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Predictors of non-adherence to an early in-hospital rehabilitation program after surgery for hip fracture in a co-managed orthogeriatric unit 在共同管理的骨科病房中,髋部骨折术后不坚持早期院内康复计划的预测因素
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-12 DOI: 10.1007/s40520-024-02857-w
Roberto Presta, Enrico Brunetti, Valeria Quaranta, Silvio Raspo, Paola Cena, Giulia Carignano, Martina Bonetto, Chiara Busso, Gianluca Isaia, Marco Marabotto, Giuseppe Massazza, Mario Bo

Background

Hip fracture is a common event in older adults, leading to an increased risk of mortality, disability, and higher healthcare costs. Early in-hospital rehabilitation after surgery within orthogeriatric units may improve outcomes with limited incident complications even in the oldest old. We aimed to determine the prevalence and predictors of non-adherence to early rehabilitation in the orthogeriatric unit of an Italian tertiary hospital and its impact on outcomes and setting at discharge.

Methods

Retrospective observational single-centered cohort study. Patients aged ≥ 65 years admitted to the orthogeriatric unit for hip fracture who underwent surgery between April 2019 and October 2020 were considered eligible if able to walk autonomously or with assistance and independent in at least 2 Basic Activities of Daily Living. Along with sociodemographic and geriatric variables, characteristics of surgery and rehabilitation, in-hospital complications and functional outcomes at discharge were collected. The primary outcome was non-adherence to the early in-hospital rehabilitation program.

Results

Among 283 older patients (mean age 82.7 years, 28.6% male), non-compliance with physical therapy was assessed in 49 cases (17.3%), characterized by worse pre-fracture clinical, cognitive, and functional status and showing worse outcomes in terms of mobilization at discharge. After multivariable analysis, non-adherence was independently associated with the onset of delirium (OR 5.26, 95%CI 2.46–11.26; p < 0.001) or infections after surgery (OR 3.26, 95%CI 1.54–6.89; p < 0.001) and a systolic blood pressure at admission < 120 mmHg (OR 4.52, 95%CI 1.96–10.43, p < 0.001).

Conclusions

Pre-fracture poor cognitive and functional status, along with lower systolic blood pressure, seem to make some patients more vulnerable to in-hospital complications (mainly delirium and infections) and negatively affect the adherence to physical therapy and, by consequence, clinical outcomes of rehabilitation.

背景髋部骨折是老年人的常见病,会增加死亡、残疾和医疗费用的风险。在老年骨科病房进行术后早期院内康复治疗可改善预后,即使是高龄老人也能减少并发症的发生。我们的目的是确定一家意大利三级医院的老年矫形科未坚持早期康复治疗的发生率和预测因素,及其对出院时的治疗效果和环境的影响。在2019年4月至2020年10月期间,因髋部骨折入住老年骨科病房并接受手术治疗的患者年龄≥65岁,如果能够自主行走或在他人协助下行走,并能独立完成至少2项基本日常生活活动,则被视为符合条件。除社会人口学和老年学变量外,还收集了手术和康复的特点、院内并发症和出院时的功能结果。结果 在283名老年患者(平均年龄82.7岁,28.6%为男性)中,有49人(17.3%)未遵守物理治疗,其特点是骨折前的临床、认知和功能状态较差,出院时的活动能力也较差。经过多变量分析,不坚持理疗与谵妄(OR 5.26,95%CI 2.46-11.26;P <;0.001)或术后感染(OR 3.26,95%CI 1.54-6.89;P <;0.001)以及入院时收缩压 <;120 mmHg(OR 4.52,95%CI 1.96-10.43,P <;0.结论 骨折前认知和功能状态不佳以及收缩压较低似乎使一些患者更容易出现院内并发症(主要是谵妄和感染),并对坚持物理治疗产生负面影响,进而影响康复的临床效果。
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引用次数: 0
Exploring the relationship between sarcopenia and 11 respiratory diseases: a comprehensive mendelian randomization analysis 探究肌肉疏松症与 11 种呼吸系统疾病的关系:泯灭随机综合分析
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-12 DOI: 10.1007/s40520-024-02855-y
Yue Su, Youqian Zhang, Di Zhang, Jinfu Xu

Background

Sarcopenia (SP) is an aging-related loss of muscle mass and function, affecting the respiratory system. However, the causality of the association between sarcopenia on lung diseases remains elusive.

Methods

The bidirectional univariate Mendelian randomization (UVMR), multivariate MR (MVMR) analysis, and mediation MR were utilized to systematically investigate the genetic causal relationship of SP and 11 respiratory diseases. Independent genomic variants related to sarcopenia or respiratory diseases were identified as instrumental variables (IVs), and the summary level data of genome-wide associated studies (GWAS) were obtained from the UK biobank and FinnGen. MVMR analysis was conducted to explore the mediation effects of body mass index (BMI), Alcohol Use Disorders Identification Test (AUDIT), smoking, education attainment (EA), physical activity, and Type 2 Diabetes Mellitus (T2DM).

Results

Forward UVMR analysis based on the primary method revealed that pneumoconiosis was associated with a higher risk of appendicular lean mass (ALM) (OR = 1.01, p = 0.03), and BMI (10.65%), smoking (10.65%), and physical activity (17.70%) had a mediating role in the effect of pneumoconiosis on ALM. In reverse MR analysis, we found that genetically predicted ALM was significantly associated with an increased risk of pulmonary embolism (PE) (OR = 1.24, p = 7.21E-05). Chronic obstructive pulmonary disease (COPD) (OR = 0.98, p = 0.002) and sarcoidosis (OR = 1.01, p = 0.004) were identified to increase the loss of left-hand grip strength (HGS). Conversely, the increase in left- HGS presented a protective effect on chronic bronchitis (CB) (OR = 0.35, p = 0.03), (OR = 0.80, p = 0.02), and asthma (OR = 0.78, p = 0.04). Similarly, the loss of the right-HGS elevated the risk of low respiratory tract infection (LRTI) (OR = 0.97, p = 0.02) and bronchiectasis (OR = 1.01, p = 0.03), which is also an independent protective factor for LRTI and asthma. In the aspects of low HGS, the risk of LRTI was increased after MVMR analysis, and the risk of sarcoidosis and pneumoconiosis was elevated in the reverse analysis. Lastly, asthma was found to be related to the loss of the usual walking pace, and the reverse MR analysis suggested a causal relationship between the usual walking pace and LRTI (OR = 0.32, p = 2.79 × 10−5), asthma (OR = 0.24, p = 2.09 × 10−6), COPD (OR = 0.22, p = 6.64 × 10−4), and PE(OR = 0.35, p = 0.03).

Conclusions

This data-driven MR analysis revealed SP was bidirectional causally associated with lung diseases, providing genetic evidence for further mechanistic and clinical studies to understand the crosstalk between SP and lung diseases.

