首页 > 最新文献

Aging Clinical and Experimental Research最新文献

英文 中文
Agreement between bioelectrical impedance analysis and equation-derived estimates of appendicular skeletal muscle in acutely hospitalized multiethnic older patients 多民族急性住院老年患者阑尾骨骼肌的生化阻抗分析与方程推导估计的一致性。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-16 DOI: 10.1007/s40520-025-03283-2
Yang Liu, Li Feng Tan, Reshma Aziz Merchant

Background

Accurate assessment of appendicular skeletal muscle (ASM) is essential for diagnosing sarcopenia. While bioelectrical impedance analysis (BIA) is widely used, equation-derived estimates may be useful when device-based methods are unavailable. We evaluated agreement between BIA-measured ASM and two equations: the COCONUT Study Group formula (NHANES-based) and the Japanese equation by Furushima et al.

Methods

We conducted a cross-sectional study of hospitalized, multiethnic older adults in Singapore (n = 295). ASM was measured using multi-frequency BIA S10. Equation-derived ASM was calculated using calf circumference, age, and sex (COCONUT) or age, anthropometry, and handgrip strength (HGS; Furushima). Agreement with BIA was assessed by Lin’s concordance correlation coefficient (CCC) and Bland-Altman analysis. Diagnostic agreement for low appendicular skeletal muscle mass index (ASMI; AWGS 2019 cut-offs) was evaluated with Cohen’s κ and area under the receiver operating characteristic curve (AUC). Analyses were stratified by sex and obesity.

Results

Furushima’s equation showed stronger concordance with BIA than COCONUT (CCC 0.696 vs. 0.538) and smaller underestimate bias (1.56 vs. 3.03 kg). For low ASMI, Furushima achieved moderate agreement (κ = 0.48; AUC = 0.78) compared with poor agreement for COCONUT (κ = 0.17; AUC = 0.62). COCONUT performed poorly among women (CCC = 0.192; bias 4.40 kg), whereas Furushima improved performance but remained low overall (CCC = 0.371). Among obese patients, Furushima demonstrated the highest concordance (CCC = 0.862; bias 0.42 kg).

Conclusions

Furushima’s equation aligns better with BIA-measured ASM than COCONUT and may complement HGS in sarcopenia screening. Equation-based estimation could aid risk stratification when BIA is unavailable, though subgroup-specific biases require caution.

背景:准确评估阑尾骨骼肌(ASM)对诊断肌肉减少症至关重要。虽然生物电阻抗分析(BIA)被广泛使用,但当基于设备的方法不可用时,方程推导的估计可能是有用的。我们评估了bia测量的ASM与两个方程之间的一致性:COCONUT Study Group公式(基于nhanes)和Furushima等人的日本方程。方法:我们对新加坡住院的多民族老年人进行了一项横断面研究(n = 295)。ASM采用多频BIA S10测量。公式导出的ASM通过小腿围、年龄和性别(COCONUT)或年龄、人体测量和握力(HGS; Furushima)来计算。采用Lin’s一致性相关系数(CCC)和Bland-Altman分析评估与BIA的一致性。采用Cohen’s κ和受试者工作特征曲线下面积(AUC)评估低阑尾骨骼肌质量指数(ASMI; AWGS 2019截止值)的诊断一致性。分析按性别和肥胖程度分层。结果:Furushima方程与BIA的一致性较COCONUT方程强(CCC 0.696比0.538),低估偏差较小(1.56比3.03 kg)。对于低ASMI, Furushima达到中等一致性(κ = 0.48, AUC = 0.78),而COCONUT的一致性较差(κ = 0.17, AUC = 0.62)。椰子在女性中表现不佳(CCC = 0.192;偏差4.40 kg),而古岛改善了表现,但总体上仍然很低(CCC = 0.371)。在肥胖患者中,Furushima的一致性最高(CCC = 0.862,偏差0.42 kg)。结论:Furushima方程与bia测量的ASM比COCONUT更符合,可以补充HGS在肌少症筛查中的应用。当BIA无法获得时,基于方程的估计有助于风险分层,但亚组特异性偏倚需要谨慎。
{"title":"Agreement between bioelectrical impedance analysis and equation-derived estimates of appendicular skeletal muscle in acutely hospitalized multiethnic older patients","authors":"Yang Liu,&nbsp;Li Feng Tan,&nbsp;Reshma Aziz Merchant","doi":"10.1007/s40520-025-03283-2","DOIUrl":"10.1007/s40520-025-03283-2","url":null,"abstract":"<div><h3>Background</h3><p>Accurate assessment of appendicular skeletal muscle (ASM) is essential for diagnosing sarcopenia. While bioelectrical impedance analysis (BIA) is widely used, equation-derived estimates may be useful when device-based methods are unavailable. We evaluated agreement between BIA-measured ASM and two equations: the COCONUT Study Group formula (NHANES-based) and the Japanese equation by Furushima et al.</p><h3>Methods</h3><p>We conducted a cross-sectional study of hospitalized, multiethnic older adults in Singapore (<i>n</i> = 295). ASM was measured using multi-frequency BIA S10. Equation-derived ASM was calculated using calf circumference, age, and sex (COCONUT) or age, anthropometry, and handgrip strength (HGS; Furushima). Agreement with BIA was assessed by Lin’s concordance correlation coefficient (CCC) and Bland-Altman analysis. Diagnostic agreement for low appendicular skeletal muscle mass index (ASMI; AWGS 2019 cut-offs) was evaluated with Cohen’s κ and area under the receiver operating characteristic curve (AUC). Analyses were stratified by sex and obesity.</p><h3>Results</h3><p>Furushima’s equation showed stronger concordance with BIA than COCONUT (CCC 0.696 vs. 0.538) and smaller underestimate bias (1.56 vs. 3.03 kg). For low ASMI, Furushima achieved moderate agreement (κ = 0.48; AUC = 0.78) compared with poor agreement for COCONUT (κ = 0.17; AUC = 0.62). COCONUT performed poorly among women (CCC = 0.192; bias 4.40 kg), whereas Furushima improved performance but remained low overall (CCC = 0.371). Among obese patients, Furushima demonstrated the highest concordance (CCC = 0.862; bias 0.42 kg).</p><h3>Conclusions</h3><p>Furushima’s equation aligns better with BIA-measured ASM than COCONUT and may complement HGS in sarcopenia screening. Equation-based estimation could aid risk stratification when BIA is unavailable, though subgroup-specific biases require caution.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03283-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145987875","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
Reducing muscle weakness in nursing home residents: a study quantifying acceptance and feasibility of a formal training algorithm, and reliability of endpoint measures. 减少养老院居民的肌肉无力:一项量化正式训练算法的接受度和可行性以及终点测量可靠性的研究。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-15 DOI: 10.1007/s40520-025-03319-7
Jonas Böcker, Ludwig Sachs, Michael Drey, Claudia Kaiser-Stolz, Wilhelm Bloch, Anja Dekant, Jörn Rittweger

Background: Sarcopenia is a growing problem, especially in nursing care. It is therefore mandatory to integrate measures such as resistance training to maintain muscle strength into nursing care.

