Archives of gerontology and geriatrics最新文献_第2页

Association of the 25-question Geriatric Locomotive Function Scale with all-cause mortality in older adults: The Nagahama study 25 个问题的老年运动功能量表与老年人全因死亡率的关系：长滨研究

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-10-22 DOI: 10.1016/j.archger.2024.105670

Yasuharu Tabara , Tome Ikezoe , Kazuya Setoh , Takahisa Kawaguchi , Fumihiko Matsuda

Backgrounds

Locomotive syndrome is a condition in which a person is at risk of requiring nursing care due to musculoskeletal disorders. The 25-question Geriatric Locomotive Function Scale (GLFS-25) was developed to determine the severity of locomotive syndrome. In this study, we aimed to determine the prognostic significance of the GLFS-25 for all-cause mortality.

Methods

The study participants consisted of 3,447 community residents aged ≥65 years. All-cause mortality was determined using residential registry records. Skeletal muscle mass assessed via bioimpedance methods was considered in the analysis as a confounding factor.

Results

During a mean follow-up period of 3,236 days (30,566 person–years), 288 cases of all-cause mortality occurred. When participants were categorized by the GLFS-25 score [grade 1: <7 points (n = 1,948); grade 2: ≥7 to <16 points (n = 894); grade 3: ≥16 points (n = 605)], their survival probability decreased linearly with increasing grade (log-rank test P = 0.014). In a Cox proportional hazards model adjusted for confounding factors, including low skeletal muscle mass, GLFS-25 grade 3 was identified as an independent risk factor for all-cause mortality (hazard ratio: 1.60; P = 0.007) in the subpopulation aged ≥70 years but not in the overall population (P = 0.062). The hazard ratio for all-cause mortality with GLFS-25 grade 3 and low skeletal muscle mass combined was 2.66 (P < 0.001).

Conclusion

The GLFS-25 is independently associated with all-cause mortality in older adults. Using this questionnaire to assess locomotive syndrome could be useful for identifying individuals at risk.

背景运动机能综合征是一种由于肌肉骨骼失调而有可能需要护理的疾病。老年运动机能量表（Geriatric Locomotive Function Scale，GLFS-25）包含 25 个问题，用于确定运动机能综合征的严重程度。本研究旨在确定 GLFS-25 对全因死亡率的预后意义。全因死亡率通过居民登记记录确定。结果在平均 3,236 天（30,566 人年）的随访期间，288 例全因死亡病例发生。根据 GLFS-25 评分对参与者进行分类[1 级：7 分（1 948 人）；2 级：≥7 分至 16 分（894 人）；3 级：≥16 分（605 人）]，随着评分的增加，参与者的生存概率呈线性下降趋势（log-rank 检验 P = 0.014）。在对混杂因素（包括低骨骼肌质量）进行调整的 Cox 比例危险模型中，GLFS-25 3 级被确定为年龄≥70 岁亚人群全因死亡的独立危险因素（危险比：1.60；P = 0.007），但在总体人群中并非如此（P = 0.062）。结论 GLFS-25 与老年人的全因死亡率密切相关。使用该问卷评估运动综合征有助于识别高危人群。

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引用次数: 0

Questionable prospective effect of grip strength on cognitive function: A simulated reanalysis and comment on Cui et al. (2024) 握力对认知功能的前瞻性影响值得怀疑：模拟再分析及对 Cui 等人（2024）的评论

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-10-22 DOI: 10.1016/j.archger.2024.105667

Kimmo Sorjonen, Bo Melin

引用次数: 0

Cerebral small vessel disease and its relationship with all-cause mortality risk: Results from the Amsterdam Ageing cohort 脑小血管疾病及其与全因死亡风险的关系：阿姆斯特丹老龄化队列研究结果

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-10-22 DOI: 10.1016/j.archger.2024.105669

Julia H.I. Wiersinga , Hadil M. Diab , Mike J.L. Peters , Marijke C. Trappenburg , Hanneke F.M. Rhodius-Meester , Majon Muller

Introduction

Cerebral Small-Vessel Disease (CSVD) is a complex condition affecting the brain's vascular network, linked to cognitive and physical decline, cerebrovascular disease, and death. This study assesses the relationship between CSVD (composite and individual features) and all-cause mortality in a large cohort of geriatric outpatients.

