Persistent inflammation is a key factor in the development of chronic pain, as diet can modulate inflammation, it may influence the risk of chronic pain risk. Pro-inflammatory dietary patterns—characterized by higher Dietary Inflammatory Index (DII) scores, indicating dietary patterns that promote systemic inflammation—may be particularly relevant. The impact of diet on inflammation and pain may vary by individual factors such as sex, age, and psychological status. This study examined this association with a particular focus on sex differences.
Methods
This cross-sectional study used baseline data from the Itabashi Longitudinal Study on Aging, a cohort of community-dwelling older adults in Tokyo. The DII was derived from dietary data collected via a self-administered diet survey. Binary logistic regression analysis was performed with sex and DII quartile interaction terms as exposure variables and chronic pain (pain lasting ≥three months) as outcome, adjusted for age, overweight, educational level, and smoking status.
Results
Using men in the lowest DII quartile as the reference group, women had significantly higher odds ratios (OR) for chronic pain across all DII quartiles (first, OR: 1.69, 95% CI: 1.16–2.46; second, OR: 1.84, 95% CI: 1.27–2.67; third, OR: 1.64, 95% CI: 1.12–2.40; and fourth, OR: 2.51, 95% CI: 1.73–3.66).
Conclusions
Our findings suggest that the association between a pro-inflammatory diet, as reflected by higher DII scores, and chronic pain may differ by sex and that systemic inflammation may be involved. These findings underscore the need for sex-specific dietary strategies to manage chronic pain.
{"title":"Association between pro-inflammatory dietary patterns and chronic pain in community-dwelling older adults: A cross-sectional study","authors":"Junji Nishimoto , Naoki Deguchi , Sho Hatanaka , Takashi Shida , Takahisa Ohta , Narumi Kojima , Maki Shirobe , Keiko Motokawa , Hirohiko Hirano , Tsuyoshi Okamura , Shuichi Awata , Hiroyuki Sasai","doi":"10.1016/j.archger.2025.106035","DOIUrl":"10.1016/j.archger.2025.106035","url":null,"abstract":"<div><h3>Background</h3><div>Persistent inflammation is a key factor in the development of chronic pain, as diet can modulate inflammation, it may influence the risk of chronic pain risk. Pro-inflammatory dietary patterns—characterized by higher Dietary Inflammatory Index (DII) scores, indicating dietary patterns that promote systemic inflammation—may be particularly relevant. The impact of diet on inflammation and pain may vary by individual factors such as sex, age, and psychological status. This study examined this association with a particular focus on sex differences.</div></div><div><h3>Methods</h3><div>This cross-sectional study used baseline data from the Itabashi Longitudinal Study on Aging, a cohort of community-dwelling older adults in Tokyo. The DII was derived from dietary data collected via a self-administered diet survey. Binary logistic regression analysis was performed with sex and DII quartile interaction terms as exposure variables and chronic pain (pain lasting ≥three months) as outcome, adjusted for age, overweight, educational level, and smoking status.</div></div><div><h3>Results</h3><div>Using men in the lowest DII quartile as the reference group, women had significantly higher odds ratios (OR) for chronic pain across all DII quartiles (first, OR: 1.69, 95% CI: 1.16–2.46; second, OR: 1.84, 95% CI: 1.27–2.67; third, OR: 1.64, 95% CI: 1.12–2.40; and fourth, OR: 2.51, 95% CI: 1.73–3.66).</div></div><div><h3>Conclusions</h3><div>Our findings suggest that the association between a pro-inflammatory diet, as reflected by higher DII scores, and chronic pain may differ by sex and that systemic inflammation may be involved. These findings underscore the need for sex-specific dietary strategies to manage chronic pain.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"140 ","pages":"Article 106035"},"PeriodicalIF":3.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214117","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}
Pub Date : 2025-09-22DOI: 10.1016/j.archger.2025.106034
Juan Gu , Yufei Qiu , Jiali Liu , Yake Yue , Mengjie Tong , Lijuan Zeng , Yiqing Yu , Fen Yang
Objective
This study aimed to explore the prevalence and influencing factors of digital smart devices (DSDs) use among older adults from a global perspective.
Methods
Systematic searches were conducted on four databases including Pubmed, Cochrane Library, Web of Science, and Embase from January 1, 2011 to April 16, 2025. Two researchers performed a thorough literature search, gathered data, and independently evaluated the quality of the articles. Subgroups, sensitivity, and meta-regression analyses were performed to address heterogeneity. Publication bias was evaluated using funnel plots and Egger’s test.
