Aging Clinical and Experimental Research最新文献

Background

The body roundness index (BRI) has emerged as a refined anthropometric indicator that integrates waist circumference and height to quantify body shape characteristics and metabolic risk. However, its longitudinal associations with mortality across diverse chronic diseases remain underexplored. This study aims to investigate these associations and their potential mechanisms.

Methods

This longitudinal study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), covering a 9-year follow-up from baseline (2011–2012) to 2020. The study cohort comprised 11,750 middle-aged and older Chinese adults. BRI was calculated using waist circumference and height. The primary outcome was all-cause mortality. Cox proportional hazards models were used to assess associations, restricted cubic spline (RCS) models explored nonlinear effects, and Kaplan-Meier survival curves provided survival rate estimates.

Results

Higher BRI levels conferred significant protective effects against all-cause mortality in the overall population (HR = 0.94, 95% CI = 0.89–0.98), hypertension (HR = 0.93, 95% CI = 0.87–0.98), lung disease (HR = 0.87, 95% CI = 0.78–0.97), asthma (HR = 0.77, 95% CI = 0.63–0.95), and dyslipidemia (HR = 0.90, 95% CI = 0.84–0.97). Conversely, elevated BRI increased liver disease mortality risk (HR = 1.32, 95% CI = 1.04–1.68). RCS modelling revealed significant non-linear relationships between BRI and mortality risk for hypertension and lung disease (non-linear P < 0.05), whereas the associations with dyslipidemia, asthma and the overall population remained essentially linear (non-linear P > 0.05).

Conclusions

BRI is a multifaceted predictor of chronic disease mortality, with associations varying by disease pathophysiology and population characteristics. It offers a pragmatic tool for refining risk stratification in aging populations and challenges one-size-fits-all approaches to obesity management. Future research should investigate dynamic BRI trajectories and interactions with disease-specific biomarkers.

Background

Deterioration of cognitive function with aging is a significant public health issue, particularly in individuals with diabetes mellitus (DM). Exercise has been shown to enhance cognitive function. However, the threshold effect of physical activity on cognitive function in older adult people with DM remains unclear.

Methods

This study analyzed data from 925 older participants (aged 60 and above) derived from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2014, representing a total weighted respondent count of 13,824,651. Cognitive function was evaluated with the Animal Fluency test (AFT) and Digit Symbol Substitution test (DSST). To assess the relationship between physical activity and cognitive function, we applied weighted linear regression models coupled with restricted cubic spline analysis. Furthermore, a two-piecewise linear regression model was utilized to detect any potential threshold effect of exercise on cognitive function.

Results

The results indicated a positive correlation between physical activity and cognitive function scores on the AFT and DSST after adjusting for potential confounders. Threshold analyses showed a consistent positive relationship for AFT scores at less than 490 MET-min/week of physical activity [β (95% CI) = 0.45 (0.20, 0.70), p = 0.001] and for DSST scores at less than 1,120 MET-min/week [β (95% CI) = 0.55 (0.20, 0.89), p = 0.004]. However, when the exercise volume reached these two inflection points, a saturation effect occurred.

Conclusion

This study shows a clear inverted U-shaped relationship between physical activity and cognitive function in older adults with DM. Cognitive benefits do not increase with higher exercise volume and approximately 490 MET-minutes/week appears to be the optimal dose for preserving cognitive function in this population. Additional research is necessary to confirm these findings in future studies using objective, precise measures such as pedometers and accelerometers.

Objective

This paper aims to assess the clinical effectiveness of an Enhanced Recovery After Surgery (ERAS)-based care bundle in facilitating early rehabilitation in patients with acute ischemic stroke (AIS).

