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

Global and regional drivers of chronic kidney disease burden in older adults: The dominant role of high fasting plasma glucose and the rise of obesity in China 老年人慢性肾脏疾病负担的全球和区域驱动因素：中国高空腹血糖和肥胖上升的主导作用

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-08-26 DOI: 10.1016/j.archger.2025.106006

Jie Gu , Huaizhou You

Background

Chronic kidney disease (CKD) is a major public health challenge for older adults, increasing global healthcare burdens. However, comprehensive global analyses of long-term trends and regional disparities in CKD burden among older adults are still lacking. To fill this critical gap, we aimed to assess global, regional, and national CKD trends and identify age-specific patterns among adults aged ≥60 years.

Methods

Data was obtained from the Global Burden of Disease (GBD) 2021 database. Temporal trends were evaluated via Joinpoint regression to compute average annual percentage changes (AAPC) values. Trends were further disaggregated by age, period, and birth cohort using an age-period-cohort model. The determinants of CKD burden were also explored.

Results

In 2021, the global prevalence of CKD in older adults was 296.22 million, with 13.47 million new cases, 1.17 million deaths, and 24.03 million disability-adjusted life years (DALYs)—representing increases of 113 %, 163 %, 177 %, and 208 % respectively since 1992. However, age-standardized prevalence rate (ASPR) slightly declined [AAPC –0.14 (95 % confidence interval:0.15 to –0.14)]. The CKD burden in older adults varied by region and age group, with notable gender disparities. Type 2 diabetes mellitus (T2DM), primarily driven by high fasting plasma glucose, emerged as a leading contributor to DALYs. In addition, high body mass index emerged as a fast-growing, previously under-recognized contributor, particularly in China and middle-SDI regions.

Conclusion

Between 1992 and 2021, CKD-related mortality and DALYs among older adults increased significantly worldwide, primarily driven by population growth and T2DM, despite a slight decline in the ASPR.

慢性肾脏疾病（CKD）是老年人面临的主要公共卫生挑战，增加了全球医疗保健负担。然而，对老年人慢性肾病负担的长期趋势和地区差异的全面全球分析仍然缺乏。为了填补这一关键空白，我们旨在评估全球、地区和国家CKD趋势，并确定年龄≥60岁的成年人的年龄特异性模式。方法数据来自全球疾病负担（GBD） 2021数据库。通过Joinpoint回归来评估时间趋势，以计算平均年百分比变化（AAPC）值。使用年龄-时期-队列模型进一步按年龄、时期和出生队列分类趋势。还探讨了CKD负担的决定因素。结果2021年，全球老年人CKD患病率为29622万，新发病例1347万，死亡117万，残疾调整生命年（DALYs） 2403万，自1992年以来分别增加了113%，163%，177%和208%。然而，年龄标准化患病率（ASPR）略有下降[AAPC -0.14(95%可信区间：0.15至-0.14)]。老年人CKD负担因地区和年龄组而异，性别差异显著。2型糖尿病（T2DM）主要由高空腹血糖引起，是DALYs的主要诱因。此外，高体重指数是一个快速增长的、以前未得到充分认识的因素，特别是在中国和sdi中部地区。结论：1992年至2021年间，全球范围内老年人ckd相关死亡率和DALYs显著增加，主要受人口增长和2型糖尿病的驱动，尽管ASPR略有下降。

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引用次数: 0

Adverse health outcomes of oral frailty in community-dwelling older adults: a systematic review and meta-analysis 社区老年人口腔虚弱的不良健康结果：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 : 2025-08-26 DOI: 10.1016/j.archger.2025.106004

Pan Li , Lixia Xie , Yifan Ou , Yutong Zhou , Wen Zhang , Yao Chen , Yijie Fang , Xinhong Yin

Introduction

Oral frailty(OF) is a comprehensive manifestation of impaired chewing, swallowing, and oral function in older adults, and is associated with adverse health outcomes such as malnutrition, physical frailty, and falls. This study analyzes the association between OF and adverse health outcomes in community-dwelling older adults to provide insights for improving their quality of life.

Methods

A literature search was conducted in PubMed, Web of Science, The Cochrane Library, Embase, and Scopus databases to identify studies related to OF in community-dwelling older adults and their adverse health outcomes. The search was limited to studies published from the inception of each database up to May 31, 2025. The focus was on studies involving community-dwelling older adults aged 60 years and older, adverse health outcomes associated with OF, and studies employing cross-sectional or cohort study designs.

