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Association between frailty status and risk of chronic lung disease: an analysis based on two national prospective cohorts 虚弱状态与慢性肺病风险之间的关系:基于两个国家前瞻性队列的分析
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-11-09 DOI: 10.1007/s40520-024-02867-8
Gui-Yu Feng, Jing-Xiao Li, Guo-Sheng Li, Jun Liu, Xiang Gao, Guan-Qiang Yan, Nuo Yang, Tao Huang, Hua-Fu Zhou

Background

The association between the frailty index (FI) and the risk of chronic lung diseases (CLDs) remains unexplored, warranting further research.

Methods and materials

This study investigated the relationship between FI and CLD risk using data from the China Health and Retirement Longitudinal Study (CHARLS) and English Longitudinal Study of Ageing (ELSA), comprising a combined sample of 9642 individuals. Propensity score weighting was used to ensure similar distribution of covariates across FI groups. The Wilcoxon rank-sum test was used to analyze differences in FI scores between groups with and without CLD. Kaplan–Meier curves and Cox regression analysis were employed to explore the association between frailty status and CLD incidence, with sensitivity analyses conducted for validation.

Results

Higher FI scores were significantly associated with increased CLD risk in both cohorts (p < .05). Kaplan–Meier survival and Cox regression analyses indicated that frail individuals have a significantly elevated risk of CLD compared to robust individuals, particularly in certain subgroups (e.g., female) within the CHARLS cohort (p < .05). The ELSA cohort yielded similar results (p < .05), affirming FI as a strong predictor of CLD. Additional risk factors identified included age, smoking, and unmarried status (p < .05). Frail individuals consistently exhibited the highest risk in both cohorts (CHARLS HR = 1.54, p = .003; ELSA HR = 6.64, p < .001). The sensitivity analysis did not substantially alter the significant associations.

Conclusion

These findings emphasize the critical role of frailty in the development of CLD, suggesting that targeted interventions could reduce CLD risk.

背景虚弱指数(FI)与慢性肺部疾病(CLD)风险之间的关系仍有待进一步研究。方法与材料本研究使用中国健康与退休纵向研究(CHARLS)和英国老龄化纵向研究(ELSA)的数据调查了虚弱指数与慢性肺部疾病风险之间的关系。采用倾向得分加权法确保协变量在 FI 组间的相似分布。Wilcoxon 秩和检验用于分析有 CLD 和无 CLD 组间 FI 分数的差异。采用 Kaplan-Meier 曲线和 Cox 回归分析探讨虚弱状态与 CLD 发病率之间的关系,并进行敏感性分析进行验证。Kaplan-Meier生存率和Cox回归分析表明,与体格健壮的人相比,体弱者患CLD的风险明显升高,尤其是在CHARLS队列中的某些亚组(如女性)(p <.05)。ELSA队列也得出了类似的结果(p <.05),肯定了FI是CLD的一个强有力的预测因素。其他风险因素包括年龄、吸烟和未婚状态(p < .05)。在两个队列中,体弱者的风险始终最高(CHARLS HR = 1.54,p = .003;ELSA HR = 6.64,p < .001)。这些发现强调了体弱在CLD发展过程中的关键作用,表明有针对性的干预措施可以降低CLD风险。
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引用次数: 0
Use of the Brief-BESTest partially instrumented with accelerometry to detect balance deterioration in middle-age 使用部分配备加速度计的 Brief-BESTest 来检测中年人的平衡能力衰退情况
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-11-09 DOI: 10.1007/s40520-024-02868-7
Guy Baranes, Roee Hayek, Itai Gutman, Silvi Frenkel-Toledo, Shmuel Springer

Background

Most standardized balance tests cannot detect subtle balance deterioration in middle age, or identify those at higher risk for accelerated balance decline due to a ceiling effect.

Aims

To determine whether the Brief Balance Evaluation Systems Test (Brief-BESTest), partially instrumented with accelerometry, can detect balance deterioration in middle age and identify individuals with poor balance.

Methods

We studied young (25.3 ± 2.3 years), early middle-aged (47.7 ± 2.6 years), and late middle-aged adults (60.6 ± 3.6 years), with 25 participants in each age group. Subjects wore an accelerometer on their lower back while performing the Brief-BESTest. Balance measurements included the Brief-BESTest total and sub-measures scores, and postural sway during the Brief-BESTest standing tasks, calculated by the 95% confidence ellipse trajectory of the center of mass (COM-95% ellipse).

