Archives of gerontology and geriatrics最新文献_第10页

Association between oral health and physical frailty in community-dwelling older adults: A systematic review and meta-analysis 社区老年人口腔健康与身体虚弱之间的关系：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 : 2026-02-01 Epub Date: 2025-10-20 DOI: 10.1016/j.archger.2025.106059

Min Jung Ko , Seongwoo Seo , Jong Seob So , Hoi-In Jung , Hong-Seop Kho , Kyung Lhi Kang , Seung-Ryong Ha , Nam-Hee Kim , Jina Lee Linton , Jeong-Hyun Kang

Objective

Oral health and function are increasingly recognized as important determinants of overall health in the older population. This systematic review aimed to synthesize current pieces of evidences on how various oral factors are associated with the onset and progression of physical frailty in community-dwelling older adults.

Methods

A comprehensive literature search was conducted using Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library. Studies including community-dwelling adults aged 50 years or older with oral health-related measures and physical frailty were included. Meta-analyses were performed, and sensitivity and subgroup analyses were conducted to validate the findings. The quality of studies was evaluated using the Risk of Bias for Nonrandomized Studies version 2.0. tool.

Results

Twenty-five articles involving 63,842 adults were selected. The parameters related to the masticatory and swallowing function and oral dryness demonstrated significant associations with physical frailty. Meta-analyses revealed significant associations of physical frailty with having fewer than 20 teeth (OR 2.62, 95 % CI [1.95–3.53]), subjective swallowing difficulty (OR 2.48, 95 % CI [1.70–3.60]), edentulism (OR 2.04, 95 % CI [1.59–2.61]), subjective masticatory difficulty (OR 2.02, 95 % CI [1.64–2.50]), subjective perception of dry mouth (OR 1.97, 95 % CI [1.61–2.41]), and perceived oral health status (OR 1.66, 95 % CI [1.59–1.73]).

Conclusions

This systematic review demonstrated that poor oral health and impaired oral function were significantly associated with physical frailty among older adults. These findings strongly support incorporating oral health screenings into routine geriatric assessments to identify older adults at risk of physical frailty and to inform targeted preventive strategies.

目的口腔健康和功能越来越被认为是老年人整体健康的重要决定因素。本系统综述旨在综合目前关于各种口腔因素如何与社区居住老年人身体虚弱的发生和进展相关的证据。方法采用Ovid-MEDLINE、Ovid-EMBASE、Cochrane Library进行综合文献检索。研究纳入了年龄在50岁或以上、有口腔健康相关措施和身体虚弱的社区居民。进行meta分析，并进行敏感性和亚组分析以验证研究结果。使用非随机研究2.0版的偏倚风险评估研究的质量。工具。结果共纳入文献25篇，涉及成人63842人。与咀嚼和吞咽功能以及口腔干燥相关的参数显示与身体虚弱有显著关联。meta分析显示，身体虚弱与牙齿少于20颗（OR 2.62, 95% CI[1.95-3.53]）、主观吞咽困难（OR 2.48, 95% CI[1.70-3.60]）、蛀牙（OR 2.04, 95% CI[1.59-2.61]）、主观咀嚼困难（OR 2.02, 95% CI[1.64-2.50]）、主观口干感觉（OR 1.97, 95% CI[1.61-2.41]）和感知口腔健康状况（OR 1.66, 95% CI[1.59-1.73]）显著相关。结论本系统综述表明，口腔健康状况不佳和口腔功能受损与老年人身体虚弱显著相关。这些发现强烈支持将口腔健康筛查纳入常规老年评估，以识别有身体虚弱风险的老年人，并为有针对性的预防策略提供信息。

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引用次数: 0

The impact of music therapy on agitation in elderly patients with dementia: A systematic review and meta-analysis 音乐治疗对老年痴呆患者躁动的影响：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 : 2026-01-01 Epub Date: 2025-09-30 DOI: 10.1016/j.archger.2025.106048

Jing Hu, Ling Xu

Agitation impacts 50 - 80 % of elderly dementia patients, imposing burdens on caregivers and healthcare systems. Pharmacological treatments are limited, whereas non-pharmacological music therapy (MT) holds promise. This study sought to evaluate MT's efficacy in alleviating agitation. A thorough search across multiple databases was carried out, incorporating 14 studies (10 RCTs, 4 pre-post trials; n = 847). Meta-analysis demonstrated that MT significantly reduced agitation with a moderate effect size (d = 0.42). Subgroup analyses yielded consistent findings. Heterogeneity was low, and publication bias was negligible. MT effectively mitigated agitation in dementia patients despite heterogeneity in aspects like music duration and genre, underscoring its generalizability, particularly in resource-constrained areas and households lacking professional nursing support. It offers evidence for integrating MT into patient care. The review was registered on PROSPERO (CRD420251033860).

