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A publication case report
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2025-04-24 DOI: 10.1016/j.jnha.2025.100560
Bruno Vellas
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引用次数: 0
Plasma senescence associated secretory proteins: A new link to mild cognitive impairment
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2025-04-24 DOI: 10.1016/j.jnha.2025.100561
Reema Banarjee, Nathan Basisty
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引用次数: 0
Association of life’s essential 8 with leukocyte telomere length and mitochondrial DNA copy number: Findings from the population-based UK Biobank study
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2025-04-17 DOI: 10.1016/j.jnha.2025.100557
Yu Tian , Shuang Kong , Li Mao , Guoying Wang , Jinxing He , Fang Lei , Lijin Lin , Jian Li

Objectives

To explore the association of Life’s Essential 8 (LE8) levels with leukocyte telomere length (LTL) and mitochondrial DNA copy number (mtDNA-CN).

Design

A cross-sectional study.

Setting and participants

225,692 participants aged 37−73 year from the UK Biobank cohort enrolled from 2006 to 2010.

Measurements

The LE8 score (0–100) was divided into low (<50), moderate (50–79), and high cardiovascular health (CVH) (≥80) categories, based on health behaviors and factors defined by the American Heart Association. LTL was measured by a validated quantitative polymerase chain reaction method. mtDNA-CN was reacted by standardized SNP probe intensities. The association of CVH (as both a continuous and categorical variable) with LTL and mtDNA-CN was examined using multiple linear regression.

Results

Of 225,692 participants, 5.3% had low CVH, 81.2% had moderate CVH, and 13.4% had high CVH. Participants with higher CVH were usually younger, female, better educated, of higher socioeconomic status, and with a lower prevalence of comorbidities. After adjusting for confounders, a higher LE8 score is associated with longer LTL (Beta = 0.075, P < 0.05) and increased mtDNA-CN (Beta = 0.094, P < 0.05). We also observed that this association was evident in the health behavior score (diet, physical activity, nicotine exposure, and sleep) and the health factors score (BMI, non-HDL cholesterol, blood glucose, and blood pressure), with a stronger positive association of health factors with LTL and mtDNA-CN (Beta = 0.019, P < 0.05; Beta = 0.037, P < 0.05).

Conclusions

Higher CVH is associated with longer LTL and increased mtDNA-CN.
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引用次数: 0
Clarifying the GDF15-LTL relationship: The role of medications, lifestyle, and morbidity
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2025-04-14 DOI: 10.1016/j.jnha.2025.100558
Chia-Ter Chao
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引用次数: 0
Association of serum 25-hydroxyvitamin D with the risk of depression in individuals with prediabetes and diabetes: A prospective cohort study
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2025-04-14 DOI: 10.1016/j.jnha.2025.100556
Huaxue Li , Guodong Liu , Yicheng Ma , Yingzhou Shi , Junming Han , Shengyu Tian , Hang Dong , Peipei Wang , Yingli Lu , Qiang Wang , Ling Gao , Yiping Cheng

Objective

Serum 25-hydroxyvitamin D [25(OH)D] is known to be associated with depression. However, the evidence concerning the association between vitamin D status and depressive episodes in population with prediabetes and diabetes remains limited. This study seeks to investigate the potential relationship between vitamin D levels and depression in this population.

Methods

This cohort study comprised 55,252 individuals with prediabetes and 17,369 patients with diabetes, who exhibited no signs of depression at baseline. Baseline 25(OH)D concentrations were assessed. Cox proportional hazard models were employed to estimate hazard ratios (HRs) and 95% CIs for depression, with adjustments made for potential confounding variables.

