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The single point insulin sensitivity estimator (SPISE) is associated with bone health in Arab adults. 单点胰岛素敏感性估计值(SPISE)与阿拉伯成年人的骨骼健康有关。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-21 DOI: 10.1007/s40520-024-02789-5
Nasser M Al-Daghri, Kaiser Wani, Malak N K Khattak, Abdullah M Alnaami, Yousef Al-Saleh, Shaun Sabico

Background: The Single Point Insulin Sensitivity Estimator (SPISE) index is a surrogate marker for insulin sensitivity. Given the emerging role of bone as an active endocrine organ, its associations with non-invasive measures of extra-skeletal functions such as insulin sensitivity warrant investigation.

Aims: This study aimed to explore the relationship between the SPISE index and Bone Mineral Density (BMD) in an adult population.

Methods: Data from a total of 1270 Arab adults (84% females, mean age 56.7 ± 8.1 years) from the Osteoporosis Registry Database of the Chair for Biomarkers of Chronic Diseases in King Saud University, Riyadh, Saudi Arabia was used in this study. T-scores and SPISE were calculated. Regression models were used to determine associations between SPISE and bone health indices.

Results: The low BMD group (N = 853; T-score <-1.0) had significantly higher SPISE values than those with normal BMD (N = 417; T-score - 1.0 and above) (4.6 ± 1.3 vs. 4.3 ± 1.2, p < 0.001). Multivariate linear regression, adjusted for covariates, confirmed a significant inverse association between SPISE and BMD for all participants (β=-0.22, p < 0.001), as well as both groups [normal BMD (β = -0.10, p = 0.02) and low BMD groups (β = -0.15, p < 0.001)]. SPISE, family history of T2DM, and history of fractures collectively account for 17% of the variances perceived in T-score for all participants (p < 0.001).

Conclusions: A significant inverse association between the SPISE index and BMD was observed in adults, suggesting a link between BMD and extra-skeletal health. Underlying mechanisms need to be investigated prospectively using BMD as secondary outcomes in lifestyle modification programs.

背景:单点胰岛素敏感性估计指数(SPISE)是胰岛素敏感性的替代指标。鉴于骨骼作为一个活跃的内分泌器官的作用正在显现,其与胰岛素敏感性等骨骼外功能的非侵入性测量之间的关系值得研究:本研究使用了沙特阿拉伯利雅得沙特国王大学慢性病生物标志物研究中心骨质疏松症登记数据库中的 1270 名阿拉伯成年人(84% 为女性,平均年龄为 56.7 ± 8.1 岁)的数据。计算了 T 值和 SPISE。使用回归模型确定 SPISE 与骨健康指数之间的关系:结果:低 BMD 组(N = 853;T-score 结论:SPISE 与骨健康指数之间存在显著的反向关系:在成人中观察到 SPISE 指数与 BMD 之间存在明显的反向关系,这表明 BMD 与骨骼外健康之间存在联系。需要将 BMD 作为生活方式调整计划的次要结果,对其基本机制进行前瞻性研究。
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引用次数: 0
Postoperative cognitive dysfunction: a concept analysis. 术后认知功能障碍:概念分析。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-21 DOI: 10.1007/s40520-024-02779-7
Hesam Aldin Varpaei, Kousha Farhadi, Mostafa Mohammadi, Alireza Khafaee Pour Khamseh, Tahereh Mokhtari

Background: Post-operative cognitive dysfunction (POCD) is a concern for clinicians that often presents post-surgery where generalized anesthesia has been used. Its prevalence ranges from 36.6% in young adults to 42.4% in older individuals. Conceptual clarity for POCD is lacking in the currently body literature. Our two-fold purpose of this concept analysis was to (1) critically appraise the various definitions, while also providing the best definition, of POCD and (2) narratively synthesize the attributes, surrogate or related terms, antecedents (risk factors), and consequences of the concept.

Method: The reporting of our review was guided by the PRISMA statement and the 6-step evolutionary approach to concept analysis developed by Rodgers. Three databases, including Medline, CINAHL, and Web of Science, were searched to retrieve relevant literature on the concept of POCD. Two independent reviewers conducted abstract and full-text screening, data extraction, and appraisal. The review process yielded a final set of 86 eligible articles.

Result: POCD was defined with varying severities ranging from subtle-to-extensive cognitive changes (1) affecting single or multiple cognitive domains that manifest following major surgery (2), is transient and reversible, and (3) may last for several weeks to years. The consequences of POCD may include impaired quality of life, resulting from withdrawal from the labor force, increased patients' dependencies, cognitive decline, an elevated risk of dementia, rising healthcare costs, and eventual mortality.

Conclusion: This review resulted in a refined definition and comprehensive analysis of POCD that can be useful to both researchers and clinicians. Future research is needed to refine the operational definitions of POCD so that they better represent the defining attributes of the concept.