烦躁影响50 - 80%的老年痴呆患者，给护理人员和医疗保健系统带来负担。药物治疗是有限的，而非药物音乐疗法（MT）有希望。本研究旨在评估MT在缓解躁动方面的功效。对多个数据库进行全面检索，纳入14项研究（10项随机对照试验，4项前后试验；n = 847）。荟萃分析显示，MT显著减少躁动，具有中等效应（d = 0.42）。亚组分析结果一致。异质性低，发表偏倚可忽略不计。尽管音乐持续时间和流派等方面存在异质性，但MT有效减轻了痴呆患者的躁动，强调了其普遍性，特别是在资源受限地区和缺乏专业护理支持的家庭。它为将MT纳入患者护理提供了证据。该综述已在PROSPERO注册（CRD420251033860）。

引用次数: 0

The interaction between activities of daily living and psychological resilience on all-cause mortality and cognitive impairment among Chinese older adults: A cohort study based on CLHLS 日常生活活动和心理弹性对中国老年人全因死亡率和认知障碍的相互作用：基于CLHLS的队列研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-01 Epub Date: 2025-09-29 DOI: 10.1016/j.archger.2025.106047

Yingtian Wang , Haining Qi , Xinru Hu , Qian Yu , Manshu Yu , Fan Yang , Xirui Qiu , Fangyi Chen , Ye Ding , Meng Jiang , Xiaoxiao Wang , Li Liu , Wei Wang

Objectives

To investigate the joint effects and interactions of psychological resilience (PR) and activities of daily living (ADL) on cognitive impairment and all-cause mortality.

Methods

Chinese older adults were recruited from the Chinese Longitudinal Healthy Longevity Survey. Cox proportional hazards regression and log-binomial regression were employed to estimate the associations between exposures and all-cause mortality and cognitive impairment (defined as MMSE score <18 or self-reported dementia). Interactions were test on the basis of multivariable regressions.

Results

Compared to participants with normal ADL and high PR (Group 1), participants with limited ADL and high PR (Group 3, HR = 2.105; 95 % CI: 1.656, 2.676) and those with limited ADL and low PR (Group 4, HR = 3.076; 95 % CI: 2.436, 3.884) showed significantly increased risks of all-cause mortality. Moreover, the synergistic interactions between ADL and PR for all-cause mortality were evidenced by relative excess risk due to interaction (RERI = 0.824; 95 % CI: 0.363, 1.286), attributable proportion due to interaction (AP = 0.268; 95 % CI: 0.121, 0.415) and synergy index (SI = 1.659; 95 % CI: 1.134, 2.426). Regarding cognitive impairment, compared to Group 1, Group 3 (RR = 1.662; 95 % CI: 1.073, 2.576) and Group 4 (RR = 2.138; 95 % CI: 1.399, 3.8) exhibited increased risks. Additionally, subgroup analysis showed additive interaction for cognitive impairment was significant only in males.

Conclusions

Limited ADL and low PR jointly increase the risks of cognitive impairment and all-cause mortality in Chinese older adults, with a synergistic additive interaction observed for all-cause mortality.

目的：探讨心理弹性（PR）和日常生活活动（ADL）对认知功能障碍和全因死亡率的共同影响和相互作用。方法：从中国健康长寿纵向调查中招募中国老年人。采用Cox比例风险回归和对数二项回归来估计暴露与全因死亡率和认知功能障碍之间的关系（定义为MMSE评分）结果：与正常ADL和高PR的参与者（1组）相比，有限ADL和高PR的参与者（3组，HR = 2.105; 95% CI: 1.656, 2.676）和有限ADL和低PR的参与者(4组，HR = 3.076；95% CI: 2.436, 3.884)显示全因死亡风险显著增加。此外，ADL和PR对全因死亡率的协同作用表现为相互作用的相对超额风险（RERI = 0.824; 95% CI: 0.363, 1.286）、相互作用的归因比例（AP = 0.268; 95% CI: 0.121, 0.415）和协同作用指数（SI = 1.659; 95% CI: 1.134, 2.426）。在认知障碍方面，与1组相比，3组（RR = 1.662; 95% CI: 1.073, 2.576）和4组（RR = 2.138; 95% CI: 1.399, 3.8）的风险增加。此外，亚组分析显示，认知障碍的加性相互作用仅在男性中显著。结论：有限的ADL和低PR共同增加了中国老年人认知功能障碍和全因死亡率的风险，并在全因死亡率中观察到协同加性相互作用。

