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Relationships between sarcopenia, depressive symptoms, and the risk of all-cause mortality in the Chinese population 中国人肌肉疏松症、抑郁症状与全因死亡风险之间的关系
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-20 DOI: 10.1016/j.jnha.2024.100316
Xiaoming Zhang , Wenfei Wang , Rui Zeng , Dongmei Ye , Fayi Xie , Lihuan Chen , Aizhang Zhu , Jiang Wang , Jie Chen , Conghua Wang
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引用次数: 0
Effect of information and communication technology-based smart care services for physical and cognitive functions in older adults living alone: A quasi-experimental study 基于信息和通信技术的智能护理服务对独居老年人身体和认知功能的影响:准实验研究
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-17 DOI: 10.1016/j.jnha.2024.100318
Du-Ri Kim , Ting-Fu Lai , Minji Sung , Minwoo Jang , Yeo-Kyung Shin , Young jin Ra , Yung Liao , Jong-Hwan Park , Myung-Jun Shin

Background

As the global population ages and the number of older adults living alone increases, societies face the responsibility of building new support systems and providing novel forms of care to ensure the independence and happiness of sick or frail older individuals. This quasi-experimental study examined the association between information and communication technology-based smart care services and the physical and cognitive functions of older individuals living alone.

Methods

This study used a suite of smart technologies (artificial intelligence speaker, radar sensor, and personalized exercise App.) and interventions tailored to the initial physical functional scores of the participants. A total of 176 participants were recruited and assigned, with 88 participants in the intervention group and 88 in the control group. The short physical performance battery (SPPB), the digit span test (DST), and the Korean mini-mental state examination (K-MMSE) were used to assess participants before and after 12 weeks.

Results

No significant differences in gender, age, or educational levels were observed between the intervention and control groups. After adjusting for baseline performance, analysis of covariance revealed that the intervention group exhibited better outcomes in the SPPB five-time chair stand score (adjusted score difference: 0.329; P = 0.044) and the backward DST (adjusted score difference: 0.472; P = 0.007), but had lower score of K-MMSE (adjusted score difference: −0.935; P = 0.021), indicating enhanced lower limb muscle strength and cognitive function in working memory.

Conclusion

ICT-based smart care services, combined with personalized exercise interventions, significantly support the physical and cognitive health of solitary older individuals. This approach highlights the potential of integrating smart technology and targeted physical activity to foster the well-being of the aging population living alone.

背景随着全球人口老龄化和独居老年人数量的增加,社会面临着建立新的支持系统和提供新型护理的责任,以确保患病或体弱老年人的独立性和幸福感。这项准实验研究考察了基于信息和通信技术的智能护理服务与独居老年人的身体和认知功能之间的关联。方法这项研究使用了一套智能技术(人工智能扬声器、雷达传感器和个性化运动应用程序),并根据参与者的初始身体功能评分量身定制了干预措施。共招募并分配了 176 名参与者,其中干预组 88 人,对照组 88 人。结果干预组和对照组在性别、年龄和教育水平上没有明显差异。调整基线成绩后,协方差分析表明,干预组在 SPPB 五次椅子站立得分(调整后的分数差异:0.329;P = 0.044)和后向 DST(调整后的分数差异:0.472;P = 0.007)方面表现出更好的结果,但 K-MMSE 分数较低(调整后的分数差异:-0.935; P = 0.021),表明下肢肌肉力量和工作记忆认知功能得到增强。这种方法凸显了将智能技术与有针对性的体育锻炼相结合,促进独居老年人口健康的潜力。
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引用次数: 0
Immunogenicity of BNT162b2 as a first booster after a ChAdOx1 primary series in a Thai geriatric population living with frailty BNT162b2 作为 ChAdOx1 初级系列治疗后的第一支增强剂在泰国老年体弱人群中的免疫原性
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-17 DOI: 10.1016/j.jnha.2024.100315
Suvimol Niyomnaitham , Kulkanya Chokephaibulkit , Chatkamol Pheerapanyawaranun , Zheng Quan Toh , Paul V. Licciardi , Arpa Satayasanskul , Laddawan Jansarikit , Prasert Assantachai

Objectives

Impact of frailty towards immunogenicity and reactogenicity of BNT162b2 boosters administered via intramuscular or intradermal routes in a Thai geriatric population

Design

Prospective, randomized, open-labeled.

Setting

Siriraj Hospital, Thailand.

Participants

Geriatric adults aged ≥65 years.

Intervention

10 μg intradermal or 30 μg intramuscular BNT162b2 (Pfizer-BioNTech).

Measurements

Anti-SARS-CoV-2 receptor binding domain IgG, neutralizing antibodies (NAb), and interferon-gamma producing cells against Wuhan and Omicron BA.4/5. Analyses were stratified based on participants’ Clinical Frailty Scale.

