Archives of gerontology and geriatrics最新文献

英文中文

Wakefulness after sleep offset and the elevated risk of mortality in older adults with evening preferences: A community-based 5-year longitudinal study

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-04-05 DOI: 10.1016/j.archger.2025.105852

Georg von Fingerhut, Keitaro Makino, Osamu Katayama, Ryo Yamaguchi, Daiki Yamagiwa, Hiroyuki Shimada

Background and Objectives

This study investigated the relationship between wakefulness after sleep offset timing (WASF), evening chronotype preferences, and mortality risk in community-dwelling older adults.

Research design and methods

We conducted a community-based longitudinal study with a sample of 4167 older adults aged ≥60. The sleep characteristics, WASF, subjective chronotype preferences, and other relevant variables of the participants at baseline were evaluated. We examined the association between WASF and mortality over a 5-year period using Cox proportional hazards models, with stratification by subjective chronotype preferences to explore potential effect modification.

Results

Data from 3734 participants were analyzed (71.1 ± 6.9 years; 2114 [56.6 %] women). The 5-year mortality incidence was 6.3 %. Overall, participants had a median (IQR) of 5.0 (2–20) min WASF, and 767 (20.6 %) were evening types. WASF of ≤5 min = 10.6 (95 % CI, 8.9–12.8), WASF of >5 min = 14.6 (95 % CI, 12.1–17.6). The mortality incidence rates per 1000 person-years were: WASF of ≤5 min = 10.6 (95 % CI, 8.9–12.8) and WASF of >5 min = 14.6 (95 % CI, 12.1–17.6). Even after adjusting for covariates, the longer WASF participants had a higher hazard ratio of 1.40 (95 % CI, 1.04–1.88) compared to the shorter WASF participants. Regular, prolonged WASF was found to be significantly associated with an increased risk of mortality among evening-type individuals (2.69; 95 % CI: 1.19–6.08) in the stratified model based on subjective chronotype preferences. However, we found no statistically significant association among the other types.

Discussion and implications

Reducing morning time in bed, and addressing prolonged WASF are crucial factors in decreasing mortality risk among older adults, especially among those with evening preferences.

{"title":"Wakefulness after sleep offset and the elevated risk of mortality in older adults with evening preferences: A community-based 5-year longitudinal study","authors":"Georg von Fingerhut, Keitaro Makino, Osamu Katayama, Ryo Yamaguchi, Daiki Yamagiwa, Hiroyuki Shimada","doi":"10.1016/j.archger.2025.105852","DOIUrl":"10.1016/j.archger.2025.105852","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>This study investigated the relationship between wakefulness after sleep offset timing (WASF), evening chronotype preferences, and mortality risk in community-dwelling older adults.</div></div><div><h3>Research design and methods</h3><div>We conducted a community-based longitudinal study with a sample of 4167 older adults aged ≥60. The sleep characteristics, WASF, subjective chronotype preferences, and other relevant variables of the participants at baseline were evaluated. We examined the association between WASF and mortality over a 5-year period using Cox proportional hazards models, with stratification by subjective chronotype preferences to explore potential effect modification.</div></div><div><h3>Results</h3><div>Data from 3734 participants were analyzed (71.1 ± 6.9 years; 2114 [56.6 %] women). The 5-year mortality incidence was 6.3 %. Overall, participants had a median (IQR) of 5.0 (2–20) min WASF, and 767 (20.6 %) were evening types. WASF of ≤5 min = 10.6 (95 % CI, 8.9–12.8), WASF of >5 min = 14.6 (95 % CI, 12.1–17.6). The mortality incidence rates per 1000 person-years were: WASF of ≤5 min = 10.6 (95 % CI, 8.9–12.8) and WASF of >5 min = 14.6 (95 % CI, 12.1–17.6). Even after adjusting for covariates, the longer WASF participants had a higher hazard ratio of 1.40 (95 % CI, 1.04–1.88) compared to the shorter WASF participants. Regular, prolonged WASF was found to be significantly associated with an increased risk of mortality among evening-type individuals (2.69; 95 % CI: 1.19–6.08) in the stratified model based on subjective chronotype preferences. However, we found no statistically significant association among the other types.</div></div><div><h3>Discussion and implications</h3><div>Reducing morning time in bed, and addressing prolonged WASF are crucial factors in decreasing mortality risk among older adults, especially among those with evening preferences.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105852"},"PeriodicalIF":3.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777634","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

Corrigendum to “Effects of Otago Exercise Program and Aquatic Exercise on Fall Risk in Older Adults: A Systematic Review”. [Archives of Gerontology and Geriatrics, 2025: 105799.]