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引用次数: 0

The effect of leisure-time physical activities on bone mineral density in postmenopausal women: Systematic review and meta-analysis 绝经后妇女闲暇时间体育活动对骨密度的影响：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 : 2026-01-01 Epub Date: 2025-10-13 DOI: 10.1016/j.archger.2025.106054

Anıl Siyahtaş , Elif Ünlügedik Sayın , Döndü Kurnaz

The aim of this systematic review and meta-analysis was to evaluate the impact of leisure-time physical activity (LTPA) on bone mineral density (BMD) in postmenopausal women. The protocol was developed according to PRISMA guidelines and registered in PROSPERO. Searches were conducted from January to February 2025 across PubMed, The Cochrane Library, EBSCO, Web of Science, PsycINFO, Scopus, National Thesis Center, TR Index, and Turkiye Clinics search engines. The methodological quality of the studies was assessed using the RoB-2 tool. Data were pooled through meta-analysis, and certainty of evidence was appraised using GRADE. 13 findings of 12 studies with a total sample size of 9836 were included in the meta-analysis. BMD across multiple anatomical sites remained stable in intervention groups, but declined in controls, although differences were not statistically significant (p > 0.05). Subgroup analyses suggested varying effectiveness by activity type, ranking them as follows: Structured physical activity modalities > Tai Chi > Pilates ≈ Handball > Step/Dance. Intervention duration appeared most favorable at 6 months, followed by 3, 12, and 9 months. LTPA does not significantly increase BMD overall in postmenopausal women, yet may help maintain bone mass and exert localized benefits depending on activity type and duration. These findings underscore the potential role of structured exercise in mitigating age-related bone loss, although further high-quality trials are warranted.

本系统综述和荟萃分析的目的是评估休闲时间体力活动（LTPA）对绝经后妇女骨矿物质密度（BMD）的影响。该协议是根据PRISMA准则制定的，并在PROSPERO注册。检索于2025年1月至2月在PubMed、Cochrane图书馆、EBSCO、Web of Science、PsycINFO、Scopus、National Thesis Center、TR Index和Turkiye Clinics搜索引擎上进行。使用rob2工具评估研究的方法学质量。通过荟萃分析汇总数据，并使用GRADE评价证据的确定性。meta分析纳入了12项研究的13项结果，总样本量为9836。干预组多解剖部位骨密度保持稳定，对照组骨密度下降，但差异无统计学意义（p < 0.05）。亚组分析表明，不同活动类型的效果不同，排名如下：结构化体育活动模式>太极拳>普拉提≈手球>步/舞。干预时间最长的是6个月，其次是3个月、12个月和9个月。LTPA对绝经后妇女的总体骨密度没有显著增加，但可能有助于维持骨量，并根据活动类型和持续时间发挥局部益处。这些发现强调了有组织的锻炼在减轻与年龄相关的骨质流失方面的潜在作用，尽管需要进一步的高质量试验。

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引用次数: 0

Normative reference values for the six-minute walk test in older adults: A systematic review and meta-analysis 老年人6分钟步行测试的规范参考值：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 : 2026-01-01 Epub Date: 2025-09-13 DOI: 10.1016/j.archger.2025.106026

Khadijeh Otadi, Kazem Malmir

Background

The six-minute walk test (6MWT) is widely used to assess functional capacity in older adults, but performance differs by various factors. This review compiled 6MWT reference values and identified key predictors of performance.

Methods

Studies on average 6MWT distances in older adults were found through PubMed, Scopus, Web of Science, Ovid, and PEDro, with no date limits. Participant data were summarized using descriptive statistics. A random-effects meta-analysis combined mean distances, with heterogeneity assessed using Cochran's Q test and I² statistics. Subgroup analyses examined variations by age, gender, BMI, height, and region, while regression analyses identified predictors of 6MWT performance.