Methods

Data from 1305 geriatric outpatients (mean age 78 ± 7; 51 % female) in the Amsterdam Ageing cohort were analysed. CSVD presence was based on brain imaging (MRI or CT), defined by a Fazekas score ≥ 2, presence of ≥1 lacunes, or (in MRI) ≥ 3 microbleeds. Mortality data (February 2016 - January 2024) was sourced from the Dutch Municipality Register. The relationship between CSVD and all-cause mortality was evaluated using a Cox proportional-hazards model, adjusting for key confounders.

Results

At baseline, 835 (64 %) of the 1305 patients had CSVD. During a median follow-up of 3.1 years (IQR 1.6–4.6 years), all-cause mortality was 40 % (333 patients) in the CSVD group and 26 % (121 patients) in the non-CSVD group, corresponding with incidence rates of 137 and 78 per 1000 patient-years, respectively. The age- and sex-adjusted hazard ratio for mortality in the CSVD group was 1.6 (95 % CI: 1.3–2.0). This association remained significant after adjusting for cardiovascular disease and its risk factors, physical function (gait speed), and cognitive function (MMSE).

Conclusion

Radiographic CSVD presence is prevalent and its integration into daily care is important as it is independently linked to increased all-cause mortality in geriatric outpatients.

导言脑小血管病（CSVD）是一种影响脑血管网络的复杂疾病，与认知和体能下降、脑血管疾病和死亡有关。本研究评估了一大批老年门诊患者中 CSVD（综合特征和个体特征）与全因死亡率之间的关系。方法分析了阿姆斯特丹老龄化队列中 1305 名老年门诊患者（平均年龄 78 ± 7 岁；51% 为女性）的数据。CSVD的存在基于脑成像（MRI或CT），定义为Fazekas评分≥2分，出现≥1个裂隙，或（在MRI中）≥3个微小出血。死亡率数据（2016 年 2 月至 2024 年 1 月）来自荷兰市政登记册。结果1305名患者中有835人（64%）基线患有CSVD。在中位随访 3.1 年（IQR 1.6-4.6 年）期间，CSVD 组的全因死亡率为 40%（333 名患者），非 CSVD 组为 26%（121 名患者），发病率分别为每 1000 患者年 137 例和 78 例。经年龄和性别调整后，CSVD 组的死亡率危险比为 1.6（95 % CI：1.3-2.0）。在对心血管疾病及其风险因素、身体功能（步态速度）和认知功能（MMSE）进行调整后，这一关联仍具有重要意义。

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引用次数: 0

Heatwaves and its impact on the depressive symptoms among Chinese community-dwelling older adults: Examining the role of social participation 热浪及其对中国社区老年人抑郁症状的影响：探讨社会参与的作用

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-10-22 DOI: 10.1016/j.archger.2024.105668

Boye Fang , Qi Zhang

Objectives

Based on the Environment-Person Fit Perspective, this study explores the relationship between heatwaves and subsequent depressive symptoms among older Chinese community dwellers. Additionally, the study investigates if this association varies among older adults with different levels of social participation.

Methods

Heatwaves were defined as the frequency of occurrences where daily maximum temperature exceeded 35 °C for 3 consecutive days. A sample including 7124 older adults aged 55 and above was selected from the 2018 China Health and Retirement Longitudinal Study. Depressive symptoms were measured by the 10-item Centre for Epidemiological Studies Depression Scale. Social participation was measured by volunteer participation and leisure participation. Multilevel fixed effect model was employed to investigate the temporal association between heatwaves and depressive symptoms, as well as the moderating effect of social participation.