Aims: The aim of this study was to investigate the acceptance and feasibility of a novel training algorithm in a nursing home environment. Furthermore, the reliability of measurements for the diagnosis of sarcopenia was tested in the nursing home setting.

Methods: Twenty-eight nursing home residents took part in the study, which encompassed two pre- and two post-examinations and a four-week training intervention. The training sessions were documented with regard to acceptance and feasibility as well as training motivation and intensity.

Results: A combined acceptance and feasibility of at least 54% was shown, quantifying adherence of the residents to the training. The operational feasibility was 91% and the exercise performance feasibility of the residents was between 88% and 94.2%. All intraclass correlation coefficients showed at least a good reliability (all ≥ 0.84). Training motivation was higher when participants trained in a group (p = 0.007), but training intensity was greater when they trained individually (p < 0.001).

Discussion: The main influencing factors for acceptance and feasibility were illness in general and a lack of motivation by the residents. Against the assumption, training was also possible during the weekends.

Conclusions: In conclusion, the study shows that our proposed training algorithm is acceptable and feasible in a nursing home environment. In future, the efficacy of the training needs to be shown.

Trial registration number: DRKS00030211; Date of registration: 2022-09-12.

背景:肌少症是一个日益严重的问题,特别是在护理中。因此,必须将阻力训练等保持肌肉力量的措施整合到护理中。目的:本研究的目的是探讨一种新的训练算法在养老院环境中的接受度和可行性。此外,测量的可靠性诊断肌肉减少症是在养老院设置进行了测试。方法:28名养老院居民参加了这项研究,其中包括两次前检查和两次后检查以及为期四周的培训干预。培训课程在接受度和可行性以及培训动机和强度方面都有记录。结果:综合接受度和可行性至少为54%,量化了住院医生对培训的依从性。操作可行性为91%,居民运动绩效可行性在88% ~ 94.2%之间。所有类内相关系数均显示至少良好的信度(均≥0.84)。参与者在集体训练时训练动机更高(p = 0.007),而单独训练时训练强度更大(p)。讨论:影响接受度和可行性的主要因素是普遍疾病和住院医师缺乏动机。与假设相反,训练也可以在周末进行。结论:综上所述,研究表明我们提出的训练算法在养老院环境中是可以接受和可行的。在未来,培训的效果需要显示出来。试验注册号:DRKS00030211;注册日期:2022-09-12。
{"title":"Reducing muscle weakness in nursing home residents: a study quantifying acceptance and feasibility of a formal training algorithm, and reliability of endpoint measures.","authors":"Jonas Böcker, Ludwig Sachs, Michael Drey, Claudia Kaiser-Stolz, Wilhelm Bloch, Anja Dekant, Jörn Rittweger","doi":"10.1007/s40520-025-03319-7","DOIUrl":"10.1007/s40520-025-03319-7","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is a growing problem, especially in nursing care. It is therefore mandatory to integrate measures such as resistance training to maintain muscle strength into nursing care.</p><p><strong>Aims: </strong>The aim of this study was to investigate the acceptance and feasibility of a novel training algorithm in a nursing home environment. Furthermore, the reliability of measurements for the diagnosis of sarcopenia was tested in the nursing home setting.</p><p><strong>Methods: </strong>Twenty-eight nursing home residents took part in the study, which encompassed two pre- and two post-examinations and a four-week training intervention. The training sessions were documented with regard to acceptance and feasibility as well as training motivation and intensity.</p><p><strong>Results: </strong>A combined acceptance and feasibility of at least 54% was shown, quantifying adherence of the residents to the training. The operational feasibility was 91% and the exercise performance feasibility of the residents was between 88% and 94.2%. All intraclass correlation coefficients showed at least a good reliability (all ≥ 0.84). Training motivation was higher when participants trained in a group (p = 0.007), but training intensity was greater when they trained individually (p < 0.001).</p><p><strong>Discussion: </strong>The main influencing factors for acceptance and feasibility were illness in general and a lack of motivation by the residents. Against the assumption, training was also possible during the weekends.</p><p><strong>Conclusions: </strong>In conclusion, the study shows that our proposed training algorithm is acceptable and feasible in a nursing home environment. In future, the efficacy of the training needs to be shown.</p><p><strong>Trial registration number: </strong>DRKS00030211; Date of registration: 2022-09-12.</p>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":" ","pages":"68"},"PeriodicalIF":3.4,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12886320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145987956","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 proton pump inhibitor use and muscle mass: a US population-based study. 质子泵抑制剂的使用与肌肉质量之间的关系:一项基于美国人群的研究。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-14 DOI: 10.1007/s40520-025-03311-1
Guang Xiong, Liwei Li, Haiyuan Zhong, Chunli Chen, Lingdan Ma, Chunmei Liang, Min Liang, Yuling He
{"title":"Association between proton pump inhibitor use and muscle mass: a US population-based study.","authors":"Guang Xiong, Liwei Li, Haiyuan Zhong, Chunli Chen, Lingdan Ma, Chunmei Liang, Min Liang, Yuling He","doi":"10.1007/s40520-025-03311-1","DOIUrl":"10.1007/s40520-025-03311-1","url":null,"abstract":"","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":" ","pages":"66"},"PeriodicalIF":3.4,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965070","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
Hospital at home for older frequent hospital users: present and future of a healthcare challenge 为经常住院的老年人提供的家庭医院:医疗保健挑战的现在和未来。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-14 DOI: 10.1007/s40520-025-03301-3
Enrico Mossello, Giulia Rivasi, Antonella Giordano, Sofia Espinoza Tofalos, Martina Rafanelli, Chiara Lorenzi, Vanni Corsoni, Matilde D’Ambrosi, Flavia Gabellini, Matteo Bulgaresi, Guglielmo Bonaccorsi, Enrico Benvenuti, Maria Chiara Cavallini, Daniela Matarrese, Andrea Ungar

Background

Frequent hospital users (FHUs) show high risk of clinical instability. A hospital-at-home (HaH) service (“GIROT”) was created in Florence, Italy, to reduce hospitalizations in older adults vulnerable to hospital-related complications.