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-04-03 DOI: 10.1016/j.archger.2025.105838

Mingyuan Dong , Xi Liu , Yongchul Choi , Ning Li

引用次数: 0

Global trends and burden of age-related hearing loss: 32-year study

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-03-31 DOI: 10.1016/j.archger.2025.105847

Lingkang Dong , Wenqi Dong , Shihui Zhang , Yuchen Jin , Yumeng Jiang , Zhuangzhuang Li , Chunyan Li , Dongzhen Yu

Background

Age-related hearing loss (ARHL) is a major cause of disability and diminished quality of life in older adults. This study uses data from the 2021 Global Burden of Disease (GBD) study to assess global ARHL.

Methods

We evaluated ARHL prevalence, DALYs (Disability-Adjusted Life Years), ASPR (Age-Standardized Prevalence Rate), and ASDR (Age-Standardized DALYs Rate). Trend analysis was conducted using Estimated Annual Percentage Change (EAPC), with projections to 2050.

Result

From 1990 and 2021, global ARHL prevalence cases and DALYs increased by 109 %, reaching 1.55 billion and 44.45 million, respectively. The ASPR increased from 17,106.88 to 18,070.26, while the crude prevalence rate significantly from 13,890.66 to 19,587.14. Both ASPR and ASDR demonstrated significant age-related increases, particularly for moderate and moderately severe ARHL, with EAPC values of 1.39 and 1.49 for ASDR, respectively. Among individuals aged over 85 years, the ASPR of ARHL is expected to reach 80 %. Prevalence cases peaked in the 55–69 age group, with the highest number of cases (179.43 million) observed in the 55–59 subgroup. High-middle SDI regions and East Asia exhibited the most rapid growth. By 2050, ARHL cases are projected to reach 2.31 billion, with ASPR and ASDR expected to continue rising.

Conclusion

ARHL has increased globally over the past three decades, largely due to population aging. The burden is most severe in middle SDI regions, East Asia, and the 55–69 age group, primarily due to their substantial population bases. Addressing this escalating challenge requires enhanced public awareness, early screening initiatives, and targeted interventions.

{"title":"Global trends and burden of age-related hearing loss: 32-year study","authors":"Lingkang Dong , Wenqi Dong , Shihui Zhang , Yuchen Jin , Yumeng Jiang , Zhuangzhuang Li , Chunyan Li , Dongzhen Yu","doi":"10.1016/j.archger.2025.105847","DOIUrl":"10.1016/j.archger.2025.105847","url":null,"abstract":"<div><h3>Background</h3><div>Age-related hearing loss (ARHL) is a major cause of disability and diminished quality of life in older adults. This study uses data from the 2021 Global Burden of Disease (GBD) study to assess global ARHL.</div></div><div><h3>Methods</h3><div>We evaluated ARHL prevalence, DALYs (Disability-Adjusted Life Years), ASPR (Age-Standardized Prevalence Rate), and ASDR (Age-Standardized DALYs Rate). Trend analysis was conducted using Estimated Annual Percentage Change (EAPC), with projections to 2050.</div></div><div><h3>Result</h3><div>From 1990 and 2021, global ARHL prevalence cases and DALYs increased by 109 %, reaching 1.55 billion and 44.45 million, respectively. The ASPR increased from 17,106.88 to 18,070.26, while the crude prevalence rate significantly from 13,890.66 to 19,587.14. Both ASPR and ASDR demonstrated significant age-related increases, particularly for moderate and moderately severe ARHL, with EAPC values of 1.39 and 1.49 for ASDR, respectively. Among individuals aged over 85 years, the ASPR of ARHL is expected to reach 80 %. Prevalence cases peaked in the 55–69 age group, with the highest number of cases (179.43 million) observed in the 55–59 subgroup. High-middle SDI regions and East Asia exhibited the most rapid growth. By 2050, ARHL cases are projected to reach 2.31 billion, with ASPR and ASDR expected to continue rising.</div></div><div><h3>Conclusion</h3><div>ARHL has increased globally over the past three decades, largely due to population aging. The burden is most severe in middle SDI regions, East Asia, and the 55–69 age group, primarily due to their substantial population bases. Addressing this escalating challenge requires enhanced public awareness, early screening initiatives, and targeted interventions.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105847"},"PeriodicalIF":3.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768547","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