Results

A total of 139 participants were included in the analysis. Two-four weeks post-booster administration, NAb titers against Wuhan but not Omicron BA.4/5 were significantly lower among frail participants than non-frail participants who received intramuscular administration. Spike-specific T cell responses were similar for frail and non-frail participants, regardless of administration route. Frail participants who received intradermal BNT162b2 had fewer local adverse events (AEs), but higher systemic AEs than non-frail participants.

Conclusion

Similar immune responses across vaccine routes warrants further evaluation of intradermal BNT162b2 in frail geriatric populations. Frail participants may be more sensitive to reporting systemic AEs.

Registration of clinical trials

The parent study was registered under the Thai Clinical Trials Registry (TCTR20220112002).

目的 在泰国老年人群中通过肌肉或皮内途径注射 BNT162b2 增强剂时,体弱对免疫原性和反应原性的影响。干预措施10 μg 皮内或 30 μg 肌肉注射 BNT162b2(辉瑞公司-BioNTech).测量抗 SARS-CoV-2 受体结合域 IgG、中和抗体(NAb)以及针对武汉和 Omicron BA.4 的γ干扰素产生细胞。/5.根据参与者的临床虚弱量表进行分层分析。在注射加强剂后两周至四周,体弱者对武汉病毒的NAb滴度明显低于肌肉注射的非体弱者,但对Omicron BA.4/5的NAb滴度则没有明显降低。无论给药途径如何,体弱者和非体弱者的尖峰特异性 T 细胞反应相似。接受皮内注射 BNT162b2 的体弱者的局部不良反应(AEs)少于非体弱者,但全身不良反应(AEs)高于非体弱者。体弱参与者可能对报告全身性 AEs 更为敏感。
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引用次数: 0
Dietary patterns and intrinsic capacity in older adults: a 6-year prospective cohort study 老年人的饮食模式和内在能力:一项为期 6 年的前瞻性队列研究。
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-09 DOI: 10.1016/j.jnha.2024.100314
Jinhee Kim , Yunhwan Lee , Miji Kim , Chang Won Won , Mi Kyung Kim , Jee-Seon Shim

Objectives

Only a few studies have investigated dietary patterns and intrinsic capacity (IC). This study examined the prospective associations between dietary patterns, IC, and IC sub-domains over 6 years in community-dwelling Korean older adults.

Design

A prospective cohort study.

Setting and participants

Data were obtained from participants aged 70–84 years in the Korean Frailty and Aging Cohort Study (2016–2022). The study population included 665 enrollees at baseline who completed IC and dietary data.

Methods

Dietary data were obtained from baseline surveys of the nutritional sub-cohort using two nonconsecutive 24‐hour dietary recalls, and dietary patterns were derived using cluster analysis. IC was constructed by measuring cognitive, locomotor, vitality, sensory, and psychological domains. A generalized estimating equation was used to analyze the longitudinal associations between dietary patterns, IC, and IC sub-domain scores.

Results

In total, 665 enrollees were included in the analysis. After adjusting for confounders, in older men, the dietary pattern of cluster 1 (variety of healthy foods and alcohols) compared to that of cluster 2 (rice and kimchi) was positively associated with changes in the IC score (ß = 0.41, 95% confidence interval [CI] = 0.04−0.78). In older women, the dietary pattern of cluster 1 (variety of healthy foods) was positively associated with changes in the IC score (ß = 0.30, 95% CI = 0.02–0.58), IC score group (ß = 0.11, 95% CI = 0.02–0.20), and psychological domain (ß = 0.25, 95% CI = 0.11–0.38) compared to that of cluster 3 (rice, vegetables, and kimchi).

Conclusions

Dietary patterns (variety of healthy foods) were positively associated with changes in IC scores and their sub-domains in older adults.

研究目的只有少数研究调查了膳食模式和内在能力(IC)。本研究调查了居住在社区的韩国老年人 6 年来的饮食模式、内在能力和内在能力子域之间的前瞻性关联:设计:前瞻性队列研究:数据来自韩国虚弱与老龄化队列研究(2016-2022 年)中 70-84 岁的参与者。研究人群包括基线时填写了 IC 和饮食数据的 665 名参与者:膳食数据来自营养亚队列的基线调查,采用两次非连续的 24 小时膳食回忆,并通过聚类分析得出膳食模式。通过测量认知、运动、活力、感官和心理领域来构建 IC。采用广义估计方程分析饮食模式、IC 和 IC 子领域得分之间的纵向联系:共有 665 名参加者被纳入分析。在对混杂因素进行调整后,在老年男性中,群组 1(各种健康食品和酒)与群组 2(大米和泡菜)相比,饮食模式与 IC 分数的变化呈正相关(ß = 0.41,95% 置信区间 [CI] = 0.04-0.78)。在老年妇女中,与组群3(大米、蔬菜和泡菜)相比,组群1(多种健康食品)的饮食模式与IC评分(ß = 0.30,95% CI = 0.02-0.58)、IC评分组别(ß = 0.11,95% CI = 0.02-0.20)和心理领域(ß = 0.25,95% CI = 0.11-0.38)的变化呈正相关:结论:膳食模式(健康食品的多样性)与老年人的 IC 评分及其子域的变化呈正相关。
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引用次数: 0
Age, sex, and APOE gene-specific associations between dynapenic obesity and dementia in a large cohort 一个大型队列中动态肥胖与痴呆症之间的年龄、性别和 APOE 基因特异性关联。
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-09 DOI: 10.1016/j.jnha.2024.100313
Zhao Yao , Jie Wang , Tianfang Zhang , Hongjing Ai , Zeinab Abdelrahman , Xiaohong Wu , Daming Wang , Fenfen Chen , Ziwei Zhang , Xiaosheng Wang , Zuyun Liu , Zuobing Chen

