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

Socioeconomic status, dietary pattern, and frailty in older adults in rural China: A prospective longitudinal study 中国农村老年人的社会经济地位、饮食模式和虚弱：一项前瞻性纵向研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-01-06 DOI: 10.1016/j.archger.2026.106130

Huaqing Liu , Yuhui Sun , Xiaoting Hu , Xi Tian , Chengchao Zhou

Objective

This study explored the association between dietary patterns and frailty, and the mediating role of diet in the socioeconomic status (SES)-frailty relationship among rural Chinese older adults.

Methods

Data came from the Shandong Rural Elderly Health Cohort Survey (2019-2022). Longitudinal associations between dietary patterns and frailty were analyzed using generalized estimating equations. Mediation pathways were examined using Hayes’ PROCESS macro to determine how dietary patterns influence the socioeconomic gradient in frailty.

Results

Of 1903 participants, 12.3 % developed frailty over 3-year follow-up, with significant differences across education and household income levels (P < 0.001). After adjustment of confounders (age, sex, marital status, education level, occupation, physical activity, smoking status, drinking status, household income, BMI, and chronic diseases), adherence to a milk–bean–egg–fruit dietary pattern was associated with a lower risk of frailty, with OR in Q2, Q3, and Q4 of 0.69 (95 % CI: 0.53‒0.91), 0.62 (95 % CI: 0.47‒0.81), and 0.53 (95 % CI: 0.40‒0.70), respectively, compared with Q1. Notably, this dietary pattern significantly mediated the associations of household income and education level with frailty risk, explaining 28.33 % and 15.58 % of the respective total effects.

Conclusions

The milk–bean–egg–fruit dietary pattern exerts a protective effect against frailty and mediates the association between socioeconomic status and frailty risk. The current findings underscore the importance of educational and socioeconomic support initiatives in rural areas as well as promoting healthier dietary habits among older adults through targeted nutritional interventions to reduce frailty risk.

目的探讨中国农村老年人饮食模式与虚弱的关系，以及饮食在社会经济地位-虚弱关系中的中介作用。方法数据来自山东省农村老年人健康队列调查（2019-2022）。使用广义估计方程分析饮食模式与脆弱之间的纵向关联。使用Hayes ' s PROCESS宏观研究了中介途径，以确定饮食模式如何影响虚弱的社会经济梯度。结果在1903名参与者中，12.3%的人在3年的随访中出现虚弱，在教育程度和家庭收入水平上存在显著差异（P < 0.001）。在调整混杂因素（年龄、性别、婚姻状况、教育水平、职业、体育活动、吸烟状况、饮酒状况、家庭收入、BMI和慢性病）后，坚持牛奶-豆类-鸡蛋-水果饮食模式与较低的虚弱风险相关，与第一季度相比，第二、第三和第四季度的OR分别为0.69 （95% CI: 0.53 - 0.91）、0.62 （95% CI: 0.47-0.81）和0.53 （95% CI: 0.40-0.70）。值得注意的是，这种饮食模式显著地介导了家庭收入和教育水平与脆弱风险的关联，分别解释了28.33%和15.58%的总效应。结论牛奶-豆类-鸡蛋-水果饮食模式对虚弱具有保护作用，并在社会经济地位与虚弱风险之间起中介作用。目前的研究结果强调了农村地区教育和社会经济支持举措的重要性，以及通过有针对性的营养干预措施促进老年人更健康的饮食习惯，以减少衰弱风险。

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引用次数: 0

Frailty's fundamental heterogeneity: From biological mechanisms to health equity 脆弱性的基本异质性：从生物机制到卫生公平

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-30 DOI: 10.1016/j.archger.2025.106128

Liang-Kung Chen

引用次数: 0

Connectedness matters more than feeling isolated: A 12-year longitudinal study of age-related decline in naming ability 联系比感觉孤立更重要：一项与年龄相关的命名能力下降的12年纵向研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-29 DOI: 10.1016/j.archger.2025.106126

