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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。
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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
Which stakeholders should be addressed to promote Geriatric Medicine among healthcare professionals, educationalists and policy-makers in European countries? – the PROGRAMMING COST 21,122 action experience 在欧洲各国的医疗保健专业人员、教育工作者和政策制定者中推广老年医学,应面向哪些利益相关者?- 计划成本 21 122 行动经验。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-23 DOI: 10.1007/s40520-024-02841-4
Sumru Savas, Nilufer Demiral Yilmaz, Marina Kotsani, Karolina Piotrowicz, Sofia Duque

Background

Geriatric Medicine (GM), concerned with well-being and health of older adults, can play a crucial role in the alignment of healthcare systems to the needs of the aged populations. However, countries have varying GM development backgrounds. The goal of PROGRAMMING- COST 21,122 Action is to propose the content of education and training activities in GM for healthcare professionals across various clinical settings, adapted to local context, needs, and assets. Defining relevant stakeholders and addressing them on both an international as well as a country-specific level is crucial for this purpose. In this paper we are describing the methods used in the PROGRAMMING Action 21,122 to map the different categories of stakeholders to be engaged in the Action.

Methods

Through conceptualizing a model for stakeholders by literature research, and online discussion group meetings, a synthesis for the potential stakeholders was defined as a template, and pilot applications were requested from participant countries.

Results

There were 24 members from 14 countries (6 males/18 females) of multidisciplinary professions involved in this study. A model for the list of stakeholders to be addressed was developed and, after seven online discussion meetings, a consensus framework was provided. Invited countries completed the templates to pilot such operationalization.

Conclusion

Our framework of stakeholders will support the research coordination and capacity-building objectives of PROGRAMMING, including the participation into the assessment of educational needs of healthcare professionals. Identified stakeholders will also be mobilized for purposes of dissemination and maximization of the Action’s impact. By defining and mapping multidisciplinary stakeholders involved in older people’s care specific to countries, particularly where GM is still emerging, GM tailored educational activities will be facilitated and optimally targeted.

背景:老年医学(GM)关注老年人的福祉和健康,在使医疗保健系统满足老年人口的需求方面发挥着至关重要的作用。然而,各国的老年医学发展背景各不相同。计划编制--COST 21 122 行动的目标是根据当地情况、需求和资产,为不同临床环境下的医疗保健专业人员提出全球机制教育和培训活动的内容。为此,界定相关利益方并在国际和国家层面上解决他们的问题至关重要。在本文中,我们将介绍 "PROGRAMMING 21 行动 "122 所使用的方法,以绘制参与该行动的各类利益相关者的地图:方法:通过文献研究和在线讨论小组会议对利益相关者模型进行概念化,将潜在利益相关者的综合情况定义为模板,并要求参与国进行试点申请:结果:共有来自 14 个国家(6 男/18 女)的 24 名多学科专业成员参与了本研究。制定了一个利益相关者名单模型,经过七次在线讨论会议,提供了一个共识框架。受邀国家填写了模板,以试点这种可操作性:我们的利益相关者框架将支持计划的研究协调和能力建设目标,包括参与医疗保健专业人员的教育需求评估。还将动员已确定的利益相关方,以传播和最大限度地扩大该行动的影响。通过确定和绘制各国参与老年人护理的多学科利益相关方,特别是全球机制仍在萌芽的国 家,将促进全球机制量身定制的教育活动,并使其具有最佳针对性。
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引用次数: 0
Robot-assisted vs. laparoscopic right hemicolectomy in octogenarians and nonagenarians: an analysis of the US nationwide inpatient sample 2005–2018 八旬老人和非八旬老人的机器人辅助与腹腔镜右半结肠切除术:2005-2018年美国全国住院病人样本分析。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-23 DOI: 10.1007/s40520-024-02833-4
Chien-Chang Lu, Chi-Tung Lu, Kai-Yen Chang, Wang Chun-Li, Chien-Ying Wu

Background

Colorectal cancer (CRC) is a significant health concern, particularly among older adults. Outcomes between laparoscopic and robot-assisted surgeries for right-sided colon cancers in the oldest old population have yet to be evaluated despite increased use of these surgeries.

Aim

This study aimed to compare clinical outcomes after robot-assisted right hemicolectomy (RARH) versus laparoscopic right hemicolectomy (LRH) in octogenarian and nonagenarian patients.