Results

Over a mean follow-up period of 11.7 years, a total of 2,409 depression events were documented in participants with diabetes; and 6,078 depression events were recorded in the prediabetic participants, during a mean follow-up of 12.3 years. Vitamin D sufficiency (≥75 nmol/L) was observed in only 12.5% of individuals with prediabetes and 11.3% of those with diabetes. After multivariate adjustment, an inverse and dose-dependent relationship was identified between serum 25(OH)D concentrations and the risk of depression in prediabetic and diabetic participants (P trend <0.05). Compared with the lowest 25(OH)D level (<25 nmol/L), the highest level (≥75 nmol/L) exhibited a 17% reduction in the risk of depressive events (HR 0.83; 95% CI 0.75−0.93) among individuals with prediabetes and a 25% reduction (HR 0.75; 95% CI 0.61−0.90) among those with diabetes。

Conclusion

The findings of this study highlight the critical importance of prioritizing serum 25(OH)D levels in the management of depression in patients with diabetes and prediabetes.
目的已知血清 25- 羟基维生素 D [25(OH)D] 与抑郁症有关。然而,有关糖尿病前期和糖尿病患者维生素 D 状态与抑郁发作之间关系的证据仍然有限。本研究旨在调查这一人群中维生素 D 水平与抑郁之间的潜在关系。方法这项队列研究包括 55252 名糖尿病前期患者和 17369 名糖尿病患者,他们在基线时没有抑郁迹象。对基线 25(OH)D 浓度进行了评估。结果在平均 11.7 年的随访期内,糖尿病患者共发生了 2,409 例抑郁事件;在平均 12.3 年的随访期内,糖尿病前期患者共发生了 6,078 例抑郁事件。只有12.5%的糖尿病前期患者和11.3%的糖尿病患者体内维生素D充足(≥75 nmol/L)。经过多变量调整后,发现血清 25(OH)D 浓度与糖尿病前期和糖尿病患者的抑郁风险之间存在反向和剂量依赖关系(P 趋势为 0.05)。与最低 25(OH)D 水平(<25 nmol/L)相比,最高水平(≥75 nmol/L)可使糖尿病前期患者的抑郁事件风险降低 17% (HR 0.83; 95% CI 0.75-0.93),降低 25% (HR 0.结论这项研究的结果突出表明,在糖尿病和糖尿病前期患者的抑郁症治疗中,优先考虑血清 25(OH)D 水平至关重要。
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引用次数: 0
Muscle power predicts frailty and other adverse events across different settings
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2025-04-03 DOI: 10.1016/j.jnha.2025.100555
Alejandro Álvarez-Bustos , Helio J. Coelho-Junior , Jose A. Carnicero , Irene Molina-Hermosilla , Blanca Alfonso-López , Ignacio Peinado , Marta Checa-López , Leocadio Rodríguez-Mañas

Objectives

To evaluate the association between lower-limb muscle power (MP) and frailty, measured using eight different scales, in older adults from four clinical settings. Additionally, to examine the predictive capacity of MP for adverse health events.

Design

A cross-sectional and longitudinal analysis using data from the Spanish cohort of the Frailtools project.

Setting

Nursing homes, primary care clinics, geriatric inpatient wards, and outpatient clinics.

Participants

245 older adults (mean age 82 ± 4.6 years, 64% women).

Measurements

MP measures were estimated using the five-time sit-to-stand (5STS) test and validated equations to obtain absolute (AMP), relative to body weight (RMP), and allometric (ALMP) values. Frailty was evaluated using eight scales, including the Frailty Phenotype and the Frailty Trait Scale. The incidence of adverse events (e.g., frailty, hospitalization, falls, and disability) was recorded over 12 months.

Results

Frailty prevalence varied significantly across scales and settings, with the lowest rates observed in primary care and the highest in nursing homes. Cross-sectional analysis revealed significant associations between all MP measures and frailty for most scales. RMP demonstrated the strongest associations, particularly with the Frailty Trait Scale-5 and FRAIL scale, across primary care, nursing homes, and outpatient clinics. Longitudinally, RMP was significantly associated with incident frailty and several adverse events, including hospitalizations (AUC: 0.71) and disability in activities of daily living (AUC: 0.71). Sex-specific MP cut-off points were identified for predicting health events. No significant differences were observed among MP measurements.

