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The potential of cannabinoids in managing cancer-related anorexia in older adults: a systematic review of the literature 大麻素在控制老年人癌症相关厌食症方面的潜力:文献系统回顾。
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-24 DOI: 10.1016/j.jnha.2024.100299
Chiara Ceolin , Marina De Rui , Adele Ravelli , Mario Virgilio Papa , Maria Devita , Giuseppe Sergi , Alessandra Coin

Background and objectives

Anorexia of aging (AoA) is a prevalent geriatric syndrome characterized by a multifactorial decline in appetite and reduced food intake associated with the aging process. This systematic review aims to investigate the use and outcomes of cannabinoids in addressing AoA, with the goal of providing a comprehensive understanding and discussing their potential integration into daily clinical practice.

Methods

A thorough search of databases (Embase Ovid, Scopus, PubMed, Cochrane Library, and Web of Science) identified 6100 studies. After eliminating duplicates and screening titles and abstracts, 25 studies underwent full appraisal. Two reviewers assessed inclusion suitability, and study methodologies were evaluated using the Newcastle-Ottawa Scale (NOS) for observational studies and the modified Jadad Scoring Scale for randomized controlled trials. Ultimately, six studies published between 2002 and 2019, involving 869 participants, were included in the review.

Results

Out of the 6 fin. l papers selected, 5 were randomized trials, and 1 was a prospective study. Megestrol acetate (800 mg/d) proved to be more effective than dronabinol 2.5 mg twice a day in increasing appetite. Nabilone (at a dosage of 0.5 mg per day) did not show superiority over placebo in alleviating symptoms such as pain, nausea, loss of appetite, and weight. However, with a double dosage followed by 1.0 mg/6 weeks, after eight weeks of treatment, patients recorded a significant increase in calorie intake and carbohydrate consumption compared to the placebo group, with some patients also experiencing substantial weight gain. Regarding delta-9-tetrahydrocannabinol (THC), a weight increase of ≥10% was observed in 17.6% of patients with doses of 5 mg or 10 mg capsules daily, without significant side effects. Additionally, patients treated with THC 2.5 mg reported improved chemosensory perception and increased appetite before meals compared to placebo. No significant side effects were reported in older adults taking cannabinoids.

Conclusions

Cannabinoids offer promise in enhancing the quality of life for older individuals with active neoplastic disease. However, to establish comprehensive guidelines, further research with larger sample sizes is essential. Only through this approach can we fully grasp the potential and application of cannabinoids in addressing the nutritional concerns associated with neoplastic diseases.

背景和目的:衰老性厌食症(AoA)是一种常见的老年综合症,其特点是与衰老过程相关的食欲下降和食物摄入量减少。本系统综述旨在调查大麻素在解决厌食症方面的应用和结果,目的是提供一个全面的认识,并讨论将其纳入日常临床实践的可能性:方法:通过对数据库(Embase Ovid、Scopus、PubMed、Cochrane Library 和 Web of Science)的全面检索,确定了 6100 项研究。在剔除重复、筛选标题和摘要后,对 25 项研究进行了全面评估。两名审稿人对纳入的适宜性进行了评估,并使用纽卡斯尔-渥太华量表(NOS)对观察性研究的研究方法进行了评估,使用修改后的贾达德评分量表对随机对照试验的研究方法进行了评估。最终,2002 年至 2019 年间发表的 6 项研究被纳入综述,涉及 869 名参与者:在入选的 6 篇论文中,5 篇为随机对照试验,1 篇为前瞻性研究。在增加食欲方面,醋酸甲地孕酮(800 毫克/天)比屈大麻酚(2.5 毫克/天,两次)更有效。在减轻疼痛、恶心、食欲不振和体重等症状方面,纳比隆(每天 0.5 毫克)没有显示出优于安慰剂。不过,在双倍剂量后,1.0 毫克/6 周的剂量在治疗八周后,患者的卡路里摄入量和碳水化合物消耗量比安慰剂组有显著增加,一些患者的体重也有大幅增加。关于δ-9-四氢大麻酚(THC),每天服用 5 毫克或 10 毫克胶囊的患者中,有 17.6% 的人体重增加≥10%,且无明显副作用。此外,与安慰剂相比,接受 2.5 毫克 THC 治疗的患者表示化学感知得到改善,餐前食欲增加。服用大麻素的老年人没有出现明显的副作用:大麻素有望提高患有活动性肿瘤疾病的老年人的生活质量。然而,要制定全面的指导方针,必须开展样本量更大的进一步研究。只有通过这种方法,我们才能充分掌握大麻素在解决与肿瘤疾病相关的营养问题方面的潜力和应用。
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引用次数: 0
Using cardiorespiratory fitness to operationalize vitality: a path analysis on the hierarchical structure of intrinsic capacity 利用心肺功能实现活力的可操作性:内在能力层次结构的路径分析
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-21 DOI: 10.1016/j.jnha.2024.100300
Ruby Yu, Derek Lai, Grace Leung, Cecilia Tong, Jean Woo