Results

Compared to the two middle-aged groups, young adults had better total Brief-BESTest and sub-measures scores, apart from the Stability-in-Gait sub-measure, and less postural sway during the Sensory-Orientation sub-measure. The total Brief-BESTest scores as well as the Biomechanical-Constraints and Sensory-Orientation sub-measures differed also between early and late middle-aged adults. Both the Brief-BESTest total scores and the Sensory-Orientation postural sway values demonstrated increased variation with age, allowing to identify subjects with poor balance. A moderate negative correlation (r = -0.43) was found between the Brief-BESTest total score and the COM-95% ellipse size, and a moderate agreement (k = 0.56) in identifying subjects with poor performance in the early but not the late middle age group.

Conclusions

The Brief-BESTest test combined with accelerometry could be a suitable screening tool to identify middle-aged people with early balance deterioration and potentially identify those with poor balance and a possible higher risk for falls. Clinicians and policymakers can use our findings to implement balance assessment programs in patients < 65 years, leading to preventive strategies before the risk increases.

背景大多数标准化的平衡测试都无法检测出中年时期细微的平衡能力衰退,也无法识别出由于天花板效应而导致平衡能力加速衰退的高危人群。方法我们对年轻人(25.3 ± 2.3 岁)、中年人早期(47.7 ± 2.6 岁)和中年人晚期(60.6 ± 3.6 岁)进行了研究,每个年龄组有 25 名参与者。受试者在进行简易平衡测试时在腰部佩戴加速度计。结果与两个中年组相比,除步态稳定性子测量外,青壮年的Brief-BESTest总分和子测量得分更高,在感觉-定向子测量中的姿势摇摆更小。中年早期和中年晚期成年人的 Brief-BESTest 总分以及 "生物力学约束 "和 "感觉-定向 "子测量也存在差异。随着年龄的增长,Brief-BESTest 总分和 "感觉-方位 "姿势摇摆值的变化也越来越大,这有助于识别平衡能力差的受试者。简短-BESTest总分与COM-95%椭圆大小之间存在中等程度的负相关(r = -0.43),在识别中年早期(而非中年晚期)表现较差的受试者方面存在中等程度的一致性(k = 0.56)。临床医生和政策制定者可以利用我们的研究结果对65岁以上的患者实施平衡评估计划,从而在风险增加之前制定预防策略。
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引用次数: 0
Dynamic changes in hs-CRP and risk of all-cause mortality among middle-aged and elderly adults: findings from a nationwide prospective cohort and mendelian randomization 中老年人 hs-CRP 的动态变化与全因死亡风险:全国性前瞻性队列和孟德尔随机化的研究结果。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-26 DOI: 10.1007/s40520-024-02865-w
Zhonghai Wang, Feng Xiong, Quanbo Zhang, Han Wang

Introduction

The general population experiences mortality rates that are related to high levels of high-sensitivity C-reactive protein (hs-CRP). We aim to assess the linkage of longitudinal trajectories in hs-CRP levels with all-cause mortality in Chinese participants.

Methods

We utilized data from the China Health and Retirement Longitudinal Study (CHARLS). The exposures were dynamic changes in the hs-CRP and cumulative hs-CRP from 2012 to 2015, and the outcome was all-cause mortality. All participants were categorized into four trajectories according to hs-CRP levels. Multivariable logistic regression analysis, adjusted for potential confounders, was employed to evaluate the relationship of different trajectories of hs-CRP with mortality risk. A two-sample Mendelian randomization (TSMR) method and SHapley Additive exPlanations (SHAP) for identifying determinants of mortality risk were also employed.

Results

The study included 5,445 participants with 233 deaths observed, yielding a mortality proportion of 4.28%. Compared to individuals maintaining low, stable levels of hs-CRP (Class 1), individuals with sustained elevated levels of hs-CRP (Class 4), those experiencing a progressive rise in hs-CRP levels (Class 2), or those transitioning from elevated to reduced hs-CRP levels (Class 3) all faced a significantly heighted death risk, with adjusted Odds Ratios (ORs) ranging from 2.34 to 2.47 across models. Moreover, a non-linear relationship was found between them. Further TSMR analysis also supported these findings. SHAP showed that hs-CRP was the fifth most important determinant of mortality risk.