背景:术后认知功能障碍(POCD)是临床医生关注的一个问题,通常在使用全身麻醉的手术后出现。其发病率从年轻人的 36.6% 到老年人的 42.4% 不等。在目前的文献中,POCD 的概念还不够清晰。我们进行概念分析的双重目的是:(1)批判性地评估 POCD 的各种定义,同时提供最佳定义;(2)叙述性地综合 POCD 的属性、替代或相关术语、前因(风险因素)和后果:我们的综述报告以 PRISMA 声明和罗杰斯提出的概念分析 6 步演进法为指导。我们搜索了三个数据库,包括 Medline、CINAHL 和 Web of Science,以检索 POCD 概念的相关文献。两位独立审稿人进行了摘要和全文筛选、数据提取和评估。审查过程最终产生了 86 篇符合条件的文章:结果:POCD 的定义有轻重之分,从细微到广泛的认知变化(1)影响单个或多个认知领域,在大手术后表现出来(2),是短暂的、可逆的,(3)可能持续数周至数年。POCD 的后果可能包括生活质量受损、退出劳动力市场、患者依赖性增加、认知能力下降、痴呆风险增加、医疗费用增加以及最终死亡:本综述对 POCD 进行了完善的定义和全面的分析,对研究人员和临床医生都很有用。未来的研究需要完善 POCD 的操作定义,使其更好地代表这一概念的定义属性。
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引用次数: 0
Radiofrequency echographic multi spectrometry (REMS) in the diagnosis and management of osteoporosis: state of the art. 骨质疏松症诊断和管理中的射频回声多谱勒测定法(REMS):最新进展。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-21 DOI: 10.1007/s40520-024-02784-w
Nicholas R Fuggle, Jean-Yves Reginster, Nasser Al-Daghri, Olivier Bruyere, Nansa Burlet, Claudia Campusano, Cyrus Cooper, Adolfo Diez Perez, Philippe Halbout, Tullio Ghi, Jean-Marc Kaufman, Andreas Kurt, Radmila Matijevic, Regis P Radermecker, Sansin Tuzun, Nicola Veronese, Rene Rizzoli, Nicholas C Harvey, Maria Luisa Brandi, Maria-Luisa Brandi

Radiofrequency Echographic Multi Spectrometry (REMS) is a radiation-free, portable technology, which can be used for the assessment and monitoring of osteoporosis at the lumbar spine and femoral neck and may facilitate wider access to axial BMD measurement compared with standard dual-energy x-ray absorptiometry (DXA).There is a growing literature demonstrating a strong correlation between DXA and REMS measures of BMD and further work supporting 5-year prediction of fracture using the REMS Fragility Score, which provides a measure of bone quality (in addition to the quantitative measure of BMD).The non-ionising radiation emitted by REMS allows it to be used in previously underserved populations including pregnant women and children and may facilitate more frequent measurement of BMD.The portability of the device means that it can be deployed to measure BMD for frail patients at the bedside (avoiding the complications in transfer and positioning which can occur with DXA), in primary care, the emergency department, low-resource settings and even at home.The current evidence base supports the technology as a useful tool in the management of osteoporosis as an alternative to DXA.

射频超声多谱勒技术(REMS)是一种无辐射的便携式技术,可用于评估和监测腰椎和股骨颈的骨质疏松症,与标准的双能 X 射线吸收测量法(DXA)相比,它能更广泛地测量轴向 BMD。越来越多的文献表明,DXA 和 REMS 测量的 BMD 之间有很强的相关性,还有更多的工作支持使用 REMS 脆性评分预测 5 年骨折情况,该评分提供了骨质的测量方法(除了 BMD 的定量测量方法外)。该设备的便携性意味着它可以在床边(避免了 DXA 在转移和定位时可能出现的并发症)、初级保健、急诊科、低资源环境甚至在家里为体弱患者测量 BMD。
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引用次数: 0
Osteosarcopenia increases the risk of mortality: a systematic review and meta-analysis of prospective observational studies. 骨质疏松症会增加死亡风险:前瞻性观察研究的系统回顾和荟萃分析。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-18 DOI: 10.1007/s40520-024-02785-9
Nicola Veronese, Francesco Saverio Ragusa, Shaun Sabico, Ligia J Dominguez, Mario Barbagallo, Gustavo Duque, Nasser Al-Daghri

Background & aims: Osteosarcopenia is a recently recognized geriatric syndrome. The association between osteosarcopenia and mortality risk is still largely underexplored. In this systematic review with meta-analysis of prospective cohort studies, we aimed to explore whether osteosarcopenia could be associated with a higher mortality risk.

Methods: Several databases were searched from the inception to 16th February 2024 for prospective cohort studies dealing with osteosarcopenia and mortality. We calculated the mortality risk in osteosarcopenia vs. controls using the most adjusted estimate available and summarized the data as risk ratios (RRs) with their 95% confidence intervals (CIs). A random-effect model was considered for all analyses.