Background

There is a lack of consensus about the operationalization of vitality, which is one of the intrinsic capacity (IC) domains. In particular, no study has investigated whether cardiorespiratory fitness (CRF) can be considered a vitality indicator.

Objective

To examine whether vitality is the upstream domain of IC, and establish the validity of CRF as a vitality indicator, using maximal oxygen consumption (VO2 max) as a representative.

Methods

561 older adults from a longitudinal cohort study were included. Variables under consideration were VO2 max, other IC domains, instrumental activities of daily living (IADL), and handgrip strength, which was considered an already validated indicator of vitality. Using handgrip strength as the reference point, path analyses were performed to examine whether VO2 max followed a similar hierarchical structure in predicting change in IADL difficulty through other IC domains.

Results

The mean age of the participants was 75.5 years. The path model in which vitality was measured by VO2 max demonstrated adequate fit, which was similar to the model in which vitality was measured by handgrip strength. Regarding the path coefficients, the model using VO2 max demonstrated significant total and indirect effects. Notably, the indirect effect was due to the locomotor domain (standardized coefficient = −0.148, p < .001), but not the cognitive or psychological domain.

Conclusion

Vitality is the upstream domain of IC. VO2 max can be considered an indicator to operationalize the vitality concept.

背景关于作为内在能力(IC)领域之一的生命力的操作化,目前还缺乏共识。目的 以最大氧耗量(VO2 max)为代表,研究生命力是否是 IC 的上游领域,并确定 CRF 作为生命力指标的有效性。方法 纳入了一项纵向队列研究中的 561 名老年人。研究考虑的变量包括最大氧耗量、其他 IC 领域、日常生活工具性活动(IADL)和手握力,后者被认为是已经验证过的活力指标。以手握强度为参考点,进行路径分析,以考察最大氧饱和度在通过其他 IC 领域预测 IADL 难度变化时是否遵循类似的层次结构。以最大氧饱和度衡量生命力的路径模型显示出足够的拟合度,这与以手握强度衡量生命力的模型相似。在路径系数方面,使用最大氧饱和度的模型显示出显著的总效应和间接效应。值得注意的是,间接效应来自运动领域(标准化系数 = -0.148,p <.001),而不是认知或心理领域。最大氧饱和度可被视为活力概念的操作化指标。
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引用次数: 0
The impact of six-week dihydrogen-pyrroloquinoline quinone supplementation on mitochondrial biomarkers, brain metabolism, and cognition in elderly individuals with mild cognitive impairment: a randomized controlled trial 为期六周的二氢吡咯喹啉醌补充剂对轻度认知障碍老年人线粒体生物标志物、大脑代谢和认知能力的影响:随机对照试验
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-21 DOI: 10.1016/j.jnha.2024.100287
Sonja Baltic , David Nedeljkovic , Nikola Todorovic , Marijana Ranisavljev , Darinka Korovljev , Jelena Cvejic , Jelena Ostojic , Tyler W. LeBaron , Judi Timmcke , Valdemar Stajer , Sergej M. Ostojic
<div><h3>Objectives</h3><p>To assess the impact of medium-term supplementation with dihydrogen and pyrroloquinoline quinone (PQQ) on mitochondrial biomarkers, brain metabolism, and cognition in elderly individuals diagnosed with mild cognitive impairment.</p></div><div><h3>Design</h3><p>A parallel-group, randomized, placebo-controlled, double-blind experimental design, maintaining a 1:1 allocation ratio between the experimental group (receiving the dihydrogen-producing minerals and PQQ) and the control group (receiving the placebo) throughout the trial.</p></div><div><h3>Setting and participants</h3><p>Thirty-four elderly individuals with mild cognitive impairment (mean age 71.9 ± 3.8 years; 28 females) voluntarily provided written consent to participate in this trial. Participants were assigned in a double-blind parallel-group design to receive either a dihydrogen-PQQ mixture (Alpha Hope®, CalerieLife, Irvine, CA) or placebo twice daily for a 6-week intervention period.