Conclusion

Lower-limb MP is a valid clinical biomarker associated with frailty and negative health events in older adults. The degree of associations varied according to frailty scale and clinical context, but no significant differences were observed when we compared their predictive ability. The proposed MP cut-off points may enhance frailty assessment and screening, particularly in primary care, nursing homes, and outpatient clinics. These findings highlight the clinical potential of incorporating MP measures into frailty tools and stress the need for further research to refine age-specific cut-off points and explore the influence of body composition.
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引用次数: 0
Is poor chewing ability a risk factor for malnutrition? A six-year longitudinal study of older adults in Sweden
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2025-04-02 DOI: 10.1016/j.jnha.2025.100554
Duangjai Lexomboon , Abhishek Kumar , Sara Freyland , Weili Xu , Gunilla Sandborgh-Englund

Objective

To investigate if poor chewing ability increases the risk of malnutrition and to compare its impact with other contributing factors.

Design

Longitudinal observational study.

Setting

Population-based survey.

Participants

1,596 community dwelling individuals aged 60 years or older who participated in the Swedish National Study on Aging and Care at Kungsholmen in 2001–2004 (baseline) and in 2007–2011 (follow-up) and were not at risk for malnutrition nor malnourished at baseline.

Measurements

The exposures were baseline chewing ability and change in chewing ability at follow-up. The primary outcome was malnutrition risk or being malnourished, as assessed by the Mini Nutritional Assessment Short-Form. The secondary outcome was weight loss over 10% at follow-up. Logistic regressions assessed the associations between the exposures and the outcomes. The average marginal effects (percentage points) compared the effect of the exposure versus covariates on outcome probability.

Results

150 (9.4%) reported having difficulty chewing hard food, while 191 (12.0%) had persistent difficulties chewing hard food or lost the ability during the follow-up. At the time of follow-up, 212 (13.3%) were at risk or malnourished, while 179 (11.2%) had weight loss of more than 10%. Self-reported difficulty chewing hard food increased the odds of being at risk or malnourished at follow-up (OR = 1.64, 95% CI = 1.06, 2.53) and having weight loss of more than 10% (OR = 1.72, 95% CI = 1.10, 2.68). Individuals who had persistent difficulty chewing hard food or lost the ability to chew hard food during the follow-up period were more likely to be at risk or malnourished (OR = 1.87, 95% CI = 1.26, 2.79) or had a weight loss of more than 10% (OR = 1.73, 95% CI = 1.12, 2.65). Having difficulty chewing hard food at baseline increased the probability of the two outcomes by approximately 6 percentage points, whereas the covariates increased or decreased the probabilities by 4–16 percentage points.

Conclusion

Poor chewing ability may be a low-risk factor for malnutrition in older individuals. Self-reported difficulty chewing hard food during dental visits should be addressed.
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引用次数: 0
The effect of 12-weeks Nutritional supplementation on Nutritional Intake and Status among Indonesian Older Outpatients with Malnutrition Risk, the Prolansia study: a randomized controlled trial
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2025-03-27 DOI: 10.1016/j.jnha.2025.100548
Esthika Dewiasty , Sjors Verlaan , Rahmi Istanti , Fariza Rahmah , Eugene Satryo , Lisette CPGM de Groot , Siti Setiati

Background

Standard care for older outpatients who are at risk of malnutrition in Indonesia is still based on the 2017’s recommendations of the Indonesian Geriatrics Society. and does not provide nutritional supplementation as recommended by ESPEN guidelines 2019/2022.

Objective

We compared the effects of supplementation of at least 400 kcal/day including 30 g or more of protein/day as nutritional intervention as recommended by the ESPEN Guideline with standard care recommended by The Indonesian Geriatrics Society, in Indonesian older adults who are at risk of malnutrition.

Methods

Older outpatients (60 years or older) at a geriatric clinic of the national referral hospital with or at risk of malnutrition were recruited. They were randomly allocated to 12 weeks of supplementation with a nutrient dense drink twice a day on top of standard care compared to standard care only. We assessed energy and nutrient intake at baseline, after 6 and 12 weeks and nutritional status, physical performance, and vitamin D level at baseline and after 12 weeks. Data analyses were blinded.

Results

As many as 105 older outpatients (65 % women, mean age 72.5 years, SD = 6.3) were randomly assigned to the intervention (n = 54) and the control group (n = 51). One hundred and one participants completed the intervention, with an average compliance of 90% to the nutritional intervention. Nutritional supplementation significantly increased daily intake of energy, protein, total fat, vitamin D, vitamin B12, calcium (all p values <0.001) and carbohydrate (p = 0.002) in both men and women after 12 weeks. The intervention group showed an increase in vitamin D levels (p = 0.008). Furthermore, the intervention group gained more body weight than the control group did (p = 0.021)), especially in women (p = 0.017). Women in the intervention group also showed more increase in skeletal muscle mass (p = 0.023). Improvements in muscle strength and physical performance were not statistically different between the groups. No significant adverse effects were noted.

