Aging Clinical and Experimental Research最新文献_第3页

Different dosing regimens for chronic knee osteoarthritis (KOA) pain management: A pooled analysis on celecoxib 慢性膝骨关节炎（KOA）疼痛管理的不同剂量方案：塞来昔布的汇总分析。

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research

Pub Date : 2026-01-23 DOI: 10.1007/s40520-025-03302-2

Ernest Choy, Nicholas Fuggle, Egbert Biesheuvel, Srinivasan Venugopal, Sagar Suresh Kumbhar, Raffaella Maria Rita Chiaese, Chris Walker, Jean-Yves Reginster

Background

Celecoxib is widely used for the management of different chronic musculoskeletal conditions including osteoarthritis (OA), but the comparative effectiveness of 200 mg once daily (OD) versus 100 mg twice daily (BID) in patients with varying baseline pain severity is not fully established.

Aims

To compare the efficacy of celecoxib 200 mg OD and 100 mg BID in reducing pain among OA patients with moderate or severe baseline pain, using pooled post hoc analyses of two similar randomized controlled trials.

Materials and methods

Data from two 6-week, double-blind, placebo-controlled trials in knee OA (n = 1,360) were pooled. Patients were stratified into moderate (VAS 40–69 mm, n = 675) or severe (VAS ≥ 70 mm, n = 685) pain subgroups. Interventions included celecoxib 100 mg BID, celecoxib 200 mg OD, or placebo. Primary endpoint was change from baseline in VAS pain at weeks 2 and 6, analyzed via mixed-effects model for repeated measures (MMRM) and ANCOVA with last observation carried forward. WOMAC pain score was a secondary endpoint.

Results

Both celecoxib regimens significantly reduced VAS pain scores versus placebo at weeks 2 and 6 in the overall and moderate pain groups (p < 0.05). In severe pain patients, both regimens were superior to placebo at week 2; however, at week 6, only the 200 mg OD regimen retained statistical significance (LS mean difference vs. placebo − 7.45, p = 0.0135), while 100 mg BID did not. WOMAC pain score results mirrored VAS findings, with 200 mg OD showing the greatest improvement in severe baseline pain.

Conclusion

Celecoxib 100 mg BID and 200 mg OD are both effective for OA pain relief, in moderate and severe pain. Findings suggest 200 mg OD may confer an advantage in patients with severe baseline pain in the long-term treatment (week 6).

背景：塞来昔布被广泛用于治疗包括骨关节炎（OA）在内的各种慢性肌肉骨骼疾病，但在不同基线疼痛严重程度的患者中，200 mg每日一次（OD）与100 mg每日两次（BID）的比较有效性尚未完全确定。目的：比较塞来昔布200mg OD和100mg BID减轻中度或重度基线疼痛OA患者疼痛的疗效，采用两项类似随机对照试验的合并事后分析。材料和方法：收集了两项为期6周、双盲、安慰剂对照的膝关节OA试验（n = 1,360）的数据。患者被分为中度（VAS 40-69 mm, n = 675）和重度（VAS≥70 mm, n = 685）疼痛亚组。干预措施包括塞来昔布100mg BID、塞来昔布200mg OD或安慰剂。主要终点是第2周和第6周VAS疼痛较基线的变化，通过重复测量混合效应模型（MMRM）和ANCOVA分析，最后一次观察延续。WOMAC疼痛评分是次要终点。结果：在全面疼痛组和中度疼痛组，两种塞来昔布方案在第2周和第6周均显著降低VAS疼痛评分(p结论：塞来昔布100mg BID和200mg OD均可有效缓解中度和重度OA疼痛。研究结果表明，在长期治疗（第6周）中，200mg OD可能会给患有严重基线疼痛的患者带来优势。

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引用次数: 0

The impact of balance exercise on brain age and brain morphometry: insights from MRI analysis. 平衡运动对脑年龄和脑形态的影响：来自MRI分析的见解。

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research

Pub Date : 2026-01-22 DOI: 10.1007/s40520-026-03322-6

Varima Narula, Denise Taylor, Ruth McLaren, Rachael L Taylor, Susan Mahon, Paul F Smith, Shikha Chaudhary, Roger W Winton, Justin Fernandez, Vickie Shim, Alan Wang