Artificial intelligence applications and aging (1995–2024): Trends, challenges, and future directions in frailty research

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-03-25 DOI: 10.1016/j.archger.2025.105837

Ali Mufraih Albarrati , Rakan Nazer , Siddig Ibrahim Abdelwahab , Mohammed Albratty

Background

Frailty, a significant predictor of adverse health outcomes, has become a focal point of research, particularly with the advent of artificial intelligence (AI) technologies. This study aimed to provide a comprehensive bibliometric analysis of research trends in AI and frailty to map conceptual developments, collaborations, and emerging themes in the field.

Methods

A systematic search was conducted using the Scopus database employing a comprehensive set of keywords related to AI and frailty. The search was refined to include only original articles in English, yielding 1213 documents. Data extraction was performed in October 2024 and exported in the CSV and BibTeX formats. Annual growth trends were analyzed using Microsoft Excel, while VOSviewer and R-package were used for bibliometric analyzes and visualization to identify key contributors, collaborations, and thematic clusters.

Results

The analysis revealed rapid growth in research publications, with AI applications in frailty gaining prominence over the past decade. Thematic clusters highlight areas such as predictive modeling, machine learning applications, and geriatric care innovations. The United States, United Kingdom, and Italy emerged as leading contributors to publications and collaborations. The key topics included prediction models, dementia, sarcopenia, and rehabilitation. This bibliometric study underscores the increasing integration of AI into frailty research, revealing key trends, collaborative networks, and emerging areas of focus.

Conclusion

These findings can guide future research, foster collaborations, and enhance the application of AI technologies to improve frailty assessment and management.

{"title":"Artificial intelligence applications and aging (1995–2024): Trends, challenges, and future directions in frailty research","authors":"Ali Mufraih Albarrati , Rakan Nazer , Siddig Ibrahim Abdelwahab , Mohammed Albratty","doi":"10.1016/j.archger.2025.105837","DOIUrl":"10.1016/j.archger.2025.105837","url":null,"abstract":"<div><h3>Background</h3><div>Frailty, a significant predictor of adverse health outcomes, has become a focal point of research, particularly with the advent of artificial intelligence (AI) technologies. This study aimed to provide a comprehensive bibliometric analysis of research trends in AI and frailty to map conceptual developments, collaborations, and emerging themes in the field.</div></div><div><h3>Methods</h3><div>A systematic search was conducted using the Scopus database employing a comprehensive set of keywords related to AI and frailty. The search was refined to include only original articles in English, yielding 1213 documents. Data extraction was performed in October 2024 and exported in the CSV and BibTeX formats. Annual growth trends were analyzed using Microsoft Excel, while VOSviewer and R-package were used for bibliometric analyzes and visualization to identify key contributors, collaborations, and thematic clusters.</div></div><div><h3>Results</h3><div>The analysis revealed rapid growth in research publications, with AI applications in frailty gaining prominence over the past decade. Thematic clusters highlight areas such as predictive modeling, machine learning applications, and geriatric care innovations. The United States, United Kingdom, and Italy emerged as leading contributors to publications and collaborations. The key topics included prediction models, dementia, sarcopenia, and rehabilitation. This bibliometric study underscores the increasing integration of AI into frailty research, revealing key trends, collaborative networks, and emerging areas of focus.</div></div><div><h3>Conclusion</h3><div>These findings can guide future research, foster collaborations, and enhance the application of AI technologies to improve frailty assessment and management.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105837"},"PeriodicalIF":3.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739876","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

