024-10-10 DOI: 10.1002/agm2.12360

Rebecca John, Kripa Elizabeth Cherian, Nitin Kapoor, Thomas Vizhalil Paul

Objectives

Excess dietary salt causes increased urinary calcium and this may lead to bone loss. We proposed to study the association between dietary salt intake and bone health in postmenopausal women from southern India.

Methods

An observational study in which community-dwelling postmenopausal women were recruited. Daily salt intake and urine calcium/creatinine ratio were assessed. Bone biochemistry and densitometric parameters such as bone mineral density (BMD), trabecular bone score (TBS) vertebral fractures, and bone strain index (BSI) were assessed using Dual Energy X-Ray Absorptiometry (DXA).

Results

A total of 383 postmenopausal women with a mean ± SD age of 59.8 ± 7.2 years and BMI of 25.2 ± 4.6 kg/m² were recruited. Among the participants, 165/383(43.1%) had osteoporosis at any site and 21% had moderate–severe vertebral fractures. The BMD at lumbar spine and femoral neck, TBS and BSI were significantly (p < 0.001) lower and the CTx was significantly (p = 0.008) higher among women with high salt intake (7.2 g/day) as compared to those with salt intake of <7.2 g/day. The prevalence of osteoporosis, low TBS, high BSI, and moderate–severe vertebral fractures significantly increased across low to high salt-intake categories. An ROC analysis showed that excess dietary salt was significantly associated with osteoporosis at any site with an AUC of 0.870 (95% CI: 0.832–0.907). On a multivariate analysis, excess salt intake conferred the highest odds of osteoporosis (OR: 2.296; 95% CI: 1.909–2.761).

Conclusions

Excess dietary salt is associated with high urinary calcium and compromised bone health among postmenopausal women from southern India. This may be a modifiable risk factor in osteoporosis and warrants further research.

目标膳食盐过量会导致尿钙增加，从而可能导致骨质流失。我们拟研究印度南部绝经后妇女的膳食盐摄入量与骨骼健康之间的关系。方法对社区绝经后妇女进行观察研究。评估了每日食盐摄入量和尿钙/肌酐比率。使用双能 X 射线吸收仪 (DXA) 评估骨生物化学和骨密度参数，如骨矿物质密度 (BMD)、骨小梁评分 (TBS)、脊椎骨折和骨应变指数 (BSI)。结果共招募了 383 名绝经后妇女，平均（±SD）年龄为 59.8 ± 7.2 岁，体重指数为 25.2 ± 4.6 kg/m2。其中，165/383（43.1%）人患有任何部位的骨质疏松症，21%的人患有中度-重度脊椎骨折。与食盐摄入量为<7.2克/天的女性相比，食盐摄入量高（7.2克/天）的女性腰椎和股骨颈的BMD、TBS和BSI显著较低（p <0.001），CTx显著较高（p = 0.008）。骨质疏松症、低TBS、高BSI和中重度椎体骨折的患病率在盐摄入量从低到高的类别中显著增加。ROC 分析表明，膳食盐过量与任何部位的骨质疏松症都有显著相关性，AUC 为 0.870（95% CI：0.832-0.907）。在多变量分析中，盐摄入过量导致骨质疏松症的几率最高（OR：2.296；95% CI：1.909-2.761）。结论在印度南部绝经后妇女中，膳食盐过量与尿钙过高和骨骼健康受损有关。这可能是骨质疏松症的一个可改变的风险因素，值得进一步研究。

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引用次数: 0

Uncontrolled blood pressure among the established hypertensive elderly people in Jashore, Bangladesh: A cross-sectional type of observational study 孟加拉国贾肖尔地区已确诊的高血压老年人中血压失控的情况：一项横断面观察研究。

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2024-08-29 DOI: 10.1002/agm2.12348

Goutam Kumar Acherjya, Ali Mohammad, Tarafder Keya, Mohammad Touhidul Islam, Md. Selim Reza, Md. Shakur Ahmed, Huq Md. Zahirul, Biswas Debashis, Shamsuzzaman Sheikh, Alam Nur