Results

A review of 23 studies involving 27,585 participants found that OF in community-dwelling older adults was associated with physical frailty (OR = 1.78, 95% CI: 1.19, 2.68), sarcopenia (OR = 2.01, 95% CI: 1.64, 2.47), falls (OR = 1.58, 95% CI: 1.37, 1.82), high oral microbial counts (OR = 3.05, 95% CI: 1.35, 6.88), malnutrition (OR=2.18, 95% CI: 1.63, 2.92), and low dietary diversity (OR=1.98, 95% CI: 1.15, 3.39).

Conclusion

There is an association between OF and adverse health outcomes in community-dwelling older adults. Investigating the relationship between OF and adverse health outcomes in community-dwelling older adults is of great significance for improving the quality of life of older adults and promoting healthy longevity.

口腔虚弱（OF）是老年人咀嚼、吞咽和口腔功能受损的综合表现，并与营养不良、身体虚弱和跌倒等不良健康结果相关。本研究分析了社区居住老年人OF与不良健康结果之间的关系，为改善他们的生活质量提供见解。方法在PubMed、Web of Science、Cochrane Library、Embase和Scopus数据库中进行文献检索，确定社区居住老年人中与of相关的研究及其不良健康结局。检索仅限于从每个数据库建立到2025年5月31日为止发表的研究。研究的重点是涉及社区居住的60岁及以上老年人、与OF相关的不良健康结果以及采用横断面或队列研究设计的研究。结果一项涉及27,585名参与者的23项研究的回顾发现，社区居住老年人的of与身体虚弱（OR= 1.78, 95% CI: 1.19, 2.68）、肌肉减少（OR= 2.01, 95% CI: 1.64, 2.47）、跌倒（OR= 1.58, 95% CI: 1.37, 1.82）、口腔微生物数量高（OR= 3.05, 95% CI: 1.35, 6.88）、营养不良（OR=2.18, 95% CI: 1.63, 2.92）和饮食多样性低（OR=1.98, 95% CI: 1.15, 3.39）相关。结论在社区居住的老年人中，OF与不良健康结局存在关联。探讨社区居住老年人OF与不良健康结局的关系，对提高老年人生活质量、促进健康长寿具有重要意义。

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引用次数: 0

Optimizing exercise dosage for executive function in alzheimer’s disease: A Bayesian dose-response meta-analysis of randomized trials 优化运动剂量对阿尔茨海默病执行功能的影响：随机试验的贝叶斯剂量-反应荟萃分析

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-08-25 DOI: 10.1016/j.archger.2025.106001

Sihong Sui , Mingyi Wang

Objective

This study aimed to identify the optimal dose range of physical exercise for improving executive function in individuals with Alzheimer’s disease (AD) and to compare the dose-dependent cognitive response profiles across different exercise modalities.

Methods

A systematic literature search was conducted across five databases-PubMed, Embase, Cochrane Library, SPORTDiscus, and Web of Science-up to June 20, 2025, with no language restrictions. All analyses were performed in R (version 4.4.2). A Bayesian framework was used to model continuous dose-response curves and to evaluate the relative effects of aerobic training, integrated physical training, and resistance exercise within a network structure.

Results

Exercise interventions demonstrated a nonlinear relationship with executive function, with the strongest effect observed at approximately 1000 MET-min/week. Among exercise types, continuous aerobic training showed significant improvement at 670 MET-min/week, indicating a relatively low-dose threshold for benefit. In contrast, integrated physical training programs required higher doses (around 1200 MET-min/week) to reach peak effect, suggesting greater intensity dependence. Resistance training did not yield consistent or statistically significant outcomes across the tested dose levels.

Conclusion

This study establishes a quantitative framework that integrates dose modeling with intervention structure to guide exercise-based cognitive strategies for AD. The findings emphasize the need to match exercise volume to modality demands and individual capacity, supporting the development of precision-oriented, non-pharmacological interventions. The identified optimal range (670–1200 MET-min/week) aligns with WHO recommendations for older adults, reinforcing both feasibility and translational potential.