Methods

A total of 120 AIS patients were randomly assigned to either a control group (n = 60), receiving routine nursing care, or an experimental group (n = 60), which received additional ERAS-guided bundled care. Outcome measures included neurological function [NIH Stroke Scale (NIHSS), modified Rankin Scale (mRS)], limb strength (Lovett scale), language ability [Boston Diagnostic Aphasia Examination (BDAE)], swallowing function [Water Swallow Test (WST)], psychological status [Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA)], and quality of life [Stroke-Specific Quality of Life Scale (SS-QOL)]. Incidence of adverse events was also recorded.

Results

Post-intervention, NIHSS and mRS scores declined more markedly in the experimental group than in the control group (P < 0.05). The experimental group had a higher number of patients with Lovett muscle strength grade 4, BDAE grades 4 and 5, and WST grade 1 compared to the control group (P < 0.05). The HAMD and HAMA scores in the experimental group were lower than those in the control group (P < 0.05). The experimental group also had lower adverse event rate compared to the control group (P < 0.05).

Conclusion

An ERAS-based care bundle can significantly enhance early functional recovery, mitigate psychological distress, and reduce complications in AIS patients, supporting its clinical applicability in stroke rehabilitation.

Growing evidence highlights the potential of multidomain lifestyle-based interventions to reduce the risk of cognitive decline among older adults at higher risk of cognitive impairment. Within these complex and often demanding interventions, adherence has emerged as a key factor influencing both outcomes and impact. Numerous studies have explored adherence from the perspective of researchers which is often defined as the extent to which a person’s behaviour corresponds with agreed recommendations from a healthcare provider. However, less is known about how members of the public understand and experience it. This article presents insights gathered from Advisory Boards established within three European-funded projects, as part of Public Involvement activities led by Alzheimer Europe in collaboration with researchers in the projects. The discussions involved 23 members of the public (lay people with and without dementia) from nine European countries and focused on adherence in the context of research-based multidomain lifestyle interventions to reduce dementia risk. Feedback from Advisory Boards members were grouped in three overarching themes: (1) “Baking your own cake” which highlights the relevance and understandings of adherence from members of the public; (2) “Striking a balance” which refers to the complexity and influencing factors linked to adherence; and (3) “A two-way process” which emphasises the involvement of members of the public and the importance of clear communication and appropriate support throughout the intervention process. Promoting adherence requires recognising participants as active partners in research which may not only improve adherence itself but also enhance the relevance, effectiveness and long-term impact of dementia prevention efforts.

Background

Intrinsic capacity (IC), the composite of physical and mental capacities, is crucial for health and well-being in older adults. With aging populations experiencing IC decline, effective interventions are needed to promote healthy aging. This study evaluated the effectiveness of a structured lifestyle counseling program on IC in older women.

Methods

In this 8-week cluster randomized controlled trial, 240 women aged ≥ 60 were equally allocated to intervention or control groups. The intervention group participated in an 8-session (30–45 min/session) counseling program delivered in small groups (10 participants each), focusing on five IC domains: nutrition (vitality), physical exercise (locomotion), psychological well-being (happiness/depression management), cognitive stimulation, and sensory health. Sessions included education, goal-setting, and interactive discussions. The control group received no intervention during the study period but obtained educational materials post-trial. IC domains were assessed at baseline and 1-week post-intervention using validated tools: SPPB and TUG (locomotion), Mini-Cog (cognition), GDS (Geriatric Depression Scale) (psychological), MNA (Mini Nutritional Assessment) (vitality), and self-reported sensory measures.

Results

The intervention group showed significantly greater improvement in overall IC compared to controls (adjusted mean difference [aMD] = 2.07, 95%CI: 1.69, 2.44). Domain-specific improvements included locomotion (aMD = 0.92, 95%CI: 0.68, 1.16), vitality (aMD =1.01 , 95%CI: 0.67, 1.33), cognition (aMD = 0.80, 95%CI: 0.52, 1.09), psychological (aMD = 2.28, 95%CI:1.37, 3.19), and sensory (aMD = 0.29, 95%CI:0.13, 0.44).