Conclusion

Nutritional supplementation is effective in improving nutritional intake and status among Indonesian outpatients with malnutrition risk, which has the potential to support and enhance the standard of care.
{"title":"The effect of 12-weeks Nutritional supplementation on Nutritional Intake and Status among Indonesian Older Outpatients with Malnutrition Risk, the Prolansia study: a randomized controlled trial","authors":"Esthika Dewiasty ,&nbsp;Sjors Verlaan ,&nbsp;Rahmi Istanti ,&nbsp;Fariza Rahmah ,&nbsp;Eugene Satryo ,&nbsp;Lisette CPGM de Groot ,&nbsp;Siti Setiati","doi":"10.1016/j.jnha.2025.100548","DOIUrl":"10.1016/j.jnha.2025.100548","url":null,"abstract":"<div><h3>Background</h3><div>Standard care for older outpatients who are at risk of malnutrition in Indonesia is still based on the 2017’s recommendations of the Indonesian Geriatrics Society. and does not provide nutritional supplementation as recommended by ESPEN guidelines 2019/2022.</div></div><div><h3>Objective</h3><div>We compared the effects of supplementation of at least 400 kcal/day including 30 g or more of protein/day as nutritional intervention as recommended by the ESPEN Guideline with standard care recommended by The Indonesian Geriatrics Society, in Indonesian older adults who are at risk of malnutrition.</div></div><div><h3>Methods</h3><div>Older outpatients (60 years or older) at a geriatric clinic of the national referral hospital with or at risk of malnutrition were recruited. They were randomly allocated to 12 weeks of supplementation with a nutrient dense drink twice a day on top of standard care compared to standard care only. We assessed energy and nutrient intake at baseline, after 6 and 12 weeks and nutritional status, physical performance, and vitamin D level at baseline and after 12 weeks. Data analyses were blinded.</div></div><div><h3>Results</h3><div>As many as 105 older outpatients (65 % women, mean age 72.5 years, SD = 6.3) were randomly assigned to the intervention (n = 54) and the control group (n = 51). One hundred and one participants completed the intervention, with an average compliance of 90% to the nutritional intervention. Nutritional supplementation significantly increased daily intake of energy, protein, total fat, vitamin D, vitamin B12, calcium (all p values &lt;0.001) and carbohydrate (p = 0.002) in both men and women after 12 weeks. The intervention group showed an increase in vitamin D levels (p = 0.008). Furthermore, the intervention group gained more body weight than the control group did (p = 0.021)), especially in women (p = 0.017). Women in the intervention group also showed more increase in skeletal muscle mass (p = 0.023). Improvements in muscle strength and physical performance were not statistically different between the groups. No significant adverse effects were noted.</div></div><div><h3>Conclusion</h3><div>Nutritional supplementation is effective in improving nutritional intake and status among Indonesian outpatients with malnutrition risk, which has the potential to support and enhance the standard of care.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 6","pages":"Article 100548"},"PeriodicalIF":4.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A vegan dietary pattern is associated with high prevalence of inadequate protein intake in older adults; a simulation study
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2025-03-26 DOI: 10.1016/j.jnha.2025.100536
Jos W. Borkent , Pol Grootswagers , Joost Linschooten , Annet J.C. Roodenburg , Marga Ocké , Marian A.E. de van der Schueren

Background

A more sustainable diet with fewer animal-based products has a lower ecological impact but might lead to a lower protein quantity and quality. The extent to which shifting to more plant-based diets impacts the adequacy of protein intake in older adults needs to be studied.

Objectives

We simulated how a transition towards a more plant-based diet (flexitarian, pescetarian, vegetarian, or vegan) affects protein availability in the diets of older adults.

Setting

Community.

Participants

Data from the Dutch National Food Consumption Survey 2019–2021 of community-dwelling older adults (n = 607) was used.

