Aging Clinical and Experimental Research最新文献

Background

Hospital readmissions are common among older multimorbid patients, and hospitalisation is associated with functional decline and reduced quality of life. Identifying patient characteristics and risk factors for repeated hospital visits following an emergency department (ED) encounter is important for guiding targeted interventions to prevent future revisits.

Aim

To characterise multimorbid older patients with frequent unplanned hospital visits following an emergency department (ED) visit, compare them to those with fewer revisits, and identify risk factors for frequent unplanned hospital revisits.

Methods

A retrospective analysis of 25 436 multimorbid patients aged ≥ 75 years who visited 8 EDs in Sweden in 2017 was performed. Patients with ≥ 3 ED visits or unplanned hospital admissions in the following year were classified as frequent hospital visitors. Their characteristics were compared to those of infrequent visitors, and binomial logistic regression was used to identify factors predictive of frequent hospital visits.

Results

An increasing number of hospital visits in the prior 12 months (odds ratio (OR) 1.25 95% confidence interval (95% CI) 1.21–1.29) and an increasing number of comorbidities (OR 1.11 95% CI 1.09–1.13) were the most impactful risk factors for multiple unplanned hospital revisits. Female sex (OR 0.81 95% CI 0.75–0.88) was the most important protective factor.

Conclusion

A history of frequent hospital visits was the strongest risk factor for future unplanned hospital visits. Several other factors were also identified, suggesting the potential for predictive models to identify at-risk patients before frequent visits occur.

Background

The global rise in dementia prevalence, a major neurocognitive disorder, poses a significant challenge to aging populations. This study aimed to determine the prevalence of dementia and its associated risk factors among community-dwelling elderly in selected provinces of Iran.

Methods

A cross-sectional study was conducted from October 2022 to March 2024, enrolling 58,228 individuals aged 60–75 years from two provinces (Qazvin and Yazd) selected via multi-stage, stratified random sampling. A multi-stage diagnostic protocol was employed, using validated Persian versions of the Geriatric Depression Scale (GDS), Abbreviated Mental Test Score (AMTS), Mini-Mental State Examination (MMSE), Functional Assessment Staging (FAST), and Montreal Cognitive Assessment (MoCA) with standardized cut-offs. Multivariable logistic regression was used to identify factors associated with dementia.

Results

After exclusions, the final analytical sample was 56,456 participants. The overall prevalence of dementia was 10.1%. Prevalence was significantly higher in women (13.2%) than in men (7.0%). In the adjusted model, female gender (aOR: 2.04, 95% CI: 1.92–2.15), older age (70–79 years vs. 60–64 years, aOR: 1.70, 95% CI: 1.59–1.82), widowhood (aOR: 1.50, 95% CI: 1.05–2.16), and lower educational attainment (illiterate vs. academic, aOR: 6.55, 95% CI: 5.43–7.91) were significantly associated with higher odds of dementia.

Conclusions

This large-scale study reveals a substantial burden of dementia in the studied Iranian provinces. The identified risk factors, including female sex, advanced age, widowhood, and low education, highlight vulnerable subgroups and underscore the urgent need for targeted public health strategies focused on early detection, risk reduction, and support systems for the elderly in Iran.

Background

Sarcopenia is a progressive skeletal muscle disorder characterized by declining muscle mass and function in older adults. This study aimed to develop and validate a four-year predictive model for sarcopenia using data from the China Health and Retirement Longitudinal Study (CHARLS) to facilitate early identification and targeted interventions.

Methods

We analyzed data from 2,173 participants enrolled in the 2011 CHARLS baseline survey after applying exclusion criteria. Predictors including anthropometric measurements, laboratory biomarkers, and cognitive function were assessed. Data were split 7:3 for training and testing, with oversampling applied to address class imbalance in the training set. LASSO regression with 10-fold cross-validation was used for feature selection, followed by multivariable logistic regression to identify significant predictors. Model performance was evaluated using ROC curves, calibration curves, and decision curve analysis (DCA).