Yanbing Hu , Chenguang Du , Xiaofeng Ma

Naming ability supports effective communication and functional independence in late life, yet it declines variably. Psychosocial factors like loneliness may exacerbate this trajectory, yet research often treats loneliness as a unitary construct. This study examined whether overall loneliness and its subdimensions, subjective isolation and structural lack of connections, differentially predict naming trajectories, and whether naming and social connectedness are bidirectionally related. Using four biennial waves of Health and Retirement Study data (2008–2020; N = 3504), we applied hierarchical linear models to analyze trajectories and cross-lagged panel models to test directionality, adjusting for demographics, health, and family factors. Greater overall loneliness predicted faster naming decline. Crucially, decomposing loneliness revealed that the lack of available social connections, a structural dimension, robustly predicted decline even after rigorous adjustment, whereas subjective isolation did not predict decline when covariates were included. Cross-lagged effects were small and stage-specific, showing that naming ability predicted later connectedness (in early and late stages) and that connectedness predicted later naming performance (in the mid-stage). These findings highlight that structural connectedness, defined as the actual availability of a social network, is more critical for preserving linguistic function than the mere feeling of isolation. Furthermore, the link between language and connection is dynamic and mutually reinforcing. Interventions should therefore prioritize maintaining social engagement and providing communication support, targeting structural connectedness as a modifiable factor to preserve language and cognitive health in aging populations.

命名能力在晚年支持有效的沟通和功能独立，但其下降有差异。孤独等社会心理因素可能会加剧这一趋势，但研究往往将孤独视为一种单一的结构。本研究考察了总体孤独及其子维度、主观孤立和结构性缺乏联系是否对命名轨迹有差异预测，以及命名和社会联系是否双向相关。利用每两年一次的四波健康与退休研究数据（2008-2020;N = 3504），我们应用层次线性模型分析轨迹，并应用交叉滞后面板模型检验方向性，调整人口统计、健康和家庭因素。更大的整体孤独感预示着更快的命名下降。至关重要的是，分解孤独表明，即使经过严格的调整，缺乏可用的社会联系（一个结构维度）也有力地预测了衰退，而当包括协变量时，主观孤立并不预测衰退。交叉滞后效应很小，而且是阶段性的，表明命名能力预测了后来的连通性（在早期和晚期），而连通性预测了后来的命名表现（在中期）。这些发现强调了结构连通性，定义为社会网络的实际可用性，对于保持语言功能比单纯的孤立感更重要。此外，语言和连接之间的联系是动态的，相互加强的。因此，干预措施应优先考虑保持社会参与和提供沟通支持，将结构性联系作为一个可改变的因素，以保持老年人的语言和认知健康。

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引用次数: 0

Perioperative multicomponent exercise rehabilitation for frail elderly patients undergoing surgical procedures: A systematic review and meta-analysis 老年体弱多病手术患者围手术期多组分运动康复：系统回顾和荟萃分析

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-29 DOI: 10.1016/j.archger.2025.106127

Xiaoqing Xie , Lanping Lei , Yuan Zhan , Caiyun He

Background

Frailty among elderly patients undergoing surgical procedures constitutes a notable risk factor for adverse postoperative outcomes. Perioperative multicomponent exercise rehabilitation presents a promising strategy; however, its overall efficacy is still uncertain. This systematic review aimed to assess the effects of these programs on frail elderly patients undergoing surgery.

Methods

A search was conducted in MEDLINE, Embase, CINAHL, Cochrane CENTRAL, Web of Science, and SPORTDiscus from inception to August 2025 for RCTs examining perioperative (primarily prehabilitation) multicomponent exercise in adults aged ≥ 65 with frailty. The JBI checklist was utilized to assess the risk of bias, while evidence certainty was evaluated using the GRADE system.

Results

Out of 663 identified records, 10 RCTs involving 1146 patients were included. A meta-analysis indicated that exercise significantly decreased postoperative complications (RR 0.72, 95% CI 0.58–0.87; high certainty) and enhanced functional capacity, evidenced by a mean difference of 26.7 meters in the Six-Minute Walk Test (95% CI 16.1–37.3; high certainty). A modest yet noteworthy decrease in length of stay (MD -0.51 days) and an enhancement in handgrip strength (MD 0.35 kg) were observed. The impacts on quality of life, disability, frailty, and readmission risk were determined to be non-significant, corroborated by low-to-moderate certainty evidence.

Conclusion

Perioperative multicomponent exercise rehabilitation significantly decreases complications and improves physical function in frail elderly patients undergoing surgery. Nonetheless, its impact on wider geriatric syndromes has yet to be established. Clinicians ought to implement these programs to enhance core recovery outcomes, while future research should focus on optimizing patient-centered benefits.