Conclusion

An 8-week lifestyle counseling intervention significantly improved intrinsic capacity and its domains in older women. These findings support the implementation of targeted, multidomain interventions to promote healthy aging, though longer-term studies are needed to assess sustained benefits.

Trial registration

Date of Registration: 26 June 2023. Date of Initial Participant Enrollment: 6 July 2023, Iranian Registry of Clinical Trials identifier: IRCT20230328057780N1, URL: https://irct.behdasht.gov.ir/trial/69321.

Severe tricuspid regurgitation (TR) is increasingly recognised as a major cause of morbidity in older adults with heart failure (HF). Conventional surgical repair or replacement carries prohibitive risks in frail patients, leading to therapeutic inertia and progressive loss of function. The development of transcatheter tricuspid edge-to-edge repair (T-TEER) offers a less invasive, guideline-supported option for selected individuals previously considered inoperable. This narrative review summarises contemporary evidence and explores the specific challenges of T-TEER in frail older adults through a cardiogeriatric lens. It integrates epidemiology, diagnostic complexity, frailty and cognitive assessment, procedural considerations, and multidisciplinary coordination. Randomised trials and real-world registries consistently demonstrate symptomatic and functional improvements with acceptable procedural risk in octogenarians. Drawing on the experience of the Cardiogeriatric Department, Hôpital La Porte Verte (Versailles, France), this review outlines an integrated model embedding geriatrics, advanced nursing, and telemonitoring (Satelia^® Cardio) within HF care. This approach aligns with the Age-Friendly Health Systems framework and the ESC 2021 Heart Failure Guidelines, emphasising functional preservation and patient-centred priorities.

Background

Cognitive impairment is a major complication in individuals with hypertension. Emerging evidence suggests that metabolic abnormalities may contribute to its pathogenesis. This study examined the association between the atherogenic index of plasma (AIP) and risk of cognitive impairment in middle-aged and older adults with hypertension.

Methods

Data were from the 2011 baseline and 2018 follow-up waves of the China Health and Retirement Longitudinal Study (CHARLS). Multivariable logistic regression was used to assess the association between baseline AIP and subsequent cognitive impairment. Dose-response patterns were explored using restricted cubic spline (RCS) models, and subgroup analyses evaluated effect modification. Predictive performance of AIP versus traditional lipids was assessed by receiver operating characteristic (ROC) curves.

Results

Among 3,739 hypertensive participants (mean age: 60.5 ± 9.1 years; 50.0% female), 43.0% developed cognitive impairment. Compared with quartile 1 (Q1), higher AIP quartiles were significantly associated with increased risk of cognitive impairment: Q2 (odds ratio [OR], 1.44; 95% confidence interval [CI], 1.15–1.80), Q3 (OR, 1.76; 95% CI, 1.40–2.20), and Q4 (OR, 1.85; 95% CI, 1.45–2.37). RCS indicated a linear dose-response (P for nonlinearity = 0.061). Subgroup analyses showed consistent associations across age, gender, body mass index, residence, and diabetes, with no significant interactions detected. AIP outperformed traditional lipid markers in predicting cognitive impairment.

Conclusion

Elevated AIP was independently associated with an increased risk of cognitive impairment among middle-aged and older adults with hypertension, suggesting its potential as a practical biomarker for early identification of cognitive risk in this high-risk population.

Background

Frailty is a critical geriatric syndrome associated with adverse health outcomes and exhibits a complex relationship with obesity. Traditional anthropometrics, such as body mass index (BMI), inadequately assess obesity-related risks in the aging population. Emerging indices better capture visceral adiposity, potentially enhancing frailty prediction. This study evaluates these indices’ associations with frailty in older adults.

Methods

This study analyzed existing data collected between 2002 and 2007 as part of the National Health and Nutrition Examination Survey (NHANES). BMI, body roundness index (BRI), a body shape index (ABSI), waist-to-height ratio (WHtR), and waist/height0.5 (WHT·5R) were calculated using waist circumference, weight, and height. We used a modified frailty index (FI) with 36 standardized parameters to quantify the severity of frailty by the cumulative proportion of deficits.