Conclusions

Our study shows all-cause mortality increases with dynamic changes in hs-CRP levels among middle-aged and elderly adults in China, and cumulative hs-CRP shows an L-shaped relationship with all-cause mortality.

导言:普通人群的死亡率与高水平的高敏C反应蛋白(hs-CRP)有关。我们旨在评估中国参与者的 hs-CRP 水平纵向轨迹与全因死亡率之间的联系:我们利用了中国健康与退休纵向研究(CHARLS)的数据。方法:我们利用了中国健康与退休纵向研究(CHARLS)的数据,暴露因子为2012年至2015年间hs-CRP和累积hs-CRP的动态变化,结局为全因死亡率。根据hs-CRP水平将所有参与者分为四个轨迹。在对潜在混杂因素进行调整后,采用多变量逻辑回归分析来评估不同轨迹的hs-CRP与死亡风险的关系。研究还采用了双样本孟德尔随机化(TSMR)方法和SHAPLE Additive exPlanations(SHAP)方法来确定死亡风险的决定因素:研究共纳入 5445 名参与者,观察到 233 例死亡,死亡率为 4.28%。与保持低水平、稳定的 hs-CRP(1 级)相比,hs-CRP 水平持续升高者(4 级)、hs-CRP 水平逐渐升高者(2 级)或 hs-CRP 水平从升高向降低过渡者(3 级)的死亡风险都显著升高,各模型的调整比值比(ORs)从 2.34 到 2.47 不等。此外,它们之间还存在非线性关系。进一步的 TSMR 分析也支持这些发现。SHAP显示,hs-CRP是决定死亡风险的第五大因素:我们的研究表明,中国中老年人的全因死亡率随着 hs-CRP 水平的动态变化而增加,累积 hs-CRP 与全因死亡率呈 L 型关系。
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引用次数: 0
Dynapenic abdominal obesity and activities of daily living disability among older adults residing in low- and middle-income countries 居住在中低收入国家的老年人腹部动态肥胖与日常生活活动障碍。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-26 DOI: 10.1007/s40520-024-02864-x
Lee Smith, Guillermo F. López Sánchez, Pinar Soysal, Karel Kostev, Louis Jacob, Nicola Veronese, Mark A. Tully, Laurie Butler, Yvonne Barnett, Damiano Pizzol, Jae Il Shin, Ai Koyanagi

Background

Dynapenic abdominal obesity (DAO) may be associated with an increased risk of disability. However, to date, this has not been investigated in low- and middle-income countries (LMICs), while the mediators are largely unknown.

Aims

Therefore, we aimed to investigate the association between DAO and activities of daily living (ADL) disability, and to identify potential mediators among older adults from six LMICs.

Methods

Cross-sectional, nationally representative data from the WHO Study on global AGEing and adult health were analyzed. Data on 20,198 adults aged ≥ 60 years were analyzed [mean (SD) age 69.3 (13.1) years; 54.1% females]. Dynapenia was defined as handgrip strength of < 26 kg for men and < 16 kg for women. Abdominal obesity was defined as waist circumference of > 88 cm for women and > 102 cm for men. DAO was defined as having both dynapenia and abdominal obesity. Disability was defined as severe or extreme difficulty in conducting at least one of six types of ADL. Multivariable logistic regression and mediation analysis were conducted.

Results

Compared to no dynapenia and no abdominal obesity, DAO was significantly associated with 2.08 (95%CI = 1.37–3.17) times higher odds for ADL disability Mediation analysis showed that diabetes (mediated percentage 4.7%), hypertension (7.2%), and angina (7.7%) were significant mediators in the association between DAO and ADL disability.

Conclusions

DAO was associated with increased odds for ADL disability among older adults from LMICs. Future longitudinal studies are warranted to assess temporal associations, and whether addressing or preventing DAO can impact on future occurrence of disability.