背景：接受外科手术的老年患者的虚弱是术后不良结果的一个显著危险因素。围手术期多组分运动康复是一种很有前景的康复策略；然而，其整体功效仍不确定。本系统综述旨在评估这些方案对接受手术的体弱老年患者的影响。方法检索MEDLINE、Embase、CINAHL、Cochrane CENTRAL、Web of Science和SPORTDiscus中从成立到2025年8月的rct，以检查≥65岁虚弱成人围手术期（主要是康复前）多组分运动。使用JBI检查表评估偏倚风险，使用GRADE系统评估证据确定性。结果在663份确定的记录中，纳入10项rct，涉及1146例患者。一项荟萃分析表明，运动显著降低了术后并发症（RR 0.72, 95% CI 0.58-0.87，高确定性），并增强了功能能力，6分钟步行测试的平均差异为26.7米（95% CI 16.1-37.3，高确定性）。观察到停留时间（MD -0.51天）的适度但值得注意的减少和握力（MD 0.35 kg）的增强。对生活质量、残疾、虚弱和再入院风险的影响被确定为无显著性，由低至中等确定性证据证实。结论围手术期多组分运动康复可明显减少老年体弱患者的并发症，改善患者的身体功能。尽管如此，它对更广泛的老年综合征的影响尚未确定。临床医生应该实施这些方案来提高核心康复结果，而未来的研究应侧重于优化以患者为中心的利益。

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引用次数: 0

From co-design to sustainable practice: Reflections on inclusive physical activity for older adults 从共同设计到可持续实践：对老年人包容性体育活动的思考

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-22 DOI: 10.1016/j.archger.2025.106125

Miglė Kiguolytė , Benjamin H L Harris , Louis J Koizia

引用次数: 0

Beyond access: Digital skills as a new social determinant of health among older adults — evidence from a longitudinal panel study 超越获取：数字技能作为老年人健康的一个新的社会决定因素——来自纵向小组研究的证据

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-16 DOI: 10.1016/j.archger.2025.106124

Hao Ji , Weiguang Pan , Junyi Xin

Background

As the digital divide shifts from access to skills, the impact of digital competence on older adults’ well-being remains underexplored. This study investigates the longitudinal relationship between digital skills and the multidimensional health of China’s older population.

Methods

Using multi-wave data from the China Longitudinal Aging Social Survey (CLASS), a nationally representative longitudinal panel study, we employed individual fixed-effects models. To mitigate endogeneity, we utilized a Bartik-style instrumental variable (IV-2SLS) strategy. A hybrid analytical approach was adopted to examine transmission mechanisms.

Results

Self-rated digital skills significantly predicted better health outcomes, including improved self-rated health (β=0.082, p < 0.001), fewer depressive symptoms (β=−0.307, p < 0.001), and greater social health (β=0.280, p < 0.001). These associations remained robust after correcting for endogeneity. The protective effect operates through a dual trajectory: reinforcing social participation and health behaviors, while enabling meaningful engagement with digital health technologies. Heterogeneity analysis revealed a pattern of “inclusive growth”: health returns were substantial for vulnerable groups (low income/education) and the oldest-old, functioning as a “compensatory resource,” though a “digital blind spot” persisted in peri‑urban areas.

Conclusion

Digital skills have emerged as a pivotal social determinant of health in later life. Policies must pivot from infrastructure provision to “precision empowerment,” prioritizing skill-building for disadvantaged older adults to ensure the equitable distribution of digital health benefits.

随着数字鸿沟从获取转向技能，数字能力对老年人福祉的影响仍未得到充分探讨。本研究探讨了数字技能与中国老年人口多维健康之间的纵向关系。方法采用具有全国代表性的纵向面板研究——中国纵向老龄化社会调查（CLASS）的多波数据，采用个体固定效应模型。为了减轻内生性，我们采用了bartik式工具变量（IV-2SLS）策略。采用混合分析方法来研究传动机制。结果自评数字技能显著预测更好的健康结果，包括改善的自评健康（β=0.082, p < 0.001），更少的抑郁症状（β= - 0.307, p < 0.001）和更大的社会健康（β=0.280, p < 0.001）。在校正了内生性后，这些关联仍然很强。这种保护作用通过双重轨迹发挥作用：加强社会参与和健康行为，同时使人们有意义地参与数字卫生技术。异质性分析揭示了一种“包容性增长”的模式：弱势群体（低收入/受教育）和最老群体的保健回报很大，可作为一种“补偿性资源”，尽管在城市周边地区仍然存在“数字盲点”。结论：数字技能已成为影响晚年健康的关键社会决定因素。政策必须从提供基础设施转向“精准赋权”，优先考虑弱势老年人的技能培养，以确保数字健康福利的公平分配。

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引用次数: 0

Inhibition of c-Jun/Bak signaling alleviates endothelial cell senescence and inflammation caused by mitochondrial dysfunction in DMED 抑制c-Jun/Bak信号可减轻DMED中线粒体功能障碍引起的内皮细胞衰老和炎症

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-16 DOI: 10.1016/j.archger.2025.106123