Objective

To investigate the associations between dynapenic obesity and the risk of dementia, and the modifying effects of age, sex, and the APOE gene, using a large population-based cohort.

Methods

279,884 participants aged 55 and above from the UK Biobank were included. The participants were classified into four categories based on body mass index and hand grip strength: healthy, obesity, dynapenia, and dynapenic obesity. The incident dementia was identified based on linked hospital records and death register data. Cox proportional hazards regression models were used to estimate the associations, followed by age-, sex-, and apolipoprotein E (APOE) gene-stratified analyses.

Results

During the median follow-up of 12.4 years, 5,170 (1.8%) participants developed dementia. Compared with the healthy group, participants with dynapenic obesity had 67% higher dementia risk (hazard ratio [HR]: 1.67, 95% confidence interval [CI]: 1.44–1.94). Compared with the healthy group, higher risks of dementia in participants with dynapenic obesity were respectively observed in male (HR: 2.03, 95% CI: 1.65–2.50), younger (<65 years, HR: 1.97, 95% CI: 1.55–2.50), and non-ε4-carrier (HR: 1.97, 95% CI: 1.60–2.44) (all P for interaction <0.05). In participants under 65 years and non-ε4-carrier, those with dynapenic obesity had the highest risk of dementia (HR: 2.63, 95% CI: 1.91–3.62), compared with the healthy group (P for second order interaction = 0.026).

Conclusions

Dynapenic obesity is associated with increased risks of dementia, especially in participants under 65 years and non-ε4-carrier, suggesting the importance of managing dynapenic obesity in the prevention of cognition-related disorders.

目的方法:纳入英国生物库中年龄在 55 岁及以上的 279,884 名参与者。根据体重指数和手部握力将参与者分为四类:健康、肥胖、动态肥胖和动态肥胖。根据关联的医院记录和死亡登记数据确定痴呆症的发病情况。研究人员使用考克斯比例危险回归模型来估算两者之间的关系,并对年龄、性别和载脂蛋白E(APOE)基因进行了分层分析:在中位 12.4 年的随访期间,有 5 170 人(1.8%)患上了痴呆症。与健康组相比,动态性肥胖患者患痴呆症的风险高出67%(危险比[HR]:1.67,95%置信区间[CI]:1.44-1.94)。与健康组相比,男性(HR:2.03,95% CI:1.65-2.50)、年轻(结论:动态肥胖会增加痴呆症的发病风险)和肥胖症患者的痴呆症发病风险分别高出67%(危险比[HR]:1.67,95% 置信区间[CI]:1.44-1.94):动态肥胖与痴呆症风险的增加有关,尤其是在 65 岁以下和非ε4 携带者中,这表明控制动态肥胖在预防认知相关疾病中的重要性。
{"title":"Age, sex, and APOE gene-specific associations between dynapenic obesity and dementia in a large cohort","authors":"Zhao Yao ,&nbsp;Jie Wang ,&nbsp;Tianfang Zhang ,&nbsp;Hongjing Ai ,&nbsp;Zeinab Abdelrahman ,&nbsp;Xiaohong Wu ,&nbsp;Daming Wang ,&nbsp;Fenfen Chen ,&nbsp;Ziwei Zhang ,&nbsp;Xiaosheng Wang ,&nbsp;Zuyun Liu ,&nbsp;Zuobing Chen","doi":"10.1016/j.jnha.2024.100313","DOIUrl":"10.1016/j.jnha.2024.100313","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the associations between dynapenic obesity and the risk of dementia, and the modifying effects of age, sex, and the APOE gene, using a large population-based cohort.</p></div><div><h3>Methods</h3><p>279,884 participants aged 55 and above from the UK Biobank were included. The participants were classified into four categories based on body mass index and hand grip strength: healthy, obesity, dynapenia, and dynapenic obesity. The incident dementia was identified based on linked hospital records and death register data. Cox proportional hazards regression models were used to estimate the associations, followed by age-, sex-, and apolipoprotein E (APOE) gene-stratified analyses.</p></div><div><h3>Results</h3><p>During the median follow-up of 12.4 years, 5,170 (1.8%) participants developed dementia. Compared with the healthy group, participants with dynapenic obesity had 67% higher dementia risk (hazard ratio [HR]: 1.67, 95% confidence interval [CI]: 1.44–1.94). Compared with the healthy group, higher risks of dementia in participants with dynapenic obesity were respectively observed in male (HR: 2.03, 95% CI: 1.65–2.50), younger (&lt;65 years, HR: 1.97, 95% CI: 1.55–2.50), and non-ε4-carrier (HR: 1.97, 95% CI: 1.60–2.44) (all P for interaction &lt;0.05). In participants under 65 years and non-ε4-carrier, those with dynapenic obesity had the highest risk of dementia (HR: 2.63, 95% CI: 1.91–3.62), compared with the healthy group (P for second order interaction = 0.026).</p></div><div><h3>Conclusions</h3><p>Dynapenic obesity is associated with increased risks of dementia, especially in participants under 65 years and non-ε4-carrier, suggesting the importance of managing dynapenic obesity in the prevention of cognition-related disorders.</p></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"28 8","pages":"Article 100313"},"PeriodicalIF":4.3,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1279770724004007/pdfft?md5=aad5846282599b28d0b6cb1691c3c72a&pid=1-s2.0-S1279770724004007-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581543","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
Differential interplay between multimorbidity patterns and frailty and their mutual mediation effect on mortality in old age 多病模式与虚弱之间的相互作用及其对老年死亡率的相互调节作用
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-05 DOI: 10.1016/j.jnha.2024.100305
Rui She , Davide Liborio Vetrano , Maria Kwan Wa Leung , Hui Jiang , Chengxuan Qiu