Results

Among 2,173 participants, 160 (7.36%) developed sarcopenia over four years. Univariate analyses showed area under the curve (AUC) values ranging from 0.461 to 0.818. Ten significant predictors were identified: age, body mass index (BMI), cognition, waist circumference, mean corpuscular volume (MCV), platelet count, glucose, creatinine, high-density lipoprotein cholesterol (HDL), and hematocrit. Advancing age and higher MCV were positively associated with sarcopenia, whereas higher BMI, larger waist circumference, and better cognitive function were protective. The model showed excellent discrimination with AUCs of 0.859 (training) and 0.842 (testing), good calibration, and favorable clinical utility across a range of thresholds. An online nomogram was developed for clinical application.

Conclusion

This study developed and validated a four-year predictive model for sarcopenia in older adults, integrating key risk factors into a user-friendly nomogram. The model enables early identification of high-risk individuals, supporting targeted interventions and enhancing sarcopenia management strategies. External validation is recommended to confirm generalizability.

Background and aim

Aging is accompanied by profound biological, psychological, and social changes, and loneliness is considered one of the essential factors threatening the mental health of the elderly. Resilience, as a vital psychological mechanism, is the ability of an individual to effectively cope with stress and return to psychological balance after difficult situations. present study aimed to investigate the relationship between resilience and loneliness in the elderly and identify the factors affecting this relationship using a decision tree.

Method

A descriptive-analytical and cross-sectional study was conducted with 1400 elderly people aged 60 and older in Tehran. Data were collected using the Resilience Questionnaire (CD-RISC-25) and the Social and Emotional Loneliness Scale (SELSA-S) and analyzed using the CART decision tree. SPSS v. 22 software was used for analysis.

Result

Based on decision tree analysis using the CART method, elderly with a resilience score of ≤ 74.5 show a higher mean loneliness (53.42 ± 12.02). elderly with a social score higher than 12.5, the mean loneliness was 62.21 ± 4.82, while in the elderly with a lower score, the mean loneliness was lower 41.62.8.01. Individuals with a romantic dimension score of ≤ 12.5 had a very low mean loneliness of 27.53 ± 6.91, while individuals with a higher score experienced a mean of 54.93 ± 9.28. overall accuracy of the model for the high and low loneliness groups was 86.90% and 85.12%, respectively.

Conclusion

The present findings emphasize that strengthening individual resilience, along with promoting social and family support and paying attention to emotional relationships, is effective in reducing loneliness in older people.

Objective

To evaluate the effects of different types and durations of exergame interventions on cognition in elderly individuals with cognitive impairment (CI) through a meta-analysis.

Methods

A computerized search was conducted in databases including Cochrane Library, PubMed, Web of Science, Embase, and CNKI from database inception to September 2025. Quality assessment and data extraction were performed on the included studies. Results measures included the MoCA , MMSE, etc. The study designs were randomized controlled trials or qua-si-experimental studies. The Cochrane Handbook’s risk of bias tool was used for quality assessment, and Rev Man 5.0 software was employed to conduct meta-analyses on the ef-fects of dance-based and movement-based exergames on cognitive function in elderly CI patients.

Results

A total of 13 studies involving 433 CI patients were included. Analysis of the 13 studies showed that dance-based exergaming was significantly superior to exercise-based exergaming in cognitive ability (SMD = 0.73, P < 0.01); interventions lasting ≥8 weeks were more effective than those lasting <8 weeks (SMD = 1.01, P = 0.02).

Conclusion

Dance-based exergames significantly improve cognition in elderly individu-als with CI, with better effects observed in long-term interventions. However, more high-quality studies are needed to verify these findings and to supplement analyses on ex-ercise dose effects.

Background

Life space is a potential biomarker for the health of older adults. In this study, we contribute up-to-date findings on the status of life space and physical performance of older adults in Singapore. More importantly, we identify the specific physical performance measures that are significantly associated with life space, elucidating specific aspects of locomotion amenable to rehabilitation.