Results
After screening 36,405 articles, we included 39 studies encompassing 528,721 participants. The pooled prevalence of DSDs use among older adults was 0.47 (95 % CI: 0.39-0.54; p < 0.001). A higher educational attainment (OR = 2.00; 95 % CI: 1.14-3.51; p < 0.05) and a more positive attitude (OR = 2.37; 95 % CI: 1.16-4.83; p < 0.05) were associated with a significantly increased likelihood of DSDs use among older adults. However, a higher age (OR = 0.85; 95 % CI: 0.73-0.99; p < 0.05) was associated with a significantly reduced use of DSDs among older adults. A total of 13 other factors for DSDs use were identified through qualitative synthesis.
Conclusion
The prevalence of DSDs use among older adults is moderate and influenced by multiple factors, including age, education and attitude towards use
目的从全球角度探讨老年人数字智能设备（dsd）的使用情况及其影响因素。方法系统检索2011年1月1日至2025年4月16日Pubmed、Cochrane Library、Web of Science、Embase 4个数据库。两位研究人员进行了彻底的文献检索，收集了数据，并独立评估了文章的质量。进行亚组、敏感性和元回归分析以解决异质性。采用漏斗图和Egger检验评价发表偏倚。在筛选了36,405篇文章后，我们纳入了39项研究，涉及528,721名参与者。老年人使用dsd的总患病率为0.47 （95% CI: 0.39-0.54; p < 0.001）。较高的教育程度（OR = 2.00; 95% CI: 1.14-3.51; p < 0.05）和更积极的态度（OR = 2.37; 95% CI: 1.16-4.83; p < 0.05）与老年人使用dsd的可能性显著增加相关。然而，较高的年龄（OR = 0.85; 95% CI: 0.73-0.99; p < 0.05）与老年人使用dsd的显著减少相关。通过定性综合，共确定了13个影响dsd使用的其他因素。结论老年人dsd的使用程度适中，受年龄、文化程度和使用态度等多种因素的影响
{"title":"Prevalence and influencing factors of digital smart devices use among older adults: a systematic review and meta-analysis","authors":"Juan Gu , Yufei Qiu , Jiali Liu , Yake Yue , Mengjie Tong , Lijuan Zeng , Yiqing Yu , Fen Yang","doi":"10.1016/j.archger.2025.106034","DOIUrl":"10.1016/j.archger.2025.106034","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore the prevalence and influencing factors of digital smart devices (DSDs) use among older adults from a global perspective.</div></div><div><h3>Methods</h3><div>Systematic searches were conducted on four databases including Pubmed, Cochrane Library, Web of Science, and Embase from January 1, 2011 to April 16, 2025. Two researchers performed a thorough literature search, gathered data, and independently evaluated the quality of the articles. Subgroups, sensitivity, and meta-regression analyses were performed to address heterogeneity. Publication bias was evaluated using funnel plots and Egger’s test.</div></div><div><h3>Results</h3><div>After screening 36,405 articles, we included 39 studies encompassing 528,721 participants. The pooled prevalence of DSDs use among older adults was 0.47 (95 % CI: 0.39-0.54; <em>p</em> < 0.001). A higher educational attainment (OR = 2.00; 95 % CI: 1.14-3.51; <em>p</em> < 0.05) and a more positive attitude (OR = 2.37; 95 % CI: 1.16-4.83; <em>p</em> < 0.05) were associated with a significantly increased likelihood of DSDs use among older adults. However, a higher age (OR = 0.85; 95 % CI: 0.73-0.99; <em>p</em> < 0.05) was associated with a significantly reduced use of DSDs among older adults. A total of 13 other factors for DSDs use were identified through qualitative synthesis.</div></div><div><h3>Conclusion</h3><div>The prevalence of DSDs use among older adults is moderate and influenced by multiple factors, including age, education and attitude towards use</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"140 ","pages":"Article 106034"},"PeriodicalIF":3.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145128261","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}
Pub Date : 2025-09-22DOI: 10.1016/j.archger.2025.106031
Li Feng Tan , Alicia Le How , Xin Xiang Lee , Benjamin Y.Q. Tan , Yee Wei Lim , Leonard Lee , Shuna S. Khoo , Lile Jia , Reshma A Merchant , on behalf of the Health District at Queenstown
Background
Intrinsic capacity (IC) is central to the World Health Organization’s life course approach to healthy ageing. Population-level data across the lifespan remain limited. This study aimed to assess the prevalence of IC deficits and to identify sociodemographic, clinical, and lifestyle factors associated with these deficits in a nationally representative community cohort in Singapore.
Methods
Cross-sectional survey of adults aged ≥21 years in the Queenstown Study. IC was assessed using a modified WHO ICOPE Step 1 screening approach. Sociodemographic and health data were collected.