Results

This study found that older adults who had experienced a greater number of heatwaves presented more severe depressive symptoms (b = 0.66, p < 0.001). However, a high level of leisure participation buffered the effect of heatwaves on depressive symptoms (b = ̶ 0.52, p < 0.05).

Conclusions

This study highlighted the differential impact of heatwaves on mental health outcomes among older adults depending on their levels of social participation. Our findings provide valuable insights into designing an integrative heatwave adaption scheme that simultaneously focuses on temperature adjustment and social participation enhancement.

研究目的本研究基于 "环境-人适应 "视角，探讨热浪与中国社区老年居民随后出现的抑郁症状之间的关系。方法：热浪是指连续 3 天日最高气温超过 35 ℃ 的频率。从2018年中国健康与退休纵向研究中选取了7124名55岁及以上的老年人作为样本。抑郁症状通过10项流行病学研究中心抑郁量表进行测量。社会参与度通过志愿者参与度和休闲参与度进行测量。采用多层次固定效应模型研究热浪与抑郁症状之间的时间关联，以及社会参与的调节作用：研究发现，经历热浪次数越多的老年人抑郁症状越严重（b = 0.66，p < 0.001）。然而，高水平的休闲参与可以缓冲热浪对抑郁症状的影响（b = ̶ 0.52，p < 0.05）：本研究强调了热浪对老年人心理健康结果的不同影响，这取决于他们的社会参与程度。我们的研究结果为设计同时注重温度调节和提高社会参与度的综合热浪适应计划提供了宝贵的见解。

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引用次数: 0

Influence of social activities on delayed memory in older adults: A cross-cultural study 社交活动对老年人延迟记忆的影响：跨文化研究

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-10-20 DOI: 10.1016/j.archger.2024.105664

Liu Yuchi , Amna Javed , Kunio Shirahada

This study investigated the impact of social activities on delayed memory among older adults, framed within Social Support Theory and Social Gerontology. By comparing Chinese and American populations, we aim to fill a gap in the cross-cultural research on this topic. Using data from the China Health and Retirement Longitudinal Study and the U.S. Health and Retirement Study, we employed quantitative analysis with Stata 18.0. We discovered that social activities like internet use, card games, and volunteer work significantly enhance delayed memory across both cultures. However, cultural differences influence the types of social activities that are more prevalent in each context and affect the degree of their impact on cognitive health. In China, card games had a stronger effect on delayed memory, while in the United States, volunteer work and internet use exerted a more pronounced impact. These findings highlight the importance of culturally tailored interventions and the combined role of family and community support systems in promoting cognitive health among older adults.

本研究以社会支持理论和社会老年学为框架，调查了社会活动对老年人延迟记忆的影响。通过比较中美两国人群，我们旨在填补该课题跨文化研究的空白。利用中国健康与退休纵向研究（China Health and Retirement Longitudinal Study）和美国健康与退休研究（U.S. Health and Retirement Study）的数据，我们使用 Stata 18.0 进行了定量分析。我们发现，在两种文化中，互联网使用、纸牌游戏和志愿者工作等社交活动都能显著增强延迟记忆。然而，文化差异会影响在不同背景下更普遍的社交活动类型，并影响其对认知健康的影响程度。在中国，纸牌游戏对延迟记忆的影响更大，而在美国，志愿者工作和互联网使用的影响更为明显。这些研究结果凸显了针对不同文化的干预措施以及家庭和社区支持系统在促进老年人认知健康方面的综合作用的重要性。

引用次数: 0

Five-factor theory of aging and death due to aging 衰老和衰老导致死亡的五因素理论。

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-10-19 DOI: 10.1016/j.archger.2024.105665