Background

Multimorbidity and frailty often concurrently occur among older adults.

Objectives

To assess the reciprocal association between multimorbidity (condition count and patterns) and frailty and examine the mutual mediation effect of multimorbidity and frailty in their associations with mortality among Chinese older adults.

Methods

This nationwide population-based longitudinal study included 16,563 participants aged ≥65 years in the Chinese Longitudinal Healthy Longevity Survey who were surveyed in 2008 and followed up in 2011, 2014, and 2018. Frailty phenotype was assessed by the modified Fried criteria and vital status was ascertained from family members. Cross-lagged panel model (CLPM) was used to test bidirectional associations between multimorbidity and frailty. The direct and indirect effects of multimorbidity and frailty on mortality were evaluated using the combined CLPM with survival analysis.

Results

Three multimorbidity patterns were identified: cardiometabolic diseases, cognitive-sensory disorder, and arthritis-digestive-respiratory diseases. The number of chronic conditions and cognitive-sensory disease pattern showed bidirectional associations with frailty across waves (range for β: 0.046−0.109; all P < 0.001), while cardiometabolic and arthritis-digestive-respiratory patterns unidirectionally predicted frailty change. Furthermore, frailty mediated 23%–27% of the association between multimorbidity and mortality. Only the number of conditions and cognitive-sensory disease pattern were significant mediators in the association between frailty and mortality, with the proportion of mediation ranging 4%–12%.

Conclusions

Multimorbidity measures including condition count and cognitive-sensory disease pattern are bi-directionally associated with frailty in older adults. These multimorbidity measures and frailty partially mediated each other’s association with mortality, with frailty acting as a more prominent pathway in the association between multimorbidity and mortality.

背景多病和虚弱常常同时出现在老年人中。目的评估多病(病症数量和模式)和虚弱之间的相互关系,研究多病和虚弱在中国老年人死亡率中的相互中介效应。 方法这项全国范围的人群纵向研究纳入了中国健康长寿纵向调查中 16563 名年龄≥65 岁的参与者,他们于 2008 年接受调查,并于 2011 年、2014 年和 2018 年接受随访。虚弱表型根据修改后的弗里德标准进行评估,生命状态则通过家庭成员确认。交叉滞后面板模型(CLPM)用于检验多病与虚弱之间的双向关联。结果确定了三种多病模式:心脏代谢疾病、认知-感官障碍和关节炎-消化-呼吸系统疾病。慢性病数量和认知-感官疾病模式与虚弱程度在不同波次之间呈现双向关联(β范围:0.046-0.109;所有 P < 0.001),而心脏代谢疾病和关节炎-消化-呼吸疾病模式单向预测虚弱程度的变化。此外,在多病症与死亡率之间的关系中,虚弱起了 23%-27% 的中介作用。只有病症数量和认知-感官疾病模式对虚弱与死亡率之间的关联有显著的中介作用,中介作用的比例为 4%-12%。结论包括病症数量和认知-感官疾病模式在内的多病症指标与老年人的虚弱有双向关联。这些多病性指标和虚弱程度在一定程度上相互调解了与死亡率的关系,而虚弱程度在多病性和死亡率之间的关系中起着更为重要的作用。
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引用次数: 0
Cross-sectional and longitudinal associations of adherence to WCRF/AICR cancer prevention recommendations with health-related quality of life in breast cancer survivors. Health-EpiGEICAM study 遵守 WCRF/AICR 癌症预防建议与乳腺癌幸存者健康相关生活质量的横向和纵向关联。健康-EpiGEICAM 研究
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-05 DOI: 10.1016/j.jnha.2024.100312
Virginia Lope , Ángel Guerrero-Zotano , Nerea Fernández de Larrea-Baz , Silvia Antolín , Marta Benavent Viñuales , Begoña Bermejo , Emma Ruiz-Moreno , José Manuel Baena-Cañada , Lorena París , Antonio Antón , José Ignacio Chacón , Montserrat Muñoz , José Angel García-Sáenz , Clara Olier , Pedro Sánchez Rovira , Angels Arcusa Lanza , Sonia González , Joan Brunet , Amparo Oltra , Susana Bezares , Marina Pollán