Physical exercise is known to delay the cognitive decline in the elderly. However, the effect of low-impact balance exercises such as yoga or Tai chi has not been explored in detail. This cross-sectional observational study used brain magnetic resonance imaging data to quantify and compare various brain structures between neurologically healthy adults aged between 55 and 65, divided into Control Group and Balance Exercise (BE) Group based on the self-reported balance exercise status. Various brain attributes such as brain age, cortical and subcortical volume, thickness, surface area, and mean curvature were extracted and computed using machine learning algorithm software like brainageR and FreeSurfer. Clinical functional assessments (balance, vestibular and cognitive measures) were also conducted for the participants. Statistical analyses were performed to determine any differences between the groups at a significance level of 5%. The BE group showed statistically significantly higher values for the right caudal anterior cingulate thickness, left and right superior temporal volume, left entorhinal volume and mean curvature, left frontal pole thickness, left superior temporal area and left inferior temporal thickness. A statistically significant cluster after correction for multiple comparisons was found in the left rostral middle frontal gyrus with a higher volume for BE group. Clinical functional assessments (balance, vestibular and cognitive) and brain age differences were nonsignificant. The significant brain regions in the BE group are involved in memory, cognition, focus, planning, language and auditory processing, decision making, emotional regulation and mental health and could be responsible for protecting and delaying the cognitive declines in the elderly.

众所周知，体育锻炼可以延缓老年人认知能力的下降。然而，瑜伽或太极等低冲击平衡运动的效果尚未得到详细探讨。本横断面观察性研究采用脑磁共振成像数据对55 ~ 65岁神经健康成人的各种脑结构进行量化和比较，根据自我报告的平衡运动状态将其分为对照组和平衡运动（BE）组。使用brainageR和FreeSurfer等机器学习算法软件提取和计算脑年龄、皮质和皮质下体积、厚度、表面积和平均曲率等各种脑属性。临床功能评估（平衡、前庭和认知测量）也对参与者进行了评估。进行统计学分析以确定组间差异，显著性水平为5%。BE组右侧扣带前尾部厚度、左右颞上体积、左鼻内体积和平均曲率、左额极厚度、左颞上面积和左颞下厚度均高于对照组，差异有统计学意义。经多次比较校正后，发现在左吻侧额中回有统计学意义的簇，BE组体积更高。临床功能评估（平衡、前庭和认知）和脑年龄差异无统计学意义。BE组的重要大脑区域涉及记忆、认知、注意力、计划、语言和听觉处理、决策、情绪调节和心理健康，可能负责保护和延缓老年人认知能力的下降。

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引用次数: 0

Acute effects of cluster vs. traditional sets on performance and perceptual responses during upper- and lower-limb power-oriented resistance exercises in older adults. 在老年人上肢和下肢力量导向的阻力练习中，集群组与传统组对表现和知觉反应的急性影响。

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research

Pub Date : 2026-01-21 DOI: 10.1007/s40520-026-03324-4

Boliang Wang, Mark Halaki, Derek L Tran, Timothy B Davies, Kimberley L Way, Jonathan Tran, Guy C Wilson, Glen M Davis, Maria A Fiatarone Singh, Daniel A Hackett

Background: Power training is critical for maintaining muscle function and independence in older adults, but excessive fatigue during traditional sets (TRAD) can reduce effectiveness and adherence. Cluster sets (CS) may help counteract these issues; however, most evidence comes from athletes, and acute responses to CS versus TRAD across exercises in older adults remain poorly understood, limiting guidance for optimal prescription.

Methods: Thirty apparently healthy, resistance-trained older adults (19 males, 11 females; 69.3 ± 6.6 years) performed chest press (CP) and leg press (LP) at 70% one-repetition maximum (1RM) at maximal concentric velocity. Participants performed CS (4 × (2 × 5), 30s intra-set rest, 150s between sets; 570s total rest) and TRAD (4 × 10, 180s rest between sets; 540s total rest) on separate occasions in randomized order. Mean concentric velocity (MCV), velocity loss (VL), rating of perceived exertion (RPE), and estimated repetitions to failure (ERF) were measured.

Results: MCV was higher in CS than TRAD for CP (p < 0.001) and LP (p = 0.005). VL was lower in CS than TRAD for CP (p < 0.001) and LP (p = 0.003), although CP exceeded 30% VL in both conditions, whereas LP remained below 20% VL. No differences were observed in RPE, whereas ERF was higher in CS for CP (p = 0.015) and LP (p = 0.045).

Conclusion: CS maintained better exercise performance in older adults, accompanied by perception that they could perform more repetitions compared to TRAD. However, the CS implemented did not significantly reduce perceived exertion.

Trials registration: This study was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) under the identifier: ACTRN12622001573741.