Results

Of 72 studies, 28 were included in the meta-analysis. Men walked farther (473.11 m) than women (428.35 m). Distance declined with age, from 587.43 m (age 60–64) to 325.53 m (age ≥80). Overweight participants walked more (461.24 m) than those with normal BMI (425.33 m). By region, Oceania showed the highest distance (485.42 m), followed by Europe, the Americas, and Asia. Meta-regression showed distance decreased by 10.25 m per year of age and increased by 4.44 m per kg of weight. Gender, BMI, and height were not significant predictors.

Conclusions

The 6MWT remains a valuable tool for assessing functional capacity in older adults. Age and weight were the most significant predictors of 6MWT performance, with distance decreasing markedly with age and increasing with body weight. Regional factors also influenced outcomes, while gender, BMI, and body height had less impact. Clinicians should use age-adjusted evaluations and promote weight management strategies to preserve mobility in older adults.

背景：6分钟步行测试（6MWT）被广泛用于评估老年人的功能能力，但其表现因各种因素而不同。这篇综述汇编了6MWT参考值，并确定了关键的性能预测指标。方法：通过PubMed， Scopus, Web of Science， Ovid和PEDro找到老年人平均6MWT距离的研究，没有日期限制。使用描述性统计对参与者数据进行汇总。随机效应荟萃分析结合平均距离，异质性评估使用科克伦的Q检验和I²统计量。亚组分析考察了年龄、性别、BMI、身高和地区的差异，而回归分析确定了6MWT表现的预测因子。结果：72项研究中，有28项纳入meta分析。男性步行距离（473.11米）比女性（428.35米）更远。随着年龄的增长，距离从587.43 m（60 ~ 64岁）下降到325.53 m（≥80岁）。超重的参与者比BMI正常的参与者（425.33米）走得多（461.24米）。从区域来看，大洋洲的距离最高（485.42米），其次是欧洲、美洲和亚洲。元回归结果显示，每年龄减少10.25米，每公斤体重增加4.44米。性别、体重指数和身高不是显著的预测因子。结论：6MWT仍然是评估老年人功能能力的有价值的工具。年龄和体重是6MWT表现最显著的预测因子，距离随年龄显著降低，随体重显著增加。地区因素也会影响结果，而性别、体重指数和身高的影响较小。临床医生应该使用年龄调整评估和促进体重管理策略，以保持老年人的活动能力。

{"title":"Normative reference values for the six-minute walk test in older adults: A systematic review and meta-analysis","authors":"Khadijeh Otadi, Kazem Malmir","doi":"10.1016/j.archger.2025.106026","DOIUrl":"10.1016/j.archger.2025.106026","url":null,"abstract":"<div><h3>Background</h3><div>The six-minute walk test (6MWT) is widely used to assess functional capacity in older adults, but performance differs by various factors. This review compiled 6MWT reference values and identified key predictors of performance.</div></div><div><h3>Methods</h3><div>Studies on average 6MWT distances in older adults were found through PubMed, Scopus, Web of Science, Ovid, and PEDro, with no date limits. Participant data were summarized using descriptive statistics. A random-effects meta-analysis combined mean distances, with heterogeneity assessed using Cochran's Q test and I² statistics. Subgroup analyses examined variations by age, gender, BMI, height, and region, while regression analyses identified predictors of 6MWT performance.</div></div><div><h3>Results</h3><div>Of 72 studies, 28 were included in the meta-analysis. Men walked farther (473.11 m) than women (428.35 m). Distance declined with age, from 587.43 m (age 60–64) to 325.53 m (age ≥80). Overweight participants walked more (461.24 m) than those with normal BMI (425.33 m). By region, Oceania showed the highest distance (485.42 m), followed by Europe, the Americas, and Asia. Meta-regression showed distance decreased by 10.25 m per year of age and increased by 4.44 m per kg of weight. Gender, BMI, and height were not significant predictors.</div></div><div><h3>Conclusions</h3><div>The 6MWT remains a valuable tool for assessing functional capacity in older adults. Age and weight were the most significant predictors of 6MWT performance, with distance decreasing markedly with age and increasing with body weight. Regional factors also influenced outcomes, while gender, BMI, and body height had less impact. Clinicians should use age-adjusted evaluations and promote weight management strategies to preserve mobility in older adults.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"140 ","pages":"Article 106026"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202311","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

Evidence for health promotion interventions to improve cognitive and physical functioning outcomes in older adults with MCI: A state-of-the-art review 健康促进干预改善老年轻度认知损伤患者认知和身体功能结局的证据：一项最新综述

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-01 Epub Date: 2025-10-01 DOI: 10.1016/j.archger.2025.106049

Tasmin Alanna Rookes , Rachael Frost , Louise Marston , Megan Armstrong , Yolanda Barrado-Martin , Kate Walters

Background

Health promotion activities for people with mild cognitive impairment (MCI) may improve their overall health and prevent progression to dementia. We need to understand the best approaches to behaviour change in this population.