背景肌肉疏松症(Sarcopenia,SP)是一种与衰老有关的肌肉质量和功能丧失,会影响呼吸系统。方法 采用双向单变量孟德尔随机分析法(UVMR)、多变量MR分析法(MVMR)和中介MR分析法,系统研究了SP与11种呼吸系统疾病的遗传因果关系。研究人员将与肌肉疏松症或呼吸系统疾病相关的独立基因组变异确定为工具变量(IVs),并从英国生物库和 FinnGen 获得了全基因组相关研究(GWAS)的汇总数据。 研究人员还进行了 MVMR 分析,以探讨体重指数(BMI)、酒精使用障碍鉴定测试(AUDIT)、吸烟、教育程度(EA)、体力活动和 2 型糖尿病(T2DM)的中介效应。结果基于主要方法的正向 UVMR 分析显示,尘肺病与较高的阑尾瘦肉(ALM)风险相关(OR = 1.01,P = 0.03),而体重指数(10.65%)、吸烟(10.65%)和体育锻炼(17.70%)在尘肺病对 ALM 的影响中起着中介作用。在反向 MR 分析中,我们发现基因预测的 ALM 与肺栓塞(PE)风险的增加显著相关(OR = 1.24,p = 7.21E-05)。慢性阻塞性肺病(COPD)(OR = 0.98,p = 0.002)和肉样瘤病(OR = 1.01,p = 0.004)被认为会增加左手握力(HGS)的损失。相反,左手握力的增加对慢性支气管炎(CB)(OR = 0.35,p = 0.03)、(OR = 0.80,p = 0.02)和哮喘(OR = 0.78,p = 0.04)有保护作用。同样,丧失右侧 HGS 会增加低呼吸道感染(LRTI)(OR = 0.97,p = 0.02)和支气管扩张(OR = 1.01,p = 0.03)的风险,这也是低呼吸道感染和哮喘的独立保护因素。在低 HGS 方面,MVMR 分析后 LRTI 风险增加,反向分析后肉样瘤病和尘肺病风险增加。最后,研究发现哮喘与丧失惯常步行速度有关,反向 MR 分析表明惯常步行速度与 LRTI(OR = 0.32,P = 2.79 × 10-5)、哮喘(OR = 0.24,P = 2.09 × 10-6)、慢性阻塞性肺病(OR = 0.22,P = 6.结论这项数据驱动的磁共振分析显示 SP 与肺部疾病存在双向因果关系,为进一步开展机理和临床研究以了解 SP 与肺部疾病之间的相互影响提供了遗传学证据。
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引用次数: 0
A systematic review and network meta-analysis on the optimal wavelength of low-level light therapy (LLLT) in treating knee osteoarthritis symptoms 关于低强度光疗法(LLLT)治疗膝骨关节炎症状最佳波长的系统综述和网络荟萃分析。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-05 DOI: 10.1007/s40520-024-02853-0
Tianxiang Fan, Yang Li, Arnold Y. L. Wong, Xiao Liang, Yarou Yuan, Peng Xia, Zhi Yao, Deli Wang, Marco Y. C. Pang, Changhai Ding, Zhaohua Zhu, Ye Li, Siu Ngor Fu

Objectives

To compare the efficacy of the various wavelengths of low-level light therapy (LLLT) in alleviating knee pain, dysfunction, and stiffness in patients with knee osteoarthritis (KOA), and to compare the effectiveness of LLLT versus sham treatment in reducing knee pain, dysfunction, and stiffness.

Methods

PubMed, Web of Science, EMBASE, and Cochrane Library were searched from inception to 12 December 2023. Randomized controlled trials that assessed the effects of different wavelengths of LLLT on alleviating pain of patients with KOA were included. A conventional meta-analysis and network meta-analysis were preformed, and standardized mean differences (SMD) with 95% confidence interval (CI) were calculated.

Results

Thirteen studies involving 673 participants with KOA met inclusion criteria. Overall, LLLT was superior to sham LLLT for relieving pain (SMD = 0.96, 95% CI 0.31–1.61) but not for improving function (SMD = 0.21, 95% CI − 0.11 to 0.53) or stiffness (SMD = 0.07, 95% CI − 0.25 to 0.39). Surface under the cumulative ranking curve (SUCRA) value ranking showed the most effective wavelength of LLLT in reducing KOA pain was 904–905 nm (SUCRA, 86.90%), followed by multi-wavelengths (MWL) (SUCRA, 56.43%) and 785–850 nm (SUCRA, 54.97%). Compared to sham LLLT, L2 (SMD = 1.42, 95% CI = 0.31–2.53) and L1 (SMD = 0.82; 95% CI = 0.11–1.50) showed a significant reduction in KOA pain. However, MWL (SMD = 0.83; 95% CI = − 0.06 to 1.72) showed similar KOA pain reduction compared to sham LLLT. The certainty of evidence showed that the quality of evidence regarding the effectiveness of overall LLLT versus sham, and 904–905 nm versus sham were low, while the quality of evidence for MWL versus sham, and 785–850 nm versus sham was very low.

Conclusion

While the 904–905 nm wavelength showed potential benefits in reducing KOA pain, the overall quality of the evidence was low. LLLT with 904–905 nm or 785–850 nm wavelengths yielded significantly better reduction in KOA pain compared to sham LLLT, but further high-quality research is warranted to validate these findings.