Results: Among 231 studies initially considered, nine articles were included after exclusions for a total of 14,429 participants (mean age: 70 years; 64.5% females). The weighted prevalence of osteosarcopenia was 12.72%. Over a mean follow-up of 6.6 years and after adjusting for a mean of four covariates, osteosarcopenia was associated with approximately 53% increased risk of mortality (RR: 1.53; 95% CI: 1.28-1.78). After accounting for publication bias, the re-calculated RR was 1.48 (95%CI: 1.23-1.72). The quality of the studies was generally good, as determined by the Newcastle Ottawa Scale.

Conclusions: Osteosarcopenia was significantly linked with an increased risk of mortality in older people, indicating the need to consider the presence of osteoporosis in patients with sarcopenia, and vice versa, since the combination of these two conditions typical of older people may lead to further complications, such as mortality.

背景与目的:骨肉疏松症是最近才被发现的一种老年综合症。骨肌肉疏松症与死亡风险之间的关联在很大程度上仍未得到充分探讨。在这篇对前瞻性队列研究进行荟萃分析的系统性综述中,我们旨在探讨骨肉疏松症是否与较高的死亡风险有关:我们在多个数据库中搜索了从开始到 2024 年 2 月 16 日有关骨肉疏松症和死亡率的前瞻性队列研究。我们使用现有的最经调整的估计值计算了骨质疏松症患者与对照组患者的死亡风险,并将数据汇总为风险比(RRs)及其 95% 置信区间(CIs)。所有分析均采用随机效应模型:在初步考虑的 231 项研究中,有 9 篇文章被排除在外,共纳入 14 429 名参与者(平均年龄:70 岁;64.5% 为女性)。骨肉疏松症的加权患病率为 12.72%。在平均 6.6 年的随访期间,在对平均四个协变量进行调整后,骨肉疏松症导致死亡风险增加约 53%(RR:1.53;95% CI:1.28-1.78)。考虑到发表偏倚后,重新计算的 RR 为 1.48(95%CI:1.23-1.72)。根据纽卡斯尔-渥太华量表(Newcastle Ottawa Scale),研究质量总体良好:结论:骨质疏松症与老年人死亡风险的增加密切相关,这表明有必要考虑到患有肌肉疏松症的患者是否存在骨质疏松症,反之亦然,因为这两种老年人的典型症状结合在一起可能会导致更多并发症,如死亡。
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引用次数: 0
Association of leukocyte telomere length with risk of all-cause and cardiovascular mortality in middle-aged and older individuals without cardiovascular disease: a prospective cohort study of NHANES 1999-2002. 白细胞端粒长度与无心血管疾病的中老年人全因和心血管死亡风险的关系:1999-2002 年 NHANES 的前瞻性队列研究。
IF 4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-13 DOI: 10.1007/s40520-024-02773-z
Qianhui Wang, Linqiang Xi, Na Yang, Jie Song, Dilare Taiwaikul, Xiaoxue Zhang, Yakun Bo, Baopeng Tang, Xianhui Zhou

Background: Leukocyte telomere length (LTL) shorting was significantly associated with mortality. This study aimed to investigate the potential association between LTL and all-cause mortality as well as cardiovascular disease (CVD) mortality in middle-aged or older individuals without a history of CVD.

Methods: A total of 4174 participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2002 were included in this analysis. Cox proportional hazards regression models were utilized to estimate the association between LTL and mortality outcomes. Restricted cubic spline (RCS) curves were employed to evaluate the potential non-linear association.

Results: Over a median follow-up period of 217 months, the weighted rates of all-cause mortality and CVD mortality were 28.58% and 8.32% respectively. Participants in the highest LTL group exhibited a significantly decreased risk of both all-cause mortality (HR: 0.65, 95% CI: 0.54-0.78, P < 0.001) and CVD mortality (HR: 0.64, 95% CI: 0.45-0.93, P < 0.001) compared to those in the lowest group. Kaplan-Meier survival curves further supported a significant association between shorter telomere length and increased risks of both all-cause and CVD mortality (log-rank test P < 0.001). RCS curves demonstrated a linear dose-response relationship between LTL and all-cause mortality as well as CVD mortality. Subgroup and sensitivity analyses confirmed the robustness of the results.

Conclusion: Shorter leukocyte telomere length could serve as a potential biomarker for risk stratification of all-cause and CVD mortality among middle-aged and older individuals without a history of CVD.