Aim

To summarise the types of health promotion interventions and current clinical effectiveness evidence for physical and cognitive functioning outcomes in people with MCI.

Design

State-of-the art review

Method

Medline was searched in April 2025, for systematic reviews synthesising randomised controlled trials testing effectiveness of health promotion interventions in older adults with MCI, published since 2015. Abstracts, titles, and full texts were single screened and, for eligible reviews, the characteristics, intervention type, primary outcome, and evidence for people with MCI, were extracted. Key messages were narratively synthesised across reviews, grouping by type of intervention and outcome measure.

Results

From 1776 titles and abstracts, 57 systematic reviews were eligible. Regular moderate intensity multicomponent physical exercise and memory-focussed cognitive training interventions had the strongest evidence base for improving cognitive functioning. However, combining physical exercise and cognitive training was more beneficial for cognitive domains and physical functioning, in comparison to doing them individually. The evidence for nutrition interventions was mixed. One review of psychological interventions showed improvements for wellbeing.

Conclusion

There is evidence that health promotion interventions can support people with MCI and dementia to improve or maintain their cognitive function, through multicomponent physical activity combined with cognitive training. More evidence is needed for nutritional recommendations, psychological interventions, and social inclusion interventions.

背景：轻度认知障碍（MCI）患者的健康促进活动可以改善他们的整体健康状况并预防痴呆症的发展。我们需要了解改变这一人群行为的最佳方法。目的：总结MCI患者身体和认知功能结局的健康促进干预类型和当前临床有效性证据。方法：于2025年4月检索Medline，检索自2015年以来发表的综合随机对照试验的系统综述，这些试验测试了老年轻度认知障碍患者健康促进干预措施的有效性。摘要、标题和全文是单筛选的，对于符合条件的综述，提取了MCI患者的特征、干预类型、主要结局和证据。关键信息通过综述进行叙述性综合，按干预类型和结果测量分组。结果：从1776篇题目和摘要中，有57篇系统评价符合条件。有规律的中等强度多成分体育锻炼和以记忆为重点的认知训练干预对改善认知功能有最有力的证据基础。然而，与单独进行相比，体育锻炼和认知训练相结合对认知领域和身体功能更有益。营养干预的证据好坏参半。一项关于心理干预的综述显示，人们的幸福感得到了改善。结论：有证据表明，健康促进干预可以通过多组分体育活动结合认知训练，支持MCI和痴呆患者改善或维持其认知功能。需要更多的证据来支持营养建议、心理干预和社会包容干预。

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引用次数: 0

Longitudinal bidirectional dynamic association between handgrip strength and cognitive function in Chinese older adults: a cross-lag modeling study 中国老年人握力与认知功能的纵向双向动态关联：一个交叉滞后模型研究。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-01 Epub Date: 2025-10-10 DOI: 10.1016/j.archger.2025.106052

Xuan Zhang, Chenxiao Jia, Haixia Hao, Yurong Liu, Wenli Lu, Yuan Wang

Objective

This study examined the bidirectional dynamic relationship between handgrip strength and cognitive function and the influence of gender and age differences among Chinese adults aged 60 and above.

Method

Data were derived from the 2013–2015 waves of the China Health and Retirement Longitudinal Study (CHARLS), including 4533 older adults. Cross-lagged panel models were used to analyze the temporal relationship between handgrip strength and cognitive function. Covariates covered sociodemographic characteristics, lifestyle factors, and health indicators. Data analysis was performed using SAS 9.4 and R 4.4.1.