Ma Jianxiong , Guo Yingxue , Zhongliao Zeng , Yuyi Li , Huang Jie , He Qiang

Endothelial dysfunction is a key contributor to diabetic complications, including erectile dysfunction (ED). Using single-cell RNA sequencing and transcriptomic analysis of diabetic ED (DMED), this study identifies the c-Jun/Bak pathway as a key driver of endothelial aging and inflammation. Hyperglucose-induced c-Jun/Bak activation initiates Bak-dependent mitochondrial dysfunction manifested as structural damage, excessive ROS production, and metabolic dysfunction. In DMED rats, penile corpus cavernosal endothelial cells exhibit elevated markers of senescence as well as overactivation of JNK and mitochondrial abnormalities. In vitro experiments showed that JNK inhibition protected mitochondrial function and attenuated aging and inflammation, whereas Bak activation reversed these benefits. While rodent models provide mechanistic insights, translational challenges require further investigation due to the complexity of human diabetes. These findings highlight mitochondrial regulation of c-Jun/Bak signaling as a therapeutic target for diabetic vascular complications, providing a novel approach for the treatment of DMED.

内皮功能障碍是糖尿病并发症的关键因素，包括勃起功能障碍（ED）。通过对糖尿病ED （DMED）的单细胞RNA测序和转录组学分析，本研究确定了c-Jun/Bak通路是内皮细胞老化和炎症的关键驱动因素。高糖诱导的c-Jun/Bak激活会引发Bak依赖的线粒体功能障碍，表现为结构损伤、ROS过量产生和代谢功能障碍。在DMED大鼠中，阴茎海绵体内皮细胞表现出衰老标记物升高、JNK过度激活和线粒体异常。体外实验表明，JNK抑制保护线粒体功能，减轻衰老和炎症，而Bak激活逆转了这些益处。虽然啮齿动物模型提供了机制见解，但由于人类糖尿病的复杂性，转化挑战需要进一步研究。这些发现突出了c-Jun/Bak信号的线粒体调控作为糖尿病血管并发症的治疗靶点，为DMED的治疗提供了新的途径。

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引用次数: 0

Watching sports and subsequent health and well-being in older adults: a longitudinal outcome-wide study 老年人观看体育运动与随后的健康和幸福：一项纵向结果研究。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-12 DOI: 10.1016/j.archger.2025.106120

Taishi Tsuji , Kenjiro Kawaguchi , Kazushige Ide , Atsushi Nakagomi , Yuya Narita , Satoru Kanamori , Katsunori Kondo

Background

Although watching sports has increasingly been associated with mental health benefits among older adults, its broader implications, positive and negative, across diverse health and well-being outcomes remain unclear. This longitudinal study examined the associations between sports watching and subsequent health and well-being outcomes among older adults.

Methods

We analyzed three-wave data (2016, 2019, and 2022) from the Japan Gerontological Evaluation Study (n = 5226 or 6975, depending on the outcome). The exposure was watching sports on-site and via television/internet in 2019. In 2022, 47 health and well-being outcomes across seven domains were assessed. Analyses adjusted for pre-baseline covariates, including corresponding outcome values from 2016.

Results

Among 5226 participants, 1260 (24.1 %) reported watching sports on-site at least once per year, and 4155 (79.5 %) reported watching via television or the internet. On-site watching (a few times per year) and media-based watching (regardless of frequency) were associated with a reduced risk of worsening depressive symptoms. Both forms were positively associated with social well-being indicators, including participation in sports groups and the number of friends seen. No significant associations were observed for health behavior outcomes. However, frequent on-site watching was associated with an increased risk of dementia.

Conclusions

Watching sports, on-site or via media, was associated with fewer depressive symptoms and enhanced social well-being in older adults. However, no associations were found with health behaviors, and frequent on-site watching may elevate dementia risk. These findings highlight the need to balance the benefits and risks of sports watching in healthy aging strategies.

背景：尽管观看体育运动越来越多地与老年人的心理健康益处联系在一起，但其对各种健康和福祉结果的积极和消极的更广泛影响尚不清楚。这项纵向研究调查了老年人观看体育比赛与随后的健康和幸福结果之间的关系。方法：我们分析了来自日本老年学评估研究的三波数据（2016年、2019年和2022年）（n = 5226或6975，取决于结果）。2019年的曝光是在现场和通过电视/互联网观看体育比赛。2022年，对七个领域的47项健康和福祉成果进行了评估。分析调整了基线前协变量，包括2016年相应的转归值。结果：在5226名参与者中，1260名（24.1%）报告每年至少观看一次现场体育比赛，4155名（79.5%）报告通过电视或互联网观看体育比赛。现场观看（每年几次）和基于媒体的观看（无论频率如何）与降低抑郁症状恶化的风险相关。这两种形式都与社会幸福感指标呈正相关，包括参加体育团体和见朋友的数量。没有观察到健康行为结果的显著关联。然而，频繁的现场观看会增加患痴呆症的风险。结论：观看体育比赛，无论是现场观看还是通过媒体观看，都与老年人抑郁症状的减少和社会幸福感的增强有关。然而，没有发现与健康行为有关，频繁的现场观看可能会增加患痴呆症的风险。这些发现强调了在健康老龄化策略中平衡观看体育比赛的益处和风险的必要性。