Danko Obradovic

This new theory of aging explains that aging and death due to aging are due to five factors, and also explains how these factors are interconnected and jointly lead to aging and death of the organism, pointing to many facts that strongly support it. The first factor is the harmful changes that occur in cellular structures. The second factor is the cessation of cell division in adult organisms, which leads to the inability to restore cellular structures. The third factor is the feature that cells do not die due to the accumulation of harmful changes that occur in the cells during the life of the organism. The fourth factor is the inability of stem cells to regenerate tissue by replacing such cells with new ones, because somatic cells do not die and there are no signals that stimulate the proliferation of stem cells and their differentiation into new ones that would replace dead cells. The fifth factor is that all cells die suddenly, due to the cessation of one of the vital functions of the organism, and not gradually during life, due to a decrease in the functionality of cells caused by the introduction of harmful changes in cellular structures, which would allow stem cells to regenerate tissues and keep the body young. Also, to show that this aging theory is valid, the theory gives its view of the evolution of five factors, which according to this theory lead to aging, which gives strong support to this theory.

这一新的衰老理论解释了衰老和衰老导致的死亡是由五个因素造成的，还解释了这些因素是如何相互关联并共同导致机体衰老和死亡的，并指出了许多事实有力地支持了这一理论。第一个因素是细胞结构发生的有害变化。第二个因素是成年生物的细胞分裂停止，导致无法恢复细胞结构。第三个因素是细胞在生物体生命过程中不会因有害变化的积累而死亡。第四个因素是干细胞无法通过用新细胞取代干细胞来再生组织，因为体细胞不会死亡，也没有信号刺激干细胞增殖并分化成新细胞来取代死亡细胞。第五个因素是，所有细胞都是由于机体的某项重要功能停止而突然死亡，而不是在生命过程中由于细胞结构发生有害变化而导致细胞功能下降而逐渐死亡，这将使干细胞能够再生组织并使身体保持年轻。另外，为了证明这一衰老理论的正确性，该理论还给出了它对五种因素演变的看法，根据这一理论，这五种因素会导致衰老，这为这一理论提供了强有力的支持。

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引用次数: 0

The effects of nordic walking on the cardiovascular risk factors in older adults: A systematic review and meta-analysis 溯溪行走对老年人心血管风险因素的影响：系统回顾和荟萃分析。

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-10-18 DOI: 10.1016/j.archger.2024.105663

Jiao Liu, Jong-Hee Kim

Objective

This study aimed to investigate the effects of Nordic walking on cardiovascular risk factors in the elderly population through a systematic review and meta-analysis of randomized controlled trials.

Methods

Literature searches were conducted in PubMed, Embase, Cochrane Library, and Web of Science through November 2023. Two authors independently assessed heterogeneity in subgroups, performed sensitivity and meta-regression analyses, and extracted data. Outcomes were measured using mean difference (MD) or standardized mean difference (SMD), each with a corresponding 95 % confidence interval (CI).

Results

A total of 22 studies comprising 1,271 subjects, with an average age of 62.21±7.76 years were included in the meta-analysis. Nordic walking significantly reduced body mass index (MD = -0.67, 95 % CI [-1.12; -0.23], p < 0.01), body weight (MD = -1.76, 95 % CI [-2.91; -0.62], p < 0.01), waist circumference (MD = -2.21, 95 % CI [-4.13; -0.29], p = 0.02), and body fat percentage (MD = -1.54, 95 % CI [-2.61; -0.48], p < 0.01). It also significantly enhanced maximal oxygen consumption (SMD = 0.60, 95 % CI [0.11; 1.10], p < 0.01), and reduced systolic blood pressure (MD = -2.92, 95 % CI [-5.23; -0.60], p < 0.01), low-density lipoprotein (SMD = -0.27, 95 % CI [-0.43; -0.12], p < 0.01), total cholesterol (SMD = -0.20, 95 % CI [-0.35; -0.05], p < 0.01), triglycerides (SMD = -0.30, 95 % CI [-0.47; -0.13], p < 0.01) in older adults, while also improving diastolic blood pressure in people over 65 years of age (MD =-5.26, [-8.79,-1.72], p < 0.01).