Results
Among 4274 participants, 29.2 % had ≥1 IC deficit; prevalence rose stepwise with age from 10.3 % (20–39 years) to 19.1 % (40–59), 45.0 % (60–79) and 74.5 % (≥80 years). Locomotion (16.8 %) and sensory (11.4 %) deficits were most common. In multivariable analysis, IC deficits were associated with older age (OR 1.05 per year, 95 % CI 1.04–1.06, p < 0.001), female sex (OR 1.19, 95 % CI 1.01–1.40, p = 0.037), underweight (OR 1.61, 95 % CI 1.18–2.20, p = 0.003), and obesity (OR 1.36, 95 % CI 1.07–1.71, p = 0.011), frailty (OR 10.94, 95 % CI 3.57–48.14, p < 0.001), impaired instrumental ADLs (OR 3.93, 95 % CI 2.11–7.84, p < 0.001), low handgrip strength (OR 1.68, 95 % CI 1.43–1.97, p < 0.001), diabetes (OR 1.45, 95 % CI 1.12–1.87, p = 0.004), and social isolation (OR 1.23, 95 % CI 1.04–1.45, p = 0.014). Higher quality of life was protective (OR 0.84, 95 % CI 0.80–0.89, p < 0.001).
Conclusion
IC deficits were prevalent even in midlife and linked to modifiable factors. These findings support the need for early, multidomain interventions to preserve function and promote healthy ageing across adulthood.
内在能力（IC）是世界卫生组织健康老龄化的生命过程方法的核心。整个生命周期的人口数据仍然有限。本研究旨在评估新加坡具有全国代表性的社区队列中IC缺陷的患病率，并确定与这些缺陷相关的社会人口统计学、临床和生活方式因素。方法对Queenstown研究中年龄≥21岁的成年人进行横断面调查。使用改进的WHO ICOPE第1步筛查方法评估IC。收集了社会人口和健康数据。结果4274名受试者中，29.2%存在≥1个IC缺陷；随着年龄的增长，患病率从10.3%（20-39岁）逐渐上升到19.1%（40-59岁）、45.0%（60-79岁）和74.5%（≥80岁）。运动障碍（16.8%）和感觉障碍（11.4%）最为常见。在多变量分析中,IC赤字与老年有关(或每年1.05,95%可信区间1.04 - -1.06,p & lt; 0.001),女性性(或1.19,95%可信区间1.01 - -1.40,p = 0.037),体重不足(或1.61,95%可信区间1.18 - -2.20,p = 0.003),和肥胖(或1.36,95%可信区间1.07 - -1.71,p = 0.011),虚弱(或10.94,95%可信区间3.57 - -48.14,p & lt; 0.001),仪器ADLs受损(或3.93,95%可信区间2.11 - -7.84,p & lt; 0.001),低握力(或1.68,95%可信区间1.43 - -1.97,p & lt; 0.001)、糖尿病(或1.45,95% CI 1.12-1.87, p = 0.004)和社会孤立（OR 1.23, 95% CI 1.04-1.45, p = 0.014）。较高的生活质量具有保护作用（OR 0.84, 95% CI 0.80-0.89, p < 0.001）。结论：即使在中年人中，视力缺陷也很普遍，并与可改变的因素有关。这些发现支持早期多领域干预的必要性，以保持功能并促进整个成年期的健康老龄化。
{"title":"Intrinsic capacity deficits across the lifespan in a nationally representative community cohort: findings from the Queenstown study","authors":"Li Feng Tan , Alicia Le How , Xin Xiang Lee , Benjamin Y.Q. Tan , Yee Wei Lim , Leonard Lee , Shuna S. Khoo , Lile Jia , Reshma A Merchant , on behalf of the Health District at Queenstown","doi":"10.1016/j.archger.2025.106031","DOIUrl":"10.1016/j.archger.2025.106031","url":null,"abstract":"<div><h3>Background</h3><div>Intrinsic capacity (IC) is central to the World Health Organization’s life course approach to healthy ageing. Population-level data across the lifespan remain limited. This study aimed to assess the prevalence of IC deficits and to identify sociodemographic, clinical, and lifestyle factors associated with these deficits in a nationally representative community cohort in Singapore.</div></div><div><h3>Methods</h3><div>Cross-sectional survey of adults aged ≥21 years in the Queenstown Study. IC was assessed using a modified WHO ICOPE Step 1 screening approach. Sociodemographic and health data were collected.</div></div><div><h3>Results</h3><div>Among 4274 participants, 29.2 % had ≥1 IC deficit; prevalence rose stepwise with age from 10.3 % (20–39 years) to 19.1 % (40–59), 45.0 % (60–79) and 74.5 % (≥80 years). Locomotion (16.8 %) and sensory (11.4 %) deficits were most common. In multivariable analysis, IC deficits were associated with older age (OR 1.05 per year, 95 % CI 1.04–1.06, <em>p</em> < 0.001), female sex (OR 1.19, 95 % CI 1.01–1.40, <em>p</em> = 0.037), underweight (OR 1.61, 95 % CI 1.18–2.20, <em>p</em> = 0.003), and obesity (OR 1.36, 95 % CI 1.07–1.71, <em>p</em> = 0.011), frailty (OR 10.94, 95 % CI 3.57–48.14, <em>p</em> < 0.001), impaired instrumental ADLs (OR 3.93, 95 % CI 2.11–7.84, <em>p</em> < 0.001), low handgrip strength (OR 1.68, 95 % CI 1.43–1.97, <em>p</em> < 0.001), diabetes (OR 1.45, 95 % CI 1.12–1.87, <em>p</em> = 0.004), and social isolation (OR 1.23, 95 % CI 1.04–1.45, <em>p</em> = 0.014). Higher quality of life was protective (OR 0.84, 95 % CI 0.80–0.89, <em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>IC deficits were prevalent even in midlife and linked to modifiable factors. These findings support the need for early, multidomain interventions to preserve function and promote healthy ageing across adulthood.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"140 ","pages":"Article 106031"},"PeriodicalIF":3.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218803","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}