Methods

This population-based, retrospective and observational study analyzed the data of adults ≥ 80 years old diagnosed with right-side colon cancer who received RARH or LRH. All data were extracted from the US National Inpatient Sample (NIS) database 2005–2018. Associations between type of surgery and in-hospital outcomes were determined using univariate and multivariable logistic regression and linear regression analysis.

Results

Data of 7,550 patients (representing 37,126 hospitalized patients in the U.S.) were analyzed. Mean age of the study population was 84.8 years, 61.4% were females, and 79.1% were non-smokers. After adjusting for relevant confounders, regression analysis showed that patients undergoing RARH had a significantly shorter LOS (adjusted Beta (aBeta), -0.24, 95% CI: -0.32, -0.15) but greater total hospital costs (aBeta, 26.54, 95% CI: 24.64, 28.44) than patients undergoing LRH. No significant differences in mortality, perioperative complications, and risk of unfavorable discharge were observed between the two procedures (p > 0.05). Stratified analyses by frailty status revealed consistent results.

Conclusions

RARH is associated with a significantly shorter LOS but higher total hospital costs than LRH among octogenarians and nonagenarians. Other short-term outcomes for this population are similar between the two procedures, including in-hospital mortality, perioperative complications, and unfavorable discharge. These findings also apply to frail patients.

背景:结肠直肠癌(CRC)是一个重大的健康问题,尤其是在老年人中。目的:本研究旨在比较八旬老人和非八旬老人接受机器人辅助右半结肠切除术(RARH)和腹腔镜右半结肠切除术(LRH)后的临床效果:这项基于人群的回顾性观察研究分析了确诊为右侧结肠癌并接受 RARH 或 LRH 手术的≥80 岁成人的数据。所有数据均提取自2005-2018年美国全国住院患者样本(NIS)数据库。采用单变量、多变量逻辑回归和线性回归分析确定手术类型与院内预后之间的关系:对7550名患者(代表美国37126名住院患者)的数据进行了分析。研究对象的平均年龄为 84.8 岁,61.4% 为女性,79.1% 不吸烟。在对相关混杂因素进行调整后,回归分析表明,与接受 LRH 治疗的患者相比,接受 RARH 治疗的患者的 LOS 明显更短(调整后 Beta (aBeta),-0.24,95% CI:-0.32,-0.15),但住院总费用更高(aBeta,26.54,95% CI:24.64,28.44)。两种手术在死亡率、围手术期并发症和不利出院风险方面无明显差异(P > 0.05)。按虚弱状态进行的分层分析结果一致:结论:与 LRH 相比,RARH 可显著缩短八旬老人和非高龄老人的住院时间,但住院总费用更高。在这一人群中,两种手术的其他短期结果相似,包括院内死亡率、围手术期并发症和不利出院。这些发现同样适用于体弱患者。
{"title":"Robot-assisted vs. laparoscopic right hemicolectomy in octogenarians and nonagenarians: an analysis of the US nationwide inpatient sample 2005–2018","authors":"Chien-Chang Lu,&nbsp;Chi-Tung Lu,&nbsp;Kai-Yen Chang,&nbsp;Wang Chun-Li,&nbsp;Chien-Ying Wu","doi":"10.1007/s40520-024-02833-4","DOIUrl":"10.1007/s40520-024-02833-4","url":null,"abstract":"<div><h3>Background</h3><p>Colorectal cancer (CRC) is a significant health concern, particularly among older adults. Outcomes between laparoscopic and robot-assisted surgeries for right-sided colon cancers in the oldest old population have yet to be evaluated despite increased use of these surgeries.</p><h3>Aim</h3><p>This study aimed to compare clinical outcomes after robot-assisted right hemicolectomy (RARH) versus laparoscopic right hemicolectomy (LRH) in octogenarian and nonagenarian patients.</p><h3>Methods</h3><p>This population-based, retrospective and observational study analyzed the data of adults ≥ 80 years old diagnosed with right-side colon cancer who received RARH or LRH. All data were extracted from the US National Inpatient Sample (NIS) database 2005–2018. Associations between type of surgery and in-hospital outcomes were determined using univariate and multivariable logistic regression and linear regression analysis.</p><h3>Results</h3><p>Data of 7,550 patients (representing 37,126 hospitalized patients in the U.S.) were analyzed. Mean age of the study population was 84.8 years, 61.4% were females, and 79.1% were non-smokers. After adjusting for relevant confounders, regression analysis showed that patients undergoing RARH had a significantly shorter LOS (adjusted Beta (aBeta), -0.24, 95% CI: -0.32, -0.15) but greater total hospital costs (aBeta, 26.54, 95% CI: 24.64, 28.44) than patients undergoing LRH. No significant differences in mortality, perioperative complications, and risk of unfavorable discharge were observed between the two procedures (<i>p</i> &gt; 0.05). Stratified analyses by frailty status revealed consistent results.</p><h3>Conclusions</h3><p>RARH is associated with a significantly shorter LOS but higher total hospital costs than LRH among octogenarians and nonagenarians. Other short-term outcomes for this population are similar between the two procedures, including in-hospital mortality, perioperative complications, and unfavorable discharge. These findings also apply to frail patients.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279171","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
Correction: Prevention at home in older persons with (pre-)frailty: analysis of participants’ recruitment and characteristics of the randomized controlled PromeTheus trial 更正:虚弱(前期)老年人的居家预防:随机对照 PromeTheus 试验的参与者招募和特点分析。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-23 DOI: 10.1007/s40520-024-02837-0
Tim Fleiner, Corinna Nerz, Michael Denkinger, Jürgen M. Bauer, Christian Grüneberg, Judith Dams, Martina Schäufele, Gisela Büchele, PromeTheus Study Group, Kilian Rapp, Christian Werner
{"title":"Correction: Prevention at home in older persons with (pre-)frailty: analysis of participants’ recruitment and characteristics of the randomized controlled PromeTheus trial","authors":"Tim Fleiner,&nbsp;Corinna Nerz,&nbsp;Michael Denkinger,&nbsp;Jürgen M. Bauer,&nbsp;Christian Grüneberg,&nbsp;Judith Dams,&nbsp;Martina Schäufele,&nbsp;Gisela Büchele,&nbsp;PromeTheus Study Group,&nbsp;Kilian Rapp,&nbsp;Christian Werner","doi":"10.1007/s40520-024-02837-0","DOIUrl":"10.1007/s40520-024-02837-0","url":null,"abstract":"","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279170","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 contribution of cognitive reserve in explaining the dual-task walking performance in iNPH patients: comparison with other cognitive, functional, and socio-demographic variables 认知储备对解释 iNPH 患者双任务步行表现的贡献:与其他认知、功能和社会人口变量的比较
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-11 DOI: 10.1007/s40520-024-02829-0
Elodie Piche, Stephane Armand, Gilles Allali, Frederic Assal

