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

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

The effects of exercise modality and dose on improving executive function in stroke patients: A systematic review and Bayesian network dose-response meta-analysis 运动方式和剂量对改善脑卒中患者执行功能的影响：一项系统综述和贝叶斯网络剂量-反应荟萃分析。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-11 DOI: 10.1016/j.archger.2025.106117

Shaoqi Zheng , Qiuxue Pan , Liping Chen

Objective

This Bayesian network meta-analysis examined exercise effects on executive function in stroke patients, exploring dose-response relationships and comparing the efficacy of different modalities to identify the optimal rehabilitation protocol.

Methods

A systematic search was conducted in PubMed, Embase, the Cochrane Library, Web of Science, and SPORTDiscus from inception to September 15, 2025. Twenty randomized controlled trials (RCTs) were included. Study quality was assessed using the PEDro scale. A Bayesian random-effects network meta-regression model examined the nonlinear dose–response relationship between exercise dosage (in Metabolic Equivalent of Task-minutes, MET-mins) and executive function, with heterogeneity, publication bias, and model robustness evaluated.

Results

The analysis demonstrated a significant inverted U-shaped relationship between weekly exercise dose and improvements in executive function, with the peak effect occurring at approximately 1000 MET-minutes per week (mean effect size = 0.65, 95 % credible interval: 0.34–1.00). Among different exercise modalities, exercise combined with cognitive training showed the most favorable and consistent association across a broad weekly dose range (approximately 170–1000 MET-minutes). Multicomponent exercise exhibited apparent benefits only at higher weekly doses (around 890–1000 MET-minutes), though with greater statistical uncertainty, whereas other modalities did not demonstrate clear or consistent effects.

Conclusion

The association between exercise and executive function in stroke patients appears to follow an optimal weekly dose (∼1000 MET-minutes) rather than a maximal one. Exercise combined with cognitive training provides synergistic, stable benefits within this range. These findings offer moderate-quality evidence to guide individualized rehabilitation that optimizes cognitive recovery and improves quality of life after stroke.

目的：通过贝叶斯网络荟萃分析，探讨运动对脑卒中患者执行功能的影响，探讨不同运动方式的剂量-反应关系，并比较不同运动方式的疗效，以确定最佳康复方案。方法：系统检索PubMed、Embase、Cochrane Library、Web of Science和SPORTDiscus自成立至2025年9月15日的文献。纳入20项随机对照试验（rct）。采用PEDro量表评估研究质量。一个贝叶斯随机效应网络元回归模型检验了运动剂量（任务分钟代谢当量，met -min）与执行功能之间的非线性剂量-反应关系，并评估了异质性、发表偏倚和模型稳健性。结果：分析表明，每周运动剂量与执行功能改善之间存在显著的倒u型关系，峰值效应发生在每周约1000 met -分钟（平均效应大小= 0.65,95%可信区间：0.34-1.00）。在不同的运动方式中，运动与认知训练相结合在较宽的周剂量范围内（约170-1000 met -分钟）显示出最有利和一致的关联。多组分运动只有在较高的周剂量（约890-1000 met -分钟）下才显示出明显的益处，尽管在统计上有更大的不确定性，而其他模式没有显示出明确或一致的效果。结论：卒中患者的运动和执行功能之间的关联似乎遵循最佳每周剂量（~ 1000 met -min），而不是最大剂量。运动与认知训练相结合在这个范围内提供了协同的、稳定的益处。这些发现为指导个性化康复提供了中等质量的证据，以优化脑卒中后的认知恢复和改善生活质量。

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引用次数: 0

From brain imaging phenotypes to vascular dementia subtypes: A comprehensive mendelian randomization study 从脑成像表型到血管性痴呆亚型：一项全面的孟德尔随机研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-11 DOI: 10.1016/j.archger.2025.106116

Congai Chen , Zehan Zhang , Qinglin Liu , Pinyi Zhou , Yiwen Deng , Jingwei Mao , Lu Liu , Bin Li

Background

Vascular dementia (VaD) is a heterogeneous disorder with distinct subtypes, each exhibiting unique neuropathological profiles. Although neuroimaging studies have identified some subtype-specific structural brain alterations, a systematic investigation establishing causal relationships between imaging-derived phenotypes (IDPs) and the development of specific VaD subtypes remains absent from current literature.