<div> <section> <h3> Objectives</h3> <p>Hypertension is one of the major modifiable risk factors for cardiovascular mortality and morbidity throughout the world. Increased life expectancy leads to increase prevalence of non-communicable diseases among the elderly people including Bangladesh. However, different studies reported high prevalence of uncontrolled hypertension ranging from 52.6% to 67.9% among the elderly people in different countries. With this view, we aimed to assess the frequency of uncontrolled blood pressure (BP) among the elderly hypertensive people and its associated risk factors and treatment pattern in Bangladesh.</p> </section> <section> <h3> Methodology</h3> <p>This cross-sectional type of observational study recruited 246 eligible hypertensive elderly patients attending in 250 Bedded General Hospital, Jashore, Bangladesh dated from 1st July to 31st December 2022. A structured questionnaire was developed and data on associated risk factors, treatment pattern and current blood pressure (BP) measurement were collected by face-to-face interview for the purposive sampling technique.</p> </section> <section> <h3> Results</h3> <p>The mean age of our study patients was 72 ± 7 years with a male and female ratio nearly 1:1. Of the total hypertensive patients aged over 65 years or more, 56.5% remained with uncontrolled hypertension even on their prescribed antihypertensive medications. The mean systolic (SBP) and diastolic (DBP) blood pressure were significantly high (<i>P</i> < 0.001) as 167 ± 22 mm Hg and 95 ± 11 mm Hg, respectively, among the uncontrolled hypertensive patients. However, we noticed the mean SBP and DBP among the total hypertensive patients were also significantly high (<i>P</i> < 0.001) as 148 ± 27 mm Hg and 87 ± 13 mm Hg, respectively. In this study, we reported that the mean number of last prescribed antihypertensive medications used by the total patients was 2 ± 1 (<i>P</i> =0.224) which was similar among the controlled and uncontrolled hypertensive patient groups. Among the elderly hypertensive patients, the most commonly prescribed antihypertensive medications were Amlodipine 39.8% (<i>P</i> =0.006), Olmesartan 29.3% (<i>P</i> = 0.186), Losartan 24.4% (<i>P</i> = 0.127), Bisoprolol 15.0% (<i>P</i> = 0.266) and Atenolol 14.6% (<i>P</i> = 0.224).</p> </section> <section> <h3> Conclusion</h3> <p>We noticed high frequency of uncontrolled blood pressure among the elderly hypertensive patients, despite of using multiple antihypertensive medications in Jashore, Bangladesh.</p> </section>

目的：高血压是全世界心血管死亡和发病的主要可改变风险因素之一。预期寿命的延长导致包括孟加拉国在内的老年人非传染性疾病的发病率增加。然而，不同的研究报告显示，在不同国家的老年人中，未得到控制的高血压发病率很高，从 52.6% 到 67.9% 不等。有鉴于此，我们旨在评估孟加拉国老年高血压患者血压失控的频率及其相关风险因素和治疗模式：这项横断面观察研究招募了 246 名符合条件的老年高血压患者，他们于 2022 年 7 月 1 日至 12 月 31 日在孟加拉国贾肖尔拥有 250 张病床的综合医院就诊。研究人员编制了一份结构化问卷，并通过有目的的抽样技术进行面对面访谈，收集了相关风险因素、治疗模式和当前血压测量的数据：研究对象的平均年龄为 72 ± 7 岁，男女比例接近 1:1。在 65 岁以上的高血压患者中，56.5% 的患者即使服用处方降压药，高血压仍未得到控制。平均收缩压（SBP）和舒张压（DBP）明显偏高（P P P =0.224），在已控制和未控制的高血压患者组中情况相似。在老年高血压患者中，最常处方的降压药是氨氯地平 39.8% (P =0.006)、奥美沙坦 29.3% (P =0.186)、洛沙坦 24.4% (P =0.127)、比索洛尔 15.0% (P =0.266)和阿替洛尔 14.6% (P=0.224)：我们注意到，在孟加拉国贾肖尔，尽管老年高血压患者使用多种降压药物，但血压失控的频率很高。

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引用次数: 0

Renal perfusion examination with contrast-enhanced ultrasound in vascular surgery 血管手术中的对比增强超声肾灌注检查。

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2024-08-19 DOI: 10.1002/agm2.12352