背景：力量训练对于维持老年人的肌肉功能和独立性至关重要，但在传统训练（TRAD）中过度疲劳会降低效果和坚持性。集群集（CS）可以帮助解决这些问题；然而，大多数证据来自运动员，老年人运动中CS与TRAD的急性反应仍然知之甚少，限制了最佳处方的指导。方法：30例明显健康、接受阻力训练的老年人（男19例，女11例，年龄69.3±6.6岁）以最大同心速度以70%的单次最大重复（1RM）进行胸压（CP）和腿压（LP）。受试者进行CS (4 × （2 × 5），组内休息30秒，组间休息150秒；总休息时间570秒)和TRAD （4 × 10，组间休息时间180秒，总休息时间540秒）。测量平均同心速度（MCV）、速度损失（VL）、感知用力等级（RPE）和估计失败重复次数（ERF）。结论：CS在老年人中保持了更好的运动表现，并伴有与TRAD相比他们可以进行更多重复的感觉。然而，CS的实施并没有显著减少运动强度。试验注册：本研究已在澳大利亚新西兰临床试验注册中心（ANZCTR）注册，编号为：ACTRN12622001573741。

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引用次数: 0

Effects of task-oriented training on balance, gait, and fall in older adults: A systematic review and meta-analysis of randomized controlled trials 任务导向训练对老年人平衡、步态和跌倒的影响：随机对照试验的系统回顾和荟萃分析。

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research

Pub Date : 2026-01-21 DOI: 10.1007/s40520-025-03303-1

Wenping Zhang, Wenjing Zhang, Guoxiu Zu, Mingyang Yao, Jiawei Li, Yifei Jin, Liduan Wang, Jiqin Tang

Background

Task-oriented training(TOT) is a rehabilitation approach focused on practicing goal-oriented, functional tasks.

Aims

To investigate the effects of TOT compared with conventional training on improving balance, gait, and fall prevention in older adults(aged ≥ 60 years).

Methods

The study was registered in PROSPERO(ID: CRD42025635269). We searched PubMed, Web of Science, Embase, and ClinicalTrials.gov up to October 2025 for eligible randomized controlled trials. Methodological quality was assessed using the PEDro scale and the Cochrane risk of bias tool. Statistical analyses were performed using Stata 18 and RevMan 5.4. Minimal clinically important difference(MCID) values were determined by reviewing relevant literature.

Results

Twenty studies were included, fifteen of which with complete data were meta-analyzed. Compared to conventional training, TOT was more effective in improving Berg Balance Scale (BBS)(MD = 2.58, P < 0.001), Timed Up and Go test (TUG test)(MD = -0.55, P < 0.001), gait speed (GS)(MD = 0.14, P < 0.001), and Activities-specific Balance Confidence Scale(MD = 17.06, P < 0.001). Improvements in BBS, TUG test and GS for individuals aged ≥ 75 reached the MCID. Although a significant main effect was observed for the Falls Efficacy Scale-International(MD = -2.80, P = 0.03), the result was not robust. The evidence regarding the effect of TOT on fall incidence or Functional Gait Assessment scores was inconclusive.

Conclusion

TOT showed superior effects over conventional training in improving balance, gait, and balance confidence, with clinically meaningful improvements in balance and gait speed. However, its impact on reducing fear of falling and fall incidence requires further validation.

背景：任务导向训练（Task-oriented training， TOT）是一种专注于练习目标导向的功能性任务的康复方法。目的：探讨与常规训练相比，TOT对老年人（≥60岁）改善平衡、步态和预防跌倒的影响。方法：该研究在PROSPERO注册（ID: CRD42025635269）。我们检索了PubMed、Web of Science、Embase和ClinicalTrials.gov，检索了截止到2025年10月的符合条件的随机对照试验。采用PEDro量表和Cochrane偏倚风险工具评估方法学质量。采用Stata 18和RevMan 5.4进行统计学分析。通过查阅相关文献确定最小临床重要差异（MCID）值。结果：纳入20项研究，其中15项数据完整的研究进行meta分析。与常规训练相比，TOT在改善Berg平衡量表（BBS）方面更有效（MD = 2.58， P）。结论：TOT在改善平衡、步态和平衡信心方面的效果优于常规训练，在平衡和步态速度方面有临床意义的改善。然而，它对减少跌倒恐惧和跌倒发生率的影响需要进一步验证。

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引用次数: 0

Quantitative sensory testing of pain in osteoporosis: a pilot randomized clinical trial with magnesium supplementation. 骨质疏松症患者疼痛的定量感觉测试：一项补充镁的随机临床试验。

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research

Pub Date : 2026-01-21 DOI: 10.1007/s40520-025-03317-9

Marie-Eva Pickering, Véronique Morel, Macian Nicolas, Christian Dualé, Elise Sortais, Thomas Graven-Nielsen, Bruno Pereira, Gisèle Pickering

Background: Bisphosphonates (BP) are a recommended treatment for osteoporosis and an analgesic effect has been suggested. Magnesium is involved in pain mechanisms, mood disorders and also in bone homeostasis. Association of BPs and magnesium has however not been studied to explore pain processes in post-menopausal osteoporosis.