Background

Idiopathic normal pressure hydrocephalus (iNPH) is a prevalent neurological disorder, but its diagnosis remains challenging. Dual-task (DT) walking performance is a reliable indicator of iNPH but less is known about the role of cognitive reserve (CR) in predicting DT walking performance.

Aims

The objective of this study was to evaluate the contribution of CR on DT walking in healthy controls (HC) and in iNPH patients (iNPH-P).

Methods

68 iNPH-P (77.2 +/- 6.7 years old) and 28 HC (74.5 +/- 5.7 years old) were evaluated on their single-task walking (Vsimple) and on 4 DT walking (walking and counting or counting backwards, naming animals, naming words beginning with the letter P) (Vcount, VcountB, Vanimals and Vletter respectively). The contribution of CR on the different DT walking speeds was compared between HC and iNPH-P. In iNPH-P, the contribution of CR on the walking speeds was compared with regard to other cognitive, functional, and socio-demographic variables.

Results

Simple linear regression demonstrated a moderate influence of CR on single and DT walking speed in iNPH-P (β > 0.3, p < .001) but not in HC where the relation was not significant. In iNPH-P, results showed that CR played a major role in explaining each of the single and DT walking speeds with NPH-scale.

Conclusion

As CR could be improved through the life cycle, these results support the idea of developing and supporting physical activity programs that will enrich social, physical, and cognitive resources to protect against age-related functional decline, especially in iNPH-P patients where the age-related deficits are greater.