Pub Date : 2025-09-22DOI: 10.1016/j.archger.2025.106033
Fei Wang , Xiang Shang , Weiran Li , Meixia Wang , Fei Li
Background
With China's aging population, cognitive impairment has become a pressing public health issue. Rural older adults face disproportionately higher risks, yet remain underrepresented in predictive modeling studies. This study aimed to develop and externally validate a nomogram to estimate cognitive impairment risk among rural older adults in China.
Methods
Data were obtained from 2228 rural participants aged ≥60 years in the 2011 China Health and Retirement Longitudinal Study (CHARLS), randomly assigned to training and internal validation cohorts. An additional 1854 rural participants from the 2013 CHARLS wave served as an external validation set. Feature selection was conducted using the least absolute shrinkage and selection operator (LASSO), followed by multivariable logistic regression to identify independent predictors. A nomogram was constructed, with model performance evaluated through ROC curves, calibration plots, and decision curve analysis (DCA).
Results
Six predictors—age, education, alcohol consumption, systolic blood pressure, handgrip strength, and depressive symptoms—were included in the final nomogram. The model achieved AUCs of 0.849 (training), 0.852 (internal validation), and 0.806 (external validation), indicating strong discriminative ability. Calibration showed good agreement between predicted and observed outcomes. DCA demonstrated favorable clinical utility across all cohorts.
Conclusion
The nomogram exhibited strong predictive performance and generalizability, offering a cost-effective and practical tool for early identification of cognitive impairment in underserved rural populations in China.
{"title":"Time-stratified modeling of cognitive impairment risk in rural aging populations: Nomogram development (2011) and external validation (2013) using CHARLS","authors":"Fei Wang , Xiang Shang , Weiran Li , Meixia Wang , Fei Li","doi":"10.1016/j.archger.2025.106033","DOIUrl":"10.1016/j.archger.2025.106033","url":null,"abstract":"<div><h3>Background</h3><div>With China's aging population, cognitive impairment has become a pressing public health issue. Rural older adults face disproportionately higher risks, yet remain underrepresented in predictive modeling studies. This study aimed to develop and externally validate a nomogram to estimate cognitive impairment risk among rural older adults in China.</div></div><div><h3>Methods</h3><div>Data were obtained from 2228 rural participants aged ≥60 years in the 2011 China Health and Retirement Longitudinal Study (CHARLS), randomly assigned to training and internal validation cohorts. An additional 1854 rural participants from the 2013 CHARLS wave served as an external validation set. Feature selection was conducted using the least absolute shrinkage and selection operator (LASSO), followed by multivariable logistic regression to identify independent predictors. A nomogram was constructed, with model performance evaluated through ROC curves, calibration plots, and decision curve analysis (DCA).</div></div><div><h3>Results</h3><div>Six predictors—age, education, alcohol consumption, systolic blood pressure, handgrip strength, and depressive symptoms—were included in the final nomogram. The model achieved AUCs of 0.849 (training), 0.852 (internal validation), and 0.806 (external validation), indicating strong discriminative ability. Calibration showed good agreement between predicted and observed outcomes. DCA demonstrated favorable clinical utility across all cohorts.</div></div><div><h3>Conclusion</h3><div>The nomogram exhibited strong predictive performance and generalizability, offering a cost-effective and practical tool for early identification of cognitive impairment in underserved rural populations in China.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"140 ","pages":"Article 106033"},"PeriodicalIF":3.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145128262","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}
Pub Date : 2025-09-21DOI: 10.1016/j.archger.2025.106032
Jolyn Johal , Heather Block , Alison Dymmott , Elsa Dent , Helen Exley , Stacey George
Objectives
To identify barriers and enablers to primary care in Australian residential aged care homes (RACHs).