背景:腹部动态肥胖(DAO)可能与残疾风险增加有关。目的:因此,我们旨在调查腹部动态肥胖与日常生活活动(ADL)残疾之间的关系,并确定六个低收入和中等收入国家老年人中的潜在中介因素:对世界卫生组织全球老龄化与成人健康研究中具有全国代表性的横断面数据进行了分析。分析了 20,198 名年龄≥ 60 岁的成年人的数据[平均(标清)年龄为 69.3 (13.1) 岁;54.1% 为女性]。女性握力88厘米,男性握力大于102厘米,即为 "握力不足"。DAO定义为同时患有动力不足症和腹部肥胖症。残疾的定义是在六种日常活动能力中至少有一种出现严重或极度困难。研究人员进行了多变量逻辑回归和中介分析:结果:与无动态腹部肥胖症和无腹部肥胖症相比,DAO 与 ADL 残疾几率增加 2.08 倍(95%CI = 1.37-3.17 倍)显著相关:DAO与低收入和中等收入国家老年人ADL残疾几率增加有关。今后有必要开展纵向研究,以评估时间上的关联,以及解决或预防DAO是否会对未来残疾的发生产生影响。
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引用次数: 0
Disability trends among elderly Ukrainians in war conditions: a 10-year retrospective study 战争条件下乌克兰老年人的残疾趋势:一项为期 10 年的回顾性研究。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-26 DOI: 10.1007/s40520-024-02863-y
Alla Kyrychenko, Inna Khanyukova, Olena Moroz, Oksana Sirenko, Olexandr Kuryata

Aim

Non-communicable diseases (NCDs) in elderly are a significant problem in Ukraine. It is expected that the ongoing war will augment this problem. The study aimed to analyze the trends of disability due to NCDs s in newly-diagnosed elderly patients between 2013 and 2023.

Methods

This retrospective study included data obtained from the official document “Report on the Causes of Disability and Indications for Medical, Professional, and Social Rehabilitation” commissioned by the Ministry of Health of Ukraine. The data on disability due to NCDs s were obtained from for 2013–2023.

Results

During the 2013–2021 the average number of disabled elderly patients due to NCDs per 10,000 elderly persons was significantly lower in compare with working-age. During the first year of full-scaled war the average number of disabled elderly patients due to NCDS s per 10,000 elderly persons dramatically increased by 2-fold, and in 2023 – by 2.8-fold against 2013 value (p < 0.05), while in working-age the disability rate increased significantly only in 2023 by 1.4-fold compared to the pre-war level. In 2013–2021 the main causes of disability among those related to NCDs in elderly were cardiovascular diseases, followed by cancer. In 2022 compared to the pre-war level, the indicators of disability of the elderly due to CVD increased by 1.5 times, due to cerebrovascular diseases - by 2.2 times, due to cancer - by 1.7 times, due to musculoskeletal diseases - by 2 times (p < 0.05). The most significant increase in the number of elderly people with disabilities during the full-scale war occurred due to coronary artery disease - by 55.1%, and osteoarthritis - by 83.4% from baseline in 2013. It estemated the differences in indicators of disability of elderly between regions of Ukraine, significantly higher indicators of disability of the elderly due to cardiovascular diseases, cancer, cerebrovascular diseases, musculoskeletal diseases were noted in the frontline regions.

Conclusions

Data on primary disability among elderly Ukrainians indicates a significant increase in NCDs-related disability during the war in compare with working population, especially in frontline regions and regions with a high concentration of displaced persons. In this structure of NCDs-related increasing disability, CVD, oncology and musculoskeletal diseases system prevailed.