Results

In the adjusted model, increases in all indices except ABSI were statistically significantly associated with increases in FI (BRI: β(95%CI) = 0.004(0.003, 0.005); BMI: β(95%CI) = 0.001(0.0001, 0.001); ABSI: β(95%CI) = 2.034(1.627, 2.440); WHtR: β(95%CI) = 0.093(0.067, 0.119); WHT·5R: β(95%CI) = 0.007(0.005,0.009)). Bootstrap analysis showed that BRI had a greater impact on FI than BMI (difference = 0.0019), while WHtR and WHT·5R had a stronger impact on FI than BRI (difference = −0.0746 and −0.0027, respectively). The effect of WHtR on FI was significantly higher than that of WHT·5R (difference = 0.0719).

Conclusion

This study highlighted that WHtR was more strongly associated with FI than BMI, BRI, and WHT·5R, and highlighted the priority of waist-centered obesity measures in frailty risk assessment and clinical intervention in the elderly.

In their cross-sectional study, Sun et al. (Aging Clin Exp Res. 2025) provide valuable evidence that the coexistence of high body fat and low muscle mass is associated with lower bone mineral density (BMD) in postmenopausal women with type 2 diabetes (T2D). While their work importantly identifies this “sarcopenic obesity” phenotype as a risk factor, our letter offers a critical appraisal to guide future research. We argue that the sole reliance on DXA-derived areal BMD is a significant limitation, as it fails to capture the deficits in bone quality (e.g., microarchitecture, material properties) that underpin the well-known paradox of increased fracture risk at normal or elevated BMD in T2D. Furthermore, the cross-sectional design and lack of biochemical data (e.g., on inflammation, adipokines, bone turnover markers) preclude any causal or mechanistic inferences about how this body composition profile affects bone.We contend that the operational definitions of sarcopenia and obesity based solely on quantity, without assessing muscle function or fat distribution, lack phenotypic precision. Moving forward, the field must adopt longitudinal designs that integrate advanced imaging (e.g., HR-pQCT) and deep metabolic phenotyping to elucidate the underlying pathways. Ultimately, this is essential for developing targeted interventions that address the intertwined pathologies of muscle, fat, and bone in this vulnerable population.

Background

The coronavirus disease 2019 (COVID-19) pandemic introduced unprecedented social distancing measures that drastically altered daily activities for older individuals.

Aims

To investigate whether the proportion of indoor falls changed during the coronavirus disease 2019 (COVID-19) social distancing period in South Korea compared to the pre-COVID-19 period.

Methods

We conducted a retrospective cohort study at a single tertiary care academic hospital in South Korea of older adult patients who presented to the emergency department and were diagnosed with hip or femur-related fractures during the pre-COVID-19 period (January 2011 to December 2019) or the social distancing period (March 2020 to March 2022). We performed 1:1 propensity score matching. We compared the proportion of indoor and outdoor falls between the two groups.

Results

A total of 2,433 patients diagnosed with hip or femur-related fractures were included (1,941 before COVID-19 and 492 during the social distancing period). After matching, the proportion of indoor falls was 61.1% in the social distancing group and 67.7% in the pre-COVID-19 group among 316 matched patients in each group (p = 0.02).

Conclusions

During the COVID-19 social distancing period in South Korea, the proportion of indoor falls decreased significantly compared to the pre-COVID-19 period among older adults with hip or femur-related fractures, suggesting a pandemic-related shift in fall patterns that highlights how lifestyle changes can impact injury patterns and inform fall prevention strategies. However, absence of data on household composition, cognitive status, and medication use, along with tertiary-center selection bias (higher comorbidity burden), limits generalizability.

Trial registration number

Not applicable.