背景:白细胞端粒长度(LTL白细胞端粒长度(LTL)缩短与死亡率显著相关。本研究旨在调查无心血管疾病史的中老年人的白细胞端粒长度与全因死亡率以及心血管疾病(CVD)死亡率之间的潜在关联:本次分析共纳入了 4174 名来自 1999 年至 2002 年间进行的美国国家健康与营养调查(NHANES)的参与者。采用 Cox 比例危险度回归模型来估算 LTL 与死亡率之间的关系。限制立方样条曲线(RCS)用于评估潜在的非线性关联:在 217 个月的中位随访期内,全因死亡率和心血管疾病死亡率的加权率分别为 28.58% 和 8.32%。LTL最高组的参与者全因死亡率和心血管疾病死亡率的风险都明显降低(HR:0.65,95% CI:0.54-0.78,P较短的白细胞端粒长度可作为一种潜在的生物标志物,用于对无心血管疾病史的中老年人的全因死亡率和心血管疾病死亡率进行风险分层。
{"title":"Association of leukocyte telomere length with risk of all-cause and cardiovascular mortality in middle-aged and older individuals without cardiovascular disease: a prospective cohort study of NHANES 1999-2002.","authors":"Qianhui Wang, Linqiang Xi, Na Yang, Jie Song, Dilare Taiwaikul, Xiaoxue Zhang, Yakun Bo, Baopeng Tang, Xianhui Zhou","doi":"10.1007/s40520-024-02773-z","DOIUrl":"10.1007/s40520-024-02773-z","url":null,"abstract":"<p><strong>Background: </strong>Leukocyte telomere length (LTL) shorting was significantly associated with mortality. This study aimed to investigate the potential association between LTL and all-cause mortality as well as cardiovascular disease (CVD) mortality in middle-aged or older individuals without a history of CVD.</p><p><strong>Methods: </strong>A total of 4174 participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2002 were included in this analysis. Cox proportional hazards regression models were utilized to estimate the association between LTL and mortality outcomes. Restricted cubic spline (RCS) curves were employed to evaluate the potential non-linear association.</p><p><strong>Results: </strong>Over a median follow-up period of 217 months, the weighted rates of all-cause mortality and CVD mortality were 28.58% and 8.32% respectively. Participants in the highest LTL group exhibited a significantly decreased risk of both all-cause mortality (HR: 0.65, 95% CI: 0.54-0.78, P < 0.001) and CVD mortality (HR: 0.64, 95% CI: 0.45-0.93, P < 0.001) compared to those in the lowest group. Kaplan-Meier survival curves further supported a significant association between shorter telomere length and increased risks of both all-cause and CVD mortality (log-rank test P < 0.001). RCS curves demonstrated a linear dose-response relationship between LTL and all-cause mortality as well as CVD mortality. Subgroup and sensitivity analyses confirmed the robustness of the results.</p><p><strong>Conclusion: </strong>Shorter leukocyte telomere length could serve as a potential biomarker for risk stratification of all-cause and CVD mortality among middle-aged and older individuals without a history of CVD.</p>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":"131"},"PeriodicalIF":4.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11176221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141309360","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
Relationship between muscle and subcutaneous adipose tissue size and density and proximal femur bone in elderly women with hip fracture. 髋部骨折老年妇女肌肉和皮下脂肪组织的大小和密度与股骨近端骨骼之间的关系。
IF 4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-11 DOI: 10.1007/s40520-024-02782-y
Yangtong Li, Chenjun Liu, Jing Lu, Hui Sun, Yuehua Li

Background: Both osteoporosis and sarcopenia are associated with aging, increasing the likelihood of falls in older adults and consequently raising the risk of hip fractures (HF).

Aims: To explore the relationship between the size and density of muscle and subcutaneous adipose tissue (SAT) and the bone mineral density (BMD) of the proximal femur in elderly women with HF.

Methods: Quantitative computed tomography (QCT) was conducted on the hips of 661 female participants who experienced low-energy acute HFs to measure both areal BMD (aBMD) and volume BMD (vBMD). Measurements were taken for the cross-sectional area (CSA) and density of the muscle around the hip and adjacent SAT. Multivariable linear regression models were applied to assess the relationship between these parameters.

Results: Most increases in the density of the gluteus medius and minimus muscle (G.Med/MinM) were correlated with higher BMD in the femoral neck fracture (FNF) group with osteoporosis. In the FNF group, gluteus maximus muscle (G.MaxM) density was negatively associated with the BMD parameters of the proximal femur in individuals with osteoporosis, while they were positively associated with nonosteoporosis. In the intertrochanteric fracture (ITF) group without osteoporosis, both FN aBMD and FN vBMD showed significant correlations with G.Med/MinM density.

Discussion: In women with HFs, bone and muscle are closely related.

Conclusions: In older women with HFs, density but not CSA of the G.Med/MinM were associated with BMD parameters of the proximal femur. Osteoporosis may influence the relationship between G.MaxM density and proximal femur BMD in elderly women with FNF.