目的:老年人非传染性疾病 (NCD) 是乌克兰的一个重大问题。预计正在进行的战争将加剧这一问题。本研究旨在分析 2013 年至 2023 年间新诊断的老年患者因非传染性疾病致残的趋势:这项回顾性研究的数据来自乌克兰卫生部委托编写的官方文件《关于残疾原因以及医疗、专业和社会康复指征的报告》。非传染性疾病导致的残疾数据来自 2013-2023 年的数据:在 2013-2021 年期间,每 10,000 名老年人中因非传染性疾病致残的平均人数明显低于工作年龄段的人数。在全面战争的第一年,每万名老年人中因非传染性疾病致残的老年患者平均人数比 2013 年急剧增加了 2 倍,到 2023 年增加了 2.8 倍(p):有关乌克兰老年人初次残疾的数据表明,与劳动人口相比,战争期间与非传染性疾病相关的残疾显著增加,尤其是在前线地区和流离失所者高度集中的地区。在与非传染性疾病相关的残疾增加结构中,心血管疾病、肿瘤和肌肉骨骼系统疾病占主导地位。
{"title":"Disability trends among elderly Ukrainians in war conditions: a 10-year retrospective study","authors":"Alla Kyrychenko,&nbsp;Inna Khanyukova,&nbsp;Olena Moroz,&nbsp;Oksana Sirenko,&nbsp;Olexandr Kuryata","doi":"10.1007/s40520-024-02863-y","DOIUrl":"10.1007/s40520-024-02863-y","url":null,"abstract":"<div><h3>Aim</h3><p>Non-communicable diseases (NCDs) in elderly are a significant problem in Ukraine. It is expected that the ongoing war will augment this problem. The study aimed to analyze the trends of disability due to NCDs s in newly-diagnosed elderly patients between 2013 and 2023.</p><h3>Methods</h3><p>This retrospective study included data obtained from the official document “Report on the Causes of Disability and Indications for Medical, Professional, and Social Rehabilitation” commissioned by the Ministry of Health of Ukraine. The data on disability due to NCDs s were obtained from for 2013–2023.</p><h3>Results</h3><p>During the 2013–2021 the average number of disabled elderly patients due to NCDs per 10,000 elderly persons was significantly lower in compare with working-age. During the first year of full-scaled war the average number of disabled elderly patients due to NCDS s per 10,000 elderly persons dramatically increased by 2-fold, and in 2023 – by 2.8-fold against 2013 value (<i>p</i> &lt; 0.05), while in working-age the disability rate increased significantly only in 2023 by 1.4-fold compared to the pre-war level. In 2013–2021 the main causes of disability among those related to NCDs in elderly were cardiovascular diseases, followed by cancer. In 2022 compared to the pre-war level, the indicators of disability of the elderly due to CVD increased by 1.5 times, due to cerebrovascular diseases - by 2.2 times, due to cancer - by 1.7 times, due to musculoskeletal diseases - by 2 times (<i>p</i> &lt; 0.05). The most significant increase in the number of elderly people with disabilities during the full-scale war occurred due to coronary artery disease - by 55.1%, and osteoarthritis - by 83.4% from baseline in 2013. It estemated the differences in indicators of disability of elderly between regions of Ukraine, significantly higher indicators of disability of the elderly due to cardiovascular diseases, cancer, cerebrovascular diseases, musculoskeletal diseases were noted in the frontline regions.</p><h3>Conclusions</h3><p>Data on primary disability among elderly Ukrainians indicates a significant increase in NCDs-related disability during the war in compare with working population, especially in frontline regions and regions with a high concentration of displaced persons. In this structure of NCDs-related increasing disability, CVD, oncology and musculoskeletal diseases system prevailed.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02863-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493056","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
The connection between anemia and limitations in daily activities among older males: the critical role of dynapenia 老年男性贫血与日常活动受限之间的联系:动态贫血症的关键作用。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-26 DOI: 10.1007/s40520-024-02859-8
Abdulkadir Karismaz, Pinar Soysal, Rafet Eren, Istemi Serin, Ceyda Aslan, Masoud Rahmati, Dong Keon Yon, Lee Smith

Aim

The aim of the present study was to examine the relationship between anemia and basic and instrumental activities of daily living in older male patients.

Methods

A total of 223 older males attending one geriatric outpatient clinic were included in this cross-sectional study. Anemia was defined as a hemoglobin level below 13 g/dL. Patients’ demographic characteristics, comorbidities, and comprehensive geriatric assessment parameters were also recorded. Handgrip strength of < 27 kg for males was accepted as dynapenia. Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL) questionnaires were used to evaluate functional capacity.

Results

The mean age (standard deviation) of the participants was 80.17 (7.69) years. The prevalence of patients with anemia was 43.9%. There was differences between anemic and non-anemic groups in terms of presence of diabetes mellitus (DM), congestive heart failure (CHF), chronic kidney disease (CKD), malnutrition, dynapenia, geriatric depression, BADL and IADL scores (all p < 0.05). In multivariate analysis, after adjusting for all confounding variables except for dynapenia, patients with anemia were associated with reduced BADL and IADL (all p < 0.05). After adjusting for all confounding variables including dynapenia, deterioration in total BADL and IADL scores did not remain significant in the anemic group compared to the non-anemic group (p > 0.05).

Conclusion

Close to one in two older outpatient men had anemia. Anemic men had a higher incidence of DM, CHF, CKD, malnutrition, geriatric depression and dynapenia. Anemia was associated with dependence in both BADL and IADL in older men. However, comorbidities, nutritional status, depressive mood and, specifically muscle strength, were important contributors to this association.