本研究旨在确定改善阿尔茨海默病（AD）患者执行功能的最佳体育锻炼剂量范围，并比较不同锻炼方式的剂量依赖性认知反应谱。方法系统检索截至2025年6月20日的pubmed、Embase、Cochrane Library、SPORTDiscus和Web of science 5个数据库，无语言限制。所有分析均在R（4.4.2版）中进行。一个贝叶斯框架被用来模拟连续的剂量-反应曲线，并在一个网络结构中评估有氧训练、综合体能训练和阻力运动的相对效果。结果运动干预表现出与执行功能的非线性关系，在大约1000 MET-min/周时观察到最强的效果。在运动类型中，持续有氧训练在670 MET-min/周时表现出显著的改善，这表明相对较低的剂量阈值是有益的。相比之下，综合体育训练计划需要更高的剂量（约1200 MET-min/周）才能达到峰值效果，这表明更大的强度依赖性。抗阻训练并没有产生一致的或统计学上显著的结果。结论本研究建立了剂量模型与干预结构相结合的定量框架，指导基于运动的AD认知策略。研究结果强调需要将运动量与模式需求和个人能力相匹配，支持以精确为导向的非药物干预措施的发展。确定的最佳范围（670-1200 MET-min/周）与世卫组织对老年人的建议一致，加强了可行性和转化潜力。

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引用次数: 0

An interactive dynamic online nomogram for predicting the heterogeneous trajectories of intrinsic capacity among older adults 预测老年人内在能力异质性轨迹的交互式动态在线nomogram

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-08-23 DOI: 10.1016/j.archger.2025.105993

Wenfeng Xu , Liyuan Tian , Hongliang Dai

Background

With increasing age, intrinsic capacity (IC) in older adults tends to decline. Currently, no studies have used nomograms to predict high-risk factors for IC decline based on its heterogeneous trajectories.

Methods

This study analyzed longitudinal data from 1801 older adults in the China Health and Retirement Longitudinal Study (CHARLS) cohort. K-means clustering identified heterogeneous IC trajectories. Least Absolute Shrinkage and Selection Operator (LASSO) and multivariate logistic regression determined independent predictors, which were used to construct and evaluate static and dynamic online nomograms. Internal validation was performed with 1000 bootstrap resamples. Model performance was assessed using area under the receiver operating characteristic curve (AUROC), calibration curves, and decision curve analysis (DCA).

Results

Two trajectories of IC changes were identified: a high IC impairment trajectory and a low IC impairment trajectory. Multivariate logistic regression analysis identified ten independent predictors for the IC change trajectory, including retirement status, pain, self-rated health status, educational level, life satisfaction, age, health satisfaction, sleep duration, residence and participation in social activities, and a dynamic online nomogram was constructed accordingly. The AUROCs of the nomogram in the training and validation sets were 0.789 and 0.758, respectively, indicating good discriminative ability. Calibration curves demonstrated high consistency between predicted and observed probabilities, and DCA showed excellent clinical utility of the nomogram in both the training and validation sets.

Conclusion

There are heterogeneous trajectories in the IC levels of older adults. The constructed nomogram can serve as a clinical tool to facilitate early identification of high-risk populations and provide strong support for health management in older adults.

随着年龄的增长，老年人的内在能力（IC）有下降的趋势。目前，还没有研究基于IC的异质性轨迹，使用nomogram来预测IC下降的高危因素。方法本研究分析了中国健康与退休纵向研究（CHARLS）队列中1801名老年人的纵向数据。K-means聚类识别异质IC轨迹。最小绝对收缩和选择算子（LASSO）和多元逻辑回归确定了独立的预测因子，用于构建和评估静态和动态在线模态图。使用1000个bootstrap样本进行内部验证。采用受试者工作特征曲线（AUROC）下面积、校准曲线和决策曲线分析（DCA）评估模型性能。结果发现两种IC变化轨迹：高IC损伤轨迹和低IC损伤轨迹。多元logistic回归分析确定了影响IC变化轨迹的10个独立预测因子，包括退休状态、疼痛、自评健康状况、受教育程度、生活满意度、年龄、健康满意度、睡眠时间、居住地和社会活动参与，并据此构建了动态在线nomogram。nomogram在训练集和验证集上的auroc分别为0.789和0.758，具有较好的判别能力。校准曲线在预测概率和观察概率之间表现出高度的一致性，DCA在训练集和验证集中都显示了良好的nomogram临床实用性。结论老年人IC水平存在异质性。所构建的nomogram可作为一种临床工具，帮助早期识别高危人群，为老年人健康管理提供有力支持。

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引用次数: 0

Balancing palliative care needs and medication appropriateness: Initiation and reinitiation of medications at the end of life 平衡姑息治疗需求和药物适当性：在生命结束时开始和重新开始药物治疗

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-08-23 DOI: 10.1016/j.archger.2025.105994

Degefaye Zelalem Anlay , Kristel Paque , Astrid D.H. Brys , Joachim Cohen , Tinne Dilles

Background

Medications deemed inappropriate and discontinued in the earlier stages of life-limiting disease may become relevant in palliative care context at the end of life. This study aims to determine the incidence of and factors associated with initiation and reinitiation of medications deemed inappropriate according to the STOPPFrail guideline.