Methods

We administered a questionnaire and physical performance tests with a large cohort of older adults (N = 1118). Key measures in this study include the University of Alabama at Birmingham’s Life Space Assessment, Timed Up and Go, Handgrip Strength, Two-minute Step Test, 10 m Walk Test, 30-seconds Chair Stand Test, 5-time Sit to Stand Test, and Short Physical Performance Battery. Controlling for sociodemographic variables, we performed a regression analysis to identify the physical performance measures that have significant impact on life space.

Results

Handgrip strength—a measure of overall strength—and gait speed—a measure of overall walking performance—were significantly associated with life space. On the contrary, tests of power or endurance, or composite tests, did not have significant associations.

Conclusions

This study shows that focusing on overall strength and walking performance of older adults can maintain or improve their life spaces, ensuring continued participation in the community. Lower body strength and power, along with cardiopulmonary endurance, appear to have less significant associations with older adults’ life space. We recommend that physicians focus on gait speed and handgrip strength for maintaining older adults’ life space.

Background

Osteoporosis is a prevalent bone disease characterized by decreased bone mass and deterioration of bone microstructure, leading to an increased risk of fractures. Pathological fractures, particularly in postmenopausal women, are a severe complication of osteoporosis. This study investigates the potential molecular role of micronutrients, particularly iron, in osteoporosis and its association with pathological fractures.

Methods

We performed a Mendelian randomization (MR) analysis using genome-wide association study (GWAS) summary data to explore the relationship between 15 trace elements (including iron, calcium, copper, and vitamins) and osteoporosis-related outcomes. Outcome data were obtained from the FinnGen database. The inverse-variance weighted (IVW) method was used to evaluate the causal effects of micronutrients on osteoporosis and osteoporosis-related fractures, including those occurring in postmenopausal women. Sensitivity analyses for pleiotropy and heterogeneity, including MR-Egger and leave-one-out analysis, were also performed.

Results

Among the 15 micronutrients analyzed, serum iron levels were significantly associated with an increased risk of osteoporosis with pathological fractures. The IVW analysis revealed a strong association between iron levels and the occurrence of osteoporosis with pathological fractures (OR = 2.630, 95% CI: 1.161–5.957, P = 0.020), as well as postmenopausal osteoporosis with fractures (OR = 2.714, 95% CI: 1.156–6.368, P = 0.022). No significant genetic association was observed between iron and osteoporosis alone (OR = 1.238, 95% CI: 0.856–1.791, P = 0.256). Other micronutrients did not show significant effects on osteoporosis or fractures. Sensitivity analyses indicated no evidence of heterogeneity or pleiotropy.

Conclusion

This study identifies serum iron levels as a molecular risk factor for osteoporosis-related pathological fractures, particularly in postmenopausal individuals, but not for osteoporosis itself. These findings highlight the potential role of iron in the pathogenesis of osteoporotic fractures and suggest further investigation into its molecular mechanisms in bone health.

The progressive aging of the Italian population and the increasing prevalence of multimorbidity and frailty call for a reorganization of health and social care services. In this paper we aim to critically examine Ministerial Decree 77/2022, within Mission 6 of the National Recovery and Resilience Plan, which establishes new models and standards for community-based care and offers an unique opportunity to deliver care that is closer to people’s homes, fostering a holistic approach that combines clinical expertise, social support, and technological innovation. The reform places Community Houses and Health Districts at the core of integration between hospitals, general practitioners, and social services. The care of frail older adults relies on population stratification through validated tools, such as the Primary Care Frailty Index (PC-FI), and on the development of individualized care plans that integrate multidisciplinary interventions. Although general practitioners remain central in the health care system, geriatricians may play a pivotal role in multidimensional assessment, pharmacological management, health promotion, and the coordination of care teams. Telemedicine and digital tools support continuity of care and ensure traceability of clinical processes. Indicators of accessibility, equity, appropriateness, acceptability, and effectiveness are proposed, including the use of Patient-Reported Outcome and Experience Measures proposed for the evaluation of its impact. The reform’s success will depend on overcoming methodological and operational barriers, reducing regional disparities, and ensuring that clinical expertise, social support, and technological innovation deliver measurable benefits for frail older adults.