Archives of gerontology and geriatrics最新文献

Nature-based approaches to dementia, cognitive impairment, and caregiver well-being: A scoping review of gardening and therapeutic strategies 以自然为基础的痴呆症、认知障碍和照顾者福祉的方法：园艺和治疗策略的范围审查

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-22 DOI: 10.1016/j.archger.2026.106152

Mary Dioise Ramos, Marcy Purnell, Jolie Harris, Gloria Giarratano

Background

Dementia is a growing global health concern, with behavioral and psychological symptoms (BPSD) contributing significantly to diminished quality of life and caregiver burden. Non-pharmacological interventions, such as gardening and nature-based therapies, are increasingly recognized for their therapeutic potential.

Objectives

This scoping review aimed to: (1) map existing evidence on gardening and garden-based interventions for individuals with dementia; (2) assess impacts on caregivers; (3) identify mechanisms of benefit; and (4) summarize effective design and implementation strategies.

Methods

Following Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a comprehensive search was conducted across five databases. Studies were screened using Covidence. Inclusion criteria encompassed peer-reviewed studies where gardening was the primary intervention for people with dementia or their caregivers. Thirty-two studies were included, spanning qualitative, quantitative, mixed-methods, and review designs.

Results

Gardening interventions consistently improved psychosocial well-being, mood, and reduced BPSD. Evidence for cognitive benefits was mixed, with stronger support for preventive effects. Caregivers experienced reduced psychological distress and enhanced social support. Mechanisms of benefit included engagement, purpose, identity reinforcement, and sensory stimulation. Effective interventions emphasized active participation, co-design, and integration into routine care. Barriers included staff risk aversion, limited access, and environmental constraints.

Conclusions

Gardening and garden-based interventions offer flexible, person-centered strategies to enhance well-being in dementia care. Their success depends on meaningful engagement, supportive design, and organizational commitment. Future research should standardize outcomes, explore caregiver-focused models, and assess economic impact.

痴呆症是一个日益严重的全球健康问题，行为和心理症状（BPSD）是导致生活质量下降和照顾者负担加重的重要原因。非药物干预措施，如园艺和基于自然的疗法，越来越多地认识到其治疗潜力。本综述旨在：(1)梳理现有的关于园艺和以园艺为基础的痴呆个体干预措施的证据；(2)评估对照顾者的影响；(3)确定效益机制；(4)总结有效的设计与实施策略。方法遵循Joanna Briggs研究所的方法和PRISMA-ScR指南，在五个数据库中进行了全面的搜索。使用covid筛查研究。纳入标准包括同行评议的研究，其中园艺是痴呆症患者或其照顾者的主要干预措施。纳入32项研究，包括定性、定量、混合方法和回顾设计。结果园艺干预持续改善心理社会健康、情绪和减少BPSD。认知益处的证据好坏参半，更有力地支持预防效果。照顾者的心理困扰减少，社会支持增强。利益机制包括参与、目的、身份强化和感官刺激。有效的干预措施强调积极参与、共同设计和融入常规护理。障碍包括员工风险规避、有限的访问和环境约束。结论园艺和基于花园的干预提供了灵活的、以人为本的策略来提高痴呆症护理的幸福感。他们的成功取决于有意义的参与、支持性设计和组织承诺。未来的研究应该使结果标准化，探索以护理者为中心的模式，并评估经济影响。

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引用次数: 0

Dual trajectories of nighttime sleep duration and frailty in relation to cardiovascular disease risk in middle-aged and older Chinese adults: a longitudinal study 中国中老年人夜间睡眠时间和虚弱程度与心血管疾病风险相关的双重轨迹：一项纵向研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-18 DOI: 10.1016/j.archger.2026.106149

Qingcui Wu , Junfeng Zhang , Jianqi Liu, Huijie Huang, Zihao Zhang, Shuoying Yue, Meng Su, Jiageng Chen, Shi Zhao, Jun Ma

Background

Little is known about the associations between long-term patterns of sleep and frailty and their impact on cardiovascular disease risk. We aimed to delineate trajectories of nighttime sleep duration and frailty, compare baseline characteristics across trajectory groups, and evaluate their independent and joint associations with cardiovascular disease (CVD) risk.

Methods

Trajectories of sleep duration and frailty index (FI) were modeled using three biennial waves (2011–2015) of the China Health and Retirement Longitudinal Study (CHARLS). Group-based and dual trajectory modeling identified distinct patterns. Baseline characteristics across trajectories were examined using multinomial logistic regression. Cox proportional hazards models estimated hazard ratios (HRs) and 95 % confidence intervals (CIs) for CVD events occurring during 2015–2018 follow-up.