背景特发性正常压力脑积水(iNPH)是一种常见的神经系统疾病,但其诊断仍具有挑战性。本研究旨在评估认知储备(CR)对健康对照组(HC)和 iNPH 患者(iNPH-P)DT 步行的影响。方法 对 68 名 iNPH-P(77.2 +/- 6.7 岁)和 28 名 HC(74.5 +/- 5.7 岁)进行了单任务步行(Vsimple)和 4 项 DT 步行(步行和数数或倒数、命名动物、命名以字母 P 开头的单词)(分别为 Vcount、VcountB、Vanimals 和 Vletter)的评估。我们比较了CR对HC和iNPH-P的不同DT行走速度的贡献。结果简单线性回归显示,在 iNPH-P 中,CR 对单次和 DT 步行速度的影响不大(β > 0.3, p <.001),但在 HC 中,这种关系并不显著。由于 CR 可以在生命周期中得到改善,这些结果支持了开发和支持体育活动项目的想法,这些项目将丰富社会、身体和认知资源,以防止与年龄相关的功能衰退,尤其是在与年龄相关的缺陷更大的 iNPH-P 患者中。
{"title":"The contribution of cognitive reserve in explaining the dual-task walking performance in iNPH patients: comparison with other cognitive, functional, and socio-demographic variables","authors":"Elodie Piche,&nbsp;Stephane Armand,&nbsp;Gilles Allali,&nbsp;Frederic Assal","doi":"10.1007/s40520-024-02829-0","DOIUrl":"10.1007/s40520-024-02829-0","url":null,"abstract":"<div><h3>Background</h3><p>Idiopathic normal pressure hydrocephalus (iNPH) is a prevalent neurological disorder, but its diagnosis remains challenging. Dual-task (DT) walking performance is a reliable indicator of iNPH but less is known about the role of cognitive reserve (CR) in predicting DT walking performance.</p><h3>Aims</h3><p>The objective of this study was to evaluate the contribution of CR on DT walking in healthy controls (HC) and in iNPH patients (iNPH-P).</p><h3>Methods</h3><p>68 iNPH-P (77.2 +/- 6.7 years old) and 28 HC (74.5 +/- 5.7 years old) were evaluated on their single-task walking (<i>Vsimple</i>) and on 4 DT walking (walking and counting or counting backwards, naming animals, naming words beginning with the letter P) (<i>Vcount</i>,<i> VcountB</i>,<i> Vanimals and Vletter</i> respectively). The contribution of CR on the different DT walking speeds was compared between HC and iNPH-P. In iNPH-P, the contribution of CR on the walking speeds was compared with regard to other cognitive, functional, and socio-demographic variables.</p><h3>Results</h3><p>Simple linear regression demonstrated a moderate influence of CR on single and DT walking speed in iNPH-P (β &gt; 0.3, <i>p</i> &lt; .001) but not in HC where the relation was not significant. In iNPH-P, results showed that CR played a major role in explaining each of the single and DT walking speeds with NPH-scale.</p><h3>Conclusion</h3><p>As CR could be improved through the life cycle, these results support the idea of developing and supporting physical activity programs that will enrich social, physical, and cognitive resources to protect against age-related functional decline, especially in iNPH-P patients where the age-related deficits are greater.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02829-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142212963","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
Causal associations between frailty and low back pain: a bidirectional two-sample mendelian randomization study 虚弱与腰背痛之间的因果关系:双向双样本泯灭随机研究
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-11 DOI: 10.1007/s40520-024-02843-2
Zuying Liu, Jiaming Fan, Huilian Bu, Lijun Fu, Cong Li, Letian Ma, Cunlong Kong, Zhongyuan Lu, Xinxin Li, Jian Wang, Qingying Liu, Jingjing Yuan, Xiaochong Fan

Background

Previous observational studies have revealed a potentially robust bidirectional relationship between frailty and low back pain (LBP). However, the precise causal relationship remains unclear.

Methods

To examine the potential causal association between frailty and LBP, we conducted bidirectional two-sample Mendelian randomization analysis (MR) study. Genetic data on frailty index (FI) and LBP were acquired from publicly available genome-wide association studies (GWAS). Various MR methodologies were utilized, such as inverse variance weighting (IVW), weighted median, and MR-Egger, to evaluate causality. Additionally, sensitivity analyses were conducted to evaluate the robustness of the findings.

Results

Genetically predicted higher FI (IVW, odds ratio [OR] = 1.66, 95% CI 1.17–2.36, p = 4.92E-03) was associated with a higher risk of LBP. As for the reverse direction, genetic liability to LBP showed consistent associations with a higher FI (IVW, OR = 1.13, 95% CI 1.07–1.19, p = 2.67E-05). The outcomes from various MR techniques and sensitivity analyses indicate the robustness of our findings.