Aim

To investigate the association of frequent hospital use with all-cause mortality and hospitalization among HaH patients.

Methods

patients referred to GIROT between January 2022 and March 2024, participated in a prospective longitudinal study. Participants were stratified by prior-year hospital admissions (0–1, 2, and 3+) and FHUs were defined based on the association between admissions and risks of subsequent hospitalization and mortality. Multivariate Cox regression assessed the independent association between FHU status and outcomes.

Results

Among 219 patients (mean age 85.9, 55% female, 44% with severe disability), the median number of hospitalizations in the previous year was 2. Over a 6-month follow-up, mortality risk was 43% and hospitalization risk was 39%. Six-month mortality was higher in subjects with 2 (58%) and 3 + admissions (48%) versus 0–1 admissions (32%), with similar patterns for hospitalization. These findings led to defining FHUs as individuals with 2 + prior hospitalizations. Shorter time-to-death was independently associated with weight loss, severe disability, heart failure with reduced ejection fraction (HFrEF), and FHU status (adjHR 1.49, 95%CI 1.00-2.21). Time-to-hospitalization was independently predicted by HFrEF and FHU status (adjHR 1.80, 95%CI 1.08–3.01).

Conclusions

FHUs (i.e., 2 + hospitalizations in the previous year) showed an increased risk of re-admission and mortality among older adults receiving HaH. Extra-hospital care pathways, including HaH and palliative care, may help reduce admissions in this population.

Graphical Abstract

背景:频繁的医院使用者(FHUs)具有较高的临床不稳定风险。意大利佛罗伦萨创建了一项居家医院服务(" GIROT "),以减少易患医院相关并发症的老年人的住院率。目的探讨高血压患者频繁住院与全因死亡率和住院率的关系。方法在2022年1月至2024年3月期间纳入GIROT的患者参与了一项前瞻性纵向研究。参与者按前一年的住院情况(0-1、2和3+)进行分层,并根据入院与随后住院和死亡风险之间的关系定义fhu。多变量Cox回归评估FHU状态与预后之间的独立关联。结果219例患者中,前一年住院次数中位数为2次,平均年龄85.9岁,女性55%,重度残疾44%。随访6个月后,死亡风险为43%,住院风险为39%。入院2次(58%)和入院3次以上(48%)的受试者6个月死亡率高于入院0-1次(32%)的受试者,住院模式相似。这些发现导致将FHUs定义为既往住院2次以上的个体。较短的死亡时间与体重减轻、严重残疾、心力衰竭伴射血分数降低(HFrEF)和FHU状态独立相关(adjHR 1.49, 95%CI 1.00-2.21)。HFrEF和FHU状态独立预测住院时间(adjHR 1.80, 95%CI 1.08-3.01)。结论sfhus(即前一年住院2次以上)在接受HaH治疗的老年人中再次入院和死亡的风险增加。院外护理途径,包括HaH和姑息治疗,可能有助于减少这一人群的入院率。图形抽象
{"title":"Hospital at home for older frequent hospital users: present and future of a healthcare challenge","authors":"Enrico Mossello,&nbsp;Giulia Rivasi,&nbsp;Antonella Giordano,&nbsp;Sofia Espinoza Tofalos,&nbsp;Martina Rafanelli,&nbsp;Chiara Lorenzi,&nbsp;Vanni Corsoni,&nbsp;Matilde D’Ambrosi,&nbsp;Flavia Gabellini,&nbsp;Matteo Bulgaresi,&nbsp;Guglielmo Bonaccorsi,&nbsp;Enrico Benvenuti,&nbsp;Maria Chiara Cavallini,&nbsp;Daniela Matarrese,&nbsp;Andrea Ungar","doi":"10.1007/s40520-025-03301-3","DOIUrl":"10.1007/s40520-025-03301-3","url":null,"abstract":"<div><h3>Background</h3><p>Frequent hospital users (FHUs) show high risk of clinical instability. A hospital-at-home (HaH) service (“GIROT”) was created in Florence, Italy, to reduce hospitalizations in older adults vulnerable to hospital-related complications.</p><h3>Aim</h3><p>To investigate the association of frequent hospital use with all-cause mortality and hospitalization among HaH patients.</p><h3>Methods</h3><p>patients referred to GIROT between January 2022 and March 2024, participated in a prospective longitudinal study. Participants were stratified by prior-year hospital admissions (0–1, 2, and 3+) and FHUs were defined based on the association between admissions and risks of subsequent hospitalization and mortality. Multivariate Cox regression assessed the independent association between FHU status and outcomes.</p><h3>Results</h3><p>Among 219 patients (mean age 85.9, 55% female, 44% with severe disability), the median number of hospitalizations in the previous year was 2. Over a 6-month follow-up, mortality risk was 43% and hospitalization risk was 39%. Six-month mortality was higher in subjects with 2 (58%) and 3 + admissions (48%) versus 0–1 admissions (32%), with similar patterns for hospitalization. These findings led to defining FHUs as individuals with 2 + prior hospitalizations. Shorter time-to-death was independently associated with weight loss, severe disability, heart failure with reduced ejection fraction (HFrEF), and FHU status (adjHR 1.49, 95%CI 1.00-2.21). Time-to-hospitalization was independently predicted by HFrEF and FHU status (adjHR 1.80, 95%CI 1.08–3.01).</p><h3>Conclusions</h3><p>FHUs (i.e., 2 + hospitalizations in the previous year) showed an increased risk of re-admission and mortality among older adults receiving HaH. Extra-hospital care pathways, including HaH and palliative care, may help reduce admissions in this population.</p><h3>Graphical Abstract</h3><div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03301-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965110","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
Prevalence and predictive factors of cognitive impairment among hospitalized older adults in iran: a cross-sectional study, 2024 伊朗住院老年人认知障碍的患病率和预测因素:一项横断面研究,2024。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-13 DOI: 10.1007/s40520-025-03299-8
Zahra Hadadian, Mohammad-Sajjad Lotfi, Zahra Rezaei-Shahsavarloo

Background

Cognitive frailty (CF), defined by the IANA/IAGG criteria as the coexistence of physical frailty and cognitive impairment without dementia, is an emerging geriatric syndrome associated with disability and adverse health outcomes.

Aims

This study aimed to estimate the prevalence of CF and develop a prediction model among hospitalized older adults in Iran.