Zhiyuan Wu, Ning Zhao, Yongjun Li

<p>A recent consensus on the standardized evaluation of renal cortical perfusion with contrast-enhanced ultrasound in elderly patients in China was published. This paper mainly aimed to briefly introduce renal perfusion examination with CEUS in vascular surgery.</p><p>The kidneys, being the most vascularized organ in the human body, are highly susceptible to inadequate blood perfusion. In a resting state, the blood flow through both kidneys in healthy adults is approximately 1200 mL/min, equivalent to 25% of cardiac output.<span><sup>1</sup></span> Approximately 94% of this renal blood flow is directed to the renal cortex.<span><sup>2</sup></span> The kidneys maintain the ability to autonomously regulate blood flow within an arterial blood pressure range of 80–180 mmHg. Renal perfusion pressure typically refers to the difference between renal artery pressure and renal vein pressure. In 1991, Gosling et al.<span><sup>3</sup></span> introduced the concept of the critical closing pressure to reflect the actual renal perfusion.</p><p>Renal perfusion can be influenced by various factors including physiological, pathological, pharmacological, traumatic, and surgical factors. Physiological factors primarily involve hemodynamic parameters (blood pressure, blood volume, cardiac output, blood viscosity, etc.) and the sympathetic-parasympathetic nervous system. Specifically, renal diseases or renal vascular-related disorders constitute the primary pathological factors affecting renal perfusion. These renal vascular-related disorders can be categorized into primary and secondary renal vascular lesions. The former encompasses renal artery atherosclerotic stenosis, renal artery dysplasia, Takayasu arteritis, renal artery aneurysm, renal artery thrombosis or embolism, renal artery dissection, renal vein thrombosis, etc. Secondary renal artery lesions may include aortic dissection, para-renal or supra-renal abdominal aortic aneurysm,<span><sup>4</sup></span> renal artery metastatic cancer,<span><sup>5</sup></span> etc. Other rare renal vascular diseases such as renal arteriovenous fistula, congenital renal artery anomalies, nutcracker syndrome, can also impact renal perfusion. Among these, renal artery atherosclerosis, renal artery fibromuscular dysplasia, and Takayasu arteritis are currently the three most common causes of renal artery stenosis (RAS). Unlike Western populations, in the Chinese population, Takayasu arteritis is more commonly observed than renal artery fibromuscular dysplasia.</p><p>RAS can lead to renal dysfunction and renovascular hypertension. The reduction in renal blood flow caused by RAS results in decreased renal perfusion, triggering a series of pathological changes, including renal ischemia, glomerular atrophy and sclerosis, interstitial fibrosis, and tubular injury, ultimately leading to impaired renal function. RAS induces glomerular atrophy and sclerosis, leading to a decrease in glomerular filtration rate and affecting renal filtrati

总之，肾脏灌注评估，尤其是通过 CEUS 进行的评估，在血管外科手术中发挥着举足轻重的作用，它有助于评估肾脏供血、指导手术决策、预测术后并发症和评估手术效果。这些进步有助于提高手术干预的成功率，改善患者预后。ZW和NZ撰写了手稿。ZW修改了手稿。所有作者均审阅并批准了本稿件。李永军，与一个或多个组织没有经济利益/安排或附属关系，在本稿件的主题背景下可能被视为实际或明显的利益冲突。本工作得到了CAMS医学科学创新基金（CIFMS-2021-I2M-1-050）和PUMC学科建设项目（编号：201920102101）的支持。

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引用次数: 0

Analysis of mortality in Parkinson disease in China: Exploration of recent and future trends 中国帕金森病死亡率分析：近期和未来趋势探讨

IF 2.2 Q3 GERIATRICS & GERONTOLOGY

Aging Medicine

Pub Date : 2024-08-19 DOI: 10.1002/agm2.12354

Jinxin Lan, Yifan Ren, Ge Song, Lu Liu, Mingyu Li, Renmu Zhang, Chunyu Yin, Hua Zhou, Xiangyuan Zhang, Bin Lv, Yaqi Ma

Objectives

Parkinson disease (PD) is the third leading cause of mortality among middle-aged and older individuals in China. This study aimed to explore the trends and distribution features of PD mortality in China from 2013 to 2021 and make predictions for the next few decades.

Methods

Relevant data were obtained from the Chinese Center for Disease Control and Prevention Disease Surveillance Point system. The joinpoint regression model was used to evaluate trends. The R software was used to predict future trends.

Results

Age-standardized mortality rate (ASMR) of PD increased from 0.59 per 100,000 individuals to 1.22 per 100,000 individuals from 2013 to 2021, with an average annual percent change (AAPC) of 9.50 (95% CI: 8.24–10.78). The all-age ASMR of PD were higher in male individuals than in female individuals, and ASMR increased with age. The number of deaths and ASMR increased gradually from west to east and from rural to urban areas. Furthermore, ASMR is expected to increase to 2.66 per 100,000 individuals by 2040.

Conclusions

The heightened focus on the ASMR of PD among male individuals, urban areas, eastern China, and individuals aged ≥85 years has become a key determinant in further decreasing mortality, thereby exhibiting novel challenges to effective strategies for disease prevention and control.

目的帕金森病（PD）是导致中国中老年人死亡的第三大原因。本研究旨在探讨2013-2021年中国帕金森病死亡率的变化趋势和分布特征，并对未来几十年的帕金森病死亡率进行预测。方法相关数据来自中国疾病预防控制中心疾病监测点系统。采用连接点回归模型评估趋势。使用 R 软件预测未来趋势。结果从2013年到2021年，PD的年龄标准化死亡率（ASMR）从每10万人中0.59例增加到每10万人中1.22例，平均年变化率（AAPC）为9.50（95% CI：8.24-10.78）。男性发病率高于女性，随着年龄的增长，发病率也在增加。死亡人数和ASMR由西向东、由农村向城市地区逐渐增加。此外，到 2040 年，ASMR 预计将增至每 10 万人 2.66 例。结论对男性、城市地区、中国东部地区和年龄≥85 岁的人群中脊髓灰质炎的 ASMR 的高度关注已成为进一步降低死亡率的关键决定因素，从而对疾病预防和控制的有效策略提出了新的挑战。

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引用次数: 0