</p></div><div><h3>Methods</h3><p>The primary endpoint was the change in serum brain-derived neurotrophic factor (BDNF) from baseline to the 6-week follow-up; secondary outcomes included cognitive function indices, specific metabolites in brain tissue, brain oxygenation, and the prevalence and severity of side effects. Interaction effects (time vs. intervention) were evaluated using two-way ANOVA with repeated measures and Friedman’s 2-way ANOVA by ranks, for normally distributed data with homogeneous variances and non-homogeneous variances, respectively.</p></div><div><h3>Results</h3><p>Dihydrogen-PQQ resulted in a significant elevation in serum BDNF levels at the six-week follow-up (<em>P</em> = 0.01); conversely, no changes in BDNF levels were observed in the placebo group throughout the study duration (<em>P</em> = 0.27). A non-significant trend in the impact of interventions on BDNF levels was observed (treatment vs. time interaction, <em>P</em> = 0.14), suggesting a tendency for dihydrogen-PQQ to upregulate BDNF levels compared to the placebo. A significant interaction effect was observed for the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) scores in the orientation domain (<em>P</em> = 0.03), indicating the superiority of dihydrogen-PQQ over placebo in enhancing this cognitive aspect. Cerebral oxygenation saturation exhibited a significant increase following the administration of the dihydrogen-PQQ mixture, from 48.4 ± 7.2% at baseline to 52.8 ± 6.6% at 6-week post-administration (<em>P</em> = 0.005). In addition, brain <em>N</em>-acetyl aspartate levels significantly increased at seven out of thirteen locations post-intervention in participants receiving the mixture (<em>P</em> ≤ 0.05).</p></div><div><h3>Conclusions</h3><p>Despite the limited number of participants included in the study for interpreting clinical parameters, the dihydrogen-PQQ mixture blend shows promise as a potential dietary intervention for enhancing mental orientation and brain met
目的评估中期补充二氢矿物质和吡咯喹啉醌(PQQ)对被诊断为轻度认知障碍的老年人的线粒体生物标志物、脑代谢和认知能力的影响。设计平行组、随机、安慰剂对照、双盲实验设计,在整个试验过程中实验组(接受产生二氢的矿物质和 PQQ)和对照组(接受安慰剂)之间保持 1:1 的分配比例。方法主要终点是血清脑源性神经营养因子(BDNF)从基线到 6 周随访期间的变化;次要结果包括认知功能指数、脑组织中的特定代谢物、脑氧饱和度以及副作用的发生率和严重程度。对于具有均一方差和非均一方差的正态分布数据,分别采用重复测量的双向方差分析和弗里德曼的双向秩和方差分析来评估交互作用(时间与干预)。结果双氢-PQQ使血清BDNF水平在6周的随访中显著升高(P = 0.01);相反,安慰剂组的BDNF水平在整个研究期间没有变化(P = 0.27)。干预措施对 BDNF 水平的影响呈不显著趋势(治疗与时间的交互作用,P = 0.14),表明与安慰剂相比,二氢-PQQ 有上调 BDNF 水平的趋势。阿尔茨海默病评估量表-认知子量表(ADAS-Cog)在定向领域的得分出现了明显的交互效应(P = 0.03),表明二氢-PQQ在提高认知能力方面优于安慰剂。服用二氢-PQQ混合物后,脑氧饱和度明显提高,从基线时的48.4 ± 7.2%提高到服用6周后的52.8 ± 6.6%(P = 0.005)。结论尽管该研究的参与者人数有限,无法解释临床参数,但二氢-PQQ混合物显示出作为一种潜在的膳食干预措施,可改善老年轻度认知功能衰退患者的精神定向和大脑新陈代谢的前景。
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引用次数: 0
Therapeutic perspectives of pre-, pro-, post-biotics in the treatment of sarcopenia 前、前、后生物制剂在治疗肌肉疏松症中的治疗前景
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-21 DOI: 10.1016/j.jnha.2024.100298
Yves Rolland , Andrea Ticinesi , Harry Sokol , Philipe De Souto Barreto
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引用次数: 0
A simplified definition of sarcopenia: muscle mass/body weight 肌肉疏松症的简化定义:肌肉质量/体重
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-21 DOI: 10.1016/j.jnha.2024.100302
William J. Evans , Luigi Ferrucci
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引用次数: 0
Diagnostic and prognostic value of calf circumference for sarcopenia in community-dwelling older adults 小腿围度对社区老年人肌少症的诊断和预后价值
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-21 DOI: 10.1016/j.jnha.2024.100290
Alejandro Álvarez-Bustos , Jose Antonio Carnicero , Helio José Coelho-Junior , Riccardo Calvani , Francisco José García-García , Emanuele Marzetti , Francesco Landi , Leocadio Rodriguez-Mañas