Methods: In this pilot ancillary study of a randomized clinical trial in post-menopausal osteoporosis, women were randomized to standard care with intravenous Zoledronate (BP group, n = 22) or BP with oral magnesium (BPMg group, n = 22), 200 mg/day for 3 months. Endpoints were quantified before and 1 year after treatment as spontaneous pain, anxiety, depression and sleep quality, as well as quantitative sensory testing of pain sensitivity by thermal thresholds and conditioned pain modulation (CPM), a psychophysical marker of the functionality of pain modulation at spinal level.

Results: Thirty-five women (68.2 ± 7.3 years old) with post-menopausal osteoporosis completed the analysis. Compared with baseline, magnesium supplementation did not change significantly any of the endpoints. CPM at baseline was low (-0.92 ± 1.14) and not reversed by treatment.

Conclusions: This study in post-menopausal osteoporosis underlines for the first time that zoledronate or zoledronate with magnesium have no effect on pain characteristics and thresholds. It shows a dysfunction of pain inhibitory pain pathways and its non-reversibility with treatments. It points towards the lack of any analgesic effect of zoledronate, and above all to a latent vulnerability of osteoporotic women who are at a potential risk of fracture with a poor pain modulation that needs to be researched further to limit future chronification.

Trial registration number: (NCT05328154), 15/03/2022.

Trial: Protocol, statistical analysis plan, participant data and other materials (including data dictionary) can be accessed on request to the corresponding author.

背景：双膦酸盐（BP）是骨质疏松症的推荐治疗药物，并且有镇痛作用。镁与疼痛机制、情绪障碍和骨骼稳态有关。然而，血压和镁的关系尚未被研究以探讨绝经后骨质疏松症的疼痛过程。方法：在一项绝经后骨质疏松症随机临床试验的先导辅助研究中，女性被随机分为标准治疗组，静脉注射唑来膦酸钠（BP组，n = 22）或口服镁（BP组，n = 22）， 200 mg/天，持续3个月。终点在治疗前和治疗后1年量化为自发性疼痛、焦虑、抑郁和睡眠质量，以及通过热阈值和条件性疼痛调节（CPM）进行疼痛敏感性的定量感觉测试，CPM是脊柱水平疼痛调节功能的心理物理标志物。结果：35例绝经后骨质疏松患者（68.2±7.3岁）完成分析。与基线相比，补充镁没有显著改变任何终点。CPM在基线时较低（-0.92±1.14），治疗后未逆转。结论：本研究首次强调了唑来膦酸盐或唑来膦酸盐联合镁对疼痛特征和阈值没有影响。它显示了疼痛抑制疼痛通路的功能障碍及其治疗的不可逆性。它指出了唑来膦酸钠缺乏任何镇痛作用，最重要的是骨质疏松症妇女的潜在脆弱性，她们有潜在的骨折风险，疼痛调节能力差，需要进一步研究以限制未来的慢性化。试验注册号：（NCT05328154）， 15/03/2022。试验：方案、统计分析计划、参与者数据等资料（包括数据字典）可向通讯作者索取。

{"title":"Quantitative sensory testing of pain in osteoporosis: a pilot randomized clinical trial with magnesium supplementation.","authors":"Marie-Eva Pickering, Véronique Morel, Macian Nicolas, Christian Dualé, Elise Sortais, Thomas Graven-Nielsen, Bruno Pereira, Gisèle Pickering","doi":"10.1007/s40520-025-03317-9","DOIUrl":"10.1007/s40520-025-03317-9","url":null,"abstract":"<p><strong>Background: </strong>Bisphosphonates (BP) are a recommended treatment for osteoporosis and an analgesic effect has been suggested. Magnesium is involved in pain mechanisms, mood disorders and also in bone homeostasis. Association of BPs and magnesium has however not been studied to explore pain processes in post-menopausal osteoporosis.</p><p><strong>Methods: </strong>In this pilot ancillary study of a randomized clinical trial in post-menopausal osteoporosis, women were randomized to standard care with intravenous Zoledronate (BP group, n = 22) or BP with oral magnesium (BPMg group, n = 22), 200 mg/day for 3 months. Endpoints were quantified before and 1 year after treatment as spontaneous pain, anxiety, depression and sleep quality, as well as quantitative sensory testing of pain sensitivity by thermal thresholds and conditioned pain modulation (CPM), a psychophysical marker of the functionality of pain modulation at spinal level.</p><p><strong>Results: </strong>Thirty-five women (68.2 ± 7.3 years old) with post-menopausal osteoporosis completed the analysis. Compared with baseline, magnesium supplementation did not change significantly any of the endpoints. CPM at baseline was low (-0.92 ± 1.14) and not reversed by treatment.</p><p><strong>Conclusions: </strong>This study in post-menopausal osteoporosis underlines for the first time that zoledronate or zoledronate with magnesium have no effect on pain characteristics and thresholds. It shows a dysfunction of pain inhibitory pain pathways and its non-reversibility with treatments. It points towards the lack of any analgesic effect of zoledronate, and above all to a latent vulnerability of osteoporotic women who are at a potential risk of fracture with a poor pain modulation that needs to be researched further to limit future chronification.</p><p><strong>Trial registration number: </strong>(NCT05328154), 15/03/2022.</p><p><strong>Trial: </strong>Protocol, statistical analysis plan, participant data and other materials (including data dictionary) can be accessed on request to the corresponding author.</p>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":" ","pages":"67"},"PeriodicalIF":3.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017032","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