Methods

A cross-sectional survey was conducted on 300 patients aged ≥ 60 years admitted to Shahid-Beheshti Hospital, Kashan, between July and September 2024. Data were collected using structured interviews incorporating the Fried Frailty Phenotype, the Clinical Dementia Rating Scale, and a researcher-developed tool assessing demographic, clinical, nutritional, psychosocial, and economic factors. Descriptive statistics and multivariable logistic regression (backward method) were applied.

Results

The mean age of participants was 71.8 ± 8.0 years, and 54.3% were male. The prevalence of CF and potentially CF was 22.7% and 23%, respectively. Protective factors included positive self-rated health (OR = 0.179), non-smoking (OR = 0.150), higher handgrip strength (OR = 0.798), good nutritional status (OR = 0.330), larger mid-upper arm and calf circumferences, and adequate appetite (OR = 0.107). Conversely, higher BMI (OR = 1.315), physical inactivity (OR = 5.966), diabetes (OR = 3.692), comorbidities (OR = 8.77), frequent physician visits (OR = 6.974), stressful life events (OR = 4.764), and poor economic status (OR = 2.724) were associated with increased risk. The model demonstrated strong predictive validity (Nagelkerke R²=0.678; Specificity = 0.921).

Conclusions

CF is prevalent among hospitalized older adults in Iran and is strongly influenced by modifiable factors. Early detection and multidomain interventions—targeting nutrition, physical activity, chronic disease control, and psychosocial well-being—may prevent CF and improve quality of life in this vulnerable group.

背景:认知衰弱(CF)被IANA/IAGG标准定义为身体虚弱和认知障碍共存,但不伴有痴呆,是一种与残疾和不良健康结果相关的新兴老年综合征。目的:本研究旨在估计CF在伊朗住院老年人中的患病率并建立预测模型。方法:对2024年7月至9月在喀山市Shahid-Beheshti医院住院的300例年龄≥60岁的患者进行横断面调查。数据通过结构化访谈收集,包括Fried脆弱表型、临床痴呆评定量表和研究人员开发的评估人口统计学、临床、营养、社会心理和经济因素的工具。采用描述性统计和多变量logistic回归(后向法)。结果:参与者平均年龄为71.8±8.0岁,男性占54.3%。CF和潜在CF的患病率分别为22.7%和23%。保护因素包括积极的自评健康(OR = 0.179)、不吸烟(OR = 0.150)、较高的握力(OR = 0.798)、良好的营养状况(OR = 0.330)、较大的上臂和小腿围以及充足的食欲(OR = 0.107)。相反,较高的BMI (OR = 1.315)、缺乏运动(OR = 5.966)、糖尿病(OR = 3.692)、合并症(OR = 8.77)、频繁就医(OR = 6.974)、生活压力事件(OR = 4.764)和经济状况不佳(OR = 2.724)与风险增加相关。该模型具有较强的预测效度(Nagelkerke R²=0.678;特异性= 0.921)。结论:CF在伊朗住院的老年人中普遍存在,并受到可改变因素的强烈影响。早期发现和多领域干预——针对营养、身体活动、慢性疾病控制和社会心理健康——可能预防CF并改善这一弱势群体的生活质量。
{"title":"Prevalence and predictive factors of cognitive impairment among hospitalized older adults in iran: a cross-sectional study, 2024","authors":"Zahra Hadadian,&nbsp;Mohammad-Sajjad Lotfi,&nbsp;Zahra Rezaei-Shahsavarloo","doi":"10.1007/s40520-025-03299-8","DOIUrl":"10.1007/s40520-025-03299-8","url":null,"abstract":"<div><h3>Background</h3><p>Cognitive frailty (CF), defined by the IANA/IAGG criteria as the coexistence of physical frailty and cognitive impairment without dementia, is an emerging geriatric syndrome associated with disability and adverse health outcomes.</p><h3>Aims</h3><p>This study aimed to estimate the prevalence of CF and develop a prediction model among hospitalized older adults in Iran.</p><h3>Methods</h3><p>A cross-sectional survey was conducted on 300 patients aged ≥ 60 years admitted to Shahid-Beheshti Hospital, Kashan, between July and September 2024. Data were collected using structured interviews incorporating the Fried Frailty Phenotype, the Clinical Dementia Rating Scale, and a researcher-developed tool assessing demographic, clinical, nutritional, psychosocial, and economic factors. Descriptive statistics and multivariable logistic regression (backward method) were applied.</p><h3>Results</h3><p>The mean age of participants was 71.8 ± 8.0 years, and 54.3% were male. The prevalence of CF and potentially CF was 22.7% and 23%, respectively. Protective factors included positive self-rated health (OR = 0.179), non-smoking (OR = 0.150), higher handgrip strength (OR = 0.798), good nutritional status (OR = 0.330), larger mid-upper arm and calf circumferences, and adequate appetite (OR = 0.107). Conversely, higher BMI (OR = 1.315), physical inactivity (OR = 5.966), diabetes (OR = 3.692), comorbidities (OR = 8.77), frequent physician visits (OR = 6.974), stressful life events (OR = 4.764), and poor economic status (OR = 2.724) were associated with increased risk. The model demonstrated strong predictive validity (Nagelkerke R²=0.678; Specificity = 0.921).</p><h3>Conclusions</h3><p>CF is prevalent among hospitalized older adults in Iran and is strongly influenced by modifiable factors. Early detection and multidomain interventions—targeting nutrition, physical activity, chronic disease control, and psychosocial well-being—may prevent CF and improve quality of life in this vulnerable group.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03299-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145958366","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
Prevalence, influencing factors, and dementia outcome of sarcopenic obesity in China 中国肌肉减少型肥胖的患病率、影响因素和痴呆转归。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-13 DOI: 10.1007/s40520-025-03318-8
Xianzhi Li, Yajie Li, Meiying Shen, Zonglei Zhou, Shunjin Liu, Li Yin, Qian Zhu, Xiangyi Xing

Background

This study examines the epidemiology of sarcopenic obesity (SO) in China, focusing on national prevalence, modifiable influencing factors, and its longitudinal association with dementia risk in middle-aged and older adults.

Methods

Using the 2015 wave of the China Health and Retirement Longitudinal Study (CHARLS), SO prevalence was estimated nationally and regionally using Bayesian spatial modeling. Modifiable influencing factors were identified via multivariable logistic regression, with their relative contributions quantified using Extreme Gradient Boosting (XGBoost). The association between baseline SO (2015) and incident dementia risk (2018) was assessed using multivariable logistic regression.