Methods

A retrospective cohort study using linked healthcare reimbursement data. We included nursing home residents aged ≥65 who died with a condition potentially amenable to palliative care between 2015 and 2019 in Belgium. Outcomes were: (1) reinitiation of previously discontinued STOPPFrail-listed medications; and (2) initiation of these medications, regardless of prior use, in the last three months. Log-binomial regression was used to estimate relative risks (RR) with 95 % confidence intervals (CI).

Results

Among 158,689 decedents, 29.7 % had at least one medication initiated, and 16.96 % reinitiated among those with at least one medication discontinued (n = 13,724). By medication type, initiation and reinitiation were significantly higher for symptomatic medications than preventive ones (initiation: 25.5 % symptomatic vs. 6.7 % preventive; reinitiation: 20.3 % symptomatic vs. 11 % preventive). The risk was higher among residents with cancer, who were hospitalized, or taking ≥10 chronic medications.

Conclusions

A significant proportion of residents undergo initiation or reinitiation of medications deemed inappropriate at the end of life per existing guidelines. Many were likely prescribed for palliative purposes. Thus, guidelines on medication appropriateness may need to more explicitly address palliative care contexts. A notable number also received preventive medications, suggesting inappropriate prescribing at the end of life that has received little attention.

背景：在限制生命的疾病的早期阶段被认为不合适和停用的药物可能在生命末期的姑息治疗背景下变得相关。本研究旨在确定根据stopp脆弱指南被认为不适当的药物开始和重新开始的发生率和相关因素。方法采用相关医疗报销数据进行回顾性队列研究。我们纳入了年龄≥65岁的养老院居民，他们在2015年至2019年期间死于可能适合姑息治疗的疾病。结果为：(1)重新使用先前停药的stoppfail药物；(2)在过去三个月内开始使用这些药物，无论之前是否使用过。采用对数二项回归估计相对风险（RR），置信区间为95%。结果在158,689例患者中，29.7%的患者至少开始使用一种药物，在至少停止使用一种药物的患者中，16.96%的患者重新开始使用药物（n = 13,724）。从用药类型来看，对症用药的起始和再起始率明显高于预防性用药（起始率：25.5%对症性对6.7%预防性；再起始率：20.3%对症性对11%预防性）。住院或服用≥10种慢性药物的癌症患者的风险更高。结论相当比例的居民在生命结束时开始或重新开始使用现有指南认为不合适的药物。许多药物可能是为了缓解病情。因此，关于药物适当性的指南可能需要更明确地解决姑息治疗的情况。相当多的人还接受了预防性药物治疗，这表明在生命结束时不适当的处方很少受到关注。

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引用次数: 0

Predictive validity of senior volunteer-led frailty check-up results for disability and mortality among community-dwelling older adults: a cohort study 老年志愿者主导的衰弱检查结果对社区老年人残疾和死亡率的预测有效性：一项队列研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-08-21 DOI: 10.1016/j.archger.2025.105998

Tomoki Tanaka , Weida Lyu , Yasuyo Yoshizawa , Bo-Kyung Son , Katsuya Iijima

A frailty checkup program (FC), a community-based frailty prevention initiative led by trained senior volunteers (FC supporters), has been implemented in over 100 municipalities in Japan. Participants create individual result sheets by marking blue signals for positive responses and red signals for negative responses. This cohort study aimed to examine the association between FC results and the risk of incident disability and mortality among community-dwelling older adults. A total of 3476 older adults (mean age, 73.0 ± 6.1 years, 74 % female) participated in FC in three municipalities between April 2017 and February 2023. At the FC sites, trained supporters evaluated 22 FC items (nutritional status, oral function, physical function, and social status). Outcome information on long-term care needs (incident disability) and mortality was collected from public records until November 2023. During the follow-up (median, 1088 days), 254 participants (7.3 %) developed incident disabilities, and 138 (4.0 %) died. A higher total number of red signals was associated with increased risk; individuals with ≥8 red signals had an increased risk of incident disability (adjusted hazard ratio [95 % confidence interval], 2.93 [2.08–4.12]). We calculated a weighted predictive probability using eight items particularly associated with increased risk of disability and mortality (5.39 [3.82–7.61], 1.94 [1.11–3.40], respectively, in the high-risk group). FC results in community-dwelling older adults were associated with a higher risk of incident disability and mortality. This study highlights the potential of the FC program in identifying high-risk individuals and guiding them to appropriate community-based interventions.

