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

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。

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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

Effects of exercise modality-dose combinations on cognitive function in Parkinson’s Disease: A bayesian dose-response systematic review and meta-analysis 运动方式-剂量组合对帕金森病患者认知功能的影响：贝叶斯剂量-反应系统评价和荟萃分析

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.2025.105996

Shang Huang , Le Zhang

Objective

This study aimed to identify the most effective exercise modalities and optimal dose ranges for improving cognitive function in individuals with Parkinson’s disease (PD).

Methods

We conducted a systematic search of five databases up to June 1, 2025, and included 33 RCTs involving 1,256 PD patients. Exercise doses were standardized using MET·min/week. A Bayesian dose–response network meta-analysis was performed in R to model nonlinear cognitive effects across nine exercise modalities. Certainty of evidence was assessed using the GRADE framework.

Results

The pooled analysis revealed an inverted U-shaped relationship between exercise dose and cognitive outcomes, with the greatest benefit observed around 890 MET·min/week. The optimal range for cognitive improvement was identified between 500 and 1000 MET·min/week, beyond which the effects plateaued or declined, particularly above 1200 MET·min/week. Among the evaluated modalities, only multicomponent training and mind-body exercise demonstrated consistent and significant cognitive improvements at moderate doses. While virtual reality and aerobic walking showed beneficial effects at specific dose points, their overall efficacy was less stable. No consistent effects were observed for cycling, dance, or resistance training within the primary dose range.

Conclusion

This study is the first to construct a comprehensive dose-modality response model for cognitive enhancement in PD, providing empirical evidence for the optimal dose range and preferred exercise strategies. The findings offer a robust basis for developing tailored, precision-based non-pharmacological interventions for individuals with PD, with potential applicability to broader populations affected by neurodegenerative conditions.

目的本研究旨在确定最有效的运动方式和最佳剂量范围，以改善帕金森病（PD）患者的认知功能。方法系统检索截至2025年6月1日的5个数据库，纳入33项随机对照试验，涉及1256例PD患者。运动剂量以MET·min/周为标准。在R中进行贝叶斯剂量-反应网络元分析，以模拟九种运动方式的非线性认知效应。使用GRADE框架评估证据的确定性。结果汇总分析显示，运动剂量与认知结果之间呈倒u型关系，在890 MET·min/周左右观察到最大的益处。认知改善的最佳范围是500到1000 MET·min/周，超过这个范围，效果趋于平稳或下降，特别是超过1200 MET·min/周。在评估的模式中，只有多成分训练和身心运动在中等剂量下表现出一致和显著的认知改善。虽然虚拟现实和有氧步行在特定剂量点显示出有益的效果，但它们的总体效果不太稳定。在初始剂量范围内，骑车、跳舞或阻力训练未观察到一致的效果。结论本研究首次构建了PD认知增强的综合剂量-模态反应模型，为PD认知增强的最佳剂量范围和首选运动策略提供了经验依据。这一发现为开发针对PD患者的量身定制的、精确的非药物干预措施提供了坚实的基础，并可能适用于受神经退行性疾病影响的更广泛人群。

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引用次数: 0

Clinical evaluation of skin aging: a systematic review 皮肤老化的临床评价：系统综述

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-08-18 DOI: 10.1016/j.archger.2025.105995

Yu-Ching Wang , Sheng-Hsiang Ma , Yun-Ting Chang , Chih-Chiang Chen

Skin aging is a multifaceted process characterized by a gradual decline in various functions, which leads to wrinkles, sagging, and dyspigmentation. Numerous tools, including photonumeric scales, descriptive scales, and quantitative instruments, have been developed to objectively assess the degree of skin aging. Despite the abundance of evaluation metrics, these scales vary substantially in quality and validity. In this systematic review, we searched MEDLINE via PubMed, EMBASE, and Cochrane databases to identify studies that examined and validated these scales. In total, we included 42 publications comprising 47 scales, including 20 for grading lines and wrinkles, 12 for assessing sagging and volume loss, 6 for evaluating texture and quality, and 9 for global assessment. The individual scales had acceptable strength of agreement and most scales achieved at least moderate inter- and intra-rater reliabilities. This study also reviews the instruments used to quantify age-related skin changes. The parameters examined included surface texture, elasticity, sagging, discoloration, structural integrity, and barrier functions.