Results

Among 10,256 participants aged ≥ 45 years, the national SO prevalence was 6.40% (95% Bayesian confidence intervals [BCIs]: 6.39–6.41%), with significant regional variation (Northern region: 8.60% [8.59–8.61%]; Southern region: 4.90% [4.86–4.94%]). Older age, female sex, hypertension, and depressive symptoms showed statistically significant associations with SO. Age emerged as the strongest predictor in XGBoost analysis. Compared to normal-weight individuals without sarcopenia, those with normal-weight sarcopenia had 63% higher dementia risk (odds ratio [OR] = 1.63; 95% confidence interval [CI]: 1.04–2.58), while SO individuals showed 89% increased risk (OR = 1.89; 95% CI: 1.67–2.15).

Conclusion

These findings emphasize the significant geographic disparity in SO prevalence across China and reveal that SO is associated with a substantially elevated risk of dementia, underscoring the need for targeted interventions in aging populations.

背景:本研究考察了中国肌肉减少性肥胖(SO)的流行病学,重点关注中老年人的全国患病率、可改变的影响因素及其与痴呆风险的纵向关联。方法:利用2015年中国健康与退休纵向研究(CHARLS)的数据,采用贝叶斯空间模型估计全国和区域的SO患病率。通过多变量逻辑回归确定可改变的影响因素,并使用极端梯度提升(XGBoost)量化其相对贡献。使用多变量逻辑回归评估基线SO(2015年)与痴呆发生率风险(2018年)之间的关系。结果:在10256名年龄≥45岁的参与者中,全国SO患病率为6.40%(95%贝叶斯置信区间[bci]: 6.39 ~ 6.41%),地区差异显著(北部地区:8.60%[8.59 ~ 8.61%],南部地区:4.90%[4.86 ~ 4.94%])。年龄较大、女性、高血压和抑郁症状与SO有统计学显著相关。在XGBoost分析中,年龄是最强的预测因子。与没有肌肉减少症的体重正常的个体相比,体重正常的肌肉减少症患者痴呆风险增加63%(比值比[OR] = 1.63; 95%可信区间[CI]: 1.04-2.58),而体重正常的个体痴呆风险增加89% (OR = 1.89; 95%可信区间[CI]: 1.67-2.15)。结论:这些发现强调了中国SO患病率的显著地域差异,并揭示了SO与痴呆风险的显著升高有关,强调了对老龄化人群进行有针对性干预的必要性。
{"title":"Prevalence, influencing factors, and dementia outcome of sarcopenic obesity in China","authors":"Xianzhi Li,&nbsp;Yajie Li,&nbsp;Meiying Shen,&nbsp;Zonglei Zhou,&nbsp;Shunjin Liu,&nbsp;Li Yin,&nbsp;Qian Zhu,&nbsp;Xiangyi Xing","doi":"10.1007/s40520-025-03318-8","DOIUrl":"10.1007/s40520-025-03318-8","url":null,"abstract":"<div><h3>Background</h3><p>This study examines the epidemiology of sarcopenic obesity (SO) in China, focusing on national prevalence, modifiable influencing factors, and its longitudinal association with dementia risk in middle-aged and older adults.</p><h3>Methods</h3><p>Using the 2015 wave of the China Health and Retirement Longitudinal Study (CHARLS), SO prevalence was estimated nationally and regionally using Bayesian spatial modeling. Modifiable influencing factors were identified via multivariable logistic regression, with their relative contributions quantified using Extreme Gradient Boosting (XGBoost). The association between baseline SO (2015) and incident dementia risk (2018) was assessed using multivariable logistic regression.</p><h3>Results</h3><p>Among 10,256 participants aged ≥ 45 years, the national SO prevalence was 6.40% (95% Bayesian confidence intervals [BCIs]: 6.39–6.41%), with significant regional variation (Northern region: 8.60% [8.59–8.61%]; Southern region: 4.90% [4.86–4.94%]). Older age, female sex, hypertension, and depressive symptoms showed statistically significant associations with SO. Age emerged as the strongest predictor in XGBoost analysis. Compared to normal-weight individuals without sarcopenia, those with normal-weight sarcopenia had 63% higher dementia risk (odds ratio [OR] = 1.63; 95% confidence interval [CI]: 1.04–2.58), while SO individuals showed 89% increased risk (OR = 1.89; 95% CI: 1.67–2.15).</p><h3>Conclusion</h3><p>These findings emphasize the significant geographic disparity in SO prevalence across China and reveal that SO is associated with a substantially elevated risk of dementia, underscoring the need for targeted interventions in aging populations.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03318-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965045","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
Nutritional screening tools as predictors of surgical outcomes in geriatric orthopedic patients: a meta-analysis 营养筛查工具作为老年骨科患者手术结果的预测因素:一项荟萃分析。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-13 DOI: 10.1007/s40520-025-03306-y
Doudou Li, Jiana Shi, Jiaqi Zheng, Ying Hu

Background

The prevalent preoperative nutritional evaluations in surgical settings tend to rely on isolated biochemical parameters, such as albumin levels, which demonstrate limited precision in forecasting postoperative complications and mortality rate. The primary objective of this study is to evaluate the predictive accuracy of nutrition screening tools in identifying postoperative risks and mortality in various orthopedic surgeries, and to determine which tools are the most reliable.

Methods

A comprehensive search was conducted in PubMed, CNKI, EMBASE, and Cochrane Central databases for studies on the relationship between nutritional status and postoperative outcomes in older orthopedic surgery patients. The search period was from the establishment of the databases to May 2025. Subgroup analyses evaluated the impact of various factors on outcomes. Meta-regression was performed to further explore heterogeneity.

Results

The current investigation encompasses 11 studies, inclusive of 201,338 geriatric orthopedic surgery patients. The result showed that malnutrition assessed by nutrition screening tools was significantly associated with postoperative complications (RR = 1.65, 95% CI: 1.26–2.15), and postoperative mortality as well (RR = 2.17, 95% CI: 1.58-3.00). Significant statistical heterogeneity was observed in the primary analyses, but sensitivity analyses confirmed the robustness of the primary findings. Subgroup analyses revealed variations based on factors like study design, geographic location, and Surgical procedure. Meta-regression identified study design as a significant predictor of postoperative complications.

Conclusion

Nutrition screening tools are effective in identifying preoperative malnutrition and can be utilized as predictive factors for the risk of adverse outcomes in older patients undergoing orthopedic surgeries.