Blood and imaging biomarkers of blood-brain barrier disruption in diabetic individuals with cognitive impairment. 认知障碍糖尿病患者血脑屏障破坏的血液和成像生物标志物。

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research

Pub Date : 2026-01-20 DOI: 10.1007/s40520-025-03316-w

Luyao Qiao, Xiaoping Tang, Jiaxing Peng, Qing Xie, Mengqian Wu, Xinyue Chen, Zhenyu Tang

Background: Blood-brain barrier (BBB) disruption is a recognized contributor to neurodegenerative diseases. However, its specific role in cognitive decline in diabetes has not been sufficiently explored.

Aims: This study aimed to evaluate the association between BBB integrity and cognitive function and to investigate the discriminative ability of BBB-related biomarkers for cognitive impairment in individuals with type 2 diabetes mellitus (T2DM).

Methods: In this case-control study, participants were recruited from the Second Affiliated Hospital of Nanchang University. All subjects underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). We compared quantitative brain imaging (Ktrans and Ve) and serum platelet-derived growth factor receptor β (PDGFRβ) between diabetic individuals with and without cognitive impairment. The relationships between these biomarkers and cognitive performance were assessed using linear regression analyses. The discriminative capacity of each biomarker for distinguishing groups was evaluated using receiver operating characteristic (ROC) curve analysis.

Results: T2DM individuals with cognitive impairment exhibited significantly elevated Ktrans and Ve levels compared to those without, which correlated inversely with MoCA scores in key brain regions. Serum PDGFRβ was also independently associated with impaired cognition. Every biomarker individually demonstrated high discriminative power for evaluating cognitive status, with AUC values of 0.908 (95% CI: 0.842 to 0.973) for Ktrans, 0.923 (95% CI: 0.86 to 0.986) for Ve, and 0.839 (95% CI: 0.751 to 0.928) for PDGFRβ.

Conclusions: Our results confirm the critical role of BBB dysfunction in diabetic cognitive impairment. The biomarkers serum PDGFRβ, Ktrans, and Ve showed potential associations with this condition, suggesting their clinical value for future clinical application in risk stratification and therapeutic monitoring in T2DM population. TRN: ChiCTR2400085417, 2024.06.06, retrospectively registered.

背景：血脑屏障（BBB）破坏是公认的神经退行性疾病的诱因。然而，其在糖尿病认知能力下降中的具体作用尚未得到充分探讨。目的：本研究旨在评估血脑屏障完整性与认知功能之间的关系，并探讨血脑屏障相关生物标志物对2型糖尿病（T2DM）患者认知功能障碍的鉴别能力。方法：在本病例-对照研究中，参与者从南昌大学第二附属医院招募。所有受试者都进行了动态对比增强磁共振成像（DCE-MRI）。我们比较了有和无认知障碍的糖尿病患者的定量脑成像（Ktrans和Ve）和血清血小板衍生生长因子受体β (PDGFRβ)。使用线性回归分析评估这些生物标志物与认知表现之间的关系。采用受试者工作特征（ROC）曲线分析评价各生物标志物对不同组的鉴别能力。结果：伴有认知障碍的T2DM患者Ktrans和Ve水平明显高于未伴有认知障碍的T2DM患者，且Ktrans和Ve水平与关键脑区MoCA评分呈负相关。血清PDGFRβ也与认知障碍独立相关。每个生物标志物在评估认知状态方面都表现出很高的判别能力，Ktrans的AUC值为0.908 (95% CI: 0.842至0.973)，Ve的AUC值为0.923 (95% CI: 0.86至0.986)，PDGFRβ的AUC值为0.839 （95% CI: 0.751至0.928）。结论：我们的研究结果证实了血脑屏障功能障碍在糖尿病认知障碍中的关键作用。生物标志物血清PDGFRβ、Ktrans和Ve与T2DM有潜在关联，提示其在未来T2DM人群风险分层和治疗监测中的临床应用价值。TRN: ChiCTR2400085417, 2024.06.06，回顾性注册。

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引用次数: 0

Ageism in suicide rates: any difference between Anglo-Saxon and Latin countries? 自杀率中的年龄歧视：盎格鲁-撒克逊国家与拉丁国家有何不同？

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research

Pub Date : 2026-01-19 DOI: 10.1007/s40520-025-03270-7

Diego De Leo, Mujde Altin, Lorenza Entilli

Background & aims

The link between ageism, mental health, and suicide has been highlighted in previous research. This article examines the possible impact of ageism on to the enduring cross-switches observed by older adults’ population from different Western countries.