Study design
Scoping review of articles published from 2019 to June 2024 in which barriers and enablers to primary care in Australian RACHs have been quantitatively measured, qualitatively collected or reported following implementation.
Data sources
Medline, CINAHL, AgeLine, Cochrane, Scopus, JBI, and Google Scholar.
Data synthesis
Of 1705 records screened, 28 studies were included, which were predominantly qualitative or mixed methods. They included general practitioner, nurse practitioner, pharmacy, allied health, oral health and dental services. Ninety barriers and 72 enablers were identified, and inductively classified into seven categories: System Level: 1. Funding and Resources; Organisational Level: 2. Employment and Service Models, 3. Management and Culture and, 4. Collaboration, Coordination and Communication; and Individual Level: 5. Workload, Job Satisfaction and Security, 6. Attributes, Skills and Preparedness for Role and, 7. Recipient Needs, Attitudes and Preferences. Barriers and enablers related to ‘Funding and Resources’ and ‘Employment and Service Models’ appeared key, interacting with multiple categories. On-site models were reported to foster greater collaboration and care.
Conclusions
This review revealed the systems-, organisational- and individual-level factors that influence primary care in Australian RACHs. These can be considered when designing future initiatives to increase primary care access in RACHs. With the Australian Government recently introducing funding to employ on-site pharmacists, this is an opportunity for systematic evaluation of on-site models to inform future policies, which can be considered for extension to other professions.
{"title":"Barriers and enablers to primary care in Australian residential aged care homes: A scoping review","authors":"Jolyn Johal , Heather Block , Alison Dymmott , Elsa Dent , Helen Exley , Stacey George","doi":"10.1016/j.archger.2025.106032","DOIUrl":"10.1016/j.archger.2025.106032","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify barriers and enablers to primary care in Australian residential aged care homes (RACHs).</div></div><div><h3>Study design</h3><div>Scoping review of articles published from 2019 to June 2024 in which barriers and enablers to primary care in Australian RACHs have been quantitatively measured, qualitatively collected or reported following implementation.</div></div><div><h3>Data sources</h3><div>Medline, CINAHL, AgeLine, Cochrane, Scopus, JBI, and Google Scholar.</div></div><div><h3>Data synthesis</h3><div>Of 1705 records screened, 28 studies were included, which were predominantly qualitative or mixed methods. They included general practitioner, nurse practitioner, pharmacy, allied health, oral health and dental services. Ninety barriers and 72 enablers were identified, and inductively classified into seven categories: System Level: 1. Funding and Resources; Organisational Level: 2. Employment and Service Models, 3. Management and Culture and, 4. Collaboration, Coordination and Communication; and Individual Level: 5. Workload, Job Satisfaction and Security, 6. Attributes, Skills and Preparedness for Role and, 7. Recipient Needs, Attitudes and Preferences. Barriers and enablers related to ‘Funding and Resources’ and ‘Employment and Service Models’ appeared key, interacting with multiple categories. On-site models were reported to foster greater collaboration and care.</div></div><div><h3>Conclusions</h3><div>This review revealed the systems-, organisational- and individual-level factors that influence primary care in Australian RACHs. These can be considered when designing future initiatives to increase primary care access in RACHs. With the Australian Government recently introducing funding to employ on-site pharmacists, this is an opportunity for systematic evaluation of on-site models to inform future policies, which can be considered for extension to other professions.</div></div><div><h3>Registration</h3><div>Open Science Framework, <span><span>https://osf.io/nyqrm/</span><svg><path></path></svg></span></div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"140 ","pages":"Article 106032"},"PeriodicalIF":3.8,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254097","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}
Pub Date : 2025-09-18DOI: 10.1016/j.archger.2025.106030
Liang-Kung Chen
{"title":"Transforming healthy aging strategies through precision health approaches","authors":"Liang-Kung Chen","doi":"10.1016/j.archger.2025.106030","DOIUrl":"10.1016/j.archger.2025.106030","url":null,"abstract":"","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106030"},"PeriodicalIF":3.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115386","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}
This study aims to examine the association between sleep and intrinsic capacity (IC), employing a machine-learning approach, to promote healthy aging and disability prevention in the community.
Methods
A cohort of 810 community-dwelling individuals aged 50 years were enrolled. Sleep patterns were assessed using the Pittsburgh Sleep Quality Index (PSQI) and its subdomains. Unsupervised machine learning through K-means clustering was applied to classify sleep patterns into four distinct categories, enabling further analysis. IC was evaluated by assessing cognitive, locomotion, vitality, psychological, and sensory functions and was subsequently rescaled using the percent of the maximum possible method.