目的:本研究旨在探讨老年男性患者贫血与日常生活基本活动和工具性活动之间的关系:这项横断面研究共纳入了 223 名在一家老年病门诊就诊的老年男性患者。贫血的定义是血红蛋白水平低于 13 g/dL。研究还记录了患者的人口统计学特征、合并症和老年医学综合评估参数。结果的手握力:参与者的平均年龄(标准差)为 80.17(7.69)岁。贫血患者占 43.9%。贫血组和非贫血组在糖尿病(DM)、充血性心力衰竭(CHF)、慢性肾脏病(CKD)、营养不良、Dynapenia、老年抑郁症、BADL 和 IADL 评分方面存在差异(均为 0.05):结论:每两名门诊老年男性中就有近一人患有贫血。贫血男性患糖尿病、慢性阻塞性肺病、慢性肾脏病、营养不良、老年抑郁症和动态痴呆症的比例较高。在老年男性中,贫血与BADL和IADL依赖性有关。然而,合并症、营养状况、抑郁情绪,特别是肌肉力量,是造成这种关联的重要因素。
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引用次数: 0
Association of biological aging with prostate cancer: insights from the National Health and Nutrition Examination Survey 生物老化与前列腺癌的关系:全国健康与营养调查的启示。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-24 DOI: 10.1007/s40520-024-02861-0
Weiqi Yin, Baiyang Song, Chengling Yu, Junhui Jiang, Zejun Yan, Chengxin Xie

The link between biological aging and prostate cancer (PCa) risk, particularly as indicated by elevated prostate-specific antigen (PSA) levels, remains uncertain. This study utilized data from the National Health and Nutrition Examination Survey (2001–2010) to explore this association. Biological age was assessed using Klemera-Doubal method age (KDMAge) and phenotypic age (PhenoAge). PCa was identified through self-reported diagnoses, and highly probable PCa was determined by PSA levels. We analyzed the prevalence of PCa and PSA-defined highly probable PCa across quartiles of biological age measures using weighted chi-square and linear trend tests. Associations were evaluated using weighted multiple logistic regression models. Among 7,209 and 6,682 males analyzed, the overall weighted prevalence of PCa was 2.86%, increasing to 9.60% in those aged 65 and above. A significant rise in PCa prevalence was observed with higher quartiles of KDMAge or PhenoAge (P for trend < 0.001), particularly in those under 65. In this younger group, higher PhenoAge acceleration quartiles were linked to increased PCa prevalence and higher risk of PCa (OR = 1.50, P = 0.015) as well as highly probable PCa in those without a diagnosis (OR = 1.28, P = 0.031). These findings suggest that accelerated biological aging is associated with an increased risk of PCa and may indicate early risk as signaled by PSA levels, even in those without a PCa diagnosis.

生物衰老与前列腺癌(PCa)风险之间的联系,尤其是前列腺特异性抗原(PSA)水平升高所显示的这种联系,目前仍不确定。本研究利用全国健康与营养调查(2001-2010 年)的数据来探讨这种关联。生物年龄采用克莱默拉-杜巴法年龄(KDMAge)和表型年龄(PhenoAge)进行评估。PCa 是通过自我报告的诊断结果确定的,而高可能性 PCa 是通过 PSA 水平确定的。我们使用加权卡方检验和线性趋势检验分析了不同生物年龄四分位数的 PCa 患病率和 PSA 定义的高危 PCa 患病率。我们使用加权多元逻辑回归模型评估了两者之间的关联。在分析的 7209 名男性和 6682 名男性中,PCa 的总体加权患病率为 2.86%,65 岁及以上人群的患病率增至 9.60%。随着 KDMAge 或 PhenoAge 四分位数的增加,PCa 患病率也明显增加(P 为趋势值)。
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引用次数: 0
Association of handgrip strength and risk of cardiovascular disease: a population-based cohort study 手握力与心血管疾病风险的关系:一项基于人群的队列研究
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-16 DOI: 10.1007/s40520-024-02856-x
Fan Zhang, Bingru Luo, Yan Bai, Ying Zhang, Liuyan Huang, Wei Lu

Background

Handgrip strength (HGS) is a simple and non-invasive measure of muscle strength, which has been proposed as a potential predictor of cardiovascular disease (CVD) risk. However, the association between HGS and CVD risk in the Chinese population remains underexplored. This study aims to investigate the relationship between handgrip strength and the risk of cardiovascular disease using data from the 2015–2018 China Health and Retirement Longitudinal Study (CHARLS).