Results

During the 2-year follow-up, both handgrip strength and cognitive function showed declining trends in older adults. Cross-lagged analysis revealed that baseline handgrip strength positively predicted follow-up cognitive function (P < 0.001), indicating that individuals with greater baseline grip strength maintained better cognitive performance. Conversely, baseline cognitive function also positively predicted follow-up handgrip strength (P < 0.001).These bidirectional associations exhibited gender differences: the predictive effect of handgrip strength on cognition was stronger in males (P < 0.001), whereas the effect of cognition on handgrip strength was more pronounced in females (P < 0.001). Age-stratified analysis demonstrated that the association between handgrip strength and cognition was strongest in the 70–79 age group (P < 0.001). However, this relationship weakened in adults aged 80 and above, potentially due to compensatory mechanisms or external environmental support.

Conclusion

A bidirectional muscle-cognition association exists in older adults, supporting the incorporation of handgrip strength testing into cognitive screening. Gender- and age-specific interventions should prioritize rural populations with low education and high-risk individuals aged 70–79 years. These findings provide a scientific basis for preventing cognitive decline in aging populations.

目的：探讨中国60岁及以上成年人握力与认知功能的双向动态关系及性别、年龄差异的影响。方法：数据来源于2013-2015年中国健康与退休纵向研究（CHARLS），共纳入4533名老年人。采用交叉滞后面板模型分析了手握力与认知功能的时间关系。协变量包括社会人口特征、生活方式因素和健康指标。采用SAS 9.4和R 4.4.1进行数据分析。结果：在2年的随访中，老年人握力和认知功能均呈现下降趋势。交叉滞后分析显示，基线握力正预测随访认知功能（P < 0.001），表明基线握力越大的个体保持更好的认知表现。相反，基线认知功能也能正向预测随访的握力（P < 0.001）。这些双向关联表现出性别差异：握力对认知的预测作用在男性中更强（P < 0.001），而认知对握力的影响在女性中更明显（P < 0.001）。年龄分层分析表明，握力与认知的相关性在70-79岁年龄组中最强（P < 0.001）。然而，这种关系在80岁及以上的成年人中减弱，可能是由于代偿机制或外部环境支持。结论：老年人存在双向肌肉认知关联，支持将握力测试纳入认知筛查。针对性别和年龄的干预措施应优先考虑农村低教育人群和70-79岁的高危人群。这些发现为预防老年人认知能力下降提供了科学依据。

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引用次数: 0

The effectiveness of cognitive behavioral therapy on loneliness among older adults: A systematic review and meta-analysis 认知行为疗法对老年人孤独感的有效性：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 : 2026-01-01 Epub Date: 2025-10-10 DOI: 10.1016/j.archger.2025.106053

Taiyuan Luan , Yue Wang , Bing Li , Rixin Qin , Zhong Li , Xuexue Lei , Haiyan Guo

Objective

To evaluate the efficacy of Cognitive Behavioral Therapy (CBT) on improving loneliness among older adults.

Design

A systematic review and meta-analysis.

Methods

A systematic search was conducted across 10 electronic databases from their inception to June 21, 2025, to identify eligible randomized controlled trials (RCTs). Studies included older adult participants aged 60 years or above. Two reviewers independently performed the screening process, data extraction, and quality assessment of the selected studies. All statistical analyses were carried out using Stata version 18.0.

Results

Eight RCTs involving 720 participants were included. Pooled analysis revealed a significant and large effect of CBT on improving loneliness among older adults (SMD = -1.00, 95 % CI, -1.59 to -0.42, p < 0.001; low-quality evidence), though substantial heterogeneity was present (I² = 90.5 %). Subgroup analyses indicated that shorter intervention duration (≤12 weeks) (SMD = -1.41, 95 % CI: -2.51 to -0.32, p = 0.011), group-based format (SMD = -1.49, 95 % CI: -2.63 to -0.36, p = 0.010), and online delivery (SMD = -1.51, 95 % CI: -3.93 to 0.92, p = 0.233) may enhance intervention effectiveness. Subgroup analyses also revealed differences across settings. CBT interventions were effective among community-dwelling older adults (SMD = -0.91, 95 % CI: -1.46 to -0.35, p = 0.001), whereas no significant effect was observed among institution-dwelling populations.

Conclusion

CBT was associated with improvements on loneliness among older adults. However, given the substantial heterogeneity observed across studies, these pooled estimates should be interpreted as exploratory rather than definitive. Subgroup findings suggest that intervention format, intervention duration, delivery modality and settings may influence outcomes. Further well-designed rcts are needed to confirm the effectiveness.