Conclusion

Our research findings provide additional evidence bolstering the bidirectional causal relationship between frailty and LBP.

背景以往的观察性研究显示,虚弱与腰背痛之间存在潜在的密切双向关系。为了研究虚弱与腰背痛之间的潜在因果关系,我们进行了双向双样本孟德尔随机分析(MR)研究。有关虚弱指数(FI)和枸杞多糖的遗传数据来自公开的全基因组关联研究(GWAS)。研究采用了各种 MR 方法,如反方差加权(IVW)、加权中位数和 MR-Egger,以评估因果关系。结果遗传预测的较高 FI(IVW,比值比 [OR] = 1.66,95% CI 1.17-2.36,p = 4.92E-03)与较高的枸杞痛风险相关。至于反方向,枸杞痛的遗传易感性与较高的 FI 有一致的关联(IVW,OR = 1.13,95% CI 1.07-1.19,p = 2.67E-05)。各种磁共振技术和敏感性分析的结果表明了我们研究结果的稳健性。
{"title":"Causal associations between frailty and low back pain: a bidirectional two-sample mendelian randomization study","authors":"Zuying Liu,&nbsp;Jiaming Fan,&nbsp;Huilian Bu,&nbsp;Lijun Fu,&nbsp;Cong Li,&nbsp;Letian Ma,&nbsp;Cunlong Kong,&nbsp;Zhongyuan Lu,&nbsp;Xinxin Li,&nbsp;Jian Wang,&nbsp;Qingying Liu,&nbsp;Jingjing Yuan,&nbsp;Xiaochong Fan","doi":"10.1007/s40520-024-02843-2","DOIUrl":"10.1007/s40520-024-02843-2","url":null,"abstract":"<div><h3>Background</h3><p>Previous observational studies have revealed a potentially robust bidirectional relationship between frailty and low back pain (LBP). However, the precise causal relationship remains unclear.</p><h3>Methods</h3><p>To examine the potential causal association between frailty and LBP, we conducted bidirectional two-sample Mendelian randomization analysis (MR) study. Genetic data on frailty index (FI) and LBP were acquired from publicly available genome-wide association studies (GWAS). Various MR methodologies were utilized, such as inverse variance weighting (IVW), weighted median, and MR-Egger, to evaluate causality. Additionally, sensitivity analyses were conducted to evaluate the robustness of the findings.</p><h3>Results</h3><p>Genetically predicted higher FI (IVW, odds ratio [OR] = 1.66, 95% CI 1.17–2.36, <i>p</i> = 4.92E-03) was associated with a higher risk of LBP. As for the reverse direction, genetic liability to LBP showed consistent associations with a higher FI (IVW, OR = 1.13, 95% CI 1.07–1.19, <i>p</i> = 2.67E-05). The outcomes from various MR techniques and sensitivity analyses indicate the robustness of our findings.</p><h3>Conclusion</h3><p>Our research findings provide additional evidence bolstering the bidirectional causal relationship between frailty and LBP.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02843-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142212964","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 association between physical activity and delayed neurocognitive recovery in elderly patients: a mediation analysis of pro-inflammatory cytokines 体育锻炼与老年患者神经认知功能延迟恢复之间的关系:促炎症细胞因子的中介分析
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-11 DOI: 10.1007/s40520-024-02846-z
Junfang Niu, Yanan Li, Qi Zhou, Xiang Liu, Peixia Yu, Fang Gao, Xia Gao, Qiujun Wang

Background

Delayed neurocognitive recovery (dNCR) can result in unfavorable outcomes in elderly surgical patients. Physical activity (PA) has been shown to improve cognitive function, potentially by reducing systemic inflammatory responses. However, there is a lack of supportive data indicating whether PA has a protective effect against dNCR.

Aims

To examine the correlation between dNCR and PA, and to further analyze if pro-inflammatory cytokines mediate this relationship.

Methods

This study is a prospective nested case-control investigation of elderly patients who had knee replacement surgery. dNCR was defined as a decline in cognitive function compared with baseline by using a battery of neuropsychological tests. PA was assessed with the Physical Activity Scale for the Elderly (PASE). Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum concentrations of IL-6, IL-1β, and TNF-α. Multivariable logistic regression analysis was conducted to assess the association between PA and dNCR. Mediation analysis was employed to evaluate whether pro-inflammatory cytokines mediate the relationship between them.