Conclusions

Nordic walking mitigates cardiovascular risk factors in older adults and is particularly effective in improving diastolic blood pressure in individuals over 65 years of age.

研究目的本研究旨在通过对随机对照试验进行系统回顾和荟萃分析，探讨北欧式健走对老年人群心血管风险因素的影响：在 PubMed、Embase、Cochrane Library 和 Web of Science 上进行文献检索，直至 2023 年 11 月。两位作者独立评估了亚组的异质性，进行了敏感性分析和元回归分析，并提取了数据。研究结果采用平均差（MD）或标准化平均差（SMD）来衡量，每种方法都有相应的95%置信区间（CI）：荟萃分析共纳入了 22 项研究，包括 1,271 名受试者，平均年龄（62.21±7.76）岁。北欧式健走能明显降低体重指数（MD = -0.67，95 % CI [-1.12; -0.23]，P <0.01）、体重（MD = -1.76，95 % CI [-2.91; -0.62]，P <0.01）、腰围（MD = -2.21，95 % CI [-4.13; -0.29]，P =0.02）和体脂百分比（MD = -1.54，95 % CI [-2.61; -0.48]，P <0.01）。它还能大大提高最大耗氧量（SMD = 0.60，95 % CI [0.11；1.10]，p < 0.01），降低收缩压（MD = -2.92，95 % CI [-5.23；-0.60]，p < 0.01）、低密度脂蛋白（SMD = -0.27，95 % CI [-0.43；-0.12]，p < 0.01）、总胆固醇（SMD = -0.20，95 % CI [-0.35；-0.05]，p < 0.01）、甘油三酯（SMD = -0.30，95 % CI [-0.47；-0.13]，p < 0.01），同时还能改善 65 岁以上人群的舒张压（MD =-5.26，[-8.79,-1.72]，p < 0.01）：结论：北欧式健走能减轻老年人的心血管风险因素，尤其能有效改善65岁以上人群的舒张压。

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引用次数: 0

The relationship between insomnia and multidimensional frailty in community-dwelling older adults: A systematic review 社区老年人失眠与多维虚弱之间的关系：系统综述。

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-10-18 DOI: 10.1016/j.archger.2024.105661

Xinghong Qi , Hui Kong , Jing Li , Cui Chen

Objective

To examine the relationship between insomnia and multidimensional frailty among community-dwelling older adults.

Method

We conducted a comprehensive search in the Pubmed, Web of Science, and Embase databases up to May 15, 2024. The included cross-sectional studies were using the Joanna Briggs Institute's Evidence-Based Health Care Center's checklist for analytical cross-sectional studies; the longitudinal study used the Newcastle-Ottawa Scale for risk of bias assessment.

Results

Out of 1571 studies, 14 were selected. The results indicate a positive relationship between insomnia and cognitive frailty, social frailty, and psychological frailty in community-dwelling older adults. However, the relationship between insomnia and total or physical frailty is unclear.

Conclusion

This study made an association between insomnia and cognitive frailty, social frailty, and psychological frailty in community-dwelling older adults. Due to the limited quality and quantity of the included studies, more high-quality cohort studies are required to verify the above conclusion.

摘要研究社区老年人失眠与多维度虚弱之间的关系：截至 2024 年 5 月 15 日，我们在 Pubmed、Web of Science 和 Embase 数据库中进行了全面检索。纳入的横断面研究采用乔安娜-布里格斯研究所循证医疗中心的横断面研究分析清单；纵向研究采用纽卡斯尔-渥太华量表进行偏倚风险评估：结果：在 1571 项研究中，有 14 项入选。结果表明，失眠与社区老年人的认知虚弱、社交虚弱和心理虚弱之间存在正相关关系。然而，失眠与总体或身体虚弱之间的关系尚不明确：本研究发现，失眠与社区老年人的认知虚弱、社交虚弱和心理虚弱之间存在关联。由于纳入研究的质量和数量有限，需要更多高质量的队列研究来验证上述结论。