Results

Among 6972 participants, four sleep trajectories and three frailty trajectories were identified. Compared with the stable-8-hours sleep trajectory, the stable-5-hours group had higher risks of CVD (HR: 1.33, 95 % CI: 1.05–1.68) and heart disease (HR: 1.42, 95 % CI: 1.07–1.88), significant only for women in sex-stratified analyses. Stable pre-frail and frail trajectories were linked to elevated risks of CVD (HR: 1.92, 95 % CI: 1.45–2.55; HR: 3.70, 95 % CI: 2.63–5.21) and heart disease (HR: 2.28, 95 % CI: 1.60–3.24; HR: 4.61, 95 % CI: 3.03–7.00) in both sexes. Dual-trajectory analyses revealed co-development patterns of sleep and frailty, with the highest CVD risk (HR: 3.04, 95 % CI: 1.88–4.91) observed among individuals with both stable pre-frail/frail and stable-5-hours trajectories.

Conclusion

Sleep duration and frailty trajectories are interrelated over time and jointly influence CVD risk. Monitoring their long-term patterns may improve the precision of CVD prevention.

背景：人们对长期睡眠模式与身体虚弱及其对心血管疾病风险的影响之间的关系知之甚少。我们的目的是描述夜间睡眠时间和虚弱的轨迹，比较轨迹组的基线特征，并评估它们与心血管疾病（CVD）风险的独立和联合关联。方法：利用中国健康与退休纵向研究（CHARLS）的三个两年一次的波（2011-2015），对睡眠时间和虚弱指数（FI）的轨迹进行建模。基于组和双轨迹建模识别出不同的模式。使用多项逻辑回归检查了跨轨迹的基线特征。Cox比例风险模型估计了2015-2018年随访期间发生的心血管事件的风险比（hr）和95%置信区间（ci）。结果：在6972名参与者中，确定了4种睡眠轨迹和3种虚弱轨迹。与稳定的8小时睡眠轨迹相比，稳定的5小时睡眠组患心血管疾病（HR: 1.33, 95% CI: 1.05-1.68）和心脏病（HR: 1.42, 95% CI: 1.07-1.88）的风险更高，仅在性别分层分析中对女性有显著性意义。稳定的体弱前期和体弱轨迹与心血管疾病（HR: 1.92, 95% CI: 1.45-2.55; HR: 3.70, 95% CI: 2.63-5.21）和心脏病（HR: 2.28, 95% CI: 1.60-3.24; HR: 4.61, 95% CI: 3.03-7.00）的风险升高有关。双轨迹分析揭示了睡眠和虚弱的共同发展模式，在稳定的前虚弱/虚弱和稳定的5小时轨迹中观察到最高的心血管疾病风险（HR: 3.04, 95% CI: 1.88-4.91）。结论：睡眠时间和虚弱轨迹随时间的推移相互关联，并共同影响心血管疾病的风险。监测他们的长期模式可以提高心血管疾病预防的准确性。

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引用次数: 0

Trends and cross-country inequalities in the global burden of environmental heat and cold exposure among the elderly population from 1990 to 2021: A population-based study 1990年至2021年全球老年人环境冷热暴露负担的趋势和跨国不平等：一项基于人群的研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-15 DOI: 10.1016/j.archger.2026.106148

Shenghao Xu , Haoyu Li , Jianlin Xiao

Background

Against the backdrop of rapid climate change, environmental heat and cold exposure (EHCE) represents a leading cause of mortality among older adults globally.

Methods

This study, based on data from the Global Burden of Disease Study 2021, analyzed the age-standardized incidence (ASIR), prevalence (ASPR), deaths (ASDR), and disability-adjusted life years (DALYs) rates of EHCE among the elderly population and evaluated the temporal trends of the burden, driving factors, and the effects of age, period, and cohort on the burden. Additionally, the slope index of inequality and concentration index were used to evaluate cross-country disparities.

Results

Although the ASIR and ASPR decreased by –1.47 % and –1.33 %, respectively, the total number of cases significantly increased. In 2021, the ASPR was 413.24 (95 % uncertainty interval [UI]: 362.36 to 475.62), with a total of 4,427,518.39 cases (95 % UI: 3,879,450.57 to 5,101,795.26), an increase of 52.48 % compared to 1990. At the regional level, Eastern Europe had the highest ASPR, at 1,233.25 (95 % UI: 1,060.62 to 1,428.94). Age had a significant positive impact on the EHCE burden, with the highest risk among individuals aged 95 and older. Decomposition analysis indicated that population growth was the primary driver of increased burden, while epidemiological changes significantly reduced it. Health inequality analysis revealed that the EHCE burden is concentrated in high SDI countries; although absolute inequality has decreased, relative inequality is still increasing.