Methods

We reviewed existing literature in the field to understand how ageism manifests across cultures. Furthermore, we explored to what extent the concept is recognized in different countries and what initiatives are currently being taken.

Results

In Latin-origin countries, many older people live alone, with children who have moved away or emigrated, and have less active social networks. By comparison, Anglo-Saxon countries provide more community services to support older adults, including programs against loneliness. The stigma attached to mental health is counteracted by active public campaigns and more accessible services. Moreover, many people in Latin countries live with low pensions and economic uncertainty, especially if alone or widowed. In Canada, Australia and New Zealand, more robust pension systems and forms of social assistance exist, reducing financial stress.

Conclusions

Based on the available literature, it doesn’t seem that ageism may justify the higher number of suicides in old age in countries such as Italy, Spain, and Portugal. At most, it can partly explain the higher rates observed by contributing to creating a climate of invisibility, exclusion and mistrust that can be fertile ground for psychological suffering. Thus, intervening against ageism could not only be seen as an ethical act, but also a concrete form of suicide prevention.

背景与目的：在以前的研究中，年龄歧视、心理健康和自杀之间的联系已经得到了强调。本文探讨了年龄歧视对不同西方国家老年人持续交叉转换的可能影响。方法：我们回顾了该领域的现有文献，以了解年龄歧视如何在不同文化中表现出来。此外，我们还探讨了不同国家对这一概念的认可程度，以及目前正在采取哪些举措。结果：在拉丁裔国家，许多老年人独自生活，他们的孩子已经搬走或移民，他们的社交网络不太活跃。相比之下，盎格鲁-撒克逊国家提供了更多的社区服务来支持老年人，包括对抗孤独的项目。积极的公共运动和更容易获得的服务消除了对精神健康的污名。此外，拉丁国家的许多人的养老金很低，经济不稳定，尤其是单身或丧偶的人。在加拿大、澳大利亚和新西兰，存在更健全的养老金制度和各种形式的社会援助，从而减轻了财政压力。结论：根据现有文献，年龄歧视似乎不能解释意大利、西班牙和葡萄牙等国老年人自杀率较高的原因。它最多只能部分解释观察到的较高比率，因为它助长了一种隐形、排斥和不信任的氛围，而这种氛围可能是心理痛苦的沃土。因此，对年龄歧视的干预不仅可以被视为一种道德行为，而且是预防自杀的具体形式。

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引用次数: 0

Acceptability of treadmill perturbation-based balance training in older adults at risk of falling: A mixed-methods evaluation of participant and trainer perspectives. 在有跌倒风险的老年人中，基于跑步机扰动的平衡训练的可接受性：参与者和训练者观点的混合方法评估。

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research

Pub Date : 2026-01-16 DOI: 10.1007/s40520-025-03320-0

Natalie Hezel, Theresa Buchner, Clemens Becker, Jürgen M Bauer, Simon Steib, Christian Werner

Background: Perturbation-based balance training (PBT) specifically targets fall mechanisms and holds promise for fall prevention in older adults, but its reliance on near-fall exposure may pose a barrier to engagement. Successful implementation depends on acceptability among participants and trainers, yet a mixed-methods, multi-perspective evaluation of PBT acceptability is lacking.

Aims: To evaluate the acceptability of treadmill PBT in older adults at risk of falling and in trainers, and to examine associations with participant characteristics.

Methods: Twenty-nine participants (79.9 ± 5.5 years) completed a 6-week treadmill PBT intervention, delivered by three trainers. Retrospective acceptability was assessed using a questionnaire (maximum score: 35 pt. for participants, 30 pt. for trainers) and semi-structured focus groups (12 participants, all trainers), guided by Theoretical Framework of Acceptability (TFA) domains and additional context-specific topics. Associations between participant characteristics and questionnaire scores were analyzed using multivariate regression. Focus-group data were analyzed deductively using the TFA.

Results: Median questionnaire scores were high for participants (28 [interquartile range, IQR 23-32] pt.) and trainers (26 [IQR 25-26] pt.). Fall history emerged as the only independent predictor of lower acceptability among participants. Focus groups revealed that both participants and trainers generally perceived PBT as acceptable. High perceived safety and effectiveness for improving reactive balance, adequate tailoring and supervision, and strong coherence were reported as facilitators. Potential barriers included anxiety, fall-related memories, the demanding nature of PBT, and setting-related factors (e.g., monotony, limited social interaction, missing handrails, narrow belt).