Objectives

Adherence to healthy lifestyle recommendations has been reported to improve health-related quality of life (HRQL) in breast cancer (BC) patients, but the influence of long-term behavioral changes remains unknown. We evaluated the association between adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations and HRQL both, at BC diagnosis and the change 7−12 years later.

Design

Prospective cohort study.

Settings and participants

A total of 406 breast cancer survivors, from the EpiGEICAM study, were recruited in 16 Spanish hospitals.

Measurements

Epidemiological, clinical, dietary, physical activity and HRQL information was collected both at recruitment and 7−12 years later. A 7-item score to measure compliance with recommendations was assessed according to the 2018 WCRF/AICR scoring criteria. HRQL was evaluated using SF-36 questionnaire. Linear mixed models for longitudinal data were used to assess the cross-sectional and longitudinal association between adherence score and the physical and mental component summary scores.

Results

At diagnosis, for each unit increase in WCRF/AICR score adherence, the HRQL physical domain increased 0.78 points (95%CI: −0.04 to 1.60; P trend:0.06). The mean change in physical HRQL from diagnosis to follow-up per unit increase in within-subject adherence score was 0.73 points (95%CI: −0.18 to 1.65; P trend: 0.12). For the mental domain, no association was observed with compliance with the recommendations at diagnosis, nor with changes in adherence over time.

Conclusions

Our results suggest that Increased adherence to WCRF/AICR cancer prevention recommendations over time could contribute to slightly improved long-term physical HRQoL in BC survivors.

目的据报道,坚持健康生活方式建议可改善乳腺癌(BC)患者的健康相关生活质量(HRQL),但长期行为改变的影响仍不清楚。我们评估了坚持2018年世界癌症研究基金会/美国癌症研究所(WCRF/AICR)癌症预防建议与HRQL之间的关系,包括BC诊断时和7-12年后的变化。根据2018年WCRF/AICR评分标准评估了7个项目的得分,以衡量建议的遵从性。HRQL 采用 SF-36 问卷进行评估。纵向数据线性混合模型用于评估依从性评分与身体和精神部分总分之间的横截面和纵向关联。结果诊断时,WCRF/AICR评分依从性每增加一个单位,HRQL身体领域增加0.78分(95%CI:-0.04至1.60;P趋势:0.06)。从诊断到随访期间,受试者内依从性评分每增加一个单位,身体 HRQL 的平均变化为 0.73 分(95%CI:-0.18 至 1.65;P 趋势:0.12)。结论:我们的研究结果表明,随着时间的推移,WCRF/AICR 癌症预防建议的坚持率的提高可略微改善巴塞尔公约(BC)幸存者的长期身体 HRQoL。
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引用次数: 0
Effects of ketogenic diet on cognitive function of patients with Alzheimer's disease: a systematic review and meta-analysis 生酮饮食对阿尔茨海默病患者认知功能的影响:系统回顾和荟萃分析。
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-28 DOI: 10.1016/j.jnha.2024.100306
Liyang Rong , Yating Peng , Qi Shen , Keying Chen , Bangjiang Fang , Weirong Li

Background

Ketogenic diets (KD) have shown remarkable effects in many disease areas. It has been demonstrated in numerous animal experiments that KD is effective in the treatment of Alzheimer's disease (AD). But the clinical effect of treating AD is uncertain.

Objective

To systematically review the impact of KD on cognitive function in AD.

Methods

We conducted a search of three international databases—PubMed, Cochrane Library, and Embase—to retrieve RCTs on the KD intervention for AD from the inception of the databases through October 2023. Two reviewers searched and screened the literature, extracted and checked relevant data independently, and assessed the risk of bias of the included studies. The meta-analysis was carried out utilizing RevMan 5.3 software.

Results

A total of 10 RCTS involving 691 patients with AD were included. There were 357 participants in the intervention group and 334 participants in the control group. The duration of the KD intervention ranged from a minimum of 3 months to a maximum of 15 months. Meta-analysis results showed that KD could effectively improve the mental state of the elderly (NM scale) [MD = 7.56, 95%CI (3.02, 12.10), P = 0.001], MMSE [MD = 1.25, 95%CI (0.46, 2.04), P = 0.002], and ADAS-Cog [MD = −3.43, 95%CI (−5.98, −0.88), P = 0.008]. The elevation of ketone body (β-hydroxybutyric) [MD = 118.84, 95%CI (15.20, 222.48), P = 0.02] may also lead to the elevation of triglyceride [MD = 0.19, 95%CI (0.03, 0.35), P = 0.02] and low density lipoprotein [MD = 0.31, 95%CI (0.04, 0.58), P = 0.02].