Conclusion

This study underscores the necessity of developing interventions targeted at the elderly population and strengthening global cooperation to address climate change.

在气候快速变化的背景下，环境冷热暴露（EHCE）是全球老年人死亡的主要原因。方法本研究基于全球疾病负担研究2021的数据，分析老年人EHCE的年龄标准化发病率（ASIR）、患病率（ASPR）、死亡率（ASDR）和残疾调整生命年（DALYs）率，并评估负担的时间趋势、驱动因素以及年龄、时期和队列对负担的影响。此外，还利用不平等斜率指数和集中度指数对跨国差异进行了评价。结果虽然ASIR和ASPR分别下降了- 1.47%和- 1.33%，但总病例数明显增加。2021年，ASPR为413.24例（95%不确定区间[UI]: 362.36 ~ 475.62），共4427518.39例（95% UI: 3879450.57 ~ 5101795.26），较1990年增加52.48%。在区域一级，东欧的ASPR最高，为1,233.25 （95% UI: 1,060.62至1,428.94）。年龄对EHCE负担有显著的正向影响，95岁及以上人群的风险最高。分解分析表明，人口增长是疾病负担增加的主要原因，而流行病学变化显著降低了疾病负担。卫生不平等分析显示，EHCE负担集中在高SDI国家；虽然绝对不平等有所减少，但相对不平等仍在增加。结论本研究强调了制定针对老年人口的干预措施和加强全球合作应对气候变化的必要性。

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引用次数: 0

What matters most to older adults? A systematic review of preferences for socially assistive robots 对老年人来说，什么最重要？对社会辅助机器人偏好的系统回顾

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-10 DOI: 10.1016/j.archger.2026.106139

Jing Wu, Jixia Cao, Pingshuang Li, Can Yang, Ying He

Background

The current level of social acceptance of socially assistive robots (SARs) remains limited. Research on user preferences plays an essential role in improving the acceptance of SARs among older adults. This study aimed to integrate evidence on older adults’ preferences for SARs to provide personalized guidance and establish a foundation for their future use in home care environments.

Methods

We searched 7 databases to find any studies designed to focus on the preferences of older adults for SARs. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT).

Results

A total of 21 studies were included. Although studies on older adults’ preferences for SARs varied considerably in design and scope, several consistent patterns emerged: (1) older adults preferred SARs that assist with household tasks; (2) they favored voice-based interaction; (3) they preferred human-like appearances; (4) their preferences regarding privacy, data storage, control, autonomy, and emotional or social interaction; and (5) most viewed SARs as assistants or companions.

Conclusion

This review highlights the diversity of older adults’ preferences for SARs, including service functions, communication, appearance, and ethical considerations. Future research should address these preferences to promote acceptance and support the integration of socially assistive robots into home care settings.

目前社会对社交辅助机器人（sar）的接受程度仍然有限。用户偏好研究在提高老年人对sar的接受度方面起着至关重要的作用。本研究旨在整合老年人对SARs偏好的证据，提供个性化指导，并为其未来在家庭护理环境中的应用奠定基础。方法我们检索了7个数据库，以找到任何旨在关注老年人对SARs的偏好的研究。使用混合方法评估工具（MMAT）评估纳入研究的质量。结果共纳入21项研究。尽管关于老年人对辅助助手的偏好的研究在设计和范围上有很大差异，但出现了一些一致的模式：(1)老年人更喜欢协助家务的辅助助手；(2)偏好语音交互；(3)他们更喜欢人类的外表；(4)他们在隐私、数据存储、控制、自主以及情感或社会互动方面的偏好；(5)大多数人将SARs视为助手或同伴。结论本综述强调了老年人对sar偏好的多样性，包括服务功能、通信、外观和伦理考虑。未来的研究应该解决这些偏好，以促进接受和支持社会辅助机器人融入家庭护理环境。

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引用次数: 0

Effects of different non-pharmacological interventions on executive function in healthy older people: A systematic review and network meta-analysis 不同非药物干预对健康老年人执行功能的影响：系统综述和网络荟萃分析

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-09 DOI: 10.1016/j.archger.2026.106141

Ying Bai , Yuan Yuan , Bopeng Qiu , Yong Yang , Chen Cheng , Junyu Wang , Hao Liu , Tao Wang , Zhiyu Xiong , Yiqi Li , Zhongli Wang , Lin Zhang

Objective

Executive function (EF) is a critical component of healthy aging, and its decline represents a fundamental challenge to neurological health. This network meta-analysis (NMA) systematically compared and ranked the effects of a spectrum of non-pharmacological interventions on overall EF and its key subdomains—working memory, cognitive flexibility, and inhibition—in healthy older adults.