研究目的比较各种波长的低强度光疗法(LLLT)在减轻膝关节骨性关节炎(KOA)患者膝关节疼痛、功能障碍和僵硬方面的疗效,并比较 LLLT 与假治疗在减轻膝关节疼痛、功能障碍和僵硬方面的疗效:方法:检索了 PubMed、Web of Science、EMBASE 和 Cochrane Library 从开始到 2023 年 12 月 12 日的资料。纳入的随机对照试验评估了不同波长的 LLLT 对缓解 KOA 患者疼痛的效果。进行了常规荟萃分析和网络荟萃分析,并计算了标准化平均差(SMD)和95%置信区间(CI):有 13 项研究符合纳入标准,涉及 673 名 KOA 患者。总体而言,LLLT 在缓解疼痛(SMD = 0.96,95% CI 0.31-1.61)方面优于假 LLLT,但在改善功能(SMD = 0.21,95% CI - 0.11 至 0.53)或僵硬(SMD = 0.07,95% CI - 0.25 至 0.39)方面则不尽相同。累积排名曲线下表面(SUCRA)值排名显示,LLLT 对减轻 KOA 疼痛最有效的波长是 904-905 nm(SUCRA,86.90%),其次是多波长(MWL)(SUCRA,56.43%)和 785-850 nm(SUCRA,54.97%)。与假 LLLT 相比,L2(SMD = 1.42,95% CI = 0.31-2.53)和 L1(SMD = 0.82;95% CI = 0.11-1.50)可显著减轻 KOA 疼痛。然而,与假LLLT相比,MWL(SMD = 0.83; 95% CI = - 0.06至1.72)显示出相似的KOA疼痛减轻效果。证据的确定性表明,整体 LLLT 与假 LLLT 相比、904-905 nm 与假 LLLT 相比,证据质量较低,而 MWL 与假 LLL 相比、785-850 nm 与假 LLLT 相比,证据质量非常低:结论:虽然 904-905 nm 波长的激光疗法在减轻 KOA 疼痛方面具有潜在优势,但总体证据质量较低。与假 LLLT 相比,904-905 nm 或 785-850 nm 波长的 LLLT 能明显更好地减轻 KOA 疼痛,但还需要进一步的高质量研究来验证这些发现。
{"title":"A systematic review and network meta-analysis on the optimal wavelength of low-level light therapy (LLLT) in treating knee osteoarthritis symptoms","authors":"Tianxiang Fan,&nbsp;Yang Li,&nbsp;Arnold Y. L. Wong,&nbsp;Xiao Liang,&nbsp;Yarou Yuan,&nbsp;Peng Xia,&nbsp;Zhi Yao,&nbsp;Deli Wang,&nbsp;Marco Y. C. Pang,&nbsp;Changhai Ding,&nbsp;Zhaohua Zhu,&nbsp;Ye Li,&nbsp;Siu Ngor Fu","doi":"10.1007/s40520-024-02853-0","DOIUrl":"10.1007/s40520-024-02853-0","url":null,"abstract":"<div><h3>Objectives</h3><p>To compare the efficacy of the various wavelengths of low-level light therapy (LLLT) in alleviating knee pain, dysfunction, and stiffness in patients with knee osteoarthritis (KOA), and to compare the effectiveness of LLLT versus sham treatment in reducing knee pain, dysfunction, and stiffness.</p><h3>Methods</h3><p>PubMed, Web of Science, EMBASE, and Cochrane Library were searched from inception to 12 December 2023. Randomized controlled trials that assessed the effects of different wavelengths of LLLT on alleviating pain of patients with KOA were included. A conventional meta-analysis and network meta-analysis were preformed, and standardized mean differences (SMD) with 95% confidence interval (CI) were calculated.</p><h3>Results</h3><p>Thirteen studies involving 673 participants with KOA met inclusion criteria. Overall, LLLT was superior to sham LLLT for relieving pain (SMD = 0.96, 95% CI 0.31–1.61) but not for improving function (SMD = 0.21, 95% CI − 0.11 to 0.53) or stiffness (SMD = 0.07, 95% CI − 0.25 to 0.39). Surface under the cumulative ranking curve (SUCRA) value ranking showed the most effective wavelength of LLLT in reducing KOA pain was 904–905 nm (SUCRA, 86.90%), followed by multi-wavelengths (MWL) (SUCRA, 56.43%) and 785–850 nm (SUCRA, 54.97%). Compared to sham LLLT, L2 (SMD = 1.42, 95% CI = 0.31–2.53) and L1 (SMD = 0.82; 95% CI = 0.11–1.50) showed a significant reduction in KOA pain. However, MWL (SMD = 0.83; 95% CI = − 0.06 to 1.72) showed similar KOA pain reduction compared to sham LLLT. The certainty of evidence showed that the quality of evidence regarding the effectiveness of overall LLLT versus sham, and 904–905 nm versus sham were low, while the quality of evidence for MWL versus sham, and 785–850 nm versus sham was very low.</p><h3>Conclusion</h3><p>While the 904–905 nm wavelength showed potential benefits in reducing KOA pain, the overall quality of the evidence was low. LLLT with 904–905 nm or 785–850 nm wavelengths yielded significantly better reduction in KOA pain compared to sham LLLT, but further high-quality research is warranted to validate these findings.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11455796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379009","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
Calf circumference was negatively associated with all-cause mortality among the Chinese centenarians: a prospective study with a 5-year follow-up 中国百岁老人的小腿围与全因死亡率呈负相关:一项为期 5 年的前瞻性随访研究。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-05 DOI: 10.1007/s40520-024-02850-3
Zhigao Sun, Hengbo Zhang, Xiaofei Liu, Xiaobing Wang, Qiong Liu, Yali Zhao, Yan Nie, Dongzong Huang, Shihui Fu

Background

Sarcopenia is an aging-related disorder characterized by a loss of muscle mass and function. Calf circumference (CC) is a useful surrogate marker of muscle mass and function. This prospective study was designed to investigate the association between CC and all-cause mortality during a follow-up for 5 years in the Chinese centenarians.

Methods

The China Hainan Centenarian Cohort Study (CHCCS) is conducted in 18 cities and counties of Hainan, China.

Results

All 231 centenarians had a mean age of 103.03 years. Survival participants had a longer CC and were often living alone compared with others (P<0.05 for all). Multivariate Cox regression models showed that CC was negatively associated with all-cause mortality (P < 0.05 for all). Participants with a longer CC had a lower mortality risk compared with others [Exp(β): 0.918; 95%confidence interval: 0.863–0.977]. Participants with a longer CC had a lower mortality risk whether they were males or females and lived with family members or alone.

Conclusion

CC was negatively associated with all-cause mortality and could be an indicator of future mortality among the Chinese centenarians. Further researches should focus on preventing a decline in the CC in order to promote human longevity.

背景:肌肉疏松症是一种与衰老有关的疾病,其特征是肌肉质量和功能下降。小腿围(CC)是肌肉质量和功能的有效替代指标。这项前瞻性研究旨在对中国百岁老人进行为期 5 年的随访,调查 CC 与全因死亡率之间的关系:中国海南百岁老人队列研究(CHCCS)在中国海南的 18 个市县开展:所有 231 名百岁老人的平均年龄为 103.03 岁。结果:231 位百岁老人的平均年龄为 103.03 岁,与其他人相比,存活者的 CC 较长,且多为独居:CC与全因死亡率呈负相关,可作为中国百岁老人未来死亡率的指标。进一步的研究应侧重于防止 CC 下降,以促进人类长寿。
{"title":"Calf circumference was negatively associated with all-cause mortality among the Chinese centenarians: a prospective study with a 5-year follow-up","authors":"Zhigao Sun,&nbsp;Hengbo Zhang,&nbsp;Xiaofei Liu,&nbsp;Xiaobing Wang,&nbsp;Qiong Liu,&nbsp;Yali Zhao,&nbsp;Yan Nie,&nbsp;Dongzong Huang,&nbsp;Shihui Fu","doi":"10.1007/s40520-024-02850-3","DOIUrl":"10.1007/s40520-024-02850-3","url":null,"abstract":"<div><h3>Background</h3><p>Sarcopenia is an aging-related disorder characterized by a loss of muscle mass and function. Calf circumference (CC) is a useful surrogate marker of muscle mass and function. This prospective study was designed to investigate the association between CC and all-cause mortality during a follow-up for 5 years in the Chinese centenarians.</p><h3>Methods</h3><p>The China Hainan Centenarian Cohort Study (CHCCS) is conducted in 18 cities and counties of Hainan, China.</p><h3>Results</h3><p>All 231 centenarians had a mean age of 103.03 years. Survival participants had a longer CC and were often living alone compared with others (<i>P</i>&lt;0.05 for all). Multivariate Cox regression models showed that CC was negatively associated with all-cause mortality (<i>P</i> &lt; 0.05 for all). Participants with a longer CC had a lower mortality risk compared with others [Exp(β): 0.918; 95%confidence interval: 0.863–0.977]. Participants with a longer CC had a lower mortality risk whether they were males or females and lived with family members or alone.</p><h3>Conclusion</h3><p>CC was negatively associated with all-cause mortality and could be an indicator of future mortality among the Chinese centenarians. Further researches should focus on preventing a decline in the CC in order to promote human longevity.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11455723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379011","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
Mediating role of accelerated aging in the association between depression and mortality risk: findings from NHANES 加速衰老在抑郁与死亡风险之间的关联中的中介作用:NHANES 的研究结果。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-05 DOI: 10.1007/s40520-024-02854-z
Cheng Xu, Jia-ni Wang, Zhen Song, Han-yu Deng, Chong-chao Li

Objective

To investigate the association between depression, accelerated biological aging, and mortality risk, and to assess whether accelerated aging mediates the relationship between major depression and mortality risk.