Conclusion

Research conducted has indicated that the KD can enhance the mental state and cognitive function of those with AD, albeit potentially leading to an elevation in blood lipid levels. In summary, the good intervention effect and safety of KD are worthy of promotion and application in clinical treatment of AD.

背景:生酮饮食(KD)在许多疾病领域都有显著疗效。大量动物实验证明,生酮饮食能有效治疗阿尔茨海默病(AD)。但治疗阿尔茨海默病的临床效果尚不确定:系统回顾 KD 对 AD 认知功能的影响:我们检索了三个国际数据库--PubMed、Cochrane Library 和 Embase,检索了从数据库建立之初到 2023 年 10 月期间有关 KD 干预 AD 的 RCT。两位审稿人对文献进行了检索和筛选,独立提取和检查了相关数据,并评估了纳入研究的偏倚风险。荟萃分析采用RevMan 5.3软件进行:共纳入了 10 项研究,涉及 691 名注意力缺失症患者。干预组有 357 名参与者,对照组有 334 名参与者。KD干预的持续时间从最短的3个月到最长的15个月不等。元分析结果显示,KD能有效改善老年人的精神状态(NM量表)[MD=7.56,95%CI(3.02,12.10),P=0.001]、MMSE[MD=1.25,95%CI(0.46,2.04),P=0.002]和ADAS-Cog[MD=-3.43,95%CI(-5.98,-0.88),P=0.008]。酮体(β-羟丁酸)[MD = 118.84,95%CI (15.20,222.48),P = 0.02]的升高还可能导致甘油三酯[MD = 0.19,95%CI (0.03,0.35),P = 0.02]和低密度脂蛋白[MD = 0.31,95%CI (0.04,0.58),P = 0.02]的升高:研究表明,KD 可以改善 AD 患者的精神状态和认知功能,尽管有可能导致血脂水平升高。综上所述,KD具有良好的干预效果和安全性,值得在AD临床治疗中推广应用。
{"title":"Effects of ketogenic diet on cognitive function of patients with Alzheimer's disease: a systematic review and meta-analysis","authors":"Liyang Rong ,&nbsp;Yating Peng ,&nbsp;Qi Shen ,&nbsp;Keying Chen ,&nbsp;Bangjiang Fang ,&nbsp;Weirong Li","doi":"10.1016/j.jnha.2024.100306","DOIUrl":"10.1016/j.jnha.2024.100306","url":null,"abstract":"<div><h3>Background</h3><p>Ketogenic diets (KD) have shown remarkable effects in many disease areas. It has been demonstrated in numerous animal experiments that KD is effective in the treatment of Alzheimer's disease (AD). But the clinical effect of treating AD is uncertain.</p></div><div><h3>Objective</h3><p>To systematically review the impact of KD on cognitive function in AD.</p></div><div><h3>Methods</h3><p>We conducted a search of three international databases—PubMed, Cochrane Library, and Embase—to retrieve RCTs on the KD intervention for AD from the inception of the databases through October 2023. Two reviewers searched and screened the literature, extracted and checked relevant data independently, and assessed the risk of bias of the included studies. The meta-analysis was carried out utilizing RevMan 5.3 software.</p></div><div><h3>Results</h3><p>A total of 10 RCTS involving 691 patients with AD were included. There were 357 participants in the intervention group and 334 participants in the control group. The duration of the KD intervention ranged from a minimum of 3 months to a maximum of 15 months. Meta-analysis results showed that KD could effectively improve the mental state of the elderly (NM scale) [MD = 7.56, 95%CI (3.02, 12.10), <em>P</em> = 0.001], MMSE [MD = 1.25, 95%CI (0.46, 2.04), <em>P</em> = 0.002], and ADAS-Cog [MD = −3.43, 95%CI (−5.98, −0.88), <em>P</em> = 0.008]. The elevation of ketone body (β-hydroxybutyric) [MD = 118.84, 95%CI (15.20, 222.48), <em>P</em> = 0.02] may also lead to the elevation of triglyceride [MD = 0.19, 95%CI (0.03, 0.35), <em>P</em> = 0.02] and low density lipoprotein [MD = 0.31, 95%CI (0.04, 0.58), <em>P</em> = 0.02].</p></div><div><h3>Conclusion</h3><p>Research conducted has indicated that the KD can enhance the mental state and cognitive function of those with AD, albeit potentially leading to an elevation in blood lipid levels. In summary, the good intervention effect and safety of KD are worthy of promotion and application in clinical treatment of AD.</p></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"28 8","pages":"Article 100306"},"PeriodicalIF":4.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1279770724003932/pdfft?md5=f335c2bd4d995643e4d44892ba4bc46e&pid=1-s2.0-S1279770724003932-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472781","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
Association of intrinsic capacity and medication non-adherence among older adults with non-communicable diseases in Taiwan 台湾患有非传染性疾病的老年人的内在能力与不坚持服药的关系。
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-28 DOI: 10.1016/j.jnha.2024.100303
Chiachi Bonnie Lee , Li-Jung Elizabeth Ku , Yu-Tsung Chou , Hung-Yu Chen , Hui-Chen Su , Yi-Lin Wu , Yu-Tai Lo , Yi-Ching Yang , Chung-Yi Li