Methods

We searched PubMed, Cochrane, Embase, and Web of Science from their inception to February 17, 2025, for randomized controlled trials (RCTs) investigating non-pharmacological interventions in healthy older people (≥ 60 years). All analyses were performed using the R package “netmeta”. The risk of bias was assessed using the revised Cochrane Risk of Bias tool (RoB 2), and the confidence in the evidence was evaluated with the CINeMA (Confidence in Network Meta-Analysis) framework.

Results

A total of 115 RCTs with 16,824 healthy older people were included, evaluating 11 types of non-pharmacological interventions. Network meta-analysis revealed comparative effectiveness among the interventions: dance showed favorable outcomes for improving overall executive function (standardized mean difference [SMD] = 0.82, 95 % confidence interval [CI]: 0.40 to 1.24) and cognitive flexibility (SMD = 0.96, 95 % CI: 0.50 to 1.43). Resistance training was associated with greater improvement in working memory (SMD = 0.86, 95 % CI: 0.51 to 1.20), while computerized cognitive training showed a positive effect on inhibition (SMD = 0.48, 95 % CI: 0.28 to 0.68).

Conclusions

This network meta-analysis suggests that dance improves overall executive function and cognitive flexibility, resistance training enhances working memory, and computerized cognitive training benefits inhibition in healthy older adults. These findings offer an evidence-based ranking to inform the selection of targeted non-pharmacological interventions in clinical and community settings.

目的：执行功能（EF）是健康衰老的重要组成部分，其下降是对神经系统健康的根本挑战。该网络荟萃分析（NMA）系统地比较和排名了一系列非药物干预对健康老年人整体EF及其关键子域（工作记忆、认知灵活性和抑制）的影响。方法：我们检索PubMed、Cochrane、Embase和Web of Science，检索从网站建立到2025年2月17日的随机对照试验（RCTs），研究健康老年人（≥60岁）的非药物干预措施。所有分析均使用R软件包“netmeta”进行。使用修订后的Cochrane偏倚风险工具（RoB 2）评估偏倚风险，并使用CINeMA（网络元分析置信度）框架评估证据的置信度。结果共纳入115项随机对照试验，共纳入16824名健康老年人，评估了11种非药物干预措施。网络荟萃分析显示了干预措施之间的比较有效性：舞蹈在改善整体执行功能（标准化平均差[SMD] = 0.82, 95%可信区间[CI]: 0.40至1.24）和认知灵活性（SMD = 0.96, 95% CI: 0.50至1.43）方面显示出良好的结果。阻力训练与工作记忆的更大改善有关（SMD = 0.86, 95% CI: 0.51至1.20），而计算机化认知训练对抑制有积极作用（SMD = 0.48, 95% CI: 0.28至0.68）。结论该网络荟萃分析表明，舞蹈可以改善健康老年人的整体执行功能和认知灵活性，阻力训练可以增强工作记忆，计算机化认知训练有利于抑制。这些发现提供了一个基于证据的排名，为临床和社区环境中有针对性的非药物干预措施的选择提供信息。

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引用次数: 0

Clinical impact of cardiac ejection fraction and atrial fibrillation on elderly hemodialysis patients 心脏射血分数与心房颤动对老年血液透析患者的临床影响

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-09 DOI: 10.1016/j.archger.2026.106140

Da Woon Kim , Yu Ah Hong , Sung Joon Shin , Soon Hyo Kwon , Sungjin Chung , Young Youl Hyun , Byung Chul Yu , Jae Won Yang , Won Min Hwang , Jang-Hee Cho , Kyung Don Yoo , In O Sun , Gang-Jee Ko , Hyunsuk Kim , Woo Yeong Park , Eunjin Bae , Sang Heon Song

Background

This study aimed to investigate all-cause mortality in elderly patients starting hemodialysis (HD) according to left ventricular ejection fraction [LVEF] and atrial fibrillation (AF).

Methods

We analyzed 1,137 incident HD patients aged ≥70 years from a retrospective multicenter cohort of the Korean Society of Geriatric Nephrology. All-cause mortality was evaluated within the first 6 months and beyond 6 months using a landmark analysis (median follow-up, 3.7 years) according to LVEF and AF status. Sequential Cox proportional hazards models were applied, adjusted for demographic and clinical factors.