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引用次数: 0

Genetically-predicted effects of lifestyle factors on frailty: Evidence from Mendelian randomization study 基因预测的生活方式因素对虚弱的影响：孟德尔随机研究的证据。

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-10-17 DOI: 10.1016/j.archger.2024.105662

Min Xin , Wenxin Wang , Ming Zhou , Yuhan Geng , Hao Liu , Wenxi Luo , Gong zi Zhang , Liping Huang

Objective

To evaluate the causal relationships between genetically predicted lifestyle factors and frailty using Mendelian randomization(MR).

Methods

We extracted summary data from genome-wide association studies conducted among individuals of European ancestry, examining lifestyle factors such as smoking, alcohol consumption, physical activity, and sedentary behaviors. The outcomes were assessed using Fried Frailty Score (FFS) and Frailty Index (FI). We conducted 2-sample single-variable Mendelian randomization (SVMR) and multivariable Mendelian randomization (MVMR) to simultaneously assess the independent causal effects were primarily estimated using inverse variance weighted methods. Multiple sensitivity and validation analyzes were used.

Results

The IVW analyzes indicated that smoking increased frailty risk (FFS: β = 0.107, 95 % CI = 0.057 to 0.156, P < 0.001; FI: β = 0.899, 95 % CI = 0.016 to 0.191, P = 0.020.), this effect was amplified in the MVMR analysis after adjusting for alcohol consumption. Strenuous sports or other exercise(SSOE) reduced frailty risk (FFS: β = -0.473, 95 % CI = -0.646 to -0.299, P < 0.001; FI: β = -0.423, 95 % CI = -0.692 to -0.154, P = 0.002). Vigorous and moderate-to-vigorous physical activities were significantly related to lower FFS, although no effects were observed on FI. Increased television watching was linked to higher frailty incidence (FFS: β = 0.227, 95 % CI = 0.197 to 0.257, P < 0.001; FI: β = 0.297, 95 % CI = 0.249 to 0.346, P < 0.001), the impact remained persistent in MVMR adjusting for driving and computer use.

Conclusion

This study suggests that modifications in smoking, alcohol consumption, and physical activity may help prevent or manage frailty.

目的利用孟德尔随机化方法（MR）评估基因预测的生活方式因素与虚弱之间的因果关系：我们从对欧洲血统个体进行的全基因组关联研究中提取了汇总数据，研究了吸烟、饮酒、体力活动和久坐行为等生活方式因素。研究结果采用弗里德虚弱评分（FFS）和虚弱指数（FI）进行评估。我们进行了双样本单变量孟德尔随机化（SVMR）和多变量孟德尔随机化（MVMR），以同时评估独立的因果效应，主要采用反方差加权法进行估计。使用了多重敏感性和验证分析：IVW分析表明，吸烟会增加虚弱风险（FFS：β = 0.107，95 % CI = 0.057 to 0.156，P < 0.001；FI：β = 0.899，95 % CI = 0.016 to 0.191，P = 0.020）。剧烈运动或其他锻炼（SSOE）可降低虚弱风险（FFS：β = -0.473，95 % CI = -0.646 to -0.299，P < 0.001；FI：β = -0.423，95 % CI = -0.692 to -0.154，P = 0.002）。剧烈和中到剧烈的体育活动与较低的 FFS 显著相关，但对 FI 没有影响。增加看电视与更高的虚弱发生率有关（FFS：β = 0.227，95 % CI = 0.197 to 0.257，P <0.001；FI：β = 0.297，95 % CI = 0.249 to 0.346，P <0.001），在调整驾驶和电脑使用的 MVMR 中，这种影响仍然存在：本研究表明，减少吸烟、饮酒和体育锻炼有助于预防或控制体弱。

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引用次数: 0

Influence of patient characteristics and discharge destination on circulatory system diseases readmissions among older heart failure patients 患者特征和出院目的地对老年心衰患者循环系统疾病再入院的影响。