Objectives

Medication non-adherence among older adults with non-communicable diseases (NCDs) remains prevalent worldwide, which causes hospitalization and mortality. Our study aimed to examine the association of medication non-adherence with level of overall intrinsic capacity (IC), pattern of IC, and specific IC component among older adults with NCDs.

Methods

A cross-sectional questionnaire-based survey of 1268 older adults aged 60 years and above was conducted in 2022 in southern Taiwan. Among them, 894 suffered from 1 more NCD were included in this study. The Integrated Care for Older People Screening Tool for Taiwanese and the Adherence to Refills and Medication Scale were used to assess IC and medication non-adherence, respectively. Latent class analysis (LCA) was used to identify patterns of IC impairment, and binary logistic regression was used to assess the association between medication non-adherence and IC.

Results

Older adults in the moderate (score: 1–2) or low (score≧3) overall IC groups were more likely to experience medication non-adherence (moderate: adjusted odds ratio (aOR) 1.57 [95% CI: 1.05–2.36]; low: 2.26 [1.40–3.67]). The “physical and nutritional impairments accompanied by depressive symptoms” group was associated with statistically higher odds of medication non-adherence (aOR 1.66 [1.01–2.73]). Older adults with cognitive impairment, hearing loss, or depressive symptoms showed greater likelihood of medication non-adherence (cognitive impairment: aOR 1.53 [1.03–2.27]; hearing loss: aOR 1.57 [1.03–2.37]; depressive symptoms: aOR 1.81 [1.17–2.80]).

Conclusions

Intervention for improving medication non-adherence among older adults with NCDs should consider IC.

目的:患有非传染性疾病(NCDs)的老年人不遵医嘱用药的现象在全球仍很普遍,这导致了住院和死亡。我们的研究旨在探讨非传染性疾病老年人不遵医嘱用药与总体内在能力(IC)水平、内在能力模式和特定内在能力组成部分之间的关系:方法:2022 年在台湾南部对 1268 名 60 岁及以上的老年人进行了横断面问卷调查。方法:2022 年在台湾南部对 1268 名 60 岁以上的老年人进行了横断面问卷调查,其中 894 名老年人患有 1 种以上的非传染性疾病。研究使用台湾老年人综合护理筛查工具(Integrated Care for Older People Screening Tool for Taiwanese)和 "续药和用药依从性量表"(Adherence to Refills and Medication Scale)分别对IC和用药不依从性进行评估。研究采用潜类分析法(LCA)确定IC受损的模式,并采用二元逻辑回归法评估不遵医嘱用药与IC之间的关联:中度(得分:1-2)或低度(得分≧3)总体 IC 组的老年人更有可能出现不坚持用药的情况(中度:调整后的几率比(aOR)为 1.57 [95% CI:1.05-2.36];低度:2.26 [1.40-3.67])。在统计学上,"身体和营养受损并伴有抑郁症状 "组出现不遵医嘱用药的几率更高(aOR:1.66 [1.01-2.73])。有认知障碍、听力损失或抑郁症状的老年人不坚持服药的可能性更大(认知障碍:aOR 1.53 [1.03-2.27];听力损失:aOR 1.57 [1.03-2.37];抑郁症状:aOR 1.81 [1.17-2.80]):结论:改善患有非传染性疾病的老年人不遵医嘱用药的干预措施应考虑 IC。
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引用次数: 0
Dietary inflammatory index, mediating biomarkers and incident frailty in Chinese community-dwelling older adults 中国社区老年人的膳食炎症指数、中介生物标志物和体弱事件。
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-25 DOI: 10.1016/j.jnha.2024.100304
Shu-Yi Li , Zhi-Hui Lu , Yi Su , Jason C.S. Leung , Timothy C.Y. Kwok

Objectives

Diet can modulate systemic inflammation, while inflammation is a critical contributory factor of frailty. However, longitudinal data on the association between dietary inflammatory index (DII) and frailty are limited, and the intermediate mechanisms remain unclear. This study aimed to examine the association between DII and incident frailty and the potential mediating roles of frailty-related biomarkers.

Design

Prospective cohort study.

Setting

The Mr. OS and Ms. OS (Hong Kong) study.

Participants

A total of 3,035 community-dwelling men and women aged above 65 years without frailty at baseline were included.