Results

A cohort of 152 patients was included, resulting in an incidence rate of dNCR of 23.68%. PA was associated with dNCR after full adjustment [OR = 0.199, (95% CI, 0.061; 0.649), P = 0.007]. Mediation analysis showed that the IL-6 mediated the statistical association between PA and dNCR, with mediation proportions (%) of 77.68 (postoperative concentration of IL-6) or 27.58 (the absolute change in IL-6 before and after surgery).

Conclusions

PA serves as a protective factor against dNCR, possibly through the reduction of pro-inflammatory cytokine concentrations.

The Chinese Clinical Trail Registry

: www.http://chictr.org.cn, Registration No. ChiCTR2300070834, Registration date: April 24, 2023.

背景神经认知功能恢复延迟(dNCR)会导致老年手术患者的不良预后。体力活动(PA)已被证明可以改善认知功能,可能是通过减少全身炎症反应。本研究是一项前瞻性巢式病例对照调查,对象是接受过膝关节置换手术的老年患者。dNCR 的定义是通过一系列神经心理学测试得出的与基线相比认知功能下降的结果。老年人体力活动量表(PASE)对老年人的体力活动进行评估。酶联免疫吸附试验(ELISA)用于测量血清中 IL-6、IL-1β 和 TNF-α 的浓度。采用多变量逻辑回归分析评估 PA 与 dNCR 之间的关系。结果 共纳入 152 例患者,dNCR 发病率为 23.68%。经全面调整后,PA 与 dNCR 相关[OR = 0.199, (95% CI, 0.061; 0.649), P = 0.007]。中介分析显示,IL-6介导了PA与dNCR之间的统计学关联,中介比例(%)为77.68(术后IL-6的浓度)或27.58(手术前后IL-6的绝对变化)。结论PA是dNCR的保护因素,可能是通过降低促炎细胞因子的浓度。中国临床路径注册中心:www.http://chictr.org.cn,注册号:ChiCTR2300070834,注册日期:2023年4月24日。
{"title":"The association between physical activity and delayed neurocognitive recovery in elderly patients: a mediation analysis of pro-inflammatory cytokines","authors":"Junfang Niu,&nbsp;Yanan Li,&nbsp;Qi Zhou,&nbsp;Xiang Liu,&nbsp;Peixia Yu,&nbsp;Fang Gao,&nbsp;Xia Gao,&nbsp;Qiujun Wang","doi":"10.1007/s40520-024-02846-z","DOIUrl":"10.1007/s40520-024-02846-z","url":null,"abstract":"<div><h3>Background</h3><p>Delayed neurocognitive recovery (dNCR) can result in unfavorable outcomes in elderly surgical patients. Physical activity (PA) has been shown to improve cognitive function, potentially by reducing systemic inflammatory responses. However, there is a lack of supportive data indicating whether PA has a protective effect against dNCR.</p><h3>Aims</h3><p>To examine the correlation between dNCR and PA, and to further analyze if pro-inflammatory cytokines mediate this relationship.</p><h3>Methods</h3><p>This study is a prospective nested case-control investigation of elderly patients who had knee replacement surgery. dNCR was defined as a decline in cognitive function compared with baseline by using a battery of neuropsychological tests. PA was assessed with the Physical Activity Scale for the Elderly (PASE). Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum concentrations of IL-6, IL-1β, and TNF-α. Multivariable logistic regression analysis was conducted to assess the association between PA and dNCR. Mediation analysis was employed to evaluate whether pro-inflammatory cytokines mediate the relationship between them.</p><h3>Results</h3><p>A cohort of 152 patients was included, resulting in an incidence rate of dNCR of 23.68%. PA was associated with dNCR after full adjustment [OR = 0.199, (95% CI, 0.061; 0.649), <i>P</i> = 0.007]. Mediation analysis showed that the IL-6 mediated the statistical association between PA and dNCR, with mediation proportions (%) of 77.68 (postoperative concentration of IL-6) or 27.58 (the absolute change in IL-6 before and after surgery).</p><h3>Conclusions</h3><p>PA serves as a protective factor against dNCR, possibly through the reduction of pro-inflammatory cytokine concentrations.</p><h3>The Chinese Clinical Trail Registry</h3><p>: www.http://chictr.org.cn, Registration No. ChiCTR2300070834, Registration date: April 24, 2023.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02846-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142212965","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 pre-stroke frailty status and stroke risk and impact on outcomes: a systematic review and meta-analysis of 1,660,328 participants 中风前虚弱状态与中风风险之间的关系及其对预后的影响:对 1,660,328 名参与者的系统回顾和荟萃分析
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-11 DOI: 10.1007/s40520-024-02845-0
Shu-Fan Chen, Hai-Han Li, Zi-Ning Guo, Ke-Yu Ling, Xiao-Li Yu, Fei Liu, Xiao-Ping Zhu, Xiaoping Zhu