Advance care planning procedure in older patients at a high risk of death after discharge from the acute geriatric unit: A study protocol

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-03-24 DOI: 10.1016/j.archger.2025.105836

Fabien Visade , Guillaume Deschasse , Frédéric Roca , Cédric Villain , Sylvia Pelayo , Romaric Marcilly , Matthieu Calafiore , Paul Quindroit , Chloé Prod'homme , Clémence Levesque , Williams Vandenberghe , Laurène Norberciak , Marie Buttitta , Carla Di Martino , Jean-Baptiste Beuscart

The SAPHARI (“Home-based Nurse Intervention in the Care of High-Risk-of-Death Patients after Discharge from a Geriatric Department”) prospective, multicenter, randomized, controlled, open-label study has been designed to evaluate the effectiveness of implementing advance care planning (ACP) in older patients at a high risk of death. Patients aged 75 or over, at a high risk of death (according to the DAMAGE prognostic score) and discharged alive to home or to a nursing home from an acute geriatric unit will be included and followed up for 12 months. We plan to randomize 104 patients into a control group or an intervention group. The patients in the intervention group will receive an in-home intervention by an expert advanced practice nurse trained in the implementation of ACP. The primary outcome will focus on the intervention's feasibility: the proportion of patients included and randomized, the proportion completing in the study, and the proportion having engaged in ACP within a month of discharge. A secondary efficacy outcome will be compliance with advance directives (drafted at the time of ACP) at 12 months in each of the two study groups. Symptom's of anxiety and depression, the intervention's acceptability, and changes in quality of life will be documented in patients, family carers, and professional caregivers. The patients' and caregivers' experience of the intervention will be explored in qualitative analyses. Lastly, the intervention's implementation will be analyzed, with a view to understanding the results and identifying factors that will foster generalization of the conclusions. Through this project, we hope to lay the foundations for better care of very frail older patients at the end of life. The results of our study will provide robust, scientific evidence to fuel the long-standing but evolving social and political debate over the right to a dignified end of life.

{"title":"Advance care planning procedure in older patients at a high risk of death after discharge from the acute geriatric unit: A study protocol","authors":"Fabien Visade , Guillaume Deschasse , Frédéric Roca , Cédric Villain , Sylvia Pelayo , Romaric Marcilly , Matthieu Calafiore , Paul Quindroit , Chloé Prod'homme , Clémence Levesque , Williams Vandenberghe , Laurène Norberciak , Marie Buttitta , Carla Di Martino , Jean-Baptiste Beuscart","doi":"10.1016/j.archger.2025.105836","DOIUrl":"10.1016/j.archger.2025.105836","url":null,"abstract":"<div><div>The SAPHARI (“Home-based Nurse Intervention in the Care of High-Risk-of-Death Patients after Discharge from a Geriatric Department”) prospective, multicenter, randomized, controlled, open-label study has been designed to evaluate the effectiveness of implementing advance care planning (ACP) in older patients at a high risk of death. Patients aged 75 or over, at a high risk of death (according to the DAMAGE prognostic score) and discharged alive to home or to a nursing home from an acute geriatric unit will be included and followed up for 12 months. We plan to randomize 104 patients into a control group or an intervention group. The patients in the intervention group will receive an in-home intervention by an expert advanced practice nurse trained in the implementation of ACP. The primary outcome will focus on the intervention's feasibility: the proportion of patients included and randomized, the proportion completing in the study, and the proportion having engaged in ACP within a month of discharge. A secondary efficacy outcome will be compliance with advance directives (drafted at the time of ACP) at 12 months in each of the two study groups. Symptom's of anxiety and depression, the intervention's acceptability, and changes in quality of life will be documented in patients, family carers, and professional caregivers. The patients' and caregivers' experience of the intervention will be explored in qualitative analyses. Lastly, the intervention's implementation will be analyzed, with a view to understanding the results and identifying factors that will foster generalization of the conclusions. Through this project, we hope to lay the foundations for better care of very frail older patients at the end of life. The results of our study will provide robust, scientific evidence to fuel the long-standing but evolving social and political debate over the right to a dignified end of life.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105836"},"PeriodicalIF":3.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726085","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