背景:目的:探讨患有高血压的老年妇女肌肉和皮下脂肪组织(SAT)的大小和密度与股骨近端骨矿密度(BMD)之间的关系:对 661 名经历过低能急性高血压的女性参与者的髋部进行了定量计算机断层扫描(QCT),以测量平均骨密度(aBMD)和体积骨密度(vBMD)。此外,还测量了髋部和邻近 SAT 周围肌肉的横截面积 (CSA) 和密度。采用多变量线性回归模型评估这些参数之间的关系:结果:在股骨颈骨折(FNF)伴骨质疏松症组中,臀中肌和臀小肌密度(G.Med/MinM)的增加大多与较高的 BMD 相关。在股骨颈骨折组中,臀大肌(G.MaxM)密度与骨质疏松症患者股骨近端 BMD 参数呈负相关,而与非骨质疏松症患者呈正相关。在无骨质疏松症的转子间骨折(ITF)组中,FN aBMD 和 FN vBMD 均与 G.Med/MinM 密度呈显著相关:讨论:在患有高血压的女性中,骨骼和肌肉密切相关:在患有心房颤动的老年妇女中,G.Med/MinM 的密度与股骨近端 BMD 参数相关,但 CSA 与之无关。骨质疏松症可能会影响FNF老年妇女的G.MaxM密度与股骨近端BMD之间的关系。
{"title":"Relationship between muscle and subcutaneous adipose tissue size and density and proximal femur bone in elderly women with hip fracture.","authors":"Yangtong Li, Chenjun Liu, Jing Lu, Hui Sun, Yuehua Li","doi":"10.1007/s40520-024-02782-y","DOIUrl":"10.1007/s40520-024-02782-y","url":null,"abstract":"<p><strong>Background: </strong>Both osteoporosis and sarcopenia are associated with aging, increasing the likelihood of falls in older adults and consequently raising the risk of hip fractures (HF).</p><p><strong>Aims: </strong>To explore the relationship between the size and density of muscle and subcutaneous adipose tissue (SAT) and the bone mineral density (BMD) of the proximal femur in elderly women with HF.</p><p><strong>Methods: </strong>Quantitative computed tomography (QCT) was conducted on the hips of 661 female participants who experienced low-energy acute HFs to measure both areal BMD (aBMD) and volume BMD (vBMD). Measurements were taken for the cross-sectional area (CSA) and density of the muscle around the hip and adjacent SAT. Multivariable linear regression models were applied to assess the relationship between these parameters.</p><p><strong>Results: </strong>Most increases in the density of the gluteus medius and minimus muscle (G.Med/MinM) were correlated with higher BMD in the femoral neck fracture (FNF) group with osteoporosis. In the FNF group, gluteus maximus muscle (G.MaxM) density was negatively associated with the BMD parameters of the proximal femur in individuals with osteoporosis, while they were positively associated with nonosteoporosis. In the intertrochanteric fracture (ITF) group without osteoporosis, both FN aBMD and FN vBMD showed significant correlations with G.Med/MinM density.</p><p><strong>Discussion: </strong>In women with HFs, bone and muscle are closely related.</p><p><strong>Conclusions: </strong>In older women with HFs, density but not CSA of the G.Med/MinM were associated with BMD parameters of the proximal femur. Osteoporosis may influence the relationship between G.MaxM density and proximal femur BMD in elderly women with FNF.</p>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":"130"},"PeriodicalIF":4.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11166751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305225","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
Mild cognitive impairment predicts the onset of Sarcopenia: a longitudinal analysis from the English Longitudinal Study on Ageing. 轻度认知障碍可预测肌肉疏松症的发病:英国老龄化纵向研究的纵向分析。
IF 4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-10 DOI: 10.1007/s40520-024-02781-z
Francesco Saverio Ragusa, Nicola Veronese, Laura Vernuccio, Ligia J Dominguez, Lee Smith, Francesco Bolzetta, Ai Koyanagi, Roberto Monastero, Mario Barbagallo

Background: Mild cognitive impairment (MCI) and sarcopenia are two common conditions in older people. It is not widely known if MCI could predict the onset of sarcopenia. Therefore, we aimed to investigate whether MCI could predict the occurrence of sarcopenia in a population of older adults.

Methods: In the ELSA (English Longitudinal Study on Ageing), MCI was defined as the absence of dementia, preserved functional capacity and low performance in three objective cognitive tests. Sarcopenia was diagnosed as having low handgrip strength and low skeletal muscle mass index during follow-up. The longitudinal association between MCI at the baseline and incident sarcopenia was assessed using a multivariable logistic regression model, reporting the data as adjusted odds ratios (OR) and 95% confidence intervals (95%CI).

Results: 3,106 participants (mean age of 63.1 years; 55.3% males) were included. People with MCI reported significantly lower mean handgrip strength values and Skeletal Mass Index (SMI), as well as a higher prevalence of obesity at baseline. At baseline, 729 people had MCI and during the ten years follow-up period, 12.1% of the initial population included had sarcopenia. On multivariate analysis, adjusted for 18 potential confounders, the presence of MCI (OR = 1.236; 95%CI: 1.090-1.596, p = 0.01) significantly predicted the onset of sarcopenia during follow-up.

Conclusion: The presence of MCI at baseline was associated with a higher incidence of sarcopenia at ten-years follow-up, demonstrating a likely role of MCI as a predictor of the onset of sarcopenia in older people.