The prevalence of frailty is increasing, and it is associated with increased risk of diseases and adverse outcomes. Although substantial research has focused on post-stroke frailty, understanding of pre-stroke frailty remains limited. Our aim was to synthesize literature on pre-stroke frailty and stroke risk to explore their relationship and impact on prognosis. A systematic search of multiple databases was conducted to identify cohort studies published until October 28, 2023. Meta-analysis was conducted using a random effects model. Heterogeneity was assessed with the I² statistic, and publication bias was evaluated using Begg’s test. Finally, we included 11 studies (n = 1,660,328 participants). The pooled hazard ratios (HRs) for stroke risk associated with pre-stroke frailty compared to non-frail individuals was 1.72 (95% confidence interval, CI: 1.46–2.02, p = 0.002, I2 = 69.2%, Begg’s test: p = 0.536). The pooled HRs for mortality and the pooled relative risk (RRs) modified Rankin Scale (mRs) associated with pre-stroke frailty were 1.68 (95% CI: 1.10–2.56, p = 0.136, I2 = 49.9%, Begg’s test: p = 0.296) and 3.11 (95% CI: 1.77–5.46, p = 0.192, I2 = 39.4%, Begg’s test: p = 1.000), respectively. In conclusion, pre-stroke frailty is strongly associated with stroke risk and impacts its prognosis, irrespective of the measurement method. Future research should focus on prospective studies to assess the effects of early intervention for frailty. This has significant implications for primary healthcare services and frailty management.

虚弱症的发病率在不断上升,它与疾病和不良后果的风险增加有关。尽管大量研究都集中在中风后虚弱方面,但对中风前虚弱的了解仍然有限。我们的目的是综合有关中风前虚弱和中风风险的文献,探讨它们之间的关系及其对预后的影响。我们对多个数据库进行了系统检索,以确定截至 2023 年 10 月 28 日发表的队列研究。采用随机效应模型进行了元分析。用 I² 统计量评估异质性,用 Begg's 检验评估发表偏倚。最后,我们纳入了 11 项研究(n = 1,660,328 名参与者)。与非虚弱个体相比,与卒中前虚弱相关的卒中风险的汇总危险比(HRs)为 1.72(95% 置信区间,CI:1.46-2.02,P = 0.002,I2 = 69.2%,Begg 检验:P = 0.536)。与卒中前虚弱相关的死亡率汇总 HRs 和修正 Rankin 量表(mRs)汇总相对风险 (RRs) 分别为 1.68(95% CI:1.10-2.56,p = 0.136,I2 = 49.9%,Begg 检验:p = 0.296)和 3.11(95% CI:1.77-5.46,p = 0.192,I2 = 39.4%,Begg 检验:p = 1.000)。总之,无论采用哪种测量方法,卒中前虚弱都与卒中风险密切相关并影响其预后。未来的研究应侧重于前瞻性研究,以评估早期干预虚弱的效果。这对初级医疗保健服务和虚弱管理具有重要意义。
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引用次数: 0
Prevalence and future estimates of frailty and pre-frailty in a population-based sample of people 70 years and older in Norway: the HUNT study 挪威 70 岁及以上人口样本中虚弱和虚弱前期的发生率和未来估计值:HUNT 研究
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-10 DOI: 10.1007/s40520-024-02839-y
Ingebjørg Lavrantsdatter Kyrdalen, Bjørn Heine Strand, Geir Selbæk, Pernille Thingstad, Heidi Ormstad, Emiel O. Hoogendijk, Håvard Kjesbu Skjellegrind, Gro Gujord Tangen

Background

Frailty in older people is a rising global health concern; therefore, monitoring prevalence estimates and presenting projections of future frailty are important for healthcare planning.

Aim

To present current prevalence estimates of frailty and pre-frailty and future projections according to both dominant frailty models in a large population-based observational study including adults ≥ 70 years in Norway.