Results
Low IC was linked to higher PSQI (OR 1.10, 95% CI 1.05-1.15, p<0.001), as well as subdomains indicating poor sleep quality, lower habitual sleep efficiency, and increased sleep disturbances. Poor sleep quality (PSQI >5) was associated with low IC and lower scores in the psychological wellbeing, and vitality subdomains. Results of K-means clustering analysis showed: Category 1 (worst sleepers) (OR 2.54, 95% CI 1.55-4.16, p<0.001), Category 2 (short and inefficient sleepers, OR 1.69, 95% CI 1.18-2.43, p=0.004), and Category 3 (inefficient sleepers, OR 1.50, 95% CI 1.02-2.20, p=0.037) exhibited a higher risk for low IC compared to robust sleepers.
Conclusions
The study highlights the crucial role of sleep quality in maintaining intrinsic capacity and promoting healthy aging. Impairments in psychological wellbeing and vitality were identified as the primary contributors. This emphasizes the importance of promoting healthy sleep habits for overall well-being.
本研究旨在研究睡眠与内在能力（IC）之间的关系，采用机器学习方法，促进社区的健康老龄化和残疾预防。方法对810名50岁的社区居民进行队列研究。使用匹兹堡睡眠质量指数（PSQI）及其子域评估睡眠模式。通过K-means聚类的无监督机器学习被应用于将睡眠模式分为四个不同的类别，从而进行进一步的分析。通过评估认知、运动、活力、心理和感觉功能来评估IC，随后使用最大可能百分比法重新缩放IC。结果慢IC与较高的PSQI （OR 1.10, 95% CI 1.05-1.15, p<0.001）以及表明睡眠质量差、习惯性睡眠效率低和睡眠障碍增加的子域有关。睡眠质量差（PSQI >5）与低IC以及心理健康和活力子域得分较低相关。k -均值聚类分析的结果显示：第一类（最差睡眠者）（OR 2.54, 95% CI 1.55-4.16, p<0.001）、第二类（短睡眠者和低效睡眠者，OR 1.69, 95% CI 1.18-2.43, p=0.004）和第三类（低效睡眠者，OR 1.50, 95% CI 1.02-2.20, p=0.037）与健康睡眠者相比，低IC的风险更高。结论本研究强调了睡眠质量在维持内在能力和促进健康衰老方面的重要作用。心理健康和活力的损害被确定为主要因素。这强调了促进健康睡眠习惯对整体健康的重要性。
{"title":"Evaluating sleep patterns and intrinsic capacity with machine learning: Results from the Gan-Dau healthy longevity plan","authors":"Kuan-Yu Peng , Wei-Ju Lee , Heng-Hsin Tung , Shih-Tsung Huang , Su-Yu Chang , Hsiu-Ling Chung , Hsiao-Chien Yeh , Wen-Huey Tsai , Shin-Shang Chou , Fei-Yuan Hsiao","doi":"10.1016/j.archger.2025.106028","DOIUrl":"10.1016/j.archger.2025.106028","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to examine the association between sleep and intrinsic capacity (IC), employing a machine-learning approach, to promote healthy aging and disability prevention in the community.</div></div><div><h3>Methods</h3><div>A cohort of 810 community-dwelling individuals aged 50 years were enrolled. Sleep patterns were assessed using the Pittsburgh Sleep Quality Index (PSQI) and its subdomains. Unsupervised machine learning through K-means clustering was applied to classify sleep patterns into four distinct categories, enabling further analysis. IC was evaluated by assessing cognitive, locomotion, vitality, psychological, and sensory functions and was subsequently rescaled using the percent of the maximum possible method.</div></div><div><h3>Results</h3><div>Low IC was linked to higher PSQI (OR 1.10, 95% CI 1.05-1.15, p<0.001), as well as subdomains indicating poor sleep quality, lower habitual sleep efficiency, and increased sleep disturbances. Poor sleep quality (PSQI >5) was associated with low IC and lower scores in the psychological wellbeing, and vitality subdomains. Results of K-means clustering analysis showed: Category 1 (worst sleepers) (OR 2.54, 95% CI 1.55-4.16, p<0.001), Category 2 (short and inefficient sleepers<strong>,</strong> OR 1.69, 95% CI 1.18-2.43, p=0.004), and Category 3 (inefficient sleepers, OR 1.50, 95% CI 1.02-2.20, p=0.037) exhibited a higher risk for low IC compared to robust sleepers.</div></div><div><h3>Conclusions</h3><div>The study highlights the crucial role of sleep quality in maintaining intrinsic capacity and promoting healthy aging. Impairments in psychological wellbeing and vitality were identified as the primary contributors. This emphasizes the importance of promoting healthy sleep habits for overall well-being.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106028"},"PeriodicalIF":3.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118268","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}
Pub Date : 2025-09-15DOI: 10.1016/j.archger.2025.106027
Stefano Cacciatore , Emanuele Marzetti , Riccardo Calvani , Matteo Tosato , Francesco Landi , Lookup 8+ Study Group
Objectives
To examine the association between cardiovascular health, assessed through an 8-factor cardiovascular health (8F–CVH) score, and self-reported walking difficulty in middle-aged (40–64 years) and older adults (≥65 years) living in the community.