Measurements

DII scores were calculated using the locally validated food frequency questionnaire. Incident frailty at year four was defined using the Fried frailty phenotype. Logistic regression was used to examine the association between DII and frailty onset. Mediation analysis was used to explore the mediating roles of frailty-related biomarkers in the DII-frailty association.

Results

During four years of follow-up, 208 individuals developed frailty. Compared with the lowest tertile of DII, the highest tertile was associated with an increased risk of incident frailty (OR: 1.82; 95% CI: 1.17–2.82; p = 0.008) after adjustment for relevant confounders. The DII-frailty association was significant in men but not in women. Furthermore, increasing serum homocysteine, decreasing serum folate, and reducing estimated glomerular filtration rate (eGFR) mediated 11.6%, 7.1%, and 9.6 % of the total relation between DII and frailty onset, respectively.

Conclusion

In this cohort study, a pro-inflammatory diet was associated with a higher risk of frailty onset, mediated by homocysteine, folate, and renal function.

目的:饮食可以调节全身性炎症,而炎症是导致虚弱的一个重要因素。然而,有关膳食炎症指数(DII)与虚弱之间关系的纵向数据非常有限,而且中间机制仍不清楚。本研究旨在探讨膳食炎症指数与体弱事件之间的关联以及体弱相关生物标志物的潜在中介作用:前瞻性队列研究:OS先生和OS女士(香港)研究:共纳入 3,035 名 65 岁以上、基线时无体弱症状的社区男性和女性:测量方法:使用经当地验证的食物频率问卷计算 DII 分数。使用弗里德虚弱表型对第四年发生的虚弱进行定义。采用逻辑回归法研究 DII 与虚弱发病之间的关系。中介分析用于探讨虚弱相关生物标志物在DII与虚弱之间关系中的中介作用:结果:在四年的随访中,有 208 人出现了虚弱。在对相关混杂因素进行调整后,与 DII 的最低三分位数相比,最高三分位数与发生虚弱的风险增加有关(OR:1.82;95% CI:1.17-2.82;p = 0.008)。DII 与虚弱的关系在男性中显著,但在女性中不显著。此外,血清同型半胱氨酸的增加、血清叶酸的减少以及肾小球滤过率(eGFR)的降低分别占DII与虚弱发病关系的11.6%、7.1%和9.6%:在这项队列研究中,促炎症饮食与较高的虚弱发病风险有关,而同型半胱氨酸、叶酸和肾功能则是诱因。
{"title":"Dietary inflammatory index, mediating biomarkers and incident frailty in Chinese community-dwelling older adults","authors":"Shu-Yi Li ,&nbsp;Zhi-Hui Lu ,&nbsp;Yi Su ,&nbsp;Jason C.S. Leung ,&nbsp;Timothy C.Y. Kwok","doi":"10.1016/j.jnha.2024.100304","DOIUrl":"10.1016/j.jnha.2024.100304","url":null,"abstract":"<div><h3>Objectives</h3><p>Diet can modulate systemic inflammation, while inflammation is a critical contributory factor of frailty. However, longitudinal data on the association between dietary inflammatory index (DII) and frailty are limited, and the intermediate mechanisms remain unclear. This study aimed to examine the association between DII and incident frailty and the potential mediating roles of frailty-related biomarkers.</p></div><div><h3>Design</h3><p>Prospective cohort study.</p></div><div><h3>Setting</h3><p>The Mr. OS and Ms. OS (Hong Kong) study.</p></div><div><h3>Participants</h3><p>A total of 3,035 community-dwelling men and women aged above 65 years without frailty at baseline were included.</p></div><div><h3>Measurements</h3><p>DII scores were calculated using the locally validated food frequency questionnaire. Incident frailty at year four was defined using the Fried frailty phenotype. Logistic regression was used to examine the association between DII and frailty onset. Mediation analysis was used to explore the mediating roles of frailty-related biomarkers in the DII-frailty association.</p></div><div><h3>Results</h3><p>During four years of follow-up, 208 individuals developed frailty. Compared with the lowest tertile of DII, the highest tertile was associated with an increased risk of incident frailty (OR: 1.82; 95% CI: 1.17–2.82; <em>p</em> = 0.008) after adjustment for relevant confounders. The DII-frailty association was significant in men but not in women. Furthermore, increasing serum homocysteine, decreasing serum folate, and reducing estimated glomerular filtration rate (eGFR) mediated 11.6%, 7.1%, and 9.6 % of the total relation between DII and frailty onset, respectively.</p></div><div><h3>Conclusion</h3><p>In this cohort study, a pro-inflammatory diet was associated with a higher risk of frailty onset, mediated by homocysteine, folate, and renal function.</p></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"28 8","pages":"Article 100304"},"PeriodicalIF":4.3,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1279770724003919/pdfft?md5=4eceacc70a850fecc32540d2832b186f&pid=1-s2.0-S1279770724003919-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460723","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
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Journal of Nutrition Health & Aging
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