皮肤老化是一个多方面的过程，其特点是各种功能逐渐下降，导致皱纹、松弛和色素沉着。许多工具，包括光子学量表、描述性量表和定量仪器，已经开发出来客观地评估皮肤老化的程度。尽管有大量的评估指标，这些量表在质量和有效性上有很大的差异。在本系统综述中，我们通过PubMed、EMBASE和Cochrane数据库检索MEDLINE，以确定检验和验证这些量表的研究。我们总共纳入了42份出版物，包括47种量表，其中20种用于分级线条和皱纹，12种用于评估下垂和体积损失，6种用于评估质地和质量，9种用于整体评估。个别量表具有可接受的一致性强度，大多数量表达到了至少中等程度的量表间和量表内信度。本研究还回顾了用于量化与年龄相关的皮肤变化的仪器。检查的参数包括表面纹理，弹性，下垂，变色，结构完整性和屏障功能。

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引用次数: 0

The relationship between heart rate variability and frailty in older adults: Systematic review and three-level meta-analysis 老年人心率变异性与虚弱之间的关系：系统评价和三水平荟萃分析

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-08-16 DOI: 10.1016/j.archger.2025.105991

Huiling Chen , Shixin Huang , Kaiji Zhou , Tao Zhang , Mimi Mun Yee Tse , Gary Tse

Background

Heart rate variability (HRV) is a potential biomarker for frailty, which is burdensome in older adults. However, existing studies report inconsistent findings regarding their relationship, and no meta-analysis has been conducted. This systematic review and meta-analysis aim to examine the association between HRV and frailty, as well as the boundary conditions that influence this relationship.

Methods

We systematically searched eight databases for studies examining three domains of HRV parameters – time-, frequency-, and nonlinear-domain – and their associations with frailty. Using a three-level random-effects meta-analytic model, we investigated the pooled effect sizes (Hedges’ g) for short-term (≤ 5 minutes) and long-term (24-hour) HRV, and potential variables moderating the relationship between HRV and frailty.

Results

We included 16 studies (n = 2365) in the review from 1132 records, and 13 of them were meta-analyzed (n = 1677) contributing 90 effect sizes. Both short-term (7 studies, 47 effect sizes) and long-term (6 studies, 43 effect sizes) models indicated lower HRV in (pre)frail individuals compared to their non-frail counterparts, while the effects were not statistically significant. For long-term HRV, the relationship was moderated by HRV domain: time-domain parameters exhibited a larger effect size (g = 2.097) than frequency-domain parameters (g = 1.698).

Conclusions

Our meta-analyses revealed a trend towards lower HRV in (pre)frail individuals; however, the effects in both models were not statistically significant. Although HRV may be a potential biomarker of frailty, the current evidence remains inconclusive. Further prospective studies are necessary, considering the heterogeneity and potential publication bias observed.

背景：心率变异性（HRV）是虚弱的潜在生物标志物，这对老年人来说是一个负担。然而，现有的研究报告了关于它们之间关系的不一致的发现，并且没有进行荟萃分析。本系统综述和荟萃分析旨在研究HRV和脆弱之间的关联，以及影响这种关系的边界条件。方法我们系统地检索了8个数据库，研究HRV参数的三个域——时间域、频率域和非线性域——以及它们与虚弱的关系。采用三水平随机效应荟萃分析模型，研究了短期（≤5分钟）和长期（24小时）HRV的综合效应大小（Hedges ' g），以及调节HRV与虚弱之间关系的潜在变量。结果我们纳入了来自1132条记录的16项研究（n = 2365），其中13项进行了meta分析（n = 1677），共贡献了90个效应量。短期（7项研究，47个效应量）和长期（6项研究，43个效应量）模型均表明，（预）体弱个体的HRV较非体弱个体低，但效果无统计学意义。长期HRV受HRV域的调节，时域参数的效应量（g = 2.097）大于频域参数（g = 1.698）。我们的荟萃分析显示，（前）体弱个体有降低HRV的趋势；然而，两种模型的效果均无统计学意义。虽然HRV可能是虚弱的潜在生物标志物，但目前的证据仍不确定。考虑到观察到的异质性和潜在的发表偏倚，进一步的前瞻性研究是必要的。