Conclusions: Treadmill PBT were generally well accepted by trainers and older adults at risk of falling but showed lower acceptability among participants with fall history. Implementing PBT in individuals with no fall history may help mitigate anxiety related to prior fall experiences and support higher acceptability.

Trial registration: DRKS00030805 (December 14, 2022).

背景：基于微扰的平衡训练（PBT）专门针对跌倒机制，并有望在老年人中预防跌倒，但其依赖于接近跌倒的暴露可能会对参与构成障碍。成功的实施取决于参与者和培训者的可接受性，但缺乏一种混合方法、多角度的PBT可接受性评估。目的：评估跑步机PBT在有跌倒风险的老年人和训练者中的可接受性，并检查与参与者特征的关联。方法：29名参与者（79.9±5.5岁）完成了为期6周的跑步机PBT干预，由3名训练员进行。在可接受性理论框架（TFA）领域和其他情境特定主题的指导下，使用问卷（参与者最高得分为35分，培训师最高得分为30分）和半结构化焦点小组（12名参与者，均为培训师）评估回顾性可接受性。采用多元回归分析被试特征与问卷得分之间的关系。使用TFA对焦点组数据进行演绎分析。结果：参与者（28[四分位间距，IQR 23-32]点）和训练者（26 [IQR 25-26]点）的问卷中位数得分较高。跌倒史是参与者可接受性较低的唯一独立预测因子。焦点小组显示，参与者和培训人员普遍认为PBT是可以接受的。据报道，提高反应性平衡、适当的剪裁和监督以及强一致性的高感知安全性和有效性是促进因素。潜在的障碍包括焦虑、与跌倒有关的记忆、PBT的高要求性质以及与环境相关的因素（例如，单调、有限的社会互动、缺少扶手、狭窄的皮带）。结论：跑步机PBT通常被训练者和有跌倒风险的老年人接受，但在有跌倒史的参与者中接受度较低。在没有跌倒史的个体中实施PBT可能有助于减轻与先前跌倒经历相关的焦虑，并支持更高的可接受性。试验注册：DRKS00030805（2022年12月14日）。

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引用次数: 0

External validation of geriatric influenza death score: a prospective validation study 老年流感死亡评分的外部验证：一项前瞻性验证研究

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research

Pub Date : 2026-01-16 DOI: 10.1007/s40520-025-03308-w

Hamideh Akbari, Abbas Pakravan Bushehri, Saeed Aqavil-Jahromi, Mohammad Eftekhari, Kourosh Javdani Esfehani, Atousa Akhgar, Mohammad Jalili

Objective

The global challenge of population aging continues to intensify. Current estimates project that by 2050, the world’s population will approach 10 billion, with elderly people comprising an estimated 1.6 billion individuals. Due to age-related immunosenescence, older adults face a significantly elevated risk of serious influenza complications compared to younger individuals. During influenza epidemic seasons, determining the appropriate disposition (discharge, hospital admission or Intensive Care Unit admission) of elderly patients with influenza presents a significant challenge. In 2018, Chung et al. developed the Geriatric Influenza Death (GID) score as a potential clinical decision rule to aid clinical decision-making for older adults with influenza. We conducted this study to externally validate the GID score.

Method and materials

In this prospective cohort study geriatric patients (aged ≥ 65 years) presenting to the Emergency Department (ED) between September 2023 and March 2024 with fever, cough, and a positive influenza test were enrolled using convenience sampling. Patients were excluded if they left against medical advice or lacked sufficient data for scoring. The GID score was calculated for each patient using clinical and laboratory data: severe coma (2 scores), history of cancer or coronary artery disease, elevated C-Reactive Protein, bandemia (1 score each). Based on the GID score, patients were categorized into low (0–1), medium [2], or high-risk (≥ 3) groups. The primary outcome was 30-day all-cause mortality. Performance of the score was assessed using the area under the receiver operating characteristic curve (AUC).

Results

Of 378 patients screened, 120 met inclusion criteria. Thirty-day mortality rates increased with the GID score: 15.9% for score 1, 41.7%% for score 2, and 44.4% for score 3. When used for predicting mortality, the GID score with a threshold of ≥ 2 demonstrated moderate performance with an AUC of 0.66 (95% Confidence Interval: 0.53–0.83) and sensitivity and specificity of 70.6% and 61.6%, respectively.

Conclusion

In summary, the GID score offers a practical and efficient method for predicting 30-day mortality and informing disposition decisions for older ED patients with influenza.