Tolerable blood pressure control levels do not impact mortality of patients over 80-year-old: Insights from NHANES 2009-2018

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-03-20 DOI: 10.1016/j.archger.2025.105828

Yueqiao Si , Binjun Lu , Lanlan Ma , Juanjuan Zheng , Wei Eric Wang

Objective

This study aimed to investigate the impact of blood pressure levels on all-cause and cardiovascular disease (CVD) mortality in hypertensive patients over 80-year-old using data from the National Health and Nutrition Examination Survey (NHANES) 2009–2018.

Methods

A total of 8406 hypertensive patients under 80-year-old and 1082 hypertensive patients over 80-year-old were included. Kaplan-Meier curves, Cox proportional hazards regression models, and restricted cubic spline plots were employed.

Results

In patients over 80-year-old, neither systolic blood pressure (SBP) nor diastolic blood pressure (DBP) was significantly associated with all-cause or CVD mortality (P > 0.05). However, in hypertensive patients under 80-year-old, significant differences in mortality were observed across different SBP and DBP subgroups (P < 0.05), with an optimal SBP range of 120–140 mmHg associated with reduced all-cause mortality risk. In patients over 80-year-old, male patients, high urinary albumin-to-creatinine ratio, total cholesterol, red blood cells, and elevated lymphocyte and neutrophil percentages were associated with increased all-cause mortality; SBP interaction with these risk factors slightly reduced the hazard ratio values separately.

Conclusion

Based on NHANES data from 2009 to 2018, tolerable SBP and DBP levels appear to have no significant impact on all-cause or CVD mortality in hypertensive patients over 80-year-old”.

{"title":"Tolerable blood pressure control levels do not impact mortality of patients over 80-year-old: Insights from NHANES 2009-2018","authors":"Yueqiao Si , Binjun Lu , Lanlan Ma , Juanjuan Zheng , Wei Eric Wang","doi":"10.1016/j.archger.2025.105828","DOIUrl":"10.1016/j.archger.2025.105828","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the impact of blood pressure levels on all-cause and cardiovascular disease (CVD) mortality in hypertensive patients over 80-year-old using data from the National Health and Nutrition Examination Survey (NHANES) 2009–2018.</div></div><div><h3>Methods</h3><div>A total of 8406 hypertensive patients under 80-year-old and 1082 hypertensive patients over 80-year-old were included. Kaplan-Meier curves, Cox proportional hazards regression models, and restricted cubic spline plots were employed.</div></div><div><h3>Results</h3><div>In patients over 80-year-old, neither systolic blood pressure (SBP) nor diastolic blood pressure (DBP) was significantly associated with all-cause or CVD mortality (<em>P</em> > 0.05). However, in hypertensive patients under 80-year-old, significant differences in mortality were observed across different SBP and DBP subgroups (<em>P</em> < 0.05), with an optimal SBP range of 120–140 mmHg associated with reduced all-cause mortality risk. In patients over 80-year-old, male patients, high urinary albumin-to-creatinine ratio, total cholesterol, red blood cells, and elevated lymphocyte and neutrophil percentages were associated with increased all-cause mortality; SBP interaction with these risk factors slightly reduced the hazard ratio values separately.</div></div><div><h3>Conclusion</h3><div>Based on NHANES data from 2009 to 2018, tolerable SBP and DBP levels appear to have no significant impact on all-cause or CVD mortality in hypertensive patients over 80-year-old”.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105828"},"PeriodicalIF":3.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768548","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

SGLT2 inhibitors and comprehensive approaches for heart failure management in frail older adults

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-03-20 DOI: 10.1016/j.archger.2025.105834

Liang-Kung Chen

引用次数: 0

Longitudinal associations between lipid panel and cognitive decline modified by APOE 4 carrier status in biracial community-dwelling older adults: Findings from the Chicago health and aging project

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-03-18 DOI: 10.1016/j.archger.2025.105825

Ted K.S. Ng , Todd Beck , Xiaoran Liu , Pankaja Desai , Thomas Holland , Klodian Dhana , Kristin Krueger , Robert S. Wilson , Denis A. Evans , Kumar B. Rajan

Background

There have been contradictory findings on the associations between lipids and cognitive decline (CD), which may be attributed to the heterogeneity in the APOE4 carrier status, given APOE's lipid transportation roles. However, extant studies rarely examined the modifying effects of APOE4 carrier status on the associations between lipids and CD.