Methods

A prospective cohort of 12,761 participants aged 20 years or older from the 2005–2010 cycle of the National Health and Nutrition Examination Survey (NHANES) was analyzed. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), with scores of ≥ 10 indicating major depression. Accelerated biological aging was measured using phenotypic age acceleration (PhenoAgeAccel). Multivariable linear regression models and subgroup analyses were used to examine the association between depression and accelerated aging, while weighted multivariable Cox proportional hazards regression models and subgroup analyses assessed the impact of major depression on mortality risk. Mediation analysis was performed to assess whether PhenoAgeAccel mediated the relationship between major depression and mortality outcomes.

Results

Among the 12,761 adults, the weighted mean age was 46.6 years, with 48.8% being male, and 6.9% experiencing major depression. The results showed a positive association between major depression and PhenoAgeAccel (β: 0.61, 95% CI: 0.06–1.16). Over a median follow-up duration of 11.3 years (interquartile range: 9.9–13.1), major depression was associated with increased all-cause mortality (HR: 1.35, 95% CI: 1.13–1.62) and cardiovascular mortality (HR: 1.73, 95% CI: 1.18–2.54). However, the relationship with cancer mortality was not statistically significant after full adjustment for confounding factors. The mediation analysis further revealed that PhenoAgeAccel accounted for 10.32% and 5.12% of the associations between major depression and all-cause mortality, and cardiovascular mortality, respectively.

Conclusion

Depression is associated with accelerated aging and contributes to increased all-cause and cardiovascular mortality. Accelerated aging partially mediates the association between major depression and mortality risk. Our findings highlight the urgent need to incorporate mental health care into public health strategies to delay population aging and reduce mortality risk.

摘要研究抑郁症、加速生物衰老与死亡风险之间的关系,并评估加速衰老是否会介导重度抑郁症与死亡风险之间的关系:方法:分析了美国国家健康与营养调查(NHANES)2005-2010 年周期中 12,761 名 20 岁及以上参与者的前瞻性队列。抑郁采用患者健康问卷-9(PHQ-9)进行评估,得分≥10分表示重度抑郁。生物衰老加速度采用表型年龄加速度(PhenoAgeAccel)进行测量。多变量线性回归模型和亚组分析用于研究抑郁症与加速衰老之间的关系,而加权多变量考克斯比例危险回归模型和亚组分析则用于评估重度抑郁症对死亡风险的影响。还进行了中介分析,以评估 PhenoAgeAccel 是否对重度抑郁症和死亡结果之间的关系起中介作用:在 12,761 名成年人中,加权平均年龄为 46.6 岁,48.8% 为男性,6.9% 患有重度抑郁症。结果显示,重度抑郁症与 PhenoAgeAccel 呈正相关(β:0.61,95% CI:0.06-1.16)。中位随访时间为 11.3 年(四分位间范围:9.9-13.1),重度抑郁症与全因死亡率(HR:1.35,95% CI:1.13-1.62)和心血管死亡率(HR:1.73,95% CI:1.18-2.54)的增加有关。然而,在对混杂因素进行全面调整后,与癌症死亡率的关系在统计学上并不显著。中介分析进一步显示,在重度抑郁症与全因死亡率和心血管死亡率之间的关系中,PhenoAgeAccel分别占10.32%和5.12%:抑郁症与加速衰老有关,并导致全因死亡率和心血管死亡率上升。加速衰老在一定程度上介导了重度抑郁症与死亡风险之间的关联。我们的研究结果突出表明,迫切需要将心理保健纳入公共卫生战略,以延缓人口老龄化并降低死亡风险。
{"title":"Mediating role of accelerated aging in the association between depression and mortality risk: findings from NHANES","authors":"Cheng Xu,&nbsp;Jia-ni Wang,&nbsp;Zhen Song,&nbsp;Han-yu Deng,&nbsp;Chong-chao Li","doi":"10.1007/s40520-024-02854-z","DOIUrl":"10.1007/s40520-024-02854-z","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the association between depression, accelerated biological aging, and mortality risk, and to assess whether accelerated aging mediates the relationship between major depression and mortality risk.</p><h3>Methods</h3><p>A prospective cohort of 12,761 participants aged 20 years or older from the 2005–2010 cycle of the National Health and Nutrition Examination Survey (NHANES) was analyzed. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), with scores of ≥ 10 indicating major depression. Accelerated biological aging was measured using phenotypic age acceleration (PhenoAgeAccel). Multivariable linear regression models and subgroup analyses were used to examine the association between depression and accelerated aging, while weighted multivariable Cox proportional hazards regression models and subgroup analyses assessed the impact of major depression on mortality risk. Mediation analysis was performed to assess whether PhenoAgeAccel mediated the relationship between major depression and mortality outcomes.</p><h3>Results</h3><p>Among the 12,761 adults, the weighted mean age was 46.6 years, with 48.8% being male, and 6.9% experiencing major depression. The results showed a positive association between major depression and PhenoAgeAccel (β: 0.61, 95% CI: 0.06–1.16). Over a median follow-up duration of 11.3 years (interquartile range: 9.9–13.1), major depression was associated with increased all-cause mortality (HR: 1.35, 95% CI: 1.13–1.62) and cardiovascular mortality (HR: 1.73, 95% CI: 1.18–2.54). However, the relationship with cancer mortality was not statistically significant after full adjustment for confounding factors. The mediation analysis further revealed that PhenoAgeAccel accounted for 10.32% and 5.12% of the associations between major depression and all-cause mortality, and cardiovascular mortality, respectively.</p><h3>Conclusion</h3><p>Depression is associated with accelerated aging and contributes to increased all-cause and cardiovascular mortality. Accelerated aging partially mediates the association between major depression and mortality risk. Our findings highlight the urgent need to incorporate mental health care into public health strategies to delay population aging and reduce mortality risk.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11455804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379021","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 negative association between sodium-driven nutrient pattern and telomere length: the chain mediating role of diastolic pressure and waist circumference 钠驱动的营养模式与端粒长度之间的负相关:舒张压和腰围的连锁中介作用。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-05 DOI: 10.1007/s40520-024-02852-1
Baodi Xing, Jie Yu, Yiwen Liu, Shuli He, Qi Gao, Xinyue Chen, Fan Ping, Lingling Xu, Wei Li, Huabing Zhang, Yuxiu Li

Background

Numerous single nutrients have been suggested to be linked with leukocyte telomere length (LTL). However, data on nutrient patterns (NPs), particularly in Chinese population, are scarce. This study aimed to examine the relationship between nutrient-based dietary patterns and LTL, and the potential role of metabolic factors.