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-10-15 DOI: 10.1016/j.archger.2024.105660

Alberto Esteban-Fernández , Manuel Anguita-Sánchez , Nicolás Rosillo , José Luis Bernal-Sobrino , Náyade Del Prado , Cristina Fernández-Pérez , Carmen Navarro-Ceballos , Sara Corredera-García , Inmaculada Fernández-Rozas , Francisco Javier Elola-Somoza

Introduction

Heart failure (HF) prevalence is rising, particularly among older people, constituting a significant cause of hospitalization. Discharge destinations, including nursing homes (NH), play a crucial role in post-hospitalization outcomes but remain underexplored.

Methods

A retrospective study utilizing the Spanish National Health System's Minimum Basic Data Set identified older HF patients (≥75 years) discharged from acute hospitals between 2016 and 2019. Patient demographics, comorbidities, and discharge destinations were analyzed. Predictors of 30-day readmissions for circulatory system diseases and NH admission were assessed using multilevel logistic regression models.

Results

Of 157,330 index episodes, 2.8 % were discharged to NH, more frequently in females. Thirty-day readmission incidence was 9.3 %, with HF exacerbations accounting for 80.6 % of cases. Predictors of 30-day readmission included renal failure (OR: 1.38), severe hematological disorders (OR: 1.30), and history of coronary revascularization surgery (OR: 1.23), while discharge to NH lowered the risk (OR: 0.70). Admission to NH was associated with neurological diseases (OR: 3.27), cardiogenic shock (OR: 3.19), stroke (OR: 2.68), advanced cancer (OR: 2.51), with higher likelihood among females (OR: 1.23). After propensity score-matched analysis, patients discharged to NH had significantly lower 30-day readmission rates than those discharged home (6.4 % vs. 28.9 %, adjusted OR: 0.169).

Conclusion

Discharge to NH is infrequent but associated with lower readmission risk for older HF patients. Female gender, specific comorbidities, and acute conditions influence NH admission. Enhanced collaboration between HF units and NH is crucial for optimizing post-hospitalization outcomes. Further research and policy initiatives are needed to improve care coordination and reduce HF readmissions.

简介心力衰竭（HF）的发病率正在上升，尤其是在老年人中，成为住院治疗的一个重要原因。出院后的去向，包括疗养院（NH），对出院后的治疗效果起着至关重要的作用，但目前仍未得到充分的研究：一项利用西班牙国家卫生系统最低基本数据集进行的回顾性研究确定了2016年至2019年期间从急症医院出院的老年高血压患者（≥75岁）。研究分析了患者的人口统计学特征、合并症和出院目的地。使用多层次逻辑回归模型评估了循环系统疾病和NH入院的30天再入院预测因素：结果：在 157330 例指数病例中，2.8% 的患者出院后入住了 NH，其中女性患者较多。30天再入院的发生率为9.3%，其中80.6%的病例为高血压加重。肾功能衰竭（OR：1.38）、严重血液病（OR：1.30）和冠状动脉血运重建手术史（OR：1.23）是导致患者 30 天后再次入院的预测因素，而出院到 NH 可降低风险（OR：0.70）。入住 NH 与神经系统疾病（OR：3.27）、心源性休克（OR：3.19）、中风（OR：2.68）、晚期癌症（OR：2.51）有关，女性的可能性更高（OR：1.23）。经过倾向得分匹配分析后，出院到NH的患者30天再入院率明显低于出院回家的患者（6.4% vs. 28.9%，调整OR：0.169）：结论：老年心房颤动患者很少出院，但出院后再入院的风险较低。女性性别、特定的合并症和急性病症都会影响入住 NH。加强心房颤动科和 NH 之间的合作对于优化出院后的治疗效果至关重要。需要进一步开展研究并制定政策措施，以改善护理协调并降低心房颤动再入院率。

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引用次数: 0