由训练有素的资深志愿者（FC支持者）领导的以社区为基础的虚弱预防计划（FC）已在日本100多个城市实施。参与者通过标记积极的蓝色信号和消极的红色信号来创建个人结果表。本队列研究旨在研究社区居住老年人FC结果与意外致残和死亡风险之间的关系。2017年4月至2023年2月，共有3476名老年人（平均年龄73.0±6.1岁，女性占74%）参加了FC。在FC现场，经过培训的支持者评估了22项FC项目（营养状况、口腔功能、身体功能和社会地位）。从公共记录中收集长期护理需求（意外残疾）和死亡率的结果信息，直至2023年11月。在随访期间（中位1088天），254名参与者（7.3%）发生意外残疾，138名参与者（4.0%）死亡。红色信号的总数越高，风险越高；红色信号≥8个的个体事件致残风险增加（校正风险比[95%置信区间]，2.93[2.08-4.12]）。我们使用与残疾和死亡风险增加特别相关的8个项目计算加权预测概率（高危组分别为5.39[3.82-7.61]和1.94[1.11-3.40]）。社区居住老年人的FC结果与较高的意外致残和死亡风险相关。本研究强调了FC项目在识别高危人群并指导他们采取适当的社区干预措施方面的潜力。

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引用次数: 0

Letter to the editor. Tackling social frailty: The role of family and community nurses 给编辑的信。解决社会脆弱性：家庭和社区护士的作用

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-08-20 DOI: 10.1016/j.archger.2025.105989

Yari Longobucco , Khadija El Aoufy

This letter commends the recent concept analysis of social frailty in older adults by Pradana et al., emphasizing its value as a framework for understanding and addressing an often-overlooked aspect of geriatric vulnerability. The authors’ identification of four antecedent domains—lifestyle, social and environmental factors, medical services, and health conditions—provides a practical scaffold for targeted interventions. Within this context, Family and Community Nurses (FCNs) are uniquely positioned to mitigate the onset and progression of social frailty through their longitudinal, holistic, and preventive role in community-based care. We highlight the need to translate conceptual antecedents into actionable strategies. FCNs can operationalize preventive measures such as home-based health promotion, motivational interviewing, and early frailty screening during home visits. By addressing lifestyle risk factors, enhancing social connections, and facilitating access to services, FCNs convert abstract determinants into individualized care plans. Their work extends to fostering community engagement, coordinating interdisciplinary collaboration, and leveraging local resources to reduce isolation and environmental deprivation. The letter underscores the value of FCNs as care coordinators within interprofessional teams, integrating health and social interventions to optimize continuity of care. In addition, telenursing emerges as an effective complement, particularly for underserved or rural populations, enabling sustained health monitoring and psychosocial support. While challenges such as workforce capacity and training must be addressed, the integration of FCNs into community-based aging programs is increasingly urgent in light of aging populations and pandemic-related exacerbations of social frailty. Grounding FCN-led practice in the identified domains can improve quality of life, resilience, and aging-in-place capacity. Policymakers are urged to embed and strengthen this role within community health systems to transform the theoretical construct of social frailty into measurable, population-level improvements.

这封信赞扬了Pradana等人最近对老年人社会脆弱性的概念分析，强调其作为理解和解决老年人脆弱性一个经常被忽视的方面的框架的价值。作者确定了四个先行领域——生活方式、社会和环境因素、医疗服务和健康状况——为有针对性的干预提供了一个实用的框架。在这种背景下，家庭和社区护士（fcn）具有独特的定位，可以通过其在社区护理中的纵向、整体和预防作用来减轻社会脆弱性的发生和发展。我们强调有必要将概念上的先决条件转化为可操作的战略。fns可以实施预防措施，如以家庭为基础的健康促进、动机性访谈和家访期间的早期虚弱筛查。通过解决生活方式风险因素、加强社会联系和促进获得服务，fns将抽象的决定因素转化为个性化的护理计划。他们的工作延伸到促进社区参与、协调跨学科合作和利用地方资源以减少孤立和环境匮乏。这封信强调了fcn作为跨专业团队中的护理协调员的价值，将卫生和社会干预措施结合起来，以优化护理的连续性。此外，远程护理是一种有效的补充，特别是对服务不足的人口或农村人口而言，能够实现持续的健康监测和社会心理支持。虽然必须解决劳动力能力和培训等挑战，但鉴于人口老龄化和与大流行病有关的社会脆弱性加剧，将fcn纳入社区老龄方案日益紧迫。将fcn主导的实践根植于确定的领域，可以提高生活质量、恢复力和原地老化能力。敦促政策制定者在社区卫生系统中嵌入和加强这一作用，将社会脆弱性的理论结构转变为可衡量的人口水平改善。