Methods

Dietary data was obtained via 24-hour food recalls, and principal component analysis (PCA) was used to identify NPs. LTL was assessed using a real-time PCR assay. Multiple linear regression was conducted to determine the association between NPs and LTL. The potential role of metabolism among them was analyzed using mediation models.

Results

A total of 779 individuals from northern China were included in this cross-sectional analysis. Five main nutrient patterns were identified. Adjusted linear regression showed that the “high sodium” pattern was inversely associated with LTL (B=-0.481(-0.549, -0.413), P < 0.05). The “high vitamin E-fat” pattern exhibited a positive correlation (B = 0.099(0.029, 0.170), P < 0.05), whereas the “high vitamin A-vitamin B2” pattern was negatively correlated with LTL (B=-0.120(-0.183, -0.057), P < 0.05), respectively. No significant associations were observed for the remaining nutrient patterns. The mediation model demonstrated that diastolic blood pressure and waist circumference could individually and collectively mediate the negative impact of the “high sodium” pattern on LTL (BDBP=-0.0173(-0.0333, -0.0041), BWC=-0.0075(-0.0186, -0.0004), Bjoint=-0.0033 (-0.0072, -0.0006), all P < 0.05). Moreover, glycosylated hemoglobin and non-high-density lipoprotein cholesterol mediate the relationship between the “high vitamin E-fat” pattern and LTL (BHbA1c=0.0170(0.0010,0.0347), Bnon-HDL-C= 0.0335 (0.0067, 0.0626), all P < 0.05), respectively.

Conclusions

The “high sodium” and “high vitamin E-fat” nutrient patterns demonstrated negative and positive associations with LTL and metabolic indicators may play complex mediating roles in these relationships.

背景:许多单一营养素被认为与白细胞端粒长度(LTL)有关。然而,有关营养素模式(NPs)的数据却很少,尤其是在中国人群中。本研究旨在探讨基于营养素的膳食模式与白细胞端粒长度之间的关系,以及代谢因素的潜在作用:方法:通过 24 小时食物回忆获得膳食数据,并使用主成分分析(PCA)确定营养素模式。采用实时 PCR 检测法评估低密度脂蛋白。采用多元线性回归法确定 NPs 与 LTL 之间的关系。使用中介模型分析了新陈代谢在其中的潜在作用:结果:这项横断面分析共纳入了来自中国北方的 779 人。确定了五种主要营养模式。调整后的线性回归显示,"高钠 "模式与LTL成反比(B=-0.481(-0.549,-0.413),P DBP=-0.0173(-0.0333,-0.0041),BWC=-0.0075(-0.0186,-0.0004),Bjoint=-0.0033(-0.0072,-0.0006),均 P HbA1c=0.0170(0.0010,0.0347),Bnon-HDL-C= 0.0335(0.0067,0.0626),均 P 结论:高钠 "和 "高维生素 E-脂肪 "营养模式与长期脂蛋白呈负相关和正相关,代谢指标可能在这些关系中起着复杂的中介作用。
{"title":"The negative association between sodium-driven nutrient pattern and telomere length: the chain mediating role of diastolic pressure and waist circumference","authors":"Baodi Xing,&nbsp;Jie Yu,&nbsp;Yiwen Liu,&nbsp;Shuli He,&nbsp;Qi Gao,&nbsp;Xinyue Chen,&nbsp;Fan Ping,&nbsp;Lingling Xu,&nbsp;Wei Li,&nbsp;Huabing Zhang,&nbsp;Yuxiu Li","doi":"10.1007/s40520-024-02852-1","DOIUrl":"10.1007/s40520-024-02852-1","url":null,"abstract":"<div><h3>Background</h3><p>Numerous single nutrients have been suggested to be linked with leukocyte telomere length (LTL). However, data on nutrient patterns (NPs), particularly in Chinese population, are scarce. This study aimed to examine the relationship between nutrient-based dietary patterns and LTL, and the potential role of metabolic factors.</p><h3>Methods</h3><p>Dietary data was obtained via 24-hour food recalls, and principal component analysis (PCA) was used to identify NPs. LTL was assessed using a real-time PCR assay. Multiple linear regression was conducted to determine the association between NPs and LTL. The potential role of metabolism among them was analyzed using mediation models.</p><h3>Results</h3><p>A total of 779 individuals from northern China were included in this cross-sectional analysis. Five main nutrient patterns were identified. Adjusted linear regression showed that the “high sodium” pattern was inversely associated with LTL (<i>B</i>=-0.481(-0.549, -0.413), <i>P</i> &lt; 0.05). The “high vitamin E-fat” pattern exhibited a positive correlation (<i>B</i> = 0.099(0.029, 0.170), <i>P</i> &lt; 0.05), whereas the “high vitamin A-vitamin B2” pattern was negatively correlated with LTL (<i>B</i>=-0.120(-0.183, -0.057), <i>P</i> &lt; 0.05), respectively. No significant associations were observed for the remaining nutrient patterns. The mediation model demonstrated that diastolic blood pressure and waist circumference could individually and collectively mediate the negative impact of the “high sodium” pattern on LTL (<i>B</i><sub>DBP</sub>=-0.0173(-0.0333, -0.0041), <i>B</i><sub>WC</sub>=-0.0075(-0.0186, -0.0004), <i>B</i><sub>joint</sub>=-0.0033 (-0.0072, -0.0006), all <i>P</i> &lt; 0.05). Moreover, glycosylated hemoglobin and non-high-density lipoprotein cholesterol mediate the relationship between the “high vitamin E-fat” pattern and LTL (<i>B</i><sub>HbA1c</sub>=0.0170(0.0010,0.0347), <i>B</i><sub>non-HDL-C</sub>= 0.0335 (0.0067, 0.0626), all <i>P</i> &lt; 0.05), respectively.</p><h3>Conclusions</h3><p>The “high sodium” and “high vitamin E-fat” nutrient patterns demonstrated negative and positive associations with LTL and metabolic indicators may play complex mediating roles in these relationships.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11455806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379022","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
Development and validation of a nomogram for predicting pulmonary complications in elderly patients undergoing thoracic surgery 开发并验证用于预测接受胸外科手术的老年患者肺部并发症的提名图。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-05 DOI: 10.1007/s40520-024-02844-1
Jingjing Liu, Dinghao Xue, Long Wang, Yanxiang Li, Luyu Liu, Guosong Liao, Jiangbei Cao, Yanhong Liu, Jingsheng Lou, Hao Li, Yongbin Yang, Weidong Mi, Qiang Fu

Background

Postoperative pulmonary complications (PPCs) remain a prevalent concern among elderly patients undergoing surgery, with a notably higher incidence observed in elderly patients undergoing thoracic surgery. This study aimed to develop a nomogram to predict the risk of PPCs in this population.