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引用次数: 0

Modification effect of polygenic risk scores on the risk of the most common multimorbidity associated with aging among Canadian adults: An analysis of the CLSA data 多基因风险评分对加拿大成年人中与衰老相关的最常见多病风险的影响：对里昂证券数据的分析

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-08-16 DOI: 10.1016/j.archger.2025.105992

Obed Mortey , Gerald Mugford , Kris Aubrey-Bassler , Hensley H Mariathas , Ugochukwu Odimba , Zhiwei Gao

Objective

We investigated the modification effects of polygenic risk score (PRS) on the risk of the most common multimorbidity (MCM) in Canadian adults associated with aging.

Methods

We utilized baseline and genomic datasets of 26,622 adults aged 45–85 years from the Canadian Longitudinal Study on Aging. Genome-wide interaction analyses and multivariate logistic regression models were used to identify susceptible markers and examine the PRS-by-age interactions. Susceptible markers with an interaction term p-value <10⁻⁵ were used to compute the PRS for each individual, which was further divided into three PRS groups (high, median, and low) by the PRS terciles. Multivariate logistic regression models were used to examine the PRS-by-age interaction, adjusting for potential confounders and population structure.

Results

Multivariate analysis showed that increasing age was significantly associated with a higher risk of MCM, regardless of the PRS group. However, individuals in the top one-third of the PRS tercile (i.e., the high PRS group) were at the highest risk of MCM. For a one-year increase in age, participants in the high PRS group were 1.13 times more likely to have MCM, whereas for a one-year increase in age, it was associated with 1.09- and 1.10-times increased risk of MCM among individuals in the median and low PRS groups, respectively.

Conclusion

PRS is an important tool for identifying individuals at a higher risk of MCM associated with aging and improves our understanding of the potential biological mechanisms of aging-related diseases.

目的探讨多基因风险评分（PRS）对加拿大成年人与衰老相关的最常见多病（MCM）风险的影响。方法：我们利用来自加拿大老龄化纵向研究的26622名45-85岁成年人的基线和基因组数据集。采用全基因组相互作用分析和多变量logistic回归模型鉴定易感标记，并检测prs -年龄相互作用。使用相互作用项p值为10−5的易感标记计算每个个体的PRS，并根据PRS等级将其进一步分为三个PRS组（高、中、低）。多变量逻辑回归模型用于检验按年龄的prs相互作用，调整潜在的混杂因素和人口结构。结果多因素分析显示，年龄的增加与MCM的高风险显著相关，无论PRS组如何。然而，前三分之一的个体（即高PRS组）患MCM的风险最高。年龄增加一年，高PRS组的参与者患MCM的可能性增加1.13倍，而年龄增加一年，中位数和低PRS组的MCM风险分别增加1.09倍和1.10倍。结论prs是识别与衰老相关的MCM高危人群的重要工具，提高了我们对衰老相关疾病潜在生物学机制的认识。

{"title":"Modification effect of polygenic risk scores on the risk of the most common multimorbidity associated with aging among Canadian adults: An analysis of the CLSA data","authors":"Obed Mortey , Gerald Mugford , Kris Aubrey-Bassler , Hensley H Mariathas , Ugochukwu Odimba , Zhiwei Gao","doi":"10.1016/j.archger.2025.105992","DOIUrl":"10.1016/j.archger.2025.105992","url":null,"abstract":"<div><h3>Objective</h3><div>We investigated the modification effects of polygenic risk score (PRS) on the risk of the most common multimorbidity (MCM) in Canadian adults associated with aging.</div></div><div><h3>Methods</h3><div>We utilized baseline and genomic datasets of 26,622 adults aged 45–85 years from the Canadian Longitudinal Study on Aging. Genome-wide interaction analyses and multivariate logistic regression models were used to identify susceptible markers and examine the PRS-by-age interactions. Susceptible markers with an interaction term p-value <10<sup>−5</sup> were used to compute the PRS for each individual, which was further divided into three PRS groups (high, median, and low) by the PRS terciles. Multivariate logistic regression models were used to examine the PRS-by-age interaction, adjusting for potential confounders and population structure.</div></div><div><h3>Results</h3><div>Multivariate analysis showed that increasing age was significantly associated with a higher risk of MCM, regardless of the PRS group. However, individuals in the top one-third of the PRS tercile (i.e., the high PRS group) were at the highest risk of MCM. For a one-year increase in age, participants in the high PRS group were 1.13 times more likely to have MCM, whereas for a one-year increase in age, it was associated with 1.09- and 1.10-times increased risk of MCM among individuals in the median and low PRS groups, respectively.</div></div><div><h3>Conclusion</h3><div>PRS is an important tool for identifying individuals at a higher risk of MCM associated with aging and improves our understanding of the potential biological mechanisms of aging-related diseases.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"138 ","pages":"Article 105992"},"PeriodicalIF":3.8,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886618","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