Background

An age-dependent normative values of calf circumference (CC) has been recently proposed as an accessible proxy for muscle mass. However, its usefulness to estimate sarcopenia has not been assessed. The objectives of the present study were to determine if the substitution of the classical way to assess muscle mass by these values have enough diagnostic accuracy and prognostic value among older adults living in the community.

Methods

Data from the Toledo Study of Healthy Ageing (TSHA) were used. CC was measured using an anthropometric tape. We used two age-groups CC cut-off points: the TSHA CC median and the one proposed in the Longevity Check-up 7+ (Lookup 7+) project. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People (EWGSOP2), the Foundation for the National Institutes of Health (FNIH), and FNIH criteria standardized for our population (sFNIH). Frailty (according to the Frailty Phenotype and the Frailty Trait Scale-5) and disability (Katz index) were assessed at baseline and follow-up. Mortality and first hospitalization were also recorded. Logistic (incident frailty and worsening disability) and Cox (mortality and hospitalization) regressions were performed. Diagnostic accuracy was assessed through Kappa index, AUCs, positive and negative predictive values. Predictive ability was assessed through AUCs and integrated AUCs (IAUCs).

Results

1531 participants (74.8 ± 5.8 years; 45.6% men) were included in the analysis. Prevalence rates of sarcopenia were 22.7% (sFNIH), 15.0% (FNIH), and 13.9% (EWGSOP2). Using TSHA-based cut-points of CC, the prevalence of sarcopenia was 16.8% (sFNIH), 11.0% (FNIH), and 11.5% (EWGSOP2). According to LC7+-based CC cut-off points, sarcopenia prevalence was 17.6% (sFNIH), 11.9% (FNIH), and 12.4% (EWGSOP2). CC cut-off points showed low-to-moderate agreement (Kappa Index values between 0.49 and 0.69) with appendicular lean mass for the evaluation of sarcopenia. Sarcopenia identified by Lookup 7+ and TSHA CC cut-off points was associated with the adverse events examined, with similar AUCs and IAUCs than original sarcopenia definitions, and were lost after adjustment by baseline frailty, except when the original EWGSOP2 definition was used.