背景:轻度认知障碍(MCI)和肌肉疏松症是老年人的两种常见病。MCI 能否预测肌肉疏松症的发病,目前还不为人们所广泛知晓。因此,我们旨在研究 MCI 能否预测老年人群中肌肉疏松症的发生:在 ELSA(英国老龄化纵向研究)中,MCI 被定义为无痴呆症、功能保持正常以及在三项客观认知测试中表现较差。在随访期间,手握力和骨骼肌质量指数较低即可诊断为 "肌肉疏松症"。我们使用多变量逻辑回归模型评估了基线MCI与肌肉疏松症之间的纵向联系,并以调整后的几率比(OR)和95%置信区间(95%CI)报告数据:共纳入 3106 名参与者(平均年龄为 63.1 岁;55.3% 为男性)。MCI患者的平均手握力值和骨骼质量指数(SMI)明显较低,基线肥胖率也较高。基线时有 729 人患有 MCI,在十年的随访期间,12.1% 的初始人群患有肌肉疏松症。在对18种潜在混杂因素进行调整的多变量分析中,MCI(OR=1.236;95%CI:1.090-1.596,p=0.01)显著预测了随访期间肌肉疏松症的发病率:结论:基线时存在 MCI 与十年随访期间较高的肌肉疏松症发病率有关,这表明 MCI 可能是老年人肌肉疏松症发病的一个预测因素。
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引用次数: 0
Association between screen time and self-reported balance disorders in middle-aged and older adults: national health and nutrition examination survey. 屏幕时间与中老年人自我报告的平衡失调之间的关系:全国健康与营养状况调查。
IF 4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-10 DOI: 10.1007/s40520-024-02778-8
Minjun Fu, Lingju Zhang, Xiaoyu Zhao, Zhijun Lv, Pei Tang

Background: Balance disorders can give rise to sensations of instability, lightheadedness, vertigo, disequilibrium, or syncope, ultimately leading to grave medical, physical, emotional, and societal ramifications. These conditions are highly prevalent among individuals aged 40 and above. Screen time encompasses activities associated with television viewing, video game playing, and non-work-related computer usage. Prolonged screen exposure may engender a spectrum of health issues and even elevate overall mortality rates. However, the available evidence on the potential link between excessive screen time and balance dysfunction remains limited.

Aims: The primary aim of this study was to explore the possible association between prolonged screen exposure and impaired balance function.

Methods: This cross-sectional study utilized data from participants who completed a comprehensive questionnaire in the NHANES database between 1999 and 2002, all of whom were aged over 40 and under 85 years. Participants' screen time was categorized into two groups (< 4 h/d and  ≥4 h/d) for subsequent data analysis. Logistic regression, combined with propensity score matching (PSM), was employed to investigate the correlation between screen time and balance disorders.

Results: A total of 5176 participants were enrolled in this study, comprising 2,586 men and 2,590 women, with a prevalence rate of balance disorders at 25.7% (1331/5176). The incidence of balance disorders was found to be significantly higher among individuals who spent 4 hours or more per day on screen time compared to those with less screen time (P<0.001). Multivariate logistic analysis conducted on the unmatched cohort revealed a significant association between screen time and balance disorders, with an odds ratio (OR) 1.8 (95%CI 1.57 ∼ 2.05). These findings remained consistent even after adjusting for confounding factors, yielding an OR 1.43 (95%CI 1.24 ∼ 1.66). Moreover, the association persisted when employing various multivariate analyses such as propensity score matching adjusted model, standardized mortality ratio weighting model and pairwise algorithmic model; all resulting in ORs ranging from 1.38 to 1.43 and p-values < 0.001.

Conclusions: After controlling for all covariates, screen time (watching TV, playing video games, and using computers outside of work) was associated with balance dysfunction among middle-aged and older adults. This finding may offer a possible idea for the prevention of dizziness and balance disorders. Nevertheless, additional research is imperative to further validate these results.

背景:平衡失调可引起不稳定、头晕、眩晕、不平衡或晕厥等感觉,最终导致严重的医疗、身体、情绪和社会后果。这些症状在 40 岁及以上的人群中非常普遍。屏幕时间包括与看电视、玩电子游戏和使用与工作无关的电脑有关的活动。长时间接触屏幕可能会引发一系列健康问题,甚至会提高总体死亡率。目的:本研究的主要目的是探讨长时间接触屏幕与平衡功能受损之间可能存在的联系:这项横断面研究利用了 1999 年至 2002 年期间在 NHANES 数据库中填写综合问卷的参与者的数据,所有参与者的年龄都在 40 岁以上、85 岁以下。参与者的屏幕时间被分为两组(结果:共有 5176 人参加了这项研究,其中男性 2586 人,女性 2590 人,平衡失调发生率为 25.7%(1331/5176)。研究发现,与使用屏幕时间较少的人相比,每天使用屏幕时间达到或超过 4 小时的人的平衡失调发生率明显更高(PConclusions:在控制了所有协变量后,屏幕时间(看电视、玩电子游戏和工作之余使用电脑)与中老年人的平衡功能障碍有关。这一发现为预防头晕和平衡失调提供了可能的思路。不过,要进一步验证这些结果,还必须进行更多的研究。
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引用次数: 0
Combined nutritional status and activities of daily living disability is associated with one-year mortality after hip fracture surgery for geriatric patients: a retrospective cohort study. 老年患者髋部骨折术后一年死亡率与营养状况和日常生活能力障碍的综合关系:一项回顾性队列研究。
IF 4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-08 DOI: 10.1007/s40520-024-02786-8
Ying Chen, Ying Guo, Gang Tong, Yu He, Ruihua Zhang, Qi Liu