Study design
Cross-sectional study.
Main outcome measures
Self-reported walking difficulty was evaluated by a single-item question: “Do you have any difficulty in walking 400 meters?”. Cardiovascular health was assessed using a composite 8F–CVH score inspired by Life’s Essential 8, including diet, physical activity, body mass index, blood pressure, total cholesterol, fasting blood glucose, smoking status, and sleep quality.
Results
Among 4141 participants (mean age 60.5 ± 11.2 years; 53.1 % women), 16.0 % reported walking difficulty. Prevalence was higher in older adults (25.0 %) than in middle-aged individuals (11.0 %; p for trend <0.001). Self-reported walking difficulty was more frequent in participants with low 8F–CVH scores (32.8 %), compared to moderate (15.5 %) and high (4.8 %) scores (p <0.001). ROC curve analysis showed modest discrimination for the total score (area under the curve [AUC] 0.67; 95 % confidence interval [CI] 0.65–0.69), with physical activity performing best among individual components (AUC 0.69; 95 % CI 0.67–0.71). After adjusting for confounders, moderate and high scores were associated with 61 % (OR 0.39, 95 % CI 0.31–0.48) and 84 % (OR 0.16, 95 % CI 0.10–0.24) lower odds of self-reported walking difficulty, respectively.
Conclusions
Better cardiovascular health is independently associated with lower odds of self-reported walking difficulty. Promoting cardiovascular health may help preserve mobility in late life.
目的通过8因素心血管健康（8F-CVH）评分评估心血管健康与社区中年（40-64岁）和老年人（≥65岁）自我报告的行走困难之间的关系。研究设计横断面研究。主要结果测量：自我报告的行走困难通过一个单项问题来评估：“你走400米有困难吗？”心血管健康的评估采用受Life’s Essential 8启发的综合8F-CVH评分，包括饮食、身体活动、体重指数、血压、总胆固醇、空腹血糖、吸烟状况和睡眠质量。结果在4141名参与者中（平均年龄60.5±11.2岁，53.1%为女性），16.0%报告行走困难。老年人的患病率（25.0%）高于中年人（11.0%；p为趋势值<；0.001）。与中等（15.5%）和高（4.8%）评分的参与者相比，8F-CVH评分低的参与者（32.8%）更频繁地自我报告行走困难（p <0.001）。ROC曲线分析显示总分存在适度差异（曲线下面积[AUC] 0.67； 95%可信区间[CI] 0.65-0.69），单项成分中体力活动表现最佳（AUC 0.69; 95% CI 0.67 - 0.71）。在调整混杂因素后，中等和高分分别与61% （OR 0.39, 95% CI 0.31-0.48）和84% （OR 0.16, 95% CI 0.10-0.24）的自我报告行走困难的低几率相关。结论较好的心血管健康状况与较低的自我报告行走困难的几率独立相关。促进心血管健康可能有助于保持晚年的活动能力。
{"title":"Association between cardiovascular health metrics and self-reported walking difficulty in community-dwelling middle-aged and older adults: results from the longevity check-up (Lookup) 8+","authors":"Stefano Cacciatore , Emanuele Marzetti , Riccardo Calvani , Matteo Tosato , Francesco Landi , Lookup 8+ Study Group","doi":"10.1016/j.archger.2025.106027","DOIUrl":"10.1016/j.archger.2025.106027","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the association between cardiovascular health, assessed through an 8-factor cardiovascular health (8F–CVH) score, and self-reported walking difficulty in middle-aged (40–64 years) and older adults (≥65 years) living in the community.</div></div><div><h3>Study design</h3><div>Cross-sectional study.</div></div><div><h3>Main outcome measures</h3><div>Self-reported walking difficulty was evaluated by a single-item question: “Do you have any difficulty in walking 400 meters?”. Cardiovascular health was assessed using a composite 8F–CVH score inspired by Life’s Essential 8, including diet, physical activity, body mass index, blood pressure, total cholesterol, fasting blood glucose, smoking status, and sleep quality.</div></div><div><h3>Results</h3><div>Among 4141 participants (mean age 60.5 ± 11.2 years; 53.1 % women), 16.0 % reported walking difficulty. Prevalence was higher in older adults (25.0 %) than in middle-aged individuals (11.0 %; p for trend <0.001). Self-reported walking difficulty was more frequent in participants with low 8F–CVH scores (32.8 %), compared to moderate (15.5 %) and high (4.8 %) scores (p <0.001). ROC curve analysis showed modest discrimination for the total score (area under the curve [AUC] 0.67; 95 % confidence interval [CI] 0.65–0.69), with physical activity performing best among individual components (AUC 0.69; 95 % CI 0.67–0.71). After adjusting for confounders, moderate and high scores were associated with 61 % (OR 0.39, 95 % CI 0.31–0.48) and 84 % (OR 0.16, 95 % CI 0.10–0.24) lower odds of self-reported walking difficulty, respectively.</div></div><div><h3>Conclusions</h3><div>Better cardiovascular health is independently associated with lower odds of self-reported walking difficulty. Promoting cardiovascular health may help preserve mobility in late life.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106027"},"PeriodicalIF":3.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095504","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}
Pub Date : 2025-09-13DOI: 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":"2025-09-13","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}
Pub Date : 2025-09-12DOI: 10.1016/j.archger.2025.106023
Gee Youn Song , Sung-Bum Lee , Minkyeung Jo , Ji-Eun Moon , Inki Moon , Jong-Koo Kim
Background and aims
Handgrip strength (HGS) has been identified as a predictor of various comorbidities, including pneumonia, chronic kidney disease, and cancer. Additionally, HGS has been associated with the prevalence of cardiovascular disease (CVD). However, the usefulness of HGS as an indicator of incident CVD remains unclear.