Measurements

Food consumption data was collected via two 24-h dietary recalls per participant. Protein availability was expressed as total protein, digestible protein, and utilizable protein (based on digestibility corrected amino acid score) intake. The percentage below estimated average requirements (EAR) for utilizable protein was assessed using an adjusted EAR.

Results

Compared to the original diet (∼62% animal-based), utilizable protein intake decreased by about 5% in the flexitarian, pescetarian and vegetarian scenarios. In the vegan scenario, both total protein intake and utilizable protein were lower, leading to nearly 35% less utilizable protein compared to the original diet. In the original diet, the protein intake of 7.5% of men and 11.1% of women did not meet the EAR. This slightly increased in the flexitarian, pescetarian, and vegetarian scenarios. In the vegan scenario, approximately 60% had a protein intake below EAR.

Conclusions

Replacing animal-based protein sources with plant-based food products in older adults reduces both protein quantity and quality, albeit minimally in non-vegan plant-rich diets. In a vegan scenario, the risk of an inadequate protein intake is imminent.
{"title":"A vegan dietary pattern is associated with high prevalence of inadequate protein intake in older adults; a simulation study","authors":"Jos W. Borkent ,&nbsp;Pol Grootswagers ,&nbsp;Joost Linschooten ,&nbsp;Annet J.C. Roodenburg ,&nbsp;Marga Ocké ,&nbsp;Marian A.E. de van der Schueren","doi":"10.1016/j.jnha.2025.100536","DOIUrl":"10.1016/j.jnha.2025.100536","url":null,"abstract":"<div><h3>Background</h3><div>A more sustainable diet with fewer animal-based products has a lower ecological impact but might lead to a lower protein quantity and quality. The extent to which shifting to more plant-based diets impacts the adequacy of protein intake in older adults needs to be studied.</div></div><div><h3>Objectives</h3><div>We simulated how a transition towards a more plant-based diet (flexitarian, pescetarian, vegetarian, or vegan) affects protein availability in the diets of older adults.</div></div><div><h3>Setting</h3><div>Community.</div></div><div><h3>Participants</h3><div>Data from the Dutch National Food Consumption Survey 2019–2021 of community-dwelling older adults (n = 607) was used.</div></div><div><h3>Measurements</h3><div>Food consumption data was collected via two 24-h dietary recalls per participant. Protein availability was expressed as total protein, digestible protein, and utilizable protein (based on digestibility corrected amino acid score) intake. The percentage below estimated average requirements (EAR) for utilizable protein was assessed using an adjusted EAR.</div></div><div><h3>Results</h3><div>Compared to the original diet (∼62% animal-based), utilizable protein intake decreased by about 5% in the flexitarian, pescetarian and vegetarian scenarios. In the vegan scenario, both total protein intake and utilizable protein were lower, leading to nearly 35% less utilizable protein compared to the original diet. In the original diet, the protein intake of 7.5% of men and 11.1% of women did not meet the EAR. This slightly increased in the flexitarian, pescetarian, and vegetarian scenarios. In the vegan scenario, approximately 60% had a protein intake below EAR.</div></div><div><h3>Conclusions</h3><div>Replacing animal-based protein sources with plant-based food products in older adults reduces both protein quantity and quality, albeit minimally in non-vegan plant-rich diets. In a vegan scenario, the risk of an inadequate protein intake is imminent.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 5","pages":"Article 100536"},"PeriodicalIF":4.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Discordance between physical and cognitive health problems over one year after critical care: Insights from severe COVID-19 patients 重症监护后一年内身体和认知健康问题的不一致性:来自 COVID-19 重症患者的启示
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2025-03-26 DOI: 10.1016/j.jnha.2025.100547
Leandro U. Taniguchi , Natalia G. Gonçalves , Naomi V. Ferreira , Laiss Bertola , Thiago J. Avelino-Silva , Murilo B. Dias , Ludhmila A. Hajjar , Wilson Jacob-Filho , Claudia K. Suemoto , Márlon J.R. Aliberti , on behalf of the CO-FRAIL Study Group EPICCoV Study Group and COVID HCFMUSP Study Group

Objectives

To investigate the longitudinal evolution of physical and cognitive problems after hospital discharge in survivors of severe COVID-19; to describe the co-occurrence of these health problems domains in the following year after discharge; and evaluate if results are different taking into account the use of invasive mechanical ventilation.