Objective: We aimed to explore the association combined nutritional status and activities of daily living disability with all-cause mortality of older adults with hip fracture in the first year after hospitalization.

Methods: This is a single-center retrospective cohort study in older adults with hip fracture patients. Clinical data and laboratory results were collected from electronic medical record system of our hospital (2014-2021). The endpoint of this study was all-cause mortality in the first year after hospitalization.

Results: A total of 303 older adults were enrolled and all-cause mortality was 21.8%. The study population was categorized by CONUT score. Patients in CONUT score 5-12 had a higher age, ASA status, CRP and creatinine level, more patients with history of fracture, pneumonia and delirium, meanwhile, lower BMI and ADL score, lower hemoglobin, lymphocyte, total protein, albumin, triglyceride, total cholesterol and one year survival than those in CONUT score 0-4 (all P < 0.05). Multivariable Cox analysis showed that BMI, ADL score and CONUT score were independent risk factors for all-cause mortality of hip fracture in older adults (HR (95% CI):2.808(1.638, 4.814), P < 0.001; 2.862(1.637, 5.003), P < 0.001; 2.322(1.236, 4.359), P = 0.009, respectively). More importantly, the combined index of CONUT and ADL score had the best predictive performance based on ROC curve (AUC 0.785, 95% CI: 0.734-0.830, P < 0.0001). Kaplan-Meier survival curves for all-cause mortality showed that patients with CONUT score increase and ADL score impairment had a higher mortality rate at 1 year compared to CONUT score decrease and ADL score well (Log Rank χ2 = 45.717, P < 0.0001).

Conclusions: Combined CONUT and ADL score is associated with one-year mortality after hip fracture surgery for geriatric patients.

目的我们旨在探讨髋部骨折老年人住院后第一年内营养状况和日常生活活动障碍与全因死亡率之间的关系:这是一项针对老年髋部骨折患者的单中心回顾性队列研究。临床数据和实验室结果来自本院的电子病历系统(2014-2021 年)。研究终点为住院后第一年的全因死亡率:共有 303 名老年人参与研究,全因死亡率为 21.8%。研究对象按 CONUT 评分进行分类。与 CONUT 评分 0-4 的患者相比,CONUT 评分 5-12 的患者年龄、ASA 状况、CRP 和肌酐水平更高,有骨折、肺炎和谵妄病史的患者更多,同时,BMI 和 ADL 评分更低,血红蛋白、淋巴细胞、总蛋白、白蛋白、甘油三酯、总胆固醇和一年存活率更低(均为 P 结论:CONUT 评分 5-12 的患者年龄、ASA 状况、CRP 和肌酐水平更高,有骨折、肺炎和谵妄病史的患者更多,同时,BMI 和 ADL 评分更低:CONUT和ADL综合评分与老年患者髋部骨折术后一年的死亡率有关。
{"title":"Combined nutritional status and activities of daily living disability is associated with one-year mortality after hip fracture surgery for geriatric patients: a retrospective cohort study.","authors":"Ying Chen, Ying Guo, Gang Tong, Yu He, Ruihua Zhang, Qi Liu","doi":"10.1007/s40520-024-02786-8","DOIUrl":"10.1007/s40520-024-02786-8","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to explore the association combined nutritional status and activities of daily living disability with all-cause mortality of older adults with hip fracture in the first year after hospitalization.</p><p><strong>Methods: </strong>This is a single-center retrospective cohort study in older adults with hip fracture patients. Clinical data and laboratory results were collected from electronic medical record system of our hospital (2014-2021). The endpoint of this study was all-cause mortality in the first year after hospitalization.</p><p><strong>Results: </strong>A total of 303 older adults were enrolled and all-cause mortality was 21.8%. The study population was categorized by CONUT score. Patients in CONUT score 5-12 had a higher age, ASA status, CRP and creatinine level, more patients with history of fracture, pneumonia and delirium, meanwhile, lower BMI and ADL score, lower hemoglobin, lymphocyte, total protein, albumin, triglyceride, total cholesterol and one year survival than those in CONUT score 0-4 (all P < 0.05). Multivariable Cox analysis showed that BMI, ADL score and CONUT score were independent risk factors for all-cause mortality of hip fracture in older adults (HR (95% CI):2.808(1.638, 4.814), P < 0.001; 2.862(1.637, 5.003), P < 0.001; 2.322(1.236, 4.359), P = 0.009, respectively). More importantly, the combined index of CONUT and ADL score had the best predictive performance based on ROC curve (AUC 0.785, 95% CI: 0.734-0.830, P < 0.0001). Kaplan-Meier survival curves for all-cause mortality showed that patients with CONUT score increase and ADL score impairment had a higher mortality rate at 1 year compared to CONUT score decrease and ADL score well (Log Rank χ2 = 45.717, P < 0.0001).</p><p><strong>Conclusions: </strong>Combined CONUT and ADL score is associated with one-year mortality after hip fracture surgery for geriatric patients.</p>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":"127"},"PeriodicalIF":4.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141287607","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
Predictive value of sarcopenia components for all-cause mortality: findings from population-based cohorts. 肌肉疏松症成分对全因死亡率的预测价值:基于人群的队列研究结果。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-06-06 DOI: 10.1007/s40520-024-02783-x
Leo D Westbury, Nicholas C Harvey, Charlotte Beaudart, Olivier Bruyère, Jane A Cauley, Peggy Cawthon, Alfonso J Cruz-Jentoft, Elizabeth M Curtis, Kristine Ensrud, Roger A Fielding, Helena Johansson, John A Kanis, Magnus K Karlsson, Nancy E Lane, Laetitia Lengelé, Mattias Lorentzon, Eugene McCloskey, Dan Mellström, Anne B Newman, Claes Ohlsson, Eric Orwoll, Jean-Yves Reginster, Eva Ribom, Björn E Rosengren, John T Schousboe, Elaine M Dennison, Cyrus Cooper