Methods

Two-sample Mendelian Randomization (MR) analyses were conducted to assess causal relationships between 3,935 brain IDPs from UK Biobank neuroimaging and four VaD subtypes (multiple infarctions, subcortical, sudden onset, and mixed) from FinnGen. Significant findings from the primary inverse variance weighted analysis were validated using Bayesian Weighted MR (BWMR) and MR Robust Adjusted Profile Score (MR-RAPS) methods to mitigate potential pleiotropy. Sensitivity analyses and reverse MR assessed robustness and directionality.

Results

Initial analyses identified highly significant causal associations for 33, 27, 25, and 30 brain IDPs with multiple infarctions, subcortical, sudden onset, and mixed VaD subtypes, respectively. Validation with BWMR and MR-RAPS confirmed 22, 17, 17, and 21 robustly causal IDPs for each subtype. Key findings included causal roles for gray matter volume/surface area changes in cognition-related regions specific to each subtype, as well as axonal and myelin damage with distinct anatomical localization in each subtype. Reverse MR found no evidence that any VaD subtype causally influenced the identified brain IDPs.

Conclusion

Our study provides robust genetic evidence for distinct causal relationships between specific patterns of brain structural alterations and different VaD subtypes. These subtype-specific neuroimaging signatures highlight divergent neuroanatomical substrates underlying VaD heterogeneity and offer potential targets for developing diagnostic biomarkers.

血管性痴呆（VaD）是一种具有不同亚型的异质性疾病，每种亚型都表现出独特的神经病理特征。尽管神经影像学研究已经确定了一些亚型特异性的脑结构改变，但目前文献中仍缺乏建立影像学衍生表型（IDPs）与特异性VaD亚型发展之间因果关系的系统调查。方法采用双样本孟德尔随机化（MR）分析，评估英国生物样本库（UK Biobank）神经成像数据中3935例脑IDPs与芬兰四种VaD亚型（多发性梗死、皮质下梗死、突发性和混合性）之间的因果关系。通过贝叶斯加权MR （BWMR）和MR稳健调整谱评分（MR- raps）方法验证了主要逆方差加权分析的重要发现，以减轻潜在的多效性。敏感性分析和反向MR评估稳健性和方向性。结果初步分析确定了33例、27例、25例和30例脑IDPs分别与多发梗死、皮质下、突然发作和混合VaD亚型有高度显著的因果关系。通过BWMR和MR-RAPS验证，每种亚型分别有22、17、17和21例idp具有明确的因果关系。主要发现包括每种亚型特异性认知相关区域灰质体积/表面积变化的因果作用，以及每种亚型中具有不同解剖定位的轴突和髓鞘损伤。反向磁共振发现没有证据表明任何VaD亚型对确定的脑IDPs有因果关系。结论本研究为脑结构改变的特定模式与不同VaD亚型之间的因果关系提供了强有力的遗传学证据。这些亚型特异性神经影像学特征突出了VaD异质性背后的不同神经解剖学基础，并为开发诊断性生物标志物提供了潜在的靶点。

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引用次数: 0

Is there a compression of morbidity and does it vary across social strata among older European adults? A retrospective cohort study of two waves 15 years apart 在欧洲老年人中是否存在发病率的压缩？在不同的社会阶层中是否存在差异？相隔15年的两波回顾性队列研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-11 DOI: 10.1016/j.archger.2025.106118

Enrique Alonso-Perez , Julie L O‘Sullivan , Jan Paul Heisig , Christoph U Correll , Elisabeth Steinhagen-Thiessen , Henrik Rudolf , Georg Fuellen , Paul Gellert

Background

Compression of morbidity may be linked to belonging to particular social strata defined by intersections of age, gender, migration and occupation. Extending the approach by Crimmins and Beltrán-Sánchez, we investigated compression of morbidity, defined as reduced socially stratified prevalence of self-reported heart disease, stroke, cancer, diabetes and functional limitations, using two samples 15 years apart.

Methods

We used data of eleven European countries from the Survey of Health, Ageing and Retirement in Europe (SHARE), comparing 2004 (N = 29,224) and 2019/2020 (N = 46,498) samples, to apply multilevel logistic regressions within an intersectional MAIHDA (Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy) framework.