Methods

A total of 2963 elderly patients who underwent thoracic surgery were enrolled and randomly divided into a training cohort (80%, n = 2369) or a validation cohort (20%, n = 593). Univariate and multivariate logistic regression analyses were conducted to identify risk factors for PPCs, and a nomogram was developed based on the findings from the training cohort. The validation cohort was used to validate the model. The predictive accuracy of the model was evaluated by receiver operating characteristic (ROC) curve, area under ROC (AUC), calibration curve, and decision curve analysis (DCA).

Results

A total of 918 (31.0%) patients reported PPCs. Nine independent risk factors for PPCs were identified: preoperative presence of chronic obstructive pulmonary disease (COPD), elevated leukocyte count, higher partial pressure of arterial carbon dioxide (PaCO2) level, surgical site, thoracotomy, intraoperative hypotension, blood loss > 100 mL, surgery duration > 180 min, and malignant tumor. The AUC value for the training cohort was 0.739 (95% CI: 0.719–0.762), and it was 0.703 for the validation cohort (95% CI: 0.657–0.749). The P-values for the Hosmer-Lemeshow test were 0.633 and 0.144 for the training and validation cohorts, respectively, indicating a notable calibration curve fit. The DCA curve indicated that the nomogram could be applied clinically if the risk threshold was between 12% and 84%, which was found to be between 8% and 82% in the validation cohort.

Conclusion

This study highlighted the pressing need for early detection of PPCs in elderly patients undergoing thoracic surgery. The nomogram exhibited promising predictive efficacy for PPCs in elderly patients undergoing thoracic surgery, enabling the identification of high-risk patients and consequently aiding in the implementation of preventive interventions.

Graphical Abstract

背景:术后肺部并发症(PPCs)仍然是接受手术的老年患者普遍关注的问题,在接受胸外科手术的老年患者中发病率明显更高。本研究旨在开发一种预测该人群肺部并发症风险的提名图:共招募了 2963 名接受胸外科手术的老年患者,并将其随机分为训练队列(80%,n = 2369)或验证队列(20%,n = 593)。进行了单变量和多变量逻辑回归分析,以确定 PPCs 的风险因素,并根据训练队列的结果绘制了提名图。验证队列用于验证模型。通过接收者操作特征曲线(ROC)、ROC下面积(AUC)、校准曲线和决策曲线分析(DCA)评估了模型的预测准确性:共有 918 名(31.0%)患者报告了 PPCs。结果:共有 918 名患者(31.0%)报告了 PPCs,其中有 9 个独立的风险因素:术前患有慢性阻塞性肺病(COPD)、白细胞计数升高、动脉二氧化碳分压(PaCO2)水平升高、手术部位、开胸手术、术中低血压、失血量大于 100 毫升、手术时间大于 180 分钟以及恶性肿瘤。训练队列的 AUC 值为 0.739(95% CI:0.719-0.762),验证队列的 AUC 值为 0.703(95% CI:0.657-0.749)。训练队列和验证队列的 Hosmer-Lemeshow 检验 P 值分别为 0.633 和 0.144,表明校准曲线拟合效果显著。DCA曲线表明,如果风险阈值在12%到84%之间,提名图就可以应用于临床,而在验证队列中,风险阈值在8%到82%之间:本研究强调了对接受胸外科手术的老年患者进行 PPC 早期检测的迫切需要。该提名图对接受胸外科手术的老年患者的 PPC 具有良好的预测效果,能够识别高风险患者,从而有助于实施预防性干预措施。
{"title":"Development and validation of a nomogram for predicting pulmonary complications in elderly patients undergoing thoracic surgery","authors":"Jingjing Liu,&nbsp;Dinghao Xue,&nbsp;Long Wang,&nbsp;Yanxiang Li,&nbsp;Luyu Liu,&nbsp;Guosong Liao,&nbsp;Jiangbei Cao,&nbsp;Yanhong Liu,&nbsp;Jingsheng Lou,&nbsp;Hao Li,&nbsp;Yongbin Yang,&nbsp;Weidong Mi,&nbsp;Qiang Fu","doi":"10.1007/s40520-024-02844-1","DOIUrl":"10.1007/s40520-024-02844-1","url":null,"abstract":"<div><h3>Background</h3><p>Postoperative pulmonary complications (PPCs) remain a prevalent concern among elderly patients undergoing surgery, with a notably higher incidence observed in elderly patients undergoing thoracic surgery. This study aimed to develop a nomogram to predict the risk of PPCs in this population.</p><h3>Methods</h3><p>A total of 2963 elderly patients who underwent thoracic surgery were enrolled and randomly divided into a training cohort (80%, <i>n</i> = 2369) or a validation cohort (20%, <i>n</i> = 593). Univariate and multivariate logistic regression analyses were conducted to identify risk factors for PPCs, and a nomogram was developed based on the findings from the training cohort. The validation cohort was used to validate the model. The predictive accuracy of the model was evaluated by receiver operating characteristic (ROC) curve, area under ROC (AUC), calibration curve, and decision curve analysis (DCA).</p><h3>Results</h3><p>A total of 918 (31.0%) patients reported PPCs. Nine independent risk factors for PPCs were identified: preoperative presence of chronic obstructive pulmonary disease (COPD), elevated leukocyte count, higher partial pressure of arterial carbon dioxide (PaCO<sub>2</sub>) level, surgical site, thoracotomy, intraoperative hypotension, blood loss &gt; 100 mL, surgery duration &gt; 180 min, and malignant tumor. The AUC value for the training cohort was 0.739 (95% <i>CI</i>: 0.719–0.762), and it was 0.703 for the validation cohort (95% <i>CI</i>: 0.657–0.749). The <i>P-</i>values for the Hosmer-Lemeshow test were 0.633 and 0.144 for the training and validation cohorts, respectively, indicating a notable calibration curve fit. The DCA curve indicated that the nomogram could be applied clinically if the risk threshold was between 12% and 84%, which was found to be between 8% and 82% in the validation cohort.</p><h3>Conclusion</h3><p>This study highlighted the pressing need for early detection of PPCs in elderly patients undergoing thoracic surgery. The nomogram exhibited promising predictive efficacy for PPCs in elderly patients undergoing thoracic surgery, enabling the identification of high-risk patients and consequently aiding in the implementation of preventive interventions.</p><h3>Graphical Abstract</h3><div><figure><div><div><picture><img></picture></div></div></figure></div></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11455794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between statin usage and mortality outcomes in aging U.S. cancer survivors: a nationwide cohort study 他汀类药物的使用与美国老年癌症幸存者死亡率之间的关系:一项全国性队列研究。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-05 DOI: 10.1007/s40520-024-02851-2
Shan Ding, Fengling Yang, Pan Lai, Weiwen Jiang, Minze Chen, Yijun Ge, Liting Zhou, Shaozhuang Chen, Jiaqi Zhang, Yanrong Ye

Background

The population of Aging cancer survivors in the United States has surged to over 16.9 million. Research on the relationship between statin usage and post-cancer survival rates remains limited.

Aims

This study aims to investigate the association between statin use and various causes of mortality among aging cancer survivors.