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引用次数: 0

Effects of a combined intervention of music-based movement, neuromodulation-synchronized cognitive training, and emotion regulation on cognitive function in community-dwelling older adults: A randomized controlled trial 音乐运动、神经调节同步认知训练和情绪调节联合干预对社区老年人认知功能的影响：一项随机对照试验

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-08-20 DOI: 10.1016/j.archger.2025.106000

Chifen Ma , Chao Wu

Background

To enhance cognitive intervention effectiveness, we developed MMNCE—integrating music-based exercise, multi-domain cognitive training with neurostimulation, and emotion-regulation education—grounded in cognitive aging theories.

Methods

In this three-arm RCT, we compared MMNCE with cognitive training plus sham neurostimulation (MCS) and a non-intervention control (NIC) among cognitively healthy (CH) and cognitively impaired (CI) older adults. A total of 166 participants (mean age: 68.95 ± 6.27; 70 CI) from community centers in Xuzhou, China, were randomized. Cognitive outcomes (MoCA and executive function) were assessed at baseline, 12, 24, and 36 weeks.

Results

At 12 weeks, 124 participants completed the intervention. Independent of the baseline cognitive status, compared to NIC, MMNCE showed larger effect sizes than MCS, with significant improvements in MoCA total scores and domains, including visuospatial ability, naming, attention, abstract reasoning, and episodic memory (η²_p = 0.15 to 0.54). MMNCE outperformed MCS on global cognition and abstraction (MoCA total η²p = 0.07, 95% CI: [0.01, 0.18]; abstraction η²p = 0.11, 95% CI: [0.03, 1]). Compared to MCS, MMNCE had a greater impact on global cognition in CH participants (η²_p = 0.11) while on abstraction in the CI group (η²_p = 0.19). In addition, MMNCE had sustained effects on global cognition. MMNCE also improved physical function and reduced depressive symptoms after intervention, which were not observed in the MCS group.

Conclusions

This study highlights MMNCE as an effective nonpharmacological intervention for preserving cognitive function in older adults. Further research is warranted to explore its impact on individuals across various stages of cognitive decline.

为了提高认知干预的有效性，我们开发了基于认知衰老理论的mmnce，整合了基于音乐的训练、神经刺激的多领域认知训练和情绪调节教育。方法在这项三组随机对照试验中，我们在认知健康（CH）和认知受损（CI）的老年人中比较了MMNCE与认知训练加假神经刺激（MCS）和非干预对照（NIC）。从中国徐州的社区中心随机抽取166名参与者（平均年龄：68.95±6.27;70 CI）。认知结果（MoCA和执行功能）在基线、12、24和36周进行评估。结果12周后，124名参与者完成了干预。与基线认知状态无关，与NIC相比，MMNCE显示出比MCS更大的效应量，MoCA总分和领域，包括视觉空间能力，命名能力，注意力，抽象推理和情景记忆（η²p = 0.15至0.54）显著改善。MMNCE在全局认知和抽象上优于MCS （MoCA总η²p = 0.07, 95% CI:[0.01, 0.18]；抽象η²p = 0.11, 95% CI:[0.03, 1]）。与MCS相比，MMNCE对CH组整体认知的影响更大（η²p = 0.11），对CI组抽象的影响更大（η²p = 0.19）。此外，MMNCE对全球认知有持续的影响。干预后，MMNCE还改善了身体功能，减轻了抑郁症状，这在MCS组中没有观察到。结论：本研究强调MMNCE是一种有效的非药物干预措施，可保护老年人的认知功能。有必要进一步研究它对不同认知衰退阶段的个体的影响。

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引用次数: 0

The association between intrinsic capacity and functional ability in older adults – exploring the role of the physical environment 老年人内在能力和功能能力之间的联系——探索物理环境的作用

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-08-19 DOI: 10.1016/j.archger.2025.105999

Jaro Govaerts , Laura A. Schaap , Erik J. Timmermans , Marjolein Visser , Martijn Huisman , Natasja M. van Schoor

Background

Ageing in place has been promoted in the Netherlands to encourage optimal functional ability (FA) and independent living among older adults. FA is likely dependent on intrinsic capacity (IC), a composite measure of an individual's mental and physical capacities-and its interaction with the physical environment in which people live. This study aimed to examine the association between IC and FA, as well as to explore how the physical environment may modify this relationship in older adults.