Conclusions

Using normalized values of CC as a criteria of muscle mass shows moderate agreement with classical criteria for diagnosing sarcopenia and offer similar predictive value in community-dwelling older adults.

背景 最近,有人提出了一个与年龄相关的小腿围(CC)常模值,作为肌肉质量的替代指标。然而,该方法在评估肌肉疏松症方面的实用性尚未得到评估。本研究的目的是确定在社区生活的老年人中,用这些数值替代传统的肌肉质量评估方法是否具有足够的诊断准确性和预后价值。使用人体测量尺测量 CC。我们使用了两个年龄组的 CC 分界点:TSHA CC 中位数和长寿体检 7+(Lookup 7+)项目中提出的 CC 分界点。肢端肥大症是根据欧洲老年人肢端肥大症工作组(EWGSOP2)、美国国立卫生研究院基金会(FNIH)以及针对我国人群标准化的 FNIH 标准(sFNIH)定义的。在基线和随访期间对虚弱程度(根据虚弱表型和虚弱特征量表-5)和残疾程度(卡茨指数)进行了评估。同时还记录了死亡率和首次住院情况。进行了 Logistic(事件性虚弱和残疾恶化)和 Cox(死亡率和住院)回归。诊断准确性通过卡帕指数、AUC、阳性和阴性预测值进行评估。结果 1531 名参与者(74.8 ± 5.8 岁;45.6% 为男性)被纳入分析。肌少症患病率分别为 22.7%(sFNIH)、15.0%(FNIH)和 13.9%(EWGSOP2)。采用基于 TSHA 的 CC 切点,肌少症患病率为 16.8%(sFNIH)、11.0%(FNIH)和 11.5%(EWGSOP2)。根据基于 LC7+ 的 CC 切分点,肌少症患病率为 17.6%(sFNIH)、11.9%(FNIH)和 12.4%(EWGSOP2)。在评估肌肉疏松症时,CC截断点与闌尾瘦体重显示出低到中等程度的一致性(Kappa指数值在0.49和0.69之间)。用 Lookup 7+ 和 TSHA CC 截断点确定的肌肉疏松症与所研究的不良事件有关,其 AUC 和 IAUC 与原始的肌肉疏松症定义相似,而且在根据基线虚弱程度进行调整后,除了使用原始的 EWGSOP2 定义外,其他定义均不适用。
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引用次数: 0
Association of oxidative balance score with all-cause mortality among older adults in the United States: evidence from NHANES 2007–2018 氧化平衡评分与美国老年人全因死亡率的关系:来自 2007-2018 年 NHANES 的证据
IF 5.8 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-19 DOI: 10.1016/j.jnha.2024.100297
Shanshan Jia, Xingwei Huo, Lirong Sun, Xiaoping Chen
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引用次数: 0
The association of non-severe COVID-19 infection and progression to frailty among robust older veterans 非严重 COVID-19 感染与体格健壮的老年退伍军人体弱多病的关系
IF 5.8 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-19 DOI: 10.1016/j.jnha.2024.100296
Natasha M. Resendes , Jerry Bradley , Fei Tang , Iriana S. Hammel , Jorge G. Ruiz

Background

Studies have shown that frailty was increased in hospitalized COVID-19 patients. However, it is not clear whether non-severe COVID-19 increases the risk for pre-frailty and frailty development. Our study aimed to determine the risk of developing frailty and pre-frailty in robust veterans who contracted non-severe COVID-19.

Methods

We conducted a retrospective cohort study to assess the association of SARS-CoV-2 infection with the development of pre-frailty and frailty status among robust U.S. veterans using VA COVID-19 Shared Data Resource. We included patients 55 years and older who had at least one SARS-CoV-2 testing between March 15, 2020, and November 30, 2020, had been active patients in the past 12 months, and had a VA frailty index of zero (robust status) at the time of testing. Cox proportional hazard model was used to assess the association between COVID-19 infection and developing frailty or pre-frailty and frailty. We also assessed the association by patients’ age groups, sex, and race.