Results

Patients were classified into four groups according to LVEF (≥50% vs. <50%) and AF status. After full adjustment, neither reduced LVEF nor AF was independently associated with 6-month mortality. Early mortality was mainly associated with older age, lower serum albumin, and impaired mobility. In the 6-month landmark analysis, compared with patients with preserved LVEF and no AF, those with reduced LVEF without AF (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.01–1.65), preserved LVEF with AF (HR 1.35, 95% CI 1.02–1.80), and reduced LVEF with AF (HR 1.69, 95% CI 1.03–2.79) had progressively higher long-term mortality risks.

Conclusions

In elderly patients initiating HD, reduced LVEF and AF were independently associated with higher long-term mortality, whereas short-term mortality was predominantly driven by frailty and nutritional status rather than cardiac factors. These findings highlight the importance of time-specific risk stratification and integrated cardiovascular and geriatric management in this population.

本研究旨在根据左室射血分数（LVEF）和房颤（AF）调查老年血液透析（HD）患者的全因死亡率。方法：我们分析了1137例年龄≥70岁的HD患者，这些患者来自韩国老年肾病学会的回顾性多中心队列。根据LVEF和AF状态，采用里程碑式分析（中位随访3.7年）评估前6个月和6个月后的全因死亡率。采用顺序Cox比例风险模型，并根据人口学和临床因素进行调整。结果根据LVEF（≥50% vs. <50%）和AF状态将患者分为4组。完全调整后，LVEF和AF的降低与6个月死亡率均无独立相关性。早期死亡主要与年龄较大、血清白蛋白较低和活动能力受损有关。在6个月的里程碑式分析中，与LVEF保留但无房颤的患者相比，LVEF减少而无房颤的患者（风险比[HR] 1.29, 95%可信区间[CI] 1.01-1.65）、LVEF保留并房颤（风险比[HR] 1.35, 95% CI 1.02-1.80）和LVEF减少并房颤（风险比[HR] 1.69, 95% CI 1.03-2.79）的长期死亡风险逐渐升高。结论在老年HD患者中，LVEF和房颤降低与较高的长期死亡率独立相关，而短期死亡率主要由虚弱和营养状况驱动，而不是心脏因素。这些发现强调了在这一人群中进行时间特异性风险分层以及心血管和老年综合管理的重要性。

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引用次数: 0

Clinical outcomes and safety of SGLT2 inhibitors in the older population with heart failure: A systematic review and meta-analysis SGLT2抑制剂在老年心力衰竭患者中的临床结局和安全性：一项系统回顾和荟萃分析

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-09 DOI: 10.1016/j.archger.2026.106138

Ayan Khalid , Rahul Balach , Anas Rasool , Shaikh Muhammad Daniyal , Muhammad Taha Nizami , Isbah Gul , Ashmat Naqvi , Gregg C. Fonarow , Saad Ahmed Waqas

Background

Heart failure (HF) predominantly affects older adults, yet this group remains underrepresented in sodium–glucose cotransporter-2 inhibitor (SGLT2i) trials. Given their frailty and multimorbidity, clarifying the potential benefit and safety of SGLT2i in older HF patients is essential.

Methods

PubMed, ScienceDirect, and Cochrane Central were searched through August 2025 for randomized controlled trials (RCTs) and observational studies comparing SGLT2i with control in patients aged ≥65 years with HF. Hazard ratios (HRs), risk ratios (RRs), and mean differences (MDs) were pooled using random-effects models.

Results

Ten studies (4 RCTs, 6 cohorts; n = 20,844) were included. SGLT2i was associated with a lower hazard of all-cause mortality (HR 0.81 [95% CI 0.72–0.90]; p < 0.001), cardiovascular (CV) death (HR 0.83 [0.74–0.94]; p = 0.004), first HF hospitalization (HR 0.73 [0.66–0.80]; p < 0.001), composite CV death or HF hospitalization (HR 0.78 [0.70–0.87]; p < 0.001), and rehospitalization (HR 0.60 [0.53–0.69]; p < 0.001). SGLT2i lowered serious adverse events (RR 0.92 [0.89–0.95]; p < 0.001) and slowed renal function decline (MD 1.86 [1.15–2.58] mL/min/1.73 m² per year; p < 0.001). An increase was observed in genital (RR 3.07 [2.03–4.64]; p < 0.001) and urinary tract infections (RR 1.19 [1.03–1.38]; p = 0.02).

Conclusions

In older patients with HF, SGLT2i was associated with lower mortality and HF hospitalizations and with a slower renal decline, while largely maintaining a favorable safety profile. These findings support the consideration of SGLT2i as an important therapeutic option for older adults with HF.