Methods

We analyzed the Chicago Health and Aging Project, a 20-year cohort study comprising older adults with lipid panel assayed, i.e., total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL), and longitudinal cognitive tests. We ran adjusted linear mixed-effects models, regressing cognitive test composite on each of the four lipids independently, first with the total sample and subsequently using interaction and stratified subgroup analyses, examining the modifying effects of APOE4 carrier status on the associations.

Results

3,496 biracial community-dwelling older adults were recruited from the South side of Chicago (58% African American & 64% women; mean follow-up = 4.6 years). In the total sample, there was a borderline association between TG and CD, estimate (SD, p-value) = 0.0001 (0.0000,0.0565). No associations were detected with other lipids. In the interaction and subgroup analyses, only in ε4 carriers that higher TC levels were significantly associated with accelerated CD, -0.020 (0.009,0.035), whereas higher TG levels were significantly associated with decelerated CD, 0.001 (0.001,0.045). No modifying effects of ε4 carrier status were detected with other lipids.

Discussion

Specific lipids, i.e., TC and TG, were associated with CD only in the ε4 carriers, highlighting the potential importance of measuring APOE4 status to better inform risk prediction and treatment.

{"title":"Longitudinal associations between lipid panel and cognitive decline modified by APOE 4 carrier status in biracial community-dwelling older adults: Findings from the Chicago health and aging project","authors":"Ted K.S. Ng , Todd Beck , Xiaoran Liu , Pankaja Desai , Thomas Holland , Klodian Dhana , Kristin Krueger , Robert S. Wilson , Denis A. Evans , Kumar B. Rajan","doi":"10.1016/j.archger.2025.105825","DOIUrl":"10.1016/j.archger.2025.105825","url":null,"abstract":"<div><h3>Background</h3><div>There have been contradictory findings on the associations between lipids and cognitive decline (CD), which may be attributed to the heterogeneity in the APOE4 carrier status, given APOE's lipid transportation roles. However, extant studies rarely examined the modifying effects of APOE4 carrier status on the associations between lipids and CD.</div></div><div><h3>Methods</h3><div>We analyzed the Chicago Health and Aging Project, a 20-year cohort study comprising older adults with lipid panel assayed, i.e., total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL), and longitudinal cognitive tests. We ran adjusted linear mixed-effects models, regressing cognitive test composite on each of the four lipids independently, first with the total sample and subsequently using interaction and stratified subgroup analyses, examining the modifying effects of APOE4 carrier status on the associations.</div></div><div><h3>Results</h3><div>3,496 biracial community-dwelling older adults were recruited from the South side of Chicago (58% African American & 64% women; mean follow-up = 4.6 years). In the total sample, there was a borderline association between TG and CD, estimate (SD, p-value) = 0.0001 (0.0000,0.0565). No associations were detected with other lipids. In the interaction and subgroup analyses, only in ε4 carriers that higher TC levels were significantly associated with accelerated CD, -0.020 (0.009,0.035), whereas higher TG levels were significantly associated with decelerated CD, 0.001 (0.001,0.045). No modifying effects of ε4 carrier status were detected with other lipids.</div></div><div><h3>Discussion</h3><div>Specific lipids, i.e., TC and TG, were associated with CD only in the ε4 carriers, highlighting the potential importance of measuring APOE4 status to better inform risk prediction and treatment.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"134 ","pages":"Article 105825"},"PeriodicalIF":3.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746948","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

Prevalence and prognostic significance of cachexia diagnosed by novel definition for Asian population among Chinese cirrhotic patients

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-03-17 DOI: 10.1016/j.archger.2025.105833

Shuangzhe Yao , Ziyi Yang , Jia Li , Binbin Peng , Han Wang , Jing Liang , Chao Sun

Background & aims

Cachexia is a multifaceted metabolic disorder often linked to chronic illnesses, characterized by substantial weight reduction, inflammatory states, and loss of appetite. The novel diagnostic criteria concerning cachexia established by the Asian Working Group for Cachexia (AWGC) have not been fully validated in Chinese populations with cirrhosis. To assess the prognostic impact of AWGC-defined cachexia among hospitalized cirrhotic patients and explore the synergistic impact of Model for End-Stage Liver Disease 3.0 (MELD 3.0) scores with cachexia status on prognosis.