背景:手术环境中流行的术前营养评估往往依赖于孤立的生化参数,如白蛋白水平,这在预测术后并发症和死亡率方面精度有限。本研究的主要目的是评估营养筛查工具在识别各种骨科手术术后风险和死亡率方面的预测准确性,并确定哪种工具最可靠。方法:综合检索PubMed、CNKI、EMBASE和Cochrane Central数据库,研究老年骨科手术患者营养状况与术后预后的关系。检索期为数据库建立至2025年5月。亚组分析评估了各种因素对结果的影响。meta回归进一步探讨异质性。结果:目前的调查包括11项研究,包括201,338例老年骨科手术患者。结果显示,营养筛查工具评估的营养不良与术后并发症(RR = 1.65, 95% CI: 1.26-2.15)和术后死亡率(RR = 2.17, 95% CI: 1.58-3.00)显著相关。在主要分析中观察到显著的统计异质性,但敏感性分析证实了主要发现的稳健性。亚组分析揭示了基于研究设计、地理位置和手术方式等因素的差异。荟萃回归确定研究设计是术后并发症的重要预测因素。结论:营养筛查工具可有效识别术前营养不良,并可作为老年骨科手术患者不良结局风险的预测因素。
{"title":"Nutritional screening tools as predictors of surgical outcomes in geriatric orthopedic patients: a meta-analysis","authors":"Doudou Li,&nbsp;Jiana Shi,&nbsp;Jiaqi Zheng,&nbsp;Ying Hu","doi":"10.1007/s40520-025-03306-y","DOIUrl":"10.1007/s40520-025-03306-y","url":null,"abstract":"<div><h3>Background</h3><p>The prevalent preoperative nutritional evaluations in surgical settings tend to rely on isolated biochemical parameters, such as albumin levels, which demonstrate limited precision in forecasting postoperative complications and mortality rate. The primary objective of this study is to evaluate the predictive accuracy of nutrition screening tools in identifying postoperative risks and mortality in various orthopedic surgeries, and to determine which tools are the most reliable.</p><h3>Methods</h3><p> A comprehensive search was conducted in PubMed, CNKI, EMBASE, and Cochrane Central databases for studies on the relationship between nutritional status and postoperative outcomes in older orthopedic surgery patients. The search period was from the establishment of the databases to May 2025. Subgroup analyses evaluated the impact of various factors on outcomes. Meta-regression was performed to further explore heterogeneity.</p><h3>Results</h3><p>The current investigation encompasses 11 studies, inclusive of 201,338 geriatric orthopedic surgery patients. The result showed that malnutrition assessed by nutrition screening tools was significantly associated with postoperative complications (RR = 1.65, 95% CI: 1.26–2.15), and postoperative mortality as well (RR = 2.17, 95% CI: 1.58-3.00). Significant statistical heterogeneity was observed in the primary analyses, but sensitivity analyses confirmed the robustness of the primary findings. Subgroup analyses revealed variations based on factors like study design, geographic location, and Surgical procedure. Meta-regression identified study design as a significant predictor of postoperative complications.</p><h3>Conclusion</h3><p>Nutrition screening tools are effective in identifying preoperative malnutrition and can be utilized as predictive factors for the risk of adverse outcomes in older patients undergoing orthopedic surgeries.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03306-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145958359","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
Disproportionate increase of extreme obesity among older adults: an exploratory analysis from the English longitudinal study of ageing 极度肥胖在老年人中不成比例的增加:来自英国老龄化纵向研究的探索性分析。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-10 DOI: 10.1007/s40520-025-03286-z
Nicola Veronese, Michela Zanetti, Vincenza Gianfredi, Daniele Nucci, Lee Smith, Stefania Maggi, Marianna Noale

Background

The global rise in obesity increasingly includes extreme forms, notably BMI ≥ 50 kg/m², which present disproportionate health risks, especially among older adults. Despite this, most epidemiological research aggregates all obesity (BMI ≥ 30 kg/m²), potentially underestimating the burden of extreme obesity. Understanding trends in this subgroup is critical for targeted public health and clinical responses.

Methods

We analyzed data from the English Longitudinal Study of Ageing (ELSA) across four waves (2004–2005 to 2016–2017). Data were analysed on the entire population and also for those aged ≥ 65 years. BMI was calculated from measured or self-reported height and weight and classified using WHO standards. Poisson regression with robust error variance was used to assess trends across BMI categories, adjusting for age and sex.

Results

Extreme obesity (BMI 50–59.9 kg/m²) increased by 50% over the 12-year period, and for the first time, individuals with BMI ≥ 60 kg/m² were observed in 2016–2017. Among older adults, mild obesity (BMI 30–39.9 kg/m²) declined slightly, while class II obesity (BMI 40–49.9 kg/m²) rose significantly. However, no individuals aged ≥ 65 years were recorded in the ≥ 60 kg/m² category. Though absolute numbers remain small, the upward trend is clear and clinically significant.

Conclusions

Extreme obesity is rising disproportionately, including among older adults, and requires urgent recognition as a distinct public health challenge. Healthcare systems must adapt to the complex needs of this population, including appropriate medical infrastructure, specialized care pathways, and enhanced clinical guidelines. Ongoing surveillance and tailored interventions are essential to address this growing burden.