心衰（HF）主要影响老年人，但这一群体在钠-葡萄糖共转运蛋白2抑制剂（SGLT2i）试验中的代表性仍然不足。考虑到老年心衰患者的脆弱性和多发病性，明确SGLT2i治疗老年心衰患者的潜在益处和安全性至关重要。方法检索spubmed、ScienceDirect和Cochrane Central截至2025年8月的随机对照试验（rct）和观察性研究，比较年龄≥65岁HF患者的SGLT2i和对照组。使用随机效应模型汇总风险比（hr）、风险比（rr）和平均差异（MDs）。结果共纳入10项研究（4项随机对照试验，6个队列，n = 20,844）。SGLT2i与全因死亡率（HR 0.81 [95% CI 0.72-0.90]; p < 0.001）、心血管（CV）死亡（HR 0.83 [0.74-0.94]; p = 0.004）、首次HF住院（HR 0.73 [0.66-0.80]; p < 0.001）、复合CV死亡或HF住院（HR 0.78 [0.70-0.87]; p < 0.001）和再住院（HR 0.60 [0.53-0.69]; p < 0.001）的风险较低相关。SGLT2i降低严重不良事件（RR 0.92 [0.89-0.95]; p < 0.001），减缓肾功能下降（MD 1.86 [1.15-2.58] mL/min/1.73 m²/年；p < 0.001）。生殖器感染（RR = 3.07 [2.03-4.64]; p < 0.001）和尿路感染（RR = 1.19 [1.03-1.38]; p = 0.02）增加。结论：在老年HF患者中，SGLT2i与较低的死亡率和HF住院率以及较慢的肾功能下降相关，同时在很大程度上保持了良好的安全性。这些发现支持SGLT2i作为老年心衰患者重要治疗选择的考虑。

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引用次数: 0

Development and external validation of a mortality prediction model for community-dwelling adults aged ≥50 years with frailty or pre-frailty ≥50岁社区居民体弱或体弱前期成人死亡率预测模型的建立和外部验证

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-09 DOI: 10.1016/j.archger.2026.106143

Kang Fu , Ruizhe Chen , Shuwen Li , Yu Zhang , Kailu Fang , Luyan Zheng , Yushi Lin , Lanjuan Li , Jie Wu

Background

Frailty and pre-frailty raise mortality risk in older adults, yet clinicians lack tailored prognostic tools. We developed and externally validated a model predicting all-cause mortality in community-dwelling adults aged ≥50 years with frailty or pre-frailty.

Methods

Using SHARE 2006–07 data (n = 15,195), we fitted a Cox model with backward selection and multiple imputation. Predictors spanned demographics, lifestyle, ADL/IADL limitations, mobility, pain and key comorbidities. We assessed discrimination by integrated and time-specific AUCs and calibration by comparing predicted versus observed mortality. External validation occurred in ELSA (n = 4464) and HRS (n = 7414).

Results

Within the SHARE cohort (61.0% female; median follow-up 3.8 years), 18.5% (n = 2811) of participants died. The final model incorporated age, sex, BMI, smoking status, IADL limitations, mobility impairments, physical activity, pain, and major comorbidities. Internal validation demonstrated robust discrimination (optimism-corrected iAUC 0.81, 95% CI 0.79–0.82), with sustained accuracy at 1-, 5-, and 7-year intervals (AUCs 0.80–0.83). External validation in ELSA (iAUC 0.83) and HRS (iAUC 0.82) confirmed strong generalizability, alongside excellent calibration across all time points.

Conclusions

We present a rigorously validated prognostic model for mortality in frail and pre-frail older adults, demonstrating high accuracy and clinical utility. By providing personalized risk estimates, this tool can enhance shared decision-making, optimize care planning, and improve outcomes for a growing at-risk population.

背景：虚弱和虚弱前期会增加老年人的死亡风险，但临床医生缺乏量身定制的预后工具。我们开发并外部验证了一个模型，该模型预测了≥50岁、体弱或体弱前期社区居住成年人的全因死亡率。方法采用SHARE 2006-07数据（n = 15,195），采用反向选择和多重插值方法拟合Cox模型。预测因素包括人口统计、生活方式、ADL/IADL限制、活动能力、疼痛和主要合并症。我们通过综合和特定时间的auc来评估歧视，并通过比较预测死亡率和观察死亡率来校准。ELSA （n = 4464）和HRS （n = 7414）进行了外部验证。在SHARE队列中（61.0%为女性，中位随访3.8年），18.5% （n = 2811）的参与者死亡。最终模型纳入了年龄、性别、BMI、吸烟状况、IADL限制、行动障碍、身体活动、疼痛和主要合并症。内部验证显示了稳健的区分（乐观校正的iAUC 0.81, 95% CI 0.79-0.82），在1年、5年和7年的间隔（auc 0.80-0.83）具有持续的准确性。ELSA （iAUC 0.83）和HRS （iAUC 0.82）的外部验证证实了较强的通用性，以及所有时间点的优秀校准。结论：我们提出了一个经过严格验证的老年人体弱和体弱前期死亡率预后模型，具有较高的准确性和临床实用性。通过提供个性化的风险评估，该工具可以加强共同决策，优化护理计划，并改善日益增长的风险人群的结果。