Methods

We retrospectively analyzed clinical data from patients with decompensated cirrhosis admitted to our tertiary hospital between January 2021 and December 2023. Cachexia was identified according to AWGC criteria, and disease severity was assessed using MELD 3.0 scores. The study's primary outcome was all-cause mortality within one year.

Results

A total of 368 patients were included in the analyses. The prevalence of cachexia was 61.7 %, and patients with cachexia had a significantly higher one-year all-cause mortality rate (26.4 % vs. 7.8 %, P < 0.001). Multivariate Cox regression analysis showed that cachexia (HR 2.68, 95 %CI 1.40–5.13, P = 0.003), along with MELD 3.0 (HR 1.18, 95 %CI 1.13–1.23, P < 0.001), were independent predictors of one-year mortality. The combined assessment of cachexia and MELD 3.0 scores yielded a higher discriminative ability for predicting one-year mortality compared to either metric alone.

Conclusions

AWGC-defined cachexia is a significant prognostic factor in hospitalized patients with cirrhosis. The integration of cachexia with MELD 3.0 scoring enhances prognostic prediction, underscoring the importance to introduce cachexia evaluation during clinical practice for this vulnerable setting.

{"title":"Prevalence and prognostic significance of cachexia diagnosed by novel definition for Asian population among Chinese cirrhotic patients","authors":"Shuangzhe Yao , Ziyi Yang , Jia Li , Binbin Peng , Han Wang , Jing Liang , Chao Sun","doi":"10.1016/j.archger.2025.105833","DOIUrl":"10.1016/j.archger.2025.105833","url":null,"abstract":"<div><h3>Background & aims</h3><div>Cachexia is a multifaceted metabolic disorder often linked to chronic illnesses, characterized by substantial weight reduction, inflammatory states, and loss of appetite. The novel diagnostic criteria concerning cachexia established by the Asian Working Group for Cachexia (AWGC) have not been fully validated in Chinese populations with cirrhosis. To assess the prognostic impact of AWGC-defined cachexia among hospitalized cirrhotic patients and explore the synergistic impact of Model for End-Stage Liver Disease 3.0 (MELD 3.0) scores with cachexia status on prognosis.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed clinical data from patients with decompensated cirrhosis admitted to our tertiary hospital between January 2021 and December 2023. Cachexia was identified according to AWGC criteria, and disease severity was assessed using MELD 3.0 scores. The study's primary outcome was all-cause mortality within one year.</div></div><div><h3>Results</h3><div>A total of 368 patients were included in the analyses. The prevalence of cachexia was 61.7 %, and patients with cachexia had a significantly higher one-year all-cause mortality rate (26.4 % vs. 7.8 %, <em>P</em> < 0.001). Multivariate Cox regression analysis showed that cachexia (HR 2.68, 95 %CI 1.40–5.13, <em>P</em> = 0.003), along with MELD 3.0 (HR 1.18, 95 %CI 1.13–1.23, <em>P</em> < 0.001), were independent predictors of one-year mortality. The combined assessment of cachexia and MELD 3.0 scores yielded a higher discriminative ability for predicting one-year mortality compared to either metric alone.</div></div><div><h3>Conclusions</h3><div>AWGC-defined cachexia is a significant prognostic factor in hospitalized patients with cirrhosis. The integration of cachexia with MELD 3.0 scoring enhances prognostic prediction, underscoring the importance to introduce cachexia evaluation during clinical practice for this vulnerable setting.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"133 ","pages":"Article 105833"},"PeriodicalIF":3.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684593","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

Association of neighborhood physical environment with falls and fear of falling in older adults: A prospective cohort study

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-03-16 DOI: 10.1016/j.archger.2025.105831

Lucía Arias-Fernández , Lucía Carcedo-Argüelles , Esther García-Esquinas , Francisco Félix Caballero , Fernando Rodríguez-Artalejo , Alberto Lana

Objectives

To explore the prospective association between physical environment characteristics of the neighborhood and risk of falls/fear of falling among community-dwelling older adults.