Methods

We analyzed NHANES data from 1999 to 2018, Statin usage, both hydrophilic and lipophilic, was derived from NHANES prescription records. We utilized Cox proportional hazards models to associate statin utilization with mortality, differentiating causes of death according to statin type and patterns of use.

Results

Within a cohort of 2,968 participants, statin usage was categorized into non-users (1,738), hydrophilic statin users (216), and lipophilic statin users (982). Compared to those who did not use statins, individuals prescribed hydrophilic statins did not show a reduced risk of all-cause mortality (adjusted hazard ratio [HR] 1.01; 95% confidence interval [CI] 0.72–1.41; P = 0.960), as outlined in Model 3. In contrast, the group receiving lipophilic statins exhibited a notable decrease in all-cause mortality risk (adjusted HR, 0.77; P = 0.003). Nonetheless, both hydrophilic and lipophilic statins were effective in diminishing the risk associated with cancer from its onset until death, with hydrophilic statins showing a greater level of efficacy.

Discussion

The potential of statins to reduce cancer-related mortality may provide avenues for targeted clinical interventions and management strategies.

Conclusions

Our study reveals that the use of lipophilic statins is significantly associated with lower all-cause and cancer-cause mortality risks among aging cancer survivors.

背景:美国的老年癌症幸存者人数已超过 1690 万。关于他汀类药物的使用与癌症后生存率之间关系的研究仍然有限。目的:本研究旨在调查老年癌症幸存者中他汀类药物的使用与各种死因之间的关系:我们分析了1999年至2018年的NHANES数据,他汀类药物(包括亲水型和亲脂型)的使用情况来自NHANES处方记录。我们利用 Cox 比例危险模型将他汀类药物的使用与死亡率联系起来,并根据他汀类药物的类型和使用模式区分死亡原因:在 2968 名参与者的队列中,他汀类药物的使用情况分为未使用(1738 人)、亲水性他汀类药物使用者(216 人)和亲脂性他汀类药物使用者(982 人)。如模型 3 所示,与不使用他汀类药物的人相比,服用亲水他汀类药物的人的全因死亡风险并没有降低(调整后危险比 [HR] 1.01;95% 置信区间 [CI] 0.72-1.41;P = 0.960)。相比之下,接受亲脂性他汀类药物治疗的组别全因死亡风险显著降低(调整后危险比为 0.77;P = 0.003)。尽管如此,亲水性他汀类药物和亲油性他汀类药物都能有效降低癌症从发病到死亡的相关风险,亲水性他汀类药物的疗效更高:讨论:他汀类药物降低癌症相关死亡率的潜力可为有针对性的临床干预和管理策略提供途径:我们的研究表明,在老年癌症幸存者中,使用亲脂性他汀类药物与降低全因和癌因死亡率风险有显著关联。
{"title":"Association between statin usage and mortality outcomes in aging U.S. cancer survivors: a nationwide cohort study","authors":"Shan Ding,&nbsp;Fengling Yang,&nbsp;Pan Lai,&nbsp;Weiwen Jiang,&nbsp;Minze Chen,&nbsp;Yijun Ge,&nbsp;Liting Zhou,&nbsp;Shaozhuang Chen,&nbsp;Jiaqi Zhang,&nbsp;Yanrong Ye","doi":"10.1007/s40520-024-02851-2","DOIUrl":"10.1007/s40520-024-02851-2","url":null,"abstract":"<div><h3>Background</h3><p>The population of Aging cancer survivors in the United States has surged to over 16.9 million. Research on the relationship between statin usage and post-cancer survival rates remains limited.</p><h3>Aims</h3><p>This study aims to investigate the association between statin use and various causes of mortality among aging cancer survivors.</p><h3>Methods</h3><p>We analyzed NHANES data from 1999 to 2018, Statin usage, both hydrophilic and lipophilic, was derived from NHANES prescription records. We utilized Cox proportional hazards models to associate statin utilization with mortality, differentiating causes of death according to statin type and patterns of use.</p><h3>Results</h3><p>Within a cohort of 2,968 participants, statin usage was categorized into non-users (1,738), hydrophilic statin users (216), and lipophilic statin users (982). Compared to those who did not use statins, individuals prescribed hydrophilic statins did not show a reduced risk of all-cause mortality (adjusted hazard ratio [HR] 1.01; 95% confidence interval [CI] 0.72–1.41; <i>P</i> = 0.960), as outlined in Model 3. In contrast, the group receiving lipophilic statins exhibited a notable decrease in all-cause mortality risk (adjusted HR, 0.77; <i>P</i> = 0.003). Nonetheless, both hydrophilic and lipophilic statins were effective in diminishing the risk associated with cancer from its onset until death, with hydrophilic statins showing a greater level of efficacy.</p><h3>Discussion</h3><p>The potential of statins to reduce cancer-related mortality may provide avenues for targeted clinical interventions and management strategies.</p><h3>Conclusions</h3><p>Our study reveals that the use of lipophilic statins is significantly associated with lower all-cause and cancer-cause mortality risks among aging cancer survivors.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between dynapenic abdominal obesity and arthritis among the middle-aged and older Chinese: a longitudinal study 中国中老年人腹部动态肥胖与关节炎的关系:一项纵向研究。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-05 DOI: 10.1007/s40520-024-02847-y
Shengliang Zhou, Naijia Luo, Haibo Si, Wacili Da, Yuan Liu, Limin Wu, Mingyang Li, Bin Shen

Background

This study aimed to assess the longitudinal association between dynapenic abdominal obesity and new-onset arthritis among the middle-aged and older Chinese population.

Methods

We included 6863 participants from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Dynapenia was defined as handgrip strength < 28 kg for males, and < 18 kg for females. Abdominal obesity was defined as a waist circumference ≥ 90 cm for males and ≥ 85 cm for females. Based on the definitions, all participants were divided into four groups: no dynapenia and no abdominal obesity (ND/NAO), abdominal obesity alone (ND/AO), dynapenia alone (D/NAO), and dynapenia and abdominal obesity (D/AO). The association between dynapenic abdominal obesity and new-onset arthritis was assessed by sex using the Poisson regression models.

Results

After a four-year follow-up, 1272 (18.53%) participants reported new-onset arthritis. Those in the D/AO group had a significantly increased risk of new-onset arthritis compared to those in the ND/NAO group (adjusted relative risk (RR): 1.34, 95% confidence interval (CI): 1.01–1.77). In females, the ND/AO (RR: 1.21, 95% CI: 1.03–1.43) and D/AO (RR: 1.39, 95% CI: 1.01–1.93) groups were associated with a higher risk of arthritis. This significant association was not observed in males.

Conclusions

Our results indicated that the combined effect of dynapenia and abdominal obesity significantly increased the risk of new-onset arthritis in females, but this association was not observed in males.