Design

Prospective cohort study.

Setting

A large academic medical center in Brazil.

Participants

Patients aged ≥50 years who survived hospitalization for COVID-19 requiring critical care.

Measurements

We evaluated participants’ status before hospital admission and one, three, six, nine, and twelve months after hospital discharge using validated questionnaires to measure frailty, persistent physical symptoms, and cognitive function. Clusters of physical and cognitive problems were defined using sequential analysis. Concordance was studied between different problems and trajectories, and after stratifying for use of invasive mechanical ventilation during ICU stay.

Results

We included 428 participants (median age was 63 years, 57% were male, 14% were frail before COVID-19, and 61% required mechanical ventilation). Physical and/or cognitive problems were experienced in 83% of responders at least once during follow-up, and half reported any problem even after one year. Most participants experienced health problems in a single health domain, with co-occurrence less than 9% in every assessment (Cramer’s V bias-corrected less than 0.1 in any assessment). Sequential analysis identified three clusters each of cognitive and physical trajectories, with different evolution and no concordance. Stratifying the sample based on the use of mechanical ventilation did not change the results.

Conclusions

Severe COVID-19 survivors frequently experience physical and/or cognitive problems, yet these conditions and their trajectories are discordant. Multidimensional evaluations post-ICU discharge can aid in delivering tailored rehabilitation programs.
{"title":"Discordance between physical and cognitive health problems over one year after critical care: Insights from severe COVID-19 patients","authors":"Leandro U. Taniguchi ,&nbsp;Natalia G. Gonçalves ,&nbsp;Naomi V. Ferreira ,&nbsp;Laiss Bertola ,&nbsp;Thiago J. Avelino-Silva ,&nbsp;Murilo B. Dias ,&nbsp;Ludhmila A. Hajjar ,&nbsp;Wilson Jacob-Filho ,&nbsp;Claudia K. Suemoto ,&nbsp;Márlon J.R. Aliberti ,&nbsp;on behalf of the CO-FRAIL Study Group EPICCoV Study Group and COVID HCFMUSP Study Group","doi":"10.1016/j.jnha.2025.100547","DOIUrl":"10.1016/j.jnha.2025.100547","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the longitudinal evolution of physical and cognitive problems after hospital discharge in survivors of severe COVID-19; to describe the co-occurrence of these health problems domains in the following year after discharge; and evaluate if results are different taking into account the use of invasive mechanical ventilation.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Setting</h3><div>A large academic medical center in Brazil.</div></div><div><h3>Participants</h3><div>Patients aged ≥50 years who survived hospitalization for COVID-19 requiring critical care.</div></div><div><h3>Measurements</h3><div>We evaluated participants’ status before hospital admission and one, three, six, nine, and twelve months after hospital discharge using validated questionnaires to measure frailty, persistent physical symptoms, and cognitive function. Clusters of physical and cognitive problems were defined using sequential analysis. Concordance was studied between different problems and trajectories, and after stratifying for use of invasive mechanical ventilation during ICU stay.</div></div><div><h3>Results</h3><div>We included 428 participants (median age was 63 years, 57% were male, 14% were frail before COVID-19, and 61% required mechanical ventilation). Physical and/or cognitive problems were experienced in 83% of responders at least once during follow-up, and half reported any problem even after one year. Most participants experienced health problems in a single health domain, with co-occurrence less than 9% in every assessment (Cramer’s V bias-corrected less than 0.1 in any assessment). Sequential analysis identified three clusters each of cognitive and physical trajectories, with different evolution and no concordance. Stratifying the sample based on the use of mechanical ventilation did not change the results.</div></div><div><h3>Conclusions</h3><div>Severe COVID-19 survivors frequently experience physical and/or cognitive problems, yet these conditions and their trajectories are discordant. Multidimensional evaluations post-ICU discharge can aid in delivering tailored rehabilitation programs.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 6","pages":"Article 100547"},"PeriodicalIF":4.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Nutrition Health & Aging
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