{"title":"Development and external validation of a mortality prediction model for community-dwelling adults aged ≥50 years with frailty or pre-frailty","authors":"Kang Fu , Ruizhe Chen , Shuwen Li , Yu Zhang , Kailu Fang , Luyan Zheng , Yushi Lin , Lanjuan Li , Jie Wu","doi":"10.1016/j.archger.2026.106143","DOIUrl":"10.1016/j.archger.2026.106143","url":null,"abstract":"<div><h3>Background</h3><div>Frailty and pre-frailty raise mortality risk in older adults, yet clinicians lack tailored prognostic tools. We developed and externally validated a model predicting all-cause mortality in community-dwelling adults aged ≥50 years with frailty or pre-frailty.</div></div><div><h3>Methods</h3><div>Using SHARE 2006–07 data (<em>n</em> = 15,195), we fitted a Cox model with backward selection and multiple imputation. Predictors spanned demographics, lifestyle, ADL/IADL limitations, mobility, pain and key comorbidities. We assessed discrimination by integrated and time-specific AUCs and calibration by comparing predicted versus observed mortality. External validation occurred in ELSA (<em>n</em> = 4464) and HRS (<em>n</em> = 7414).</div></div><div><h3>Results</h3><div>Within the SHARE cohort (61.0% female; median follow-up 3.8 years), 18.5% (<em>n</em> = 2811) of participants died. The final model incorporated age, sex, BMI, smoking status, IADL limitations, mobility impairments, physical activity, pain, and major comorbidities. Internal validation demonstrated robust discrimination (optimism-corrected iAUC 0.81, 95% CI 0.79–0.82), with sustained accuracy at 1-, 5-, and 7-year intervals (AUCs 0.80–0.83). External validation in ELSA (iAUC 0.83) and HRS (iAUC 0.82) confirmed strong generalizability, alongside excellent calibration across all time points.</div></div><div><h3>Conclusions</h3><div>We present a rigorously validated prognostic model for mortality in frail and pre-frail older adults, demonstrating high accuracy and clinical utility. By providing personalized risk estimates, this tool can enhance shared decision-making, optimize care planning, and improve outcomes for a growing at-risk population.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"143 ","pages":"Article 106143"},"PeriodicalIF":3.8,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mapping assistive technologies along the progression of Alzheimer's disease: A scoping review 绘制辅助技术沿着阿尔茨海默病的进展：范围审查

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-09 DOI: 10.1016/j.archger.2026.106142

Nadia Mirjan , Aleksandra Zecevic , Leena Shoemaker

Background and objectives

A growing population of people living with Alzheimer’s Disease requires improved supports for aging in place. Assistive technologies (ATs) can delay institutionalization, reduce care partner strain, and improve quality of life for this population. The abilities and needs of this population change during disease progression, but it remains unclear which ATs are best suited for specific stages. The purpose of this scoping review was to provide a snapshot in time by mapping currently available ATs assessed in peer-reviewed research, across the seven stages of Alzheimer’s Disease progression.

Research design and methods

The review followed the Arksey and O’Malley framework to identify and harvest information from Medline, Scopus, CINAHL, and Embase databases. Inclusion criteria were Alzheimer’s Disease, technology interventions of any type and duration, English language, and the period between 2000 and 2023. Data was extracted and analyzed using six predetermined domains of ATs for dementia: safety devices, clinical devices, memory aids, ATs for preventing social isolation, ATs for leisure activities, and ATs for supporting everyday tasks.

Results

A total of 87 ATs, reported in 47 articles, were mapped along seven stages of the disease. A variety of ATs are available, with high technology (e.g., tracking devices) targeting initial stages, and low technology (e.g., weighted blanket) targeting later stages. Music therapies were present across all disease stages.

Discussion and implications

The map has the potential to inform people with Alzheimer’s Disease, care partners, technology companies, policy makers and service providers on current AT availability and need for further development.