研究背景本研究旨在评估中国中老年人群中动态腹型肥胖与新发关节炎之间的纵向联系:我们纳入了中国健康与退休纵向研究(CHARLS)2011 年和 2015 年的 6863 名参与者。结果:经过四年的随访,1272 名中国中老年人患上了动力性关节炎:经过四年的随访,1272 名参与者(18.53%)报告了新发关节炎。与 ND/NAO 组相比,D/AO 组患者新发关节炎的风险明显增加(调整后相对风险 (RR):1.34,95% 置信区间):1.34,95% 置信区间 (CI):1.01-1.77)。在女性中,ND/AO 组(RR:1.21,95% 置信区间:1.03-1.43)和 D/AO 组(RR:1.39,95% 置信区间:1.01-1.93)患关节炎的风险较高。结论:我们的研究结果表明,动态关节炎和腹型肥胖的共同作用会显著增加女性罹患新发关节炎的风险,但在男性中却没有观察到这种关联。
{"title":"Association between dynapenic abdominal obesity and arthritis among the middle-aged and older Chinese: a longitudinal study","authors":"Shengliang Zhou,&nbsp;Naijia Luo,&nbsp;Haibo Si,&nbsp;Wacili Da,&nbsp;Yuan Liu,&nbsp;Limin Wu,&nbsp;Mingyang Li,&nbsp;Bin Shen","doi":"10.1007/s40520-024-02847-y","DOIUrl":"10.1007/s40520-024-02847-y","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to assess the longitudinal association between dynapenic abdominal obesity and new-onset arthritis among the middle-aged and older Chinese population.</p><h3>Methods</h3><p>We included 6863 participants from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Dynapenia was defined as handgrip strength &lt; 28 kg for males, and &lt; 18 kg for females. Abdominal obesity was defined as a waist circumference ≥ 90 cm for males and ≥ 85 cm for females. Based on the definitions, all participants were divided into four groups: no dynapenia and no abdominal obesity (ND/NAO), abdominal obesity alone (ND/AO), dynapenia alone (D/NAO), and dynapenia and abdominal obesity (D/AO). The association between dynapenic abdominal obesity and new-onset arthritis was assessed by sex using the Poisson regression models.</p><h3>Results</h3><p>After a four-year follow-up, 1272 (18.53%) participants reported new-onset arthritis. Those in the D/AO group had a significantly increased risk of new-onset arthritis compared to those in the ND/NAO group (adjusted relative risk (RR): 1.34, 95% confidence interval (CI): 1.01–1.77). In females, the ND/AO (RR: 1.21, 95% CI: 1.03–1.43) and D/AO (RR: 1.39, 95% CI: 1.01–1.93) groups were associated with a higher risk of arthritis. This significant association was not observed in males.</p><h3>Conclusions</h3><p>Our results indicated that the combined effect of dynapenia and abdominal obesity significantly increased the risk of new-onset arthritis in females, but this association was not observed in males.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11455664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379010","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
Increased nocturnal urinary cortisol levels in the elderly patients with depression, coexisting major geriatric syndromes and combined pathogenetic mechanisms 老年抑郁症患者夜间尿皮质醇水平升高、并存的主要老年综合征及综合发病机制。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-27 DOI: 10.1007/s40520-024-02849-w
Antonio Martocchia, Manuela Stefanelli, Maurizio Gallucci, Marianna Noale, Stefania Maggi, Maurizio Cassol, Demetrio Postacchini, Antonella Proietti, Mario Barbagallo, Ligia J. Dominguez, Claudio Ferri, Giovambattista Desideri, Lavinia Toussan, Francesca Pastore, Giulia M. Falaschi, Giuseppe Paolisso, Paolo Falaschi, The AGICO Investigators

Background

The mechanisms at the basis of depression are still matter of debate, but several studies in the literature suggest common pathways with dementia (genetic predispositions, metabolic and inflammatory mechanisms, neuropathological changes) and other geriatric syndromes.

Aims

To evaluate the role of cortisol (as marker of the HPA, hypothalamus–pituitary–adrenal axis hyperactivity) in elderly subjects with depressive symptoms (by the means of the AGICO, AGIng and COrtisol, study), in relationship to the presence of the major geriatric syndromes.

Methods

The AGICO study enrolled patients from ten Geriatric Units in Italy. Every subject received a comprehensive geriatric assessment or CGA (including the Mini Mental State Examination or MMSE, Geriatric Depression Scale or GDS and Cornell Scale for Depression in Dementia or CSDD), the neurological examination (with a computed tomography scan or magnetic resonance imaging of the brain), the assessment of the metabolic syndrome (MetS), the evaluation of the cortisol activity by two consecutive urine collections (diurnal and nocturnal), a CGA-derived frailty index (FI) and a modified measure of allostatic load (AL).

Results

The MMSE scores were significantly and inversely related to the values of GDS (p < 0.001) and CSDD (p < 0.05), respectively. The patients with depressive symptoms (GDS/CSDD > 8) showed significantly increased disability, MetS, inflammation, FI and AL and significantly reduced MMSE and renal function.

The diurnal and nocturnal urinary cortisol levels in the patients with depressive symptoms (GDS/CSDD > 8) were higher with respects to controls (p < 0.05 for nocturnal difference).

Discussion

The AGICO study showed that the stress response is activated in the patients with depression.

Conclusion

The depression in elderly patient should be reconsidered as a systemic disease, with coexisting major geriatric syndromes (disability, dementia, frailty) and combined pathogenetic mechanisms (metabolic syndrome, impaired renal function, low-grade inflammation, and allostatic load). Cortisol confirmed its role as principal mediator of the aging process in both dementia and metabolic syndrome.

背景:抑郁症的发病机制仍存在争议,但一些文献研究表明,抑郁症与痴呆症(遗传倾向、新陈代谢和炎症机制、神经病理学变化)和其他老年综合征存在共同的发病途径。目的:通过 AGICO、AGIng 和 COrtisol 研究,评估皮质醇(作为下丘脑-垂体-肾上腺轴亢进的标志物)在有抑郁症状的老年受试者中的作用,以及与主要老年综合征的关系:AGICO 研究招募了来自意大利 10 个老年病科的患者。每位受试者都接受了老年病综合评估(包括迷你精神状态检查(MMSE)、老年抑郁量表(GDS)和康奈尔老年痴呆抑郁量表(CSDD))、神经系统检查(脑部计算机断层扫描或磁共振成像)、代谢综合征(MetS)评估、通过连续两次收集尿液(昼尿和夜尿)评估皮质醇活性、CGA 衍生的虚弱指数(FI)和改良的异位负荷测量法(AL)。结果显示MMSE 评分与 GDS 值呈显著反比关系(p 8),表明残疾、MetS、炎症、FI 和 AL 显著增加,MMSE 和肾功能显著降低。与对照组相比,抑郁症状患者(GDS/CSDD > 8)的昼夜尿皮质醇水平更高(P 讨论):AGICO研究表明,抑郁症患者的应激反应被激活:结论:老年抑郁症应被视为一种全身性疾病,与主要老年综合征(残疾、痴呆、虚弱)和综合发病机制(代谢综合征、肾功能受损、低度炎症和异位负荷)并存。皮质醇证实了其在痴呆症和代谢综合征中作为衰老过程主要介质的作用。
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引用次数: 0
期刊
Aging Clinical and Experimental Research
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