背景:全球肥胖的增加越来越多地包括极端形式,特别是BMI≥50 kg/m²,这带来了不成比例的健康风险,特别是在老年人中。尽管如此,大多数流行病学研究汇总了所有肥胖(BMI≥30 kg/m²),可能低估了极端肥胖的负担。了解这一亚群的趋势对于有针对性的公共卫生和临床反应至关重要。方法:我们分析了英国老龄化纵向研究(ELSA)四波(2004-2005年至2016-2017年)的数据。对整个人群以及年龄≥65岁的人群的数据进行分析。BMI根据测量或自我报告的身高和体重计算,并根据世卫组织标准进行分类。使用具有稳健误差方差的泊松回归来评估BMI类别的趋势,并根据年龄和性别进行调整。结果:极端肥胖(BMI 50-59.9 kg/m²)在12年间增加了50%,2016-2017年首次观察到BMI≥60 kg/m²的个体。在老年人中,轻度肥胖(BMI 30-39.9 kg/m²)略有下降,而II类肥胖(BMI 40-49.9 kg/m²)显著上升。然而,在≥60 kg/m²类别中,没有记录到年龄≥65岁的个体。虽然绝对数字仍然很小,但上升趋势明显且具有临床意义。结论:极度肥胖正在不成比例地上升,包括在老年人中,需要紧急认识到这是一个独特的公共卫生挑战。卫生保健系统必须适应这一人群的复杂需求,包括适当的医疗基础设施、专门的护理途径和加强的临床指南。持续监测和有针对性的干预措施对于解决这一日益加重的负担至关重要。
{"title":"Disproportionate increase of extreme obesity among older adults: an exploratory analysis from the English longitudinal study of ageing","authors":"Nicola Veronese,&nbsp;Michela Zanetti,&nbsp;Vincenza Gianfredi,&nbsp;Daniele Nucci,&nbsp;Lee Smith,&nbsp;Stefania Maggi,&nbsp;Marianna Noale","doi":"10.1007/s40520-025-03286-z","DOIUrl":"10.1007/s40520-025-03286-z","url":null,"abstract":"<div><h3>Background</h3><p>The global rise in obesity increasingly includes extreme forms, notably BMI ≥ 50 kg/m², which present disproportionate health risks, especially among older adults. Despite this, most epidemiological research aggregates all obesity (BMI ≥ 30 kg/m²), potentially underestimating the burden of extreme obesity. Understanding trends in this subgroup is critical for targeted public health and clinical responses.</p><h3>Methods</h3><p>We analyzed data from the English Longitudinal Study of Ageing (ELSA) across four waves (2004–2005 to 2016–2017). Data were analysed on the entire population and also for those aged ≥ 65 years. BMI was calculated from measured or self-reported height and weight and classified using WHO standards. Poisson regression with robust error variance was used to assess trends across BMI categories, adjusting for age and sex.</p><h3>Results</h3><p>Extreme obesity (BMI 50–59.9 kg/m²) increased by 50% over the 12-year period, and for the first time, individuals with BMI ≥ 60 kg/m² were observed in 2016–2017. Among older adults, mild obesity (BMI 30–39.9 kg/m²) declined slightly, while class II obesity (BMI 40–49.9 kg/m²) rose significantly. However, no individuals aged ≥ 65 years were recorded in the ≥ 60 kg/m² category. Though absolute numbers remain small, the upward trend is clear and clinically significant.</p><h3>Conclusions</h3><p>Extreme obesity is rising disproportionately, including among older adults, and requires urgent recognition as a distinct public health challenge. Healthcare systems must adapt to the complex needs of this population, including appropriate medical infrastructure, specialized care pathways, and enhanced clinical guidelines. Ongoing surveillance and tailored interventions are essential to address this growing burden.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03286-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948416","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 of frailty with health care costs using the FRAIL scale 使用体弱量表研究体弱与卫生保健费用的关系。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-10 DOI: 10.1007/s40520-025-03272-5
John T. Schousboe, Lisa Langsetmo, Allyson M. Kats, Cynthia Boyd, Kerry M. Sheets, Howard A. Fink, Kristine E. Ensrud

Background

The self-reported FRAIL scale is suitable for frailty assessment in the busy primary care practice setting.

Aim

To estimate the association between phenotypic frailty assessed by FRAIL and subsequent health care costs in older men and women.

Methods

Prospective study of 7947 community-dwelling adults (mean age 79.2 years, 52.6% female) enrolled in 4 cohort studies of older adults linked to U.S. Medicare claims. The primary predictor was the FRAIL scale categorized into 3 levels (robust, pre-frail, and frail). A multimorbidity index (Hierarchical Conditions Category score) and the Kim frailty indicator (approximating the deficit accumulation index) were derived from U.S. Medicare claims. Annualized total and sector-specific health care costs (U.S. 2023 dollars) for 36 months after the index examination were ascertained from claims. Generalized linear models with gamma variance and log link functions were used to estimate the association of FRAIL category with subsequent health care costs.

Results

After accounting for claims-based indicators of multimorbidity and frailty, estimated annualized mean total health care costs for individuals categorized as robust were $9742 in women and $13,319 in men. Compared with robust individuals, adjusted mean annualized incremental costs for prefrailty were $4104 (95% C.I. 604–5604) in women and $1955 (95% C.I. 102–3808) in men and for frailty were $9028 (95% C.I. 6653–11402) in women and $6604 (95% C.I. 3168–11039) in men.

Discussion and conclusion

Pre-frailty and frailty assessed using the self-reported FRAIL scale are associated with higher subsequent total health care costs, even after accounting for claims-based indicators of multimorbidity and frailty.

背景自我报告虚弱量表适用于繁忙的初级保健实践环境中的虚弱评估。目的评估老年男性和女性的表型脆弱性与随后的医疗保健费用之间的关系。方法前瞻性研究7947名社区居民(平均年龄79.2岁,52.6%为女性)纳入4项与美国医疗保险索赔相关的老年人队列研究。主要预测指标是虚弱量表,分为3个等级(健全性、预虚弱和虚弱)。多病指数(分层条件类别得分)和Kim虚弱指数(近似赤字积累指数)来自美国医疗保险索赔。从索赔中确定指数检查后36个月的年化总医疗费用和特定行业的医疗费用(2023美元)。使用广义线性模型与gamma方差和对数链接函数来估计虚弱类别与后续医疗保健费用的关联。结果在考虑了基于索赔的多病和虚弱指标后,被归类为健康的个体的年化平均总医疗费用估计为女性9742美元,男性13319美元。与健康个体相比,女性衰弱的调整后平均年化增量成本为4104美元(95% C.I. 604-5604),男性为1955美元(95% C.I. 102-3808);女性衰弱的调整后平均年化增量成本为9028美元(95% C.I. 6653-11402),男性为6604美元(95% C.I. 3168-11039)。讨论和结论使用自我报告的虚弱量表评估的虚弱前期和虚弱与随后较高的医疗保健总成本相关,即使在考虑了基于索赔的多病和虚弱指标之后也是如此。
{"title":"The association of frailty with health care costs using the FRAIL scale","authors":"John T. Schousboe,&nbsp;Lisa Langsetmo,&nbsp;Allyson M. Kats,&nbsp;Cynthia Boyd,&nbsp;Kerry M. Sheets,&nbsp;Howard A. Fink,&nbsp;Kristine E. Ensrud","doi":"10.1007/s40520-025-03272-5","DOIUrl":"10.1007/s40520-025-03272-5","url":null,"abstract":"<div><h3>Background</h3><p>The self-reported FRAIL scale is suitable for frailty assessment in the busy primary care practice setting.</p><h3>Aim</h3><p>To estimate the association between phenotypic frailty assessed by FRAIL and subsequent health care costs in older men and women.</p><h3>Methods</h3><p>Prospective study of 7947 community-dwelling adults (mean age 79.2 years, 52.6% female) enrolled in 4 cohort studies of older adults linked to U.S. Medicare claims. The primary predictor was the FRAIL scale categorized into 3 levels (robust, pre-frail, and frail). A multimorbidity index (Hierarchical Conditions Category score) and the Kim frailty indicator (approximating the deficit accumulation index) were derived from U.S. Medicare claims. Annualized total and sector-specific health care costs (U.S. 2023 dollars) for 36 months after the index examination were ascertained from claims. Generalized linear models with gamma variance and log link functions were used to estimate the association of FRAIL category with subsequent health care costs.</p><h3>Results</h3><p>After accounting for claims-based indicators of multimorbidity and frailty, estimated annualized mean total health care costs for individuals categorized as robust were $9742 in women and $13,319 in men. Compared with robust individuals, adjusted mean annualized incremental costs for prefrailty were $4104 (95% C.I. 604–5604) in women and $1955 (95% C.I. 102–3808) in men and for frailty were $9028 (95% C.I. 6653–11402) in women and $6604 (95% C.I. 3168–11039) in men.</p><h3>Discussion and conclusion</h3><p>Pre-frailty and frailty assessed using the self-reported FRAIL scale are associated with higher subsequent total health care costs, even after accounting for claims-based indicators of multimorbidity and frailty.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03272-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948427","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
Beyond bone effects: the role of denosumab in muscle Health – A systematic review 超越骨骼效应:地诺单抗在肌肉健康中的作用-系统综述。
IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2026-01-09 DOI: 10.1007/s40520-025-03285-0
Chiara Ceolin, Chiara Ziliotto, Mario Virgilio Papa, Anna Bertocco, Giuseppe Sergi, Marina De Rui