Enhancing the usability of the 2023 beers criteria: A structured framework for geriatric prescribing safety 提高2023啤酒标准的可用性：老年处方安全的结构化框架

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-08-15 DOI: 10.1016/j.archger.2025.105988

Ying-Mei Wang , Pei-Chen Lee , Hung-Wei Shen , Yuh-Lih Chang , Tzeng-Ji Chen

Background

The American Geriatrics Society (AGS) Beers Criteria is one of the most widely used tools for identifying potentially inappropriate medications (PIMs) in older adults worldwide. However, its narrative format, ambiguous definitions, and lack of machine readability hinder integration with electronic health records (EHRs), clinical decision support systems, and real-world data analysis. Therefore, this study aimed to develop a structured, programmable, and multidimensional evaluation framework to transform the 2023 AGS Beers Criteria into computable logic components, thereby supporting automated PIM identification and clinical application.

Methods

We systematically reviewed 87 PIM-related statements from Tables 2–6 of the 2023 AGS Beers Criteria. A multidisciplinary team deconstructed each criterion into structured logical components and categorized them into the following five main domains: within-prescription, outside-prescription, recommendation/strength, key issues, and interpretative information. Twenty-four subcategories were identified, including dose, route, laboratory data, co-medications, grouping issues, and ambiguous expressions.

Results

Only 8.0% of the 2023 AGS Beers Criteria could be evaluated using drug names alone, while 92.0% required multi-factorial analysis. We identified 404 computable elements: 30.2% could be assessed using prescription-only data, 25.2% required external data such as diagnoses or laboratory data, and 44.6% involved interpretive or structural complexity.

Conclusion

This novel framework addresses key barriers to the programmatic implementation of the 2023 AGS Beers Criteria. It enables artificial intelligence-supported PIM identification, facilitates EHR integration, and establishes a scalable infrastructure for geriatric pharmacovigilance, ultimately improving medication safety for older adults.

美国老年病学会（AGS）比尔斯标准是全球范围内识别老年人潜在不适当药物（PIMs）最广泛使用的工具之一。然而，它的叙述格式、模糊的定义和缺乏机器可读性阻碍了与电子健康记录（EHRs）、临床决策支持系统和现实世界数据分析的集成。因此，本研究旨在开发一个结构化的、可编程的、多维的评估框架，将2023 AGS Beers标准转化为可计算的逻辑组件，从而支持PIM的自动化识别和临床应用。方法系统地回顾了2023 AGS Beers标准表2-6中的87项pim相关陈述。多学科团队将每个标准解构为结构化的逻辑组件，并将其分为以下五个主要领域：内部处方、外部处方、推荐/强度、关键问题和解释性信息。确定了24个亚类别，包括剂量、途径、实验室数据、联合用药、分组问题和歧义表达。结果在2023 AGS Beers标准中，仅8.0%的标准可以单独使用药品名称进行评价，92.0%的标准需要进行多因素分析。我们确定了404个可计算元素：30.2%可以使用处方数据进行评估，25.2%需要外部数据，如诊断或实验室数据，44.6%涉及解释或结构复杂性。这个新颖的框架解决了2023 AGS Beers标准程序化实施的主要障碍。它实现了人工智能支持的PIM识别，促进了EHR整合，并建立了可扩展的老年药物警戒基础设施，最终提高了老年人的用药安全性。

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引用次数: 0