目的：评价认知行为疗法（CBT）改善老年人孤独感的效果。设计：系统回顾和荟萃分析。方法：系统检索10个电子数据库，从其建立到2025年6月21日，以确定符合条件的随机对照试验（rct）。研究对象为60岁或以上的老年人。两名审稿人独立进行筛选过程、数据提取和所选研究的质量评估。所有统计分析使用Stata 18.0版本进行。结果：纳入8项随机对照试验，共720名受试者。合并分析显示，CBT对改善老年人孤独感有显著而巨大的影响（SMD = -1.00, 95% CI, -1.59至-0.42,p < 0.001；低质量证据），尽管存在大量异质性（I²= 90.5%）。亚组分析表明，较短的干预时间（≤12周）（SMD = -1.41, 95% CI: -2.51至-0.32,p = 0.011）、基于组的形式（SMD = -1.49, 95% CI: -2.63至-0.36,p = 0.010）和在线交付（SMD = -1.51, 95% CI: -3.93至0.92,p = 0.233）可提高干预效果。亚组分析也揭示了不同设置之间的差异。CBT干预在社区居住的老年人中是有效的（SMD = -0.91, 95% CI: -1.46至-0.35,p = 0.001），而在机构居住人群中没有观察到显著的效果。结论：CBT与老年人孤独感的改善有关。然而，考虑到研究中观察到的大量异质性，这些汇总估计应该被解释为探索性的，而不是决定性的。亚组研究结果表明，干预形式、干预持续时间、交付方式和环境可能会影响结果。需要进一步精心设计的随机对照试验来证实其有效性。

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引用次数: 0

The effectiveness of artificial agents on loneliness reduction in older adults: a systematic review and meta-analysis 人工药物减少老年人孤独感的有效性：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 : 2026-01-01 Epub Date: 2025-10-14 DOI: 10.1016/j.archger.2025.106056

Zhengke Fu , Mengsi Yan , Xuefeng Han , Kaixuan Zhang , Xianghong Zhao

This meta-analysis reviewed studies comparing loneliness of older adults receiving artificial agent interventions with those not receiving them, to evaluate this treatment’s efficacy in alleviating loneliness and other mental health problems among older people; and assess factors that moderate intervention effectiveness. Eligible studies were identified by a systematic search of PubMed, the Cochrane Central Register of Controlled Trials, EMBASE, CINAHL (EBSCO), PsycINFO (EBSCO), CNKI, Wanfang, Weipu, SinoMed, and ClinicalTrials.gov. Standardized mean differences with 95 % confidence intervals were extracted and pooled. Meta-regression and subgroup analysis determined the influence of trial characteristics. A total of 16 studies with 781 participants were included. Artificial agent treatment may significantly reduce loneliness in older adults, with acceptable heterogeneity (SMD= -0.69 [95 % CI, -0.89 to -0.40]; p=.000; I²=64.51 %). Artificial agents reduced loneliness more markedly for participants dwelling in non-community-based settings (p=.016). Social robots reduced loneliness more effectively than app/web-based agents (p=.033). Animal-shaped artificial agents had a significantly larger effect size than humanoid agents on loneliness reduction (p=.016). Longer session duration (p=.005), fewer weekly sessions (p=.000), and shorter session times (p=.005) produced greater loneliness reduction. Artificial agents had a significant effect on depression (SMD=-0.42, [95 % CI -0.72 to -0.12], P=.01), but no significant effects on quality of life or happiness (SMD=0.24, [95 % CI -1.0 to 0.58], P=.16 and SMD=0.63, [95 % CI -1.09 to 2.35], P=.47, respectively). Findings suggested artificial agents may alleviate loneliness in older adults. Treatment effectiveness may be moderated by participants’ settings, session length, treatment duration, sessions per week, agent delivery platform, and agent type.