Methods
In this nationwide cohort study, 173,195 subjects were enrolled and followed for 4.1 years. A total of 35,664 participants were included in the final analysis. During the follow-up, 131 participants developed cerebrovascular disease, 401 experienced coronary heart disease (CHD), and 526 developed CVD. Anthropometric, laboratory, and lifestyle factors were assessed in relation to CVD risk.
Results
Participantswere categorised into quartiles based on their relative handgrip strength (RGS). Cox regression analyses revealed an inverse association between RGS and new-onset cerebrovascular disease, CHD, and CVD. After controlling for confounders, the hazard ratios (HRs) [95 % confidence intervals (CIs)] for new-onset CHD were 0.63 (0.41–0.98) in men and 0.50 (0.26–0.95) in women. Additionally, after adjusting for confounders, the HRs [95 % CIs] for incident CVD in the highest quartile (Q4)were 0.68 (0.47–1.00) in men and 0.50 (0.28–0.89) in women. As RGS increased, the incidence of CHD and CVD significantly decreased, with stronger associations observed in women.
Discussion and Conclusions
This novel study demonstrates an association between RGS and incident CHD and CVD, with stronger significance in women. In clinical settings, RGS can be a useful surrogate markerof CHD and CVD, and regular assessments may help detect these conditions early.
{"title":"Handgrip strength as a predictor of new-onset cardiovascular disease: insights from the Korean genome and epidemiology study (KoGES) cohort","authors":"Gee Youn Song , Sung-Bum Lee , Minkyeung Jo , Ji-Eun Moon , Inki Moon , Jong-Koo Kim","doi":"10.1016/j.archger.2025.106023","DOIUrl":"10.1016/j.archger.2025.106023","url":null,"abstract":"<div><h3>Background and aims</h3><div>Handgrip strength (HGS) has been identified as a predictor of various comorbidities, including pneumonia, chronic kidney disease, and cancer. Additionally, HGS has been associated with the prevalence of cardiovascular disease (CVD). However, the usefulness of HGS as an indicator of incident CVD remains unclear.</div></div><div><h3>Methods</h3><div>In this nationwide cohort study, 173,195 subjects were enrolled and followed for 4.1 years. A total of 35,664 participants were included in the final analysis. During the follow-up, 131 participants developed cerebrovascular disease, 401 experienced coronary heart disease (CHD), and 526 developed CVD. Anthropometric, laboratory, and lifestyle factors were assessed in relation to CVD risk.</div></div><div><h3>Results</h3><div>Participantswere categorised into quartiles based on their relative handgrip strength (RGS). Cox regression analyses revealed an inverse association between RGS and new-onset cerebrovascular disease, CHD, and CVD. After controlling for confounders, the hazard ratios (HRs) [95 % confidence intervals (CIs)] for new-onset CHD were 0.63 (0.41–0.98) in men and 0.50 (0.26–0.95) in women. Additionally, after adjusting for confounders, the HRs [95 % CIs] for incident CVD in the highest quartile (Q4)were 0.68 (0.47–1.00) in men and 0.50 (0.28–0.89) in women. As RGS increased, the incidence of CHD and CVD significantly decreased, with stronger associations observed in women.</div></div><div><h3>Discussion and Conclusions</h3><div>This novel study demonstrates an association between RGS and incident CHD and CVD, with stronger significance in women. In clinical settings, RGS can be a useful surrogate markerof CHD and CVD, and regular assessments may help detect these conditions early.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106023"},"PeriodicalIF":3.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095505","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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