Background

Denosumab, a monoclonal antibody targeting RANKL, is widely used for the treatment of osteoporosis. In addition to its skeletal benefits, emerging evidence suggests that denosumab may also exert positive effects on muscle health by modulating inflammation, myostatin expression, and insulin sensitivity through the RANK/RANKL/OPG pathway.

Aims

To systematically review the available literature on the effects of denosumab on muscle-related outcomes, including muscle strength, muscle mass, physical performance, and fall risk.

Methods

A systematic review was conducted in accordance with PRISMA guidelines. Databases including PubMed, Embase, and Cochrane Library were searched through May 2025 for studies evaluating the impact of denosumab on muscle health in human subjects. Outcomes of interest included grip strength, lean muscle mass, gait speed, fall incidence, and physical performance tests.

Results

Seven studies met the inclusion criteria, including randomized trials and observational cohorts. Most reported favorable outcomes for denosumab compared to bisphosphonates or placebo, particularly in grip strength and physical performance. Preclinical studies further support the biological role of RANKL in muscle dysfunction. However, one recent randomized controlled trial in older adults residing in long-term care settings found no significant effect on muscle outcomes, highlighting inconsistencies in the evidence.

Discussion

Denosumab shows potential for improving muscle-related outcomes in older adults, particularly those with osteosarcopenia.

Conclusions

Current evidence is heterogeneous and inconclusive. Further high-quality randomized trials are needed to clarify the effects of denosumab on muscle health and its possible role in sarcopenia prevention and management.

背景:Denosumab是一种靶向RANKL的单克隆抗体,被广泛用于治疗骨质疏松症。除了对骨骼有益外,新出现的证据表明,denosumab还可能通过RANK/RANKL/OPG通路调节炎症、肌肉生长抑制素表达和胰岛素敏感性,从而对肌肉健康产生积极影响。目的:系统回顾关于denosumab对肌肉相关结果的影响的现有文献,包括肌肉力量、肌肉质量、身体表现和跌倒风险。方法:按照PRISMA指南进行系统评价。截至2025年5月,检索了PubMed、Embase和Cochrane图书馆等数据库,以评估denosumab对人类受试者肌肉健康的影响。研究结果包括握力、瘦肌肉质量、步态速度、跌倒发生率和体能测试。结果:7项研究符合纳入标准,包括随机试验和观察性队列。与双膦酸盐或安慰剂相比,大多数报告了denosumab的有利结果,特别是在握力和身体表现方面。临床前研究进一步支持RANKL在肌肉功能障碍中的生物学作用。然而,最近的一项随机对照试验发现,长期护理环境对老年人的肌肉预后没有显著影响,这突出了证据的不一致性。讨论:Denosumab显示出改善老年人肌肉相关结果的潜力,特别是那些骨骼肌减少症患者。结论:目前的证据是不一致和不确定的。需要进一步的高质量随机试验来阐明denosumab对肌肉健康的影响及其在肌肉减少症预防和治疗中的可能作用。
{"title":"Beyond bone effects: the role of denosumab in muscle Health – A systematic review","authors":"Chiara Ceolin,&nbsp;Chiara Ziliotto,&nbsp;Mario Virgilio Papa,&nbsp;Anna Bertocco,&nbsp;Giuseppe Sergi,&nbsp;Marina De Rui","doi":"10.1007/s40520-025-03285-0","DOIUrl":"10.1007/s40520-025-03285-0","url":null,"abstract":"<div><h3>Background</h3><p>Denosumab, a monoclonal antibody targeting RANKL, is widely used for the treatment of osteoporosis. In addition to its skeletal benefits, emerging evidence suggests that denosumab may also exert positive effects on muscle health by modulating inflammation, myostatin expression, and insulin sensitivity through the RANK/RANKL/OPG pathway.</p><h3>Aims</h3><p>To systematically review the available literature on the effects of denosumab on muscle-related outcomes, including muscle strength, muscle mass, physical performance, and fall risk.</p><h3>Methods</h3><p>A systematic review was conducted in accordance with PRISMA guidelines. Databases including PubMed, Embase, and Cochrane Library were searched through May 2025 for studies evaluating the impact of denosumab on muscle health in human subjects. Outcomes of interest included grip strength, lean muscle mass, gait speed, fall incidence, and physical performance tests.</p><h3>Results</h3><p>Seven studies met the inclusion criteria, including randomized trials and observational cohorts. Most reported favorable outcomes for denosumab compared to bisphosphonates or placebo, particularly in grip strength and physical performance. Preclinical studies further support the biological role of RANKL in muscle dysfunction. However, one recent randomized controlled trial in older adults residing in long-term care settings found no significant effect on muscle outcomes, highlighting inconsistencies in the evidence.</p><h3>Discussion</h3><p>Denosumab shows potential for improving muscle-related outcomes in older adults, particularly those with osteosarcopenia.</p><h3>Conclusions</h3><p>Current evidence is heterogeneous and inconclusive. Further high-quality randomized trials are needed to clarify the effects of denosumab on muscle health and its possible role in sarcopenia prevention and management.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"38 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-025-03285-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941944","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
期刊
Aging Clinical and Experimental Research
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1