Findings

Overall patterns did not show compression of morbidity in terms of lower prevalence after 15 years, but intersectional analyses revealed specific compression patterns. Certain strata showed reduced heart disease prevalence, with older men with migration background experiencing the strongest declines from initially high levels. However, no social stratum showed morbidity compression for stroke. Blue-collar low-skill men exhibited particularly increased cancer prevalence across waves. Among older men, diabetes prevalence increased substantially. Reductions in functional limitation prevalence emerged across waves for all female groups aged 70–79, and for blue-collar high-skill men.

Interpretation

Overall, we found that compression of morbidity was largely intersectionally stratified, evidencing the impact of social inequalities in healthy life expectancy. This calls for stratified preventive measures at public health level in the future.

Funding

Einstein Foundation Berlin (EZ-2019–555–2).

发病率的压缩可能与属于年龄、性别、移徙和职业交叉界定的特定社会阶层有关。我们扩展了Crimmins和Beltrán-Sánchez的方法，研究了发病率的压缩，定义为自我报告的心脏病、中风、癌症、糖尿病和功能限制的社会分层患病率降低，使用两个相隔15年的样本。方法我们使用来自欧洲健康、老龄化和退休调查（SHARE）的11个欧洲国家的数据，比较2004年（N = 29,224）和2019/2020年（N = 46,498）个样本，在交叉MAIHDA（个体异质性和歧视准确性的多层次分析）框架内应用多层次逻辑回归。研究结果：总体模式未显示15年后发病率降低，但交叉分析揭示了特定的压缩模式。某些阶层显示心脏病患病率降低，具有移民背景的老年男性从最初的高水平下降幅度最大。然而，没有社会阶层表现出卒中的发病率压缩。蓝领低技能男性的癌症患病率在各个时段都明显增加。在老年男性中，糖尿病患病率大幅上升。在70-79岁的所有女性群体和蓝领高技能男性群体中，功能限制患病率都出现了下降。总体而言，我们发现发病率的压缩在很大程度上是交叉分层的，证明了社会不平等对健康预期寿命的影响。这就要求今后在公共卫生层面采取分层预防措施。资助柏林爱因斯坦基金会（EZ-2019-555-2）。

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引用次数: 0

Development and validation of a modified phenoage for biological aging and chronic diseases in a chinese cohort 一种改良表型在中国生物衰老和慢性疾病中的发展和验证。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-09 DOI: 10.1016/j.archger.2025.106114

Jialiang Zheng , Tao Liu , Yumei Luo, Xing Wei

Objective

To address the original PhenoAge’s reliance on C-reactive protein (CRP)—a non-routine clinical biomarker—and enhance practical utility in routine healthcare settings, we developed a modified algorithm (PA-CRP) excluding CRP while retaining its core multi-omics integration framework, and further evaluated its associations with chronic diseases and lifestyle factors in a Chinese cohort.

Methods

Both PA-CRP and its derivative PA-CRP_Advance (biological age minus chronological age) were first developed and validated for their validity based on the NHANES dataset. Subsequently, the algorithm was applied to a Chinese university-based cohort (n = 4295), with multivariable logistic and linear regression models (adjusted for key confounders) to assess associations with chronic conditions and lifestyle factors.

Results

PA-CRP demonstrated strong validity in reflecting biological aging and predicting mortality. In the Chinese cohort, it was significantly associated with hypertension, hyperlipidemia, hyperglycemia, and cataracts, while PA-CRP_Advance showed targeted links to hyperuricemia and hyperglycemia. Smoking was confirmed as a key driver of accelerated biological aging, and physical activity exhibited a non-linear protective effect; alcohol consumption showed no significant association.

Conclusion

PA-CRP is a valid, pragmatic tool for assessing biological aging and chronic disease risk in Chinese adults. Its exclusion of CRP enables broad application in routine clinical and public health contexts where CRP is unavailable, supporting its utility as a cross-population applicable biological aging metric.