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引用次数: 0

Heatmap of 10-year disability risk according to the frailty–intrinsic capacity (FR-IC) index in older Japanese adults 根据脆弱-内在能力（FR-IC）指数的日本老年人10年残疾风险热图

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-12 DOI: 10.1016/j.archger.2025.106119

Rei Otsuka , Shu Zhang , Yukiko Nishita , Chikako Tange , Mana Tateishi , Hyuma Makizako , Kaori Kinoshita , Fumihiro Mizokami , Mai Kabayama , Kei Kamide , Shosuke Satake , Hidenori Arai

引用次数: 0

Usefulness of the global leadership initiative on malnutrition -GLIM- criteria to identify malnutrition in older adults: systematic review and meta-analyses 营养不良全球领导倡议- glim -标准识别老年人营养不良的有用性：系统回顾和荟萃分析

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-12 DOI: 10.1016/j.archger.2025.106121

Gustavo Díaz , Carla M. Prado , Maria Cristina Gonzalez , Maria Paula Rugeles

Aim

Malnutrition is highly prevalent among older subjects, yet no universal method for its identification has been established. This study aimed to evaluate the concurrent and predictive validity of the GLIM criteria in older adults.

Methods

A systematic review and meta-analysis were conducted in five databases involving older adults (≥60 years). Concurrent validity utilizes reference nutritional assessment tools, while predictive validity focuses on key outcomes, including mortality, hospitalization, and healthcare costs.

Results

The search yielded 683 references. Thirteen hospital-based studies from four continents (n = 9164) met the inclusion criteria. GLIM implementation commonly used the MNA-SF for screening, while muscle mass was assessed with calf circumference, BIA, or DXA. The global prevalence of malnutrition, as reported by GLIM, ranged from 14.1% to 71.9%. A meta-analysis of four studies (n = 1221) showed that malnutrition diagnosis by GLIM criteria demonstrated a pooled sensitivity of 0.79 (95% CI: 0.69–0.86) and specificity of 0.88 (95% CI: 0.81–0.93), with moderate heterogeneity and no publication bias. Predictive validity analyses showed that malnutrition diagnosed by GLIM was associated with higher in-hospital and post-discharge mortality, lower ADL scores at discharge and follow-up, and longer hospital stays. Malnutrition was also associated with an increased risk of hospital complications and higher healthcare costs. No validation studies were found in nursing homes or community-dwelling older adults.

Conclusion

The GLIM criteria appear suitable for identifying malnutrition in clinical settings and predicting key adverse outcomes. However, their application in community-dwelling and nursing home populations remains inconclusive until further evidence becomes available.

营养不良在老年人中非常普遍，但目前还没有确定营养不良的普遍方法。本研究旨在评估老年人GLIM标准的并发性和预测性有效性。方法对涉及老年人（≥60岁）的5个数据库进行系统评价和荟萃分析。并发效度利用参考营养评估工具，而预测效度侧重于关键结果，包括死亡率、住院率和医疗费用。结果共检索到文献683篇。来自四大洲的13项基于医院的研究（n = 9164）符合纳入标准。GLIM的实施通常使用MNA-SF进行筛选，而肌肉质量则通过小腿围、BIA或DXA进行评估。GLIM报告的全球营养不良发生率从14.1%到71.9%不等。四项研究（n = 1221）的荟萃分析显示，GLIM标准诊断营养不良的总敏感性为0.79 (95% CI: 0.69-0.86)，特异性为0.88 (95% CI: 0.81-0.93)，具有中等异质性，无发表偏倚。预测效度分析显示，GLIM诊断的营养不良与较高的住院和出院后死亡率、较低的出院和随访时ADL评分以及较长的住院时间有关。营养不良还与住院并发症风险增加和医疗费用增加有关。没有在养老院或社区居住的老年人中发现验证性研究。结论GLIM标准适用于临床诊断营养不良和预测主要不良结局。然而，在获得进一步的证据之前，它们在社区居住和养老院人群中的应用仍不确定。

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引用次数: 0