目的：全球人口老龄化挑战持续加剧。根据目前的估计，到2050年，世界人口将接近100亿，其中老年人估计将达到16亿。由于与年龄相关的免疫衰老，与年轻人相比，老年人面临严重流感并发症的风险显着升高。在流感流行季节，确定老年流感患者的适当处置（出院、住院或入住重症监护病房）是一项重大挑战。2018年，Chung等人开发了老年流感死亡（GID）评分，作为一种潜在的临床决策规则，以帮助患有流感的老年人进行临床决策。我们进行这项研究是为了从外部验证GID评分。方法和材料：在这项前瞻性队列研究中，采用方便抽样方法纳入了2023年9月至2024年3月期间因发烧、咳嗽和流感检测阳性而就诊于急诊科（ED）的老年患者（年龄≥65岁）。如果患者违背医嘱或缺乏足够的数据进行评分，则将其排除在外。使用临床和实验室数据计算每位患者的GID评分：严重昏迷（2分）、癌症或冠状动脉疾病史、c反应蛋白升高、带状血症（各1分）。根据GID评分，将患者分为低（0-1）、中（[2]）和高风险（≥3）组。主要终点为30天全因死亡率。使用受试者工作特征曲线（AUC）下的面积来评估评分的表现。结果：在筛选的378例患者中，120例符合纳入标准。30天死亡率随GID评分增加：评分1为15.9%，评分2为41.7%，评分3为44.4%。当用于预测死亡率时，阈值≥2的GID评分表现为中等效果，AUC为0.66(95%置信区间：0.53-0.83)，敏感性和特异性分别为70.6%和61.6%。结论：总的来说，GID评分为预测老年ED流感患者的30天死亡率和告知处置决策提供了一种实用而有效的方法。

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引用次数: 0

From breath to brain: influenza vaccination as a pragmatic strategy for dementia prevention. 从呼吸到大脑：流感疫苗接种作为预防痴呆的实用策略。

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research

Pub Date : 2026-01-16 DOI: 10.1007/s40520-026-03323-5

Lorenzo Blandi, Marco Del Riccio

Aging populations require scalable strategies to delay or prevent dementia. Beyond the prevention of neurological injury associated with seasonal influenza, vaccination may help mitigate vascular and neuroinflammatory injury underlying cognitive impairment. Influenza infection can cause a marked short‑term increase in myocardial infarction risk, and acute infections have also been associated with transient increases in stroke risk. Experimental models show prolonged microglial activation and synaptic loss even from non-neurotropic strains - processes likely modulated by vaccination. Epidemiologic data consistently support this evidence; a 2023 meta-analysis, including observational studies, of ~ 2.09 million adults identified a 31% lower risk of incident dementia; US matched cohorts demonstrated 40% lower risk of Alzheimer's disease (absolute decrease 3.4%); Veterans Health data showed a 0.86 hazard ratio for dementia; and UK Biobank data showed lower risk for all-cause (0.83 h), and vascular dementia (0.58 h) with a dose-response association by vaccination term. Randomized trials suggest fewer adverse cardiovascular events in vaccine recipients giving even more biological plausibility to this concept. Despite that, prevention through influenza vaccination is not fully realized in older adults due to low levels of perceived risk, vaccine confidence, and variations in clinical practice guidance. This public health perspective reviews the physiopathological and epidemiological evidence in support of influenza vaccination as a pragmatic, dementia risk-modifying intervention within healthy aging strategies and encourages the inclusion of vaccination status in hospital discharge and chronic-care pathways, integration of cognitive outcomes in monitoring, and equity-centered research to eliminate barriers to behavioral and implementation.

人口老龄化需要可扩展的策略来延迟或预防痴呆症。除了预防与季节性流感相关的神经损伤外，疫苗接种还可能有助于减轻认知障碍背后的血管和神经炎症损伤。流感感染可导致心肌梗死风险在短期内显著增加，急性感染也与卒中风险的短暂增加有关。实验模型显示，即使非嗜神经菌株也会延长小胶质细胞的激活和突触的丧失，这一过程可能是由疫苗调节的。流行病学数据一贯支持这一证据；2023年的一项荟萃分析，包括对约209万成年人的观察性研究，发现发生痴呆的风险降低了31%；美国匹配队列显示阿尔茨海默病风险降低40%（绝对降低3.4%）；退伍军人健康数据显示，患痴呆症的风险比为0.86；和UK Biobank的数据显示，全因风险（0.83小时）和血管性痴呆（0.58小时）较低，与疫苗接种期的剂量反应相关。随机试验表明，疫苗接种者的心血管不良事件较少，这一概念在生物学上更加可信。尽管如此，由于认知风险水平低、疫苗信心低以及临床实践指导的差异，在老年人中并没有完全实现通过流感疫苗接种进行预防。这一公共卫生观点回顾了支持流感疫苗接种作为一种实用的、在健康老龄化策略中改变痴呆风险的干预措施的生理病理和流行病学证据，并鼓励在出院和慢性护理途径中纳入疫苗接种情况，在监测中整合认知结果，以及以公平为中心的研究，以消除行为和实施的障碍。

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引用次数: 0