目的：为了解决最初的PhenoAge对c反应蛋白(CRP)-一种非常规临床生物标志物的依赖，并增强其在常规医疗保健环境中的实用性，我们开发了一种改进的算法（PA-CRP），在保留其核心多组学整合框架的同时排除CRP，并在中国队列中进一步评估其与慢性疾病和生活方式因素的关联。方法：首先基于NHANES数据集开发PA-CRP及其衍生物PA-CRP_Advance（生物年龄减去实足年龄）并验证其有效性。随后，将该算法应用于中国大学的队列（n = 4295），使用多变量logistic和线性回归模型（针对关键混杂因素进行调整）来评估慢性疾病和生活方式因素的相关性。结果：PA-CRP在反映生物衰老和预测死亡率方面具有较强的有效性。在中国队列中，它与高血压、高脂血症、高血糖和白内障显著相关，而PA-CRP_Advance显示与高尿酸血症和高血糖有针对性的联系。吸烟被证实是加速生物衰老的关键驱动因素，而体育活动表现出非线性的保护作用；饮酒没有明显的相关性。结论：PA-CRP是评估中国成人生物衰老和慢性疾病风险的有效、实用的工具。排除c反应蛋白可以在常规临床和公共卫生环境中广泛应用c反应蛋白，支持其作为跨人群适用的生物衰老指标的效用。

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引用次数: 0

Chronic loneliness and incident chronic lung diseases in two prospective cohorts 两个前瞻性队列的慢性孤独和偶发慢性肺部疾病

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-12-06 DOI: 10.1016/j.archger.2025.106112

Bo Yan , Yuechang Li , Haoyu Wu , Xiaomin Wang , Hui Zhu , Xudong Zhou

Background

Loneliness has been recognized as an independent predictor of incident chronic lung diseases. However, previous studies only focused on baseline loneliness status, not taking into consideration the changes in loneliness status during follow-up. This study examined the association of chronic loneliness and incident chronic lung diseases.

Methods

This multicohort study used data from the US Health and Retirement Study (HRS) and the China Health and Retirement Longitudinal Study (CHARLS), consisting of participants aged 45 years or older from China and participants aged 50 years or older from the US. Participants’ self-reported loneliness at baseline was treated as both a continuous variable and a dichotomous variable (low vs. High), and its change patterns were categorised as “stable low”, “low-high”, “high-low”, and “stable high”. Cox proportional hazards regression models were used to estimate the risk of developing chronic lung diseases.

Findings

A total of 18,031 (HRS: 8636; CHARLS: 9395) individuals were included for loneliness change analyses. Compared with individuals assigned to “stable low” loneliness change status, significant increased risks of incident chronic lung diseases were observed among those belonging to “low-high”, “high-low” and “stable high” groups in both cohorts ([CHARLS] “low-high”, HR:1.46, 95 % CI:1.24–1.72; “high-low”, HR:1.19, 95 % CI:1.02–1.38; “stable high”, HR:1.60, 95 % CI:1.36–1.89; [HRS] “low-high”, HR:1.39, 95 % CI:1.05–1.84; “high-low”, HR:1.34, 95 % CI:1.03–1.75; “stable high”, HR:1.60, 95 % CI:1.20–2.15).

Conclusions

Chronic loneliness was associated with higher risks of incident chronic lung diseases. Recovery or relief from loneliness might play an important role in the prevention of chronic lung diseases.

背景：孤独感已被认为是慢性肺部疾病发生的独立预测因子。然而，以往的研究只关注基线的孤独感状态，没有考虑到随访中孤独感状态的变化。本研究探讨慢性孤独感与偶发慢性肺部疾病的关系。方法本多队列研究采用美国健康与退休研究（HRS）和中国健康与退休纵向研究（CHARLS）的数据，包括来自中国的45岁及以上的参与者和来自美国的50岁及以上的参与者。参与者基线自述的孤独感被视为连续变量和二分类变量（低与高），其变化模式被分类为“稳定低”、“低-高”、“高-低”和“稳定高”。采用Cox比例风险回归模型估计发生慢性肺部疾病的风险。结果：共有18031人（HRS: 8636; CHARLS: 9395）被纳入孤独感变化分析。与被分配到“稳定低”孤独变化状态的个体相比，两个队列中属于“低-高”、“高-低”和“稳定高”组的个体发生慢性肺部疾病的风险显著增加([CHARLS]“低-高”组，HR:1.46, 95% CI: 1.24-1.72；“高-低”组，HR:1.19, 95% CI: 1.02-1.38；“稳定高”组，HR:1.60, 95% CI: 1.36-1.89; [HRS]“低-高”组，HR:1.39, 95% CI: 1.05-1.84；“稳定高位”，HR:1.60, 95% CI: 1.20-2.15)。结论慢性孤独感与慢性肺部疾病发生风险增高有关。从孤独中恢复或缓解可能在预防慢性肺部疾病中发挥重要作用。

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