Methods

We included 9369 participants aged 45 years and older from the CHARLS dataset. HGS was measured using a dynamometer, and the average of three measurements for each hand was recorded. Participants were categorized into quartile based on their HGS levels. The primary outcome was the incidence of CVD, including heart diseases, and stroke, obtained through self-reports and verified by medical records. Cox proportional hazards models were used to estimate hazard ratio (HR) and 95% confidence interval (95% CI) for the association between HGS and CVD risk, and using restricted cubic spline to construct a linear relationship, adjusting for potential covariates including demographic factors, lifestyle factors, body composition, and health status. The robustness of the results was determined by stratified analysis.

Results

During a mean follow-up of 3 years, 1198 CVD events were reported, including 851 heart diseases and 427 strokes. After multivariate adjustment, the HR and 95% CI corresponding to CVD risk for participants in the HGS 2nd, 3rd, and 4th quartiles compared with those in the lowest quartile were 0.824 (95% CI: 0.692–0.981), 0.756 (95% CI: 0.614–0.929), 0.625 (95% CI: 0.484–0.807) (Pfor trend: <0.001), respectively. All subgroups analyzed found similar results. For CVD components, HGS was similarly linearly associated with heart disease, and had an inverted U-shape relationship with the risk of stroke, with a potential threshold of 23.16 kg.

Conclusions

Higher HGS was significantly associated with decreased risk of CVD, including heart disease and stroke, in middle-aged and older adults, suggesting that HGS may be a promising measurable predictor of CVD in this population.

背景手握力(HGS)是一种简单、无创的肌肉力量测量方法,被认为是心血管疾病(CVD)风险的潜在预测指标。然而,在中国人群中,握力与心血管疾病风险之间的关系仍未得到充分探索。本研究旨在利用 2015-2018 年中国健康与退休纵向研究(CHARLS)的数据,探讨手握力与心血管疾病风险之间的关系。使用测力计测量 HGS,记录每只手三次测量的平均值。根据 HGS 水平将参与者分为四分位。主要结果是心血管疾病(包括心脏病和中风)的发病率,通过自我报告获得,并通过医疗记录核实。采用 Cox 比例危险模型估算 HGS 与心血管疾病风险之间的危险比 (HR) 和 95% 置信区间 (95%CI),并使用限制性三次样条构建线性关系,同时调整潜在的协变量,包括人口统计学因素、生活方式因素、身体成分和健康状况。结果在平均 3 年的随访期间,共报告了 1198 起心血管疾病事件,包括 851 起心脏病和 427 起中风。经多变量调整后,与最低四分位数的参与者相比,HGS第二、第三和第四四分位数参与者的心血管疾病风险HR和95% CI分别为0.824(95% CI:0.692-0.981)、0.756(95% CI:0.614-0.929)、0.625(95% CI:0.484-0.807)(趋势P:<0.001)。所有亚组分析结果相似。结论较高的 HGS 与中老年人心血管疾病(包括心脏病和中风)风险的降低显著相关,这表明 HGS 可能是这一人群心血管疾病的一个有希望的可测量预测指标。
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引用次数: 0
Functional foods in Mediterranean diet: exploring the functional features of vegetable case-studies obtained also by biotechnological approaches 地中海饮食中的功能食品:探索通过生物技术方法获得的蔬菜案例研究的功能特点
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-16 DOI: 10.1007/s40520-024-02860-1
Anna Rita Bavaro, Annamaria Tarantini, Angelica Bruno, Antonio F. Logrieco, Antonia Gallo, Giovanni Mita, Francesca Valerio, Gianluca Bleve, Angela Cardinali

The Mediterranean Diet (MedDiet) is a widely recognized dietary pattern, with its effects largely attributed to “functional foods” which are able to positively influence one or more target functions, improving health and maintaining a state of well-being.

In this review, three “case-study” typical of the MedDiet, such as artichokes, capers and table olives are considered as traditional functional vegetables rich in bioactive compounds, mainly polyphenols. The review extensively discusses the antioxidant effects of these molecules, as well as their role in aging prevention and reduction, maintaining human health, and influencing the abundance and composition of intestinal microbiota. Additionally, this review focuses on the fate of the dietary polyphenols along the digestive tract.

Among biotechnological strategies, the review explores the role of fermentation process in modifying the biochemical profile, recovery, bioaccessibility and bioavailability of bioactive compounds present in some vegetable foods of MedDiet. Finally, the main challenges in the selection, addition, and maintenance of probiotic strains in traditional food products are also summarized, with a view to develop new probiotic carriers for “functional diets”.