本荟萃分析回顾了比较接受人工干预与未接受人工干预的老年人孤独感的研究，以评估这种治疗在缓解老年人孤独感和其他心理健康问题方面的疗效；并评估影响干预效果的因素。通过系统检索PubMed、Cochrane中央对照试验注册库、EMBASE、CINAHL （EBSCO）、PsycINFO （EBSCO）、中国知网、万方、唯普、中国医学信息网和ClinicalTrials.gov来确定符合条件的研究。提取95%置信区间的标准化平均差异并汇总。meta回归和亚组分析确定了试验特征的影响。共纳入16项研究，781名参与者。人工药物治疗可显著减少老年人的孤独感，存在可接受的异质性（SMD= -0.69 [95% CI, -0.89至-0.40];p= 0.000; I2= 64.51%）。对于居住在非社区环境中的参与者，人工代理更显著地减少了孤独感（p= 0.016）。社交机器人比应用程序/网络代理更有效地减少孤独感（p= 0.033）。动物形人工agent对减少孤独感的效果显著大于类人agent （p= 0.016）。较长的治疗时间（p= 0.005），较少的每周治疗（p= 0.00000）和较短的治疗时间（p= 0.005）产生了更大的孤独感减少。人工药物对抑郁有显著影响（SMD=-0.42, [95% CI -0.72 ~ -0.12]， P= 0.01），但对生活质量和幸福感无显著影响（SMD=0.24, [95% CI -1.0 ~ 0.58]， P= 0.16； SMD=0.63, [95% CI -1.09 ~ 2.35]， P= 0.47）。研究结果表明，人工药剂可能会减轻老年人的孤独感。治疗效果可能受到参与者设置、疗程长度、治疗持续时间、每周疗程、药物递送平台和药物类型的影响。

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引用次数: 0

Effects of dual-task prioritization training on dual-task walking in older people: A single-blinded randomized controlled trial 双任务优先级训练对老年人双任务行走的影响：一项单盲随机对照试验

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-01 Epub Date: 2025-10-08 DOI: 10.1016/j.archger.2025.106050

Wei-Chen Chen , Yea-Ru Yang , Ching-Ya Chiu , Ray-Yau Wang

Objective

Dual-task walking (DTW) performance is commonly reduced in older adults and is associated with a higher risk of falls. While dual-task deficits have been documented, it remains unclear how different task prioritization strategies during training influence DTW outcomes. This study compared effects of posture-first (PF), supraposture-first (SF), and conventional training on DTW performance in older adults.

Methods

A three-arm randomized, single-blind controlled study was conducted. Thirty-nine community-dwelling older adults were randomly assigned to PF, SF, or control groups to receive 12-session of cognitive-motor dual-task training with distinct task prioritization instructions. Cognitive and motor DTW performance, Trail Making Test Part B, Berg Balance Scale, single-task walking performance, and secondary task performance were assessed pre- and post-intervention.

Results

The PF group showed significant improvements in both cognitive and motor DTW performance, including speed (cognitive: p = 0.001, motor: p = 0.008), cadence (p < 0.001), and dual-task cost (DTC-speed) (p < 0.001). Compared to the SF and control groups, the PF group showed greater improvements in stride length (p = 0.009 vs. SF; p = 0.001 vs. control) and DTC (p = 0.025 vs. SF; p = 0.005 vs. control) during cognitive DTW. During motor DTW, improvements in speed (p = 0.008), cadence (p = 0.016), and DTC (p = 0.049) were also greater than in the SF group.

Conclusions

Posture-first strategy during training enhances cognitive and motor DTW performance more effectively than other approaches. These findings support its implementation to improve functional mobility and dual-task coordination in older adults.

目的：老年人双任务行走（DTW）的表现通常会下降，并且与摔倒的风险增加有关。虽然双任务缺陷已被记录在案，但尚不清楚训练期间不同的任务优先级策略如何影响DTW结果。本研究比较了姿势优先（PF）、上姿势优先（SF）和常规训练对老年人DTW表现的影响。方法采用三组随机、单盲对照研究。39名居住在社区的老年人被随机分配到PF组、SF组或对照组，接受12次认知-运动双任务训练，并根据不同的任务优先级指示进行训练。评估干预前后的认知和运动DTW表现、造径测试B部分、Berg平衡量表、单任务步行表现和次要任务表现。结果PF组在认知和运动DTW表现上均有显著改善，包括速度（认知：p = 0.001，运动：p = 0.008）、节奏（p < 0.001）和双任务成本（DTC-speed）（p < 0.001）。与SF组和对照组相比，PF组在认知DTW期间步幅（p = 0.009 vs SF; p = 0.001 vs对照组）和DTC （p = 0.025 vs SF; p = 0.005 vs对照组）有更大的改善。在运动DTW期间，速度（p = 0.008），节奏（p = 0.016）和DTC （p = 0.049）的改善也大于SF组。结论在训练过程中，姿势优先策略比其他方法更能提高认知和运动能力。这些发现支持其实施，以改善老年人的功能流动性和双任务协调。

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引用次数: 0