Study Design

Prospective cohort analysis using data from the Seniors-ENRICA-2 cohort (metropolitan Madrid, Spain).

Methods

At baseline (2015–17), a neighborhood physical characteristics score was developed using the Physical Activity Neighborhood Environment Scale and an additional indicator of distance to green areas. In the second wave of follow-up (2019–20) we collected self-reported incident falls and fear of falling, assessed with the Short Falls Efficacy Scale International. Adjusted odds ratios (OR) and 95 % confidence intervals (CI) for the association between neighborhood environment perception and incidence of falls/fear of falling were calculated using logistic regression.

Results

Among 1823 participants, 27.7 % reported a fall during the previous year and 32.1 % were concerned about having a fall. Better neighborhood environment was associated with lower risk of falls (OR: 0.75; 95 %CI: 0.57–0.99) and fear of falling (0.73; 0.55–0.96). Specifically, low traffic intensity (0.68; 0.52–0.90) and sidewalks in good condition (0.75; 0.59–0.95) were associated with lower risk of falling. Moreover, available facilities for biking (0.77; 0.61–0.96), sidewalks in good condition (0.67; 0.52–0.86), night security (0.80; 0.60–0.99) and day security (0.62; 0.44–0.98) were independently associated with lower fear of falling.

Conclusions

Better neighborhood physical environments could play a key role in the prevention of falls and fear of falling among older adults. Policies aiming to improve residential environments can have broad implications for achieving healthy aging.

{"title":"Association of neighborhood physical environment with falls and fear of falling in older adults: A prospective cohort study","authors":"Lucía Arias-Fernández , Lucía Carcedo-Argüelles , Esther García-Esquinas , Francisco Félix Caballero , Fernando Rodríguez-Artalejo , Alberto Lana","doi":"10.1016/j.archger.2025.105831","DOIUrl":"10.1016/j.archger.2025.105831","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the prospective association between physical environment characteristics of the neighborhood and risk of falls/fear of falling among community-dwelling older adults.</div></div><div><h3>Study Design</h3><div>Prospective cohort analysis using data from the Seniors-ENRICA-2 cohort (metropolitan Madrid, Spain).</div></div><div><h3>Methods</h3><div>At baseline (2015–17), a neighborhood physical characteristics score was developed using the Physical Activity Neighborhood Environment Scale and an additional indicator of distance to green areas. In the second wave of follow-up (2019–20) we collected self-reported incident falls and fear of falling, assessed with the Short Falls Efficacy Scale International. Adjusted odds ratios (OR) and 95 % confidence intervals (CI) for the association between neighborhood environment perception and incidence of falls/fear of falling were calculated using logistic regression.</div></div><div><h3>Results</h3><div>Among 1823 participants, 27.7 % reported a fall during the previous year and 32.1 % were concerned about having a fall. Better neighborhood environment was associated with lower risk of falls (OR: 0.75; 95 %CI: 0.57–0.99) and fear of falling (0.73; 0.55–0.96). Specifically, low traffic intensity (0.68; 0.52–0.90) and sidewalks in good condition (0.75; 0.59–0.95) were associated with lower risk of falling. Moreover, available facilities for biking (0.77; 0.61–0.96), sidewalks in good condition (0.67; 0.52–0.86), night security (0.80; 0.60–0.99) and day security (0.62; 0.44–0.98) were independently associated with lower fear of falling.</div></div><div><h3>Conclusions</h3><div>Better neighborhood physical environments could play a key role in the prevention of falls and fear of falling among older adults. Policies aiming to improve residential environments can have broad implications for achieving healthy aging.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"133 ","pages":"Article 105831"},"PeriodicalIF":3.5,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684594","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}

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