地中海饮食(MedDiet)是一种广受认可的饮食模式,其效果主要归功于 "功能性食品",这些食品能够对一种或多种目标功能产生积极影响,从而改善健康状况并保持幸福感。在本综述中,朝鲜蓟、辣椒和食用橄榄这三种典型的地中海饮食 "案例研究 "被视为富含生物活性化合物(主要是多酚)的传统功能性蔬菜。这篇综述广泛讨论了这些分子的抗氧化作用,以及它们在预防和减少衰老、保持人体健康和影响肠道微生物群的丰度和组成方面的作用。此外,这篇综述还关注了膳食多酚在消化道中的去向。在生物技术策略中,综述探讨了发酵过程在改变生物活性化合物的生化特征、回收率、生物可及性和生物利用率方面的作用。最后,还总结了在传统食品中选择、添加和维持益生菌菌株的主要挑战,以期为 "功能性膳食 "开发新的益生菌载体。
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引用次数: 0
Effects of traditional Chinese medicine on outcomes and costs of dementia care: results from a retrospective real-world study 中医药对痴呆症治疗效果和成本的影响:一项回顾性真实世界研究的结果
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-12 DOI: 10.1007/s40520-024-02858-9
Yi-Xiang Weng, Chien-Chung Yang, Wen-Chuin Hsu, Raymond N. Kuo

Objectives

This study aims to assess the impact of Traditional Chinese Medicine (TCM) on dementia patients, utilizing real-world data. Specifically, it seeks to evaluate how TCM influences clinical outcomes by examining changes in the Clinical Dementia Rating (CDR) and Mini-Mental State Examination (MMSE) scores, as well as its effect on medical expenses over a two-year period. Data from a multi-center research database spanning from 2004 to 2021 will be used to achieve these objectives, addressing the current gap in empirical data concerning intuitive outcomes and cognitive function assessments.

Methods

Propensity score matching was adopted to improve comparability among the intervention and control groups. Due to repeated dependent variable measurements, the generalized estimating equation was used to control for socio-demographic characteristics, regional characteristics, and Western medicine treatments for dementia.

Results

After propensity score matching, a total of 441 research subjects were included: 90 in the TCM intervention group and 351 in the non-TCM intervention group. The results of multivariate regression analysis showed that compared with the non-TCM intervention group, the MMSE scores in the TCM intervention group increased by 0.608 points each year. The annual change in CDR scores in the TCM intervention group was 0.702 times that of the non-TCM utilization group. After TCM intervention, annual outpatient expenses increased by US$492.2, hospitalization expenses increased by US$324.3, and total medical expenses increased by US$815.9, compared with the non-intervention group.

Conclusions

TCM interventions significantly decelerate cognitive decline in dementia patients, evidenced by slower reductions in MMSE scores and mitigated increases in CDR scores. However, these benefits are accompanied by increased medical expenses, particularly for outpatient care. Future healthcare strategies should balance the cognitive benefits of TCM with its economic impact, advocating for its inclusion in dementia care protocols.

目标本研究旨在利用真实世界的数据,评估传统中医药(TCM)对痴呆症患者的影响。具体而言,研究旨在通过考察临床痴呆评分(CDR)和迷你精神状态检查(MMSE)分数的变化,以及两年内中医对医疗费用的影响,评估中医如何影响临床疗效。为了实现这些目标,我们将使用一个跨度为 2004 年至 2021 年的多中心研究数据库中的数据,以弥补目前在直观结果和认知功能评估方面的经验数据缺口。由于因变量的重复测量,研究人员采用了广义估计方程来控制社会人口特征、地区特征以及西医治疗痴呆症的方法:其中中医干预组 90 人,非中医干预组 351 人。多变量回归分析结果显示,与非中医干预组相比,中医干预组的 MMSE 评分每年增加 0.608 分。中医干预组 CDR 评分的年变化是非中医干预组的 0.702 倍。中医干预后,与未干预组相比,每年的门诊费用增加了 492.2 美元,住院费用增加了 324.3 美元,总医疗费用增加了 815.9 美元。然而,这些益处伴随着医疗费用的增加,尤其是门诊护理费用的增加。未来的医疗策略应在中医的认知益处和经济影响之间取得平衡,倡导将中医纳入痴呆症护理方案。
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引用次数: 0
期刊
Aging Clinical and Experimental Research
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