Methods

Data of older adults of the Longitudinal Aging Study Amsterdam were used (n=1,637). FA was assessed as six-year functional decline (yes/no). IC scores (0-100) and characteristics of the physical environment, i.e., urbanisation, air pollution (particulate matter (PM₁₀) and nitrogen dioxide (NO₂)), area-level socio-economic status, and neighbourhood walkability, were assessed at baseline. Multiple logistic regression analyses were conducted to investigate the association between IC and functional decline, and the modifying effect of each environmental variable.

Results

The mean age at baseline was 69.39 years (SD=7.51) and 54.7% were women. Higher IC was associated with lower odds of functional decline (OR: 0.90, 95% CI: 0.88-0.93). Stratified analyses showed a stronger inverse association between IC and functional decline in lower PM₁₀ (OR: 0.84, 95% CI: 0.76-0.92), compared to higher PM₁₀ environments (OR: 0.92, 95% CI: 0.89-0.95) in fully adjusted models.

Conclusion

Higher IC was related to less functional decline. Exposure to higher levels of PM₁₀ appears to mitigate the protective association between IC and FA in older adults.

在荷兰，为了鼓励老年人的最佳功能能力（FA）和独立生活，促进了适当的老龄化。FA可能依赖于内在能力（IC），这是一种对个人精神和身体能力的综合衡量，以及它与人们生活的物理环境的相互作用。本研究旨在研究IC和FA之间的关系，并探讨物理环境如何改变老年人的这种关系。方法采用阿姆斯特丹纵向衰老研究的老年人数据（n= 1637）。FA评估为六年功能衰退（是/否）。IC得分（0-100）和物理环境特征，即城市化、空气污染（颗粒物（PM10）和二氧化氮（NO2））、区域层面的社会经济状况和社区可步行性，以基线为基础进行评估。通过多元logistic回归分析，探讨IC与功能衰退之间的关系，以及各环境变量的调节作用。结果基线时平均年龄为69.39岁（SD=7.51），女性占54.7%。较高的IC与较低的功能衰退几率相关（OR: 0.90, 95% CI: 0.88-0.93）。分层分析显示，在完全调整的模型中，与高PM10环境（OR: 0.92, 95% CI: 0.89-0.95）相比，低PM10环境中IC与功能下降之间存在更强的负相关（OR: 0.84, 95% CI: 0.76-0.92）。结论IC越高，功能衰退越少。暴露于较高水平的PM10似乎可以减轻老年人IC和FA之间的保护性关联。

{"title":"The association between intrinsic capacity and functional ability in older adults – exploring the role of the physical environment","authors":"Jaro Govaerts , Laura A. Schaap , Erik J. Timmermans , Marjolein Visser , Martijn Huisman , Natasja M. van Schoor","doi":"10.1016/j.archger.2025.105999","DOIUrl":"10.1016/j.archger.2025.105999","url":null,"abstract":"<div><h3>Background</h3><div>Ageing in place has been promoted in the Netherlands to encourage optimal functional ability (FA) and independent living among older adults. FA is likely dependent on intrinsic capacity (IC), a composite measure of an individual's mental and physical capacities-and its interaction with the physical environment in which people live. This study aimed to examine the association between IC and FA, as well as to explore how the physical environment may modify this relationship in older adults.</div></div><div><h3>Methods</h3><div>Data of older adults of the Longitudinal Aging Study Amsterdam were used (n=1,637). FA was assessed as six-year functional decline (yes/no). IC scores (0-100) and characteristics of the physical environment, i.e., urbanisation, air pollution (particulate matter (PM<sub>10</sub>) and nitrogen dioxide (NO<sub>2</sub>)), area-level socio-economic status, and neighbourhood walkability, were assessed at baseline. Multiple logistic regression analyses were conducted to investigate the association between IC and functional decline, and the modifying effect of each environmental variable.</div></div><div><h3>Results</h3><div>The mean age at baseline was 69.39 years (SD=7.51) and 54.7% were women. Higher IC was associated with lower odds of functional decline (OR: 0.90, 95% CI: 0.88-0.93). Stratified analyses showed a stronger inverse association between IC and functional decline in lower PM<sub>10</sub> (OR: 0.84, 95% CI: 0.76-0.92), compared to higher PM<sub>10</sub> environments (OR: 0.92, 95% CI: 0.89-0.95) in fully adjusted models.</div></div><div><h3>Conclusion</h3><div>Higher IC was related to less functional decline. Exposure to higher levels of PM<sub>10</sub> appears to mitigate the protective association between IC and FA in older adults.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 105999"},"PeriodicalIF":3.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988956","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