Methods

In this population-based observational study, we included 9956 participants from the HUNT4 70 + study, conducting assessments at field stations, homes, and nursing homes. Frailty was assessed using Fried criteria and a 35-item frailty index (HUNT4-FI). Inverse probability weighting and calibration using post-stratification weights and aggregated register data for Norway according to age, sex, and education ensured representativeness, and population projection models were used to estimate future prevalence.

Results

According to Fried criteria, the current prevalence rates of frailty and pre-frailty in people ≥ 70 years were 10.6% and 41.9%, respectively, and for HUNT4-FI 35.8% and 33.2%, respectively. Compared to previous European estimates we identified higher overall frailty prevalence, but lower prevalence in younger age groups. Projections suggest the number of Norwegian older adults living with frailty will close to double by 2040.

Conclusion

Frailty in older people in Norway is more prevalent than previous European estimates, emphasising the imperative for effective interventions aimed to delay and postpone frailty and ensure healthcare system sustainability in an ageing population. Future planning should consider the great heterogeneity in health and functioning within the 70 + population.

背景老年人体弱是全球日益关注的健康问题;因此,监测患病率估计值和预测未来的体弱情况对于医疗保健规划非常重要。方法在这项基于人群的观察性研究中,我们纳入了 HUNT4 70 + 研究的 9956 名参与者,在现场站、家庭和养老院进行评估。采用弗里德标准和 35 项虚弱指数(HUNT4-FI)对虚弱程度进行评估。结果根据弗里德标准,目前挪威≥70岁人群的虚弱率和前期虚弱率分别为10.6%和41.9%,HUNT4-FI分别为35.8%和33.2%。与欧洲以往的估计值相比,我们发现总体虚弱患病率较高,但年轻年龄组的患病率较低。预测表明,到2040年,挪威患有虚弱症的老年人数量将翻一番。 结论:挪威老年人虚弱症的发病率高于欧洲的估计值,这表明必须采取有效的干预措施,以延缓和推迟虚弱症的发生,并确保医疗保健系统在人口老龄化过程中的可持续性。未来的规划应考虑到70岁以上人口在健康和功能方面的巨大差异。
{"title":"Prevalence and future estimates of frailty and pre-frailty in a population-based sample of people 70 years and older in Norway: the HUNT study","authors":"Ingebjørg Lavrantsdatter Kyrdalen,&nbsp;Bjørn Heine Strand,&nbsp;Geir Selbæk,&nbsp;Pernille Thingstad,&nbsp;Heidi Ormstad,&nbsp;Emiel O. Hoogendijk,&nbsp;Håvard Kjesbu Skjellegrind,&nbsp;Gro Gujord Tangen","doi":"10.1007/s40520-024-02839-y","DOIUrl":"10.1007/s40520-024-02839-y","url":null,"abstract":"<div><h3>Background</h3><p>Frailty in older people is a rising global health concern; therefore, monitoring prevalence estimates and presenting projections of future frailty are important for healthcare planning.</p><h3>Aim</h3><p>To present current prevalence estimates of frailty and pre-frailty and future projections according to both dominant frailty models in a large population-based observational study including adults ≥ 70 years in Norway.</p><h3>Methods</h3><p>In this population-based observational study, we included 9956 participants from the HUNT4 70 + study, conducting assessments at field stations, homes, and nursing homes. Frailty was assessed using Fried criteria and a 35-item frailty index (HUNT4-FI). Inverse probability weighting and calibration using post-stratification weights and aggregated register data for Norway according to age, sex, and education ensured representativeness, and population projection models were used to estimate future prevalence.</p><h3>Results</h3><p>According to Fried criteria, the current prevalence rates of frailty and pre-frailty in people ≥ 70 years were 10.6% and 41.9%, respectively, and for HUNT4-FI 35.8% and 33.2%, respectively. Compared to previous European estimates we identified higher overall frailty prevalence, but lower prevalence in younger age groups. Projections suggest the number of Norwegian older adults living with frailty will close to double by 2040.</p><h3>Conclusion</h3><p>Frailty in older people in Norway is more prevalent than previous European estimates, emphasising the imperative for effective interventions aimed to delay and postpone frailty and ensure healthcare system sustainability in an ageing population. Future planning should consider the great heterogeneity in health and functioning within the 70 + population.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02839-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142212968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Aging Clinical and Experimental Research
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