背景与目的随着阿尔茨海默病患者人数的增加，需要对老年化提供更好的支持。辅助技术（at）可以延迟机构化，减少护理伙伴的压力，并改善这一人群的生活质量。这一人群的能力和需求在疾病进展过程中发生变化，但目前尚不清楚哪种ATs最适合特定阶段。本综述的目的是通过绘制同行评议研究中评估的目前可用的ATs，在阿尔茨海默病进展的七个阶段提供一个及时的快照。研究设计和方法本综述遵循Arksey和O 'Malley框架，从Medline、Scopus、CINAHL和Embase数据库中识别和获取信息。纳入标准为阿尔茨海默病、任何类型和持续时间的技术干预、英语语言和2000年至2023年之间的时间。数据的提取和分析使用了六个预先确定的痴呆人工智能领域：安全装置、临床装置、记忆辅助装置、防止社会隔离的人工智能、用于休闲活动的人工智能和用于支持日常任务的人工智能。结果47篇文章共报道了87个at，沿疾病的7个阶段进行了绘制。各种各样的ATs都是可用的，高技术（例如，跟踪装置）针对初始阶段，低技术（例如，加权毯）针对后期阶段。音乐疗法存在于所有疾病阶段。讨论和影响该地图有可能使阿尔茨海默病患者、护理合作伙伴、技术公司、政策制定者和服务提供商了解目前的辅助治疗可用性和进一步发展的需要。

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引用次数: 0

The effects of functional exercise on healthy aging in women over 60 years of age: A systematic review and meta-analysis 功能性运动对60岁以上女性健康衰老的影响：系统回顾和荟萃分析

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-07 DOI: 10.1016/j.archger.2026.106129

Hugo Rodríguez-Otero , Pablo Hernandez-Lucas , Juan Lopez-Barreiro , Raquel Leirós-Rodríguez

Introduction

Healthy aging is a major public health priority, particularly for women, who have a longer life expectancy and a high prevalence of conditions associated with frailty, sarcopenia, and loss of functional independence. Therefore, the objective of this systematic review and meta-analysis was to evaluate the effects of functional exercise on physical and psychosocial outcomes in women over 60 years of age.

Methods

A systematic review and meta-analysis was conducted following PRISMA guidelines. Searches were performed in PubMed, Scopus, Web of Science, and Cochrane Library up to September 2025. Only randomized controlled trials involving women aged 60 years and older who participated in functional exercise interventions were included. Methodological quality was assessed with the PEDro scale, and pooled analyses were conducted using standardized mean differences (SMD) with 95% confidence intervals.

Results

Seventeen randomized controlled trials with a total of 968 participants met the inclusion criteria. Meta-analyses showed that functional exercise significantly improved physical capacities, including functionality (SMD = 0.81; 95% CI = 0.62 to 0.99), strength (SMD = 0.51; 95% CI = 0.11 to 0.91), and power (SMD = 0.28; 95% CI = 0.10 to 0.46). Additional evidence suggested improvements in psychosocial outcomes and reductions in proinflammatory cytokines, although results were more heterogeneous. The overall methodological quality of the included studies was moderate to high.

Conclusions

Functional exercise may be a beneficial strategy to enhance physical and psychosocial capacities in women over 60 years of age. It may also contribute to modulating inflammatory and immunosenescence-related responses; however, the evidence remains limited and should be interpreted with caution. Further high-quality studies are needed to support its integration into healthy aging and preventive care programs.

健康老龄化是一个主要的公共卫生优先事项，特别是对妇女而言，她们的预期寿命较长，并且与身体虚弱、肌肉减少症和丧失功能独立性相关的疾病非常普遍。因此，本系统综述和荟萃分析的目的是评估功能性锻炼对60岁以上女性身体和心理结局的影响。方法按照PRISMA指南进行系统评价和荟萃分析。截至2025年9月，在PubMed、Scopus、Web of Science和Cochrane Library中进行了搜索。只纳入了年龄在60岁及以上的女性参与功能性运动干预的随机对照试验。采用PEDro量表评估方法学质量，并采用95%置信区间的标准化平均差异（SMD）进行合并分析。结果17项随机对照试验共968名受试者符合纳入标准。荟萃分析显示，功能性锻炼显著改善了身体能力，包括功能（SMD = 0.81; 95% CI = 0.62至0.99）、力量（SMD = 0.51; 95% CI = 0.11至0.91）和力量（SMD = 0.28; 95% CI = 0.10至0.46）。其他证据表明，社会心理结果得到改善，促炎细胞因子减少，尽管结果更加不一致。纳入研究的总体方法学质量为中等至高。结论功能锻炼可能是提高60岁以上妇女身体和心理社会能力的有益策略。它也可能有助于调节炎症和免疫衰老相关反应；然而，证据仍然有限，应谨慎解释。需要进一步的高质量研究来支持其纳入健康老龄化和预防保健计划。

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引用次数: 0