Background: Low grip strength and gait speed are associated with mortality. However, investigation of the additional mortality risk explained by these measures, over and above other factors, is limited.

Aim: We examined whether grip strength and gait speed improve discriminative capacity for mortality over and above more readily obtainable clinical risk factors.

Methods: Participants from the Health, Aging and Body Composition Study, Osteoporotic Fractures in Men Study, and the Hertfordshire Cohort Study were analysed. Appendicular lean mass (ALM) was ascertained using DXA; muscle strength by grip dynamometry; and usual gait speed over 2.4-6 m. Verified deaths were recorded. Associations between sarcopenia components and mortality were examined using Cox regression with cohort as a random effect; discriminative capacity was assessed using Harrell's Concordance Index (C-index).

Results: Mean (SD) age of participants (n = 8362) was 73.8(5.1) years; 5231(62.6%) died during a median follow-up time of 13.3 years. Grip strength (hazard ratio (95% CI) per SD decrease: 1.14 (1.10,1.19)) and gait speed (1.21 (1.17,1.26)), but not ALM index (1.01 (0.95,1.06)), were associated with mortality in mutually-adjusted models after accounting for age, sex, BMI, smoking status, alcohol consumption, physical activity, ethnicity, education, history of fractures and falls, femoral neck bone mineral density (BMD), self-rated health, cognitive function and number of comorbidities. However, a model containing only age and sex as exposures gave a C-index (95% CI) of 0.65(0.64,0.66), which only increased to 0.67(0.67,0.68) after inclusion of grip strength and gait speed.

Conclusions: Grip strength and gait speed may generate only modest adjunctive risk information for mortality compared with other more readily obtainable risk factors.

背景:低握力和步速与死亡率有关。目的:我们研究了握力和步速是否比更容易获得的临床风险因素更能提高对死亡率的判别能力:方法:我们对健康、衰老和身体成分研究、男性骨质疏松性骨折研究和赫特福德郡队列研究的参与者进行了分析。使用 DXA 确定关节瘦体重 (ALM);通过握力测定法确定肌肉力量;以及 2.4-6 米的正常步速。使用以队列为随机效应的 Cox 回归法研究了肌肉疏松症各组成部分与死亡率之间的关系;使用 Harrell's Concordance Index (C-index) 评估了判别能力:参与者(n = 8362)的平均(标清)年龄为 73.8(5.1)岁;5231(62.6%)人在 13.3 年的中位随访时间内死亡。握力(每标准差下降的危险比(95% CI):1.14(1.10,1.10,1.10)):在考虑了年龄、性别、体重指数(BMI)、吸烟状况、饮酒量、体力活动、种族、教育程度、骨折和跌倒史、股骨颈骨矿密度(BMD)、自评健康状况、认知功能和合并症数量后,在相互调整的模型中,握力(每 SD 下降的危险比(95% CI):1.14 (1.10,1.19))和步速(1.21 (1.17,1.26))与死亡率相关,而 ALM 指数(1.01 (0.95,1.06))与死亡率无关。然而,仅将年龄和性别作为暴露因子的模型得出的C指数(95% CI)为0.65(0.64,0.66),只有在纳入握力和步速后才增至0.67(0.67,0.68):结论:与其他更容易获得的风险因素相比,握力和步速只能提供适度的死亡率辅助风险信息。
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引用次数: 0
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Aging Clinical and Experimental Research
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