BMP10 attenuates age-related atrial fibrillation susceptibility through improving mitochondrial function in atrial cardiomyocytes BMP10通过改善心房心肌细胞线粒体功能减弱年龄相关心房颤动易感性

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-08-19 DOI: 10.1016/j.archger.2025.105997

Qiang Gao , Yukai Cao , Xinbo Zhao , Hongyuan Mu , Yue Li , Yue Yuan

Background

Although emerging clinical studies exhibit a strong association of circulating bone morphogenetic protein (BMP10) level with adverse outcomes in patients with atrial fibrillation (AF), also in older individuals. The exact role of BMP10 in age-related AF pathogenesis and potential mechanisms remain unknown.

Methods

Aged rats were subjected to injection of negative control (NC) or adeno-associated virus 9 (AAV9) to overexpress BMP10, then intracardiac electrophysiology, echocardiography and histology were performed after 4 weeks. Proteomics was conducted to reveal the differential proteins in rat atria. Mitochondrial morphology, reactive oxygen species (ROS) and metabolic substrates were assessed by transmission electron microscopy, mitoSOX and testing assay.

Results

Aged rats and AF patients exhibited elevated serum BMP10 levels compared to young controls. Increased BMP10 protein expression correlated with atrial remodeling and AF phenotype of aged rats compared to young rats. Overexpression of BMP10 mitigated the pacing-induced AF incidence and increased conduction velocity compared to controls. Atrial fibrosis, inflammatory foci were reduced with restored electrical activity in AAV-BMP10 treated rats. Proteomics indicated improved atrial mitochondrial metabolism related to signal transducer and activator of transcription 3 (STAT3) signaling in AAV-BMP10 injection rats. Overexpressing BMP10 diminished ROS production by regulating phosphorylation of STAT3 translocation into mitochondria. Moreover, overexpressing BMP10 stimulated mitochondrial electron transport chain complexes to generate more ATP by upregulating biogenesis makers in atrial cardiomyocytes.

Conclusions

Our work demonstrates that BMP10 alleviates age-related atrial arrhythmogenesis via mitochondrial STAT3 impacts in atrial cardiomyocytes.

尽管新出现的临床研究表明循环骨形态发生蛋白（BMP10）水平与房颤（AF）患者的不良结局密切相关，但在老年人中也是如此。BMP10在年龄相关性房颤发病机制中的确切作用和潜在机制尚不清楚。方法老龄大鼠注射阴性对照（NC）或腺相关病毒9 （AAV9）过表达BMP10, 4周后进行心内电生理、超声心动图和组织学检查。用蛋白质组学方法研究大鼠心房的差异蛋白。通过透射电镜、mitoSOX和检测方法检测线粒体形态、活性氧（ROS）和代谢底物。结果老年大鼠和房颤患者血清BMP10水平高于年轻对照组。老年大鼠与年轻大鼠相比，BMP10蛋白表达增加与心房重构和房颤表型相关。与对照组相比，BMP10的过表达减轻了起搏诱导的房颤发生率，并增加了传导速度。在AAV-BMP10治疗的大鼠中，心房纤维化、炎症灶随着电活动的恢复而减少。蛋白质组学表明，注射AAV-BMP10后，心房线粒体代谢与STAT3信号传导相关。过表达BMP10通过调节STAT3转运到线粒体的磷酸化来减少ROS的产生。此外，BMP10的过表达通过上调心房心肌细胞的生物生成因子，刺激线粒体电子传递链复合物产生更多的ATP。结论BMP10通过影响心房心肌细胞的线粒体STAT3，减轻了年龄相关性心房心律失常的发生。

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引用次数: 0