Findings

We identified 82070 veterans mean age 68.3 ± 7.8, 74738 (91.1%) male, 53899 (65.7%) white, 7557 (9.2%) with mild COVID-19 infection. Over the follow up period of 36 months, testing positive for COVID-19 was associated with a 66% increase in the hazard of becoming frail (adjusted HR = 1.66, 95%CI: 1.32–2.08), and a 68% increase in the hazard of becoming pre-frail (adjusted HR = 1.68, 95%CI: 1.45–1.94). Among male patients, mild COVID-19 infection was associated with a 54% increase in the hazard of becoming frail (adjusted HR = 1.54, 95% CI: 1.21−1.96), while among female patients there was a 330% increase (adjusted HR = 4.30, 95% CI: 2.13−8.64).

Conclusions and relevance

Non-severe COVID-19 infection that occurred in robust older adults increased the risk of developing frailty. Further multi-center prospective cohort studies evaluating the mechanism of action and clinical trials of treatment options for post-COVID frailty are indicated in Veterans to support clinical care.

背景研究表明,住院的 COVID-19 患者虚弱程度增加。然而,尚不清楚非重度 COVID-19 是否会增加虚弱前期和虚弱发展的风险。我们的研究旨在确定感染了非重度 COVID-19 的健壮退伍军人发生虚弱和虚弱前期的风险。方法我们利用退伍军人事务部 COVID-19 共享数据资源开展了一项回顾性队列研究,以评估 SARS-CoV-2 感染与美国健壮退伍军人发生虚弱前期和虚弱状态的关联。我们纳入了在 2020 年 3 月 15 日至 2020 年 11 月 30 日期间至少接受过一次 SARS-CoV-2 检测、在过去 12 个月中一直是活跃患者且在检测时退伍军人虚弱指数为零(虚弱状态)的 55 岁及以上患者。我们使用 Cox 比例危险模型来评估 COVID-19 感染与虚弱或虚弱前期和虚弱之间的关系。我们还根据患者的年龄组、性别和种族评估了两者之间的关系。研究结果我们发现有 82070 名退伍军人平均年龄为 68.3 ± 7.8 岁,74738 人(91.1%)为男性,53899 人(65.7%)为白人,7557 人(9.2%)为轻度 COVID-19 感染者。在 36 个月的随访期内,COVID-19 检测呈阳性的患者体弱的风险增加了 66%(调整后 HR = 1.66,95%CI:1.32-2.08),体弱前期的风险增加了 68%(调整后 HR = 1.68,95%CI:1.45-1.94)。在男性患者中,轻度 COVID-19 感染与体弱风险增加 54% 相关(调整后 HR = 1.54,95% CI:1.21-1.96),而在女性患者中,体弱风险增加 330%(调整后 HR = 4.30,95% CI:2.13-8.64)。退伍军人需要进一步开展多中心前瞻性队列研究,评估 COVID 后虚弱的作用机制并对治疗方案进行临床试验,以支持临床治疗。
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引用次数: 0
In response to: Letter to the Editor regarding “The role of nutritional supplement on post-stroke fatigue: a pilot randomized controlled trial” 作为回应:致编辑的信,内容涉及 "营养补充剂对中风后疲劳的作用:随机对照试验"
IF 5.8 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-19 DOI: 10.1016/j.jnha.2024.100301
Silvia Giovannini , Chiara Iacovelli , Claudia Loreti , Giovanni Frisullo , Letizia Castelli
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引用次数: 0
Letter to the Editor regarding “The role of nutritional supplement on post-stroke fatigue: A pilot randomized controlled trial” 致编辑的信,内容涉及 "营养补充剂对中风后疲劳的作用:随机对照试验"
IF 5.8 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-11 DOI: 10.1016/j.jnha.2024.100288
Xinjie Wang , Hui Ma
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引用次数: 0
期刊
Journal of Nutrition Health & Aging
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