Archives of gerontology and geriatrics最新文献_第3页

Dual trajectories of nighttime sleep duration and frailty in relation to cardiovascular disease risk in middle-aged and older Chinese adults: a longitudinal study 中国中老年人夜间睡眠时间和虚弱程度与心血管疾病风险相关的双重轨迹：一项纵向研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-18 DOI: 10.1016/j.archger.2026.106149

Qingcui Wu , Junfeng Zhang , Jianqi Liu, Huijie Huang, Zihao Zhang, Shuoying Yue, Meng Su, Jiageng Chen, Shi Zhao, Jun Ma

Background

Little is known about the associations between long-term patterns of sleep and frailty and their impact on cardiovascular disease risk. We aimed to delineate trajectories of nighttime sleep duration and frailty, compare baseline characteristics across trajectory groups, and evaluate their independent and joint associations with cardiovascular disease (CVD) risk.

Methods

Trajectories of sleep duration and frailty index (FI) were modeled using three biennial waves (2011–2015) of the China Health and Retirement Longitudinal Study (CHARLS). Group-based and dual trajectory modeling identified distinct patterns. Baseline characteristics across trajectories were examined using multinomial logistic regression. Cox proportional hazards models estimated hazard ratios (HRs) and 95 % confidence intervals (CIs) for CVD events occurring during 2015–2018 follow-up.

Results

Among 6972 participants, four sleep trajectories and three frailty trajectories were identified. Compared with the stable-8-hours sleep trajectory, the stable-5-hours group had higher risks of CVD (HR: 1.33, 95 % CI: 1.05–1.68) and heart disease (HR: 1.42, 95 % CI: 1.07–1.88), significant only for women in sex-stratified analyses. Stable pre-frail and frail trajectories were linked to elevated risks of CVD (HR: 1.92, 95 % CI: 1.45–2.55; HR: 3.70, 95 % CI: 2.63–5.21) and heart disease (HR: 2.28, 95 % CI: 1.60–3.24; HR: 4.61, 95 % CI: 3.03–7.00) in both sexes. Dual-trajectory analyses revealed co-development patterns of sleep and frailty, with the highest CVD risk (HR: 3.04, 95 % CI: 1.88–4.91) observed among individuals with both stable pre-frail/frail and stable-5-hours trajectories.

Conclusion

Sleep duration and frailty trajectories are interrelated over time and jointly influence CVD risk. Monitoring their long-term patterns may improve the precision of CVD prevention.

背景：人们对长期睡眠模式与身体虚弱及其对心血管疾病风险的影响之间的关系知之甚少。我们的目的是描述夜间睡眠时间和虚弱的轨迹，比较轨迹组的基线特征，并评估它们与心血管疾病（CVD）风险的独立和联合关联。方法：利用中国健康与退休纵向研究（CHARLS）的三个两年一次的波（2011-2015），对睡眠时间和虚弱指数（FI）的轨迹进行建模。基于组和双轨迹建模识别出不同的模式。使用多项逻辑回归检查了跨轨迹的基线特征。Cox比例风险模型估计了2015-2018年随访期间发生的心血管事件的风险比（hr）和95%置信区间（ci）。结果：在6972名参与者中，确定了4种睡眠轨迹和3种虚弱轨迹。与稳定的8小时睡眠轨迹相比，稳定的5小时睡眠组患心血管疾病（HR: 1.33, 95% CI: 1.05-1.68）和心脏病（HR: 1.42, 95% CI: 1.07-1.88）的风险更高，仅在性别分层分析中对女性有显著性意义。稳定的体弱前期和体弱轨迹与心血管疾病（HR: 1.92, 95% CI: 1.45-2.55; HR: 3.70, 95% CI: 2.63-5.21）和心脏病（HR: 2.28, 95% CI: 1.60-3.24; HR: 4.61, 95% CI: 3.03-7.00）的风险升高有关。双轨迹分析揭示了睡眠和虚弱的共同发展模式，在稳定的前虚弱/虚弱和稳定的5小时轨迹中观察到最高的心血管疾病风险（HR: 3.04, 95% CI: 1.88-4.91）。结论：睡眠时间和虚弱轨迹随时间的推移相互关联，并共同影响心血管疾病的风险。监测他们的长期模式可以提高心血管疾病预防的准确性。

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引用次数: 0

A machine learning model for prediction of risk of dementia superimposed on delirium in intensive care patients 用于预测重症监护患者谵妄叠加痴呆风险的机器学习模型。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-02-02 DOI: 10.1016/j.archger.2026.106161

Xinya Li , Weisheng Chen , Zhigang Wang , Lei Wang , Xi Huai , Hongtao Cheng , Yu Wang , Jun Lyu

Background

The objective of this study was to construct a predictive model using multiple machine learning algorithms to predict the risk of dementia superimposed on delirium (DSD) in dementia patients in the ICU.

Methods

The data for this study were sourced from the Medical Information Mart for Intensive Care IV database. The dataset was divided into a development set (70%) and a test set (30%). Feature selection was conducted using the Boruta algorithm to identify clinically relevant predictors, followed by model development using logistic regression, decision trees, random forest, XGBoost, glmnet, k-nearest neighbors (KNN), support vector machine (SVM), and neural network (NNET). The performance of the model was evaluated using several performance metrics, including the area under the curve (AUC), accuracy, precision, sensitivity, specificity, and the F-beta score.

Results

The findings demonstrated that the XGBoost model showed stable and acceptable discriminative performance, with an AUC of 0.7072 in the development set and 0.7258 in the test set, along with reasonable agreement between predicted and observed risks. The model achieved a balanced classification profile, with satisfactory specificity and sensitivity, and an F-beta score of 0.7594 in the test set. Decision curve analysis indicated that the XGBoost model provided net clinical benefit across a range of decision thresholds.

Conclusions

XGBoost-based machine learning models demonstrate moderate discriminative ability for predicting the occurrence of DSD in ICU patients with dementia and may support risk stratification in similar ICU settings, pending further external validation in independent cohorts.

背景：本研究的目的是利用多种机器学习算法构建预测模型，预测ICU痴呆患者痴呆叠加谵妄（DSD）的风险。方法：本研究的数据来源于重症监护医学信息市场IV数据库。数据集分为开发集（70%）和测试集（30%）。使用Boruta算法进行特征选择以识别临床相关预测因子，然后使用逻辑回归、决策树、随机森林、XGBoost、glmnet、k近邻（KNN）、支持向量机（SVM）和神经网络（NNET）进行模型开发。使用几个性能指标评估模型的性能，包括曲线下面积（AUC）、准确性、精密度、灵敏度、特异性和F-beta评分。结果：研究结果表明，XGBoost模型具有稳定且可接受的判别性能，开发集的AUC为0.7072，测试集的AUC为0.7258，预测风险与观测风险之间具有合理的一致性。该模型实现了平衡的分类特征，具有令人满意的特异性和敏感性，在测试集中的F-beta得分为0.7594。决策曲线分析表明，XGBoost模型在一系列决策阈值范围内提供净临床获益。结论：基于xgboost的机器学习模型在预测ICU痴呆患者发生DSD方面表现出中度判别能力，可能支持类似ICU环境中的风险分层，有待于独立队列的进一步外部验证。

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引用次数: 0

Multi-dimensional social frailty index for predicting disability and mortality in community-dwelling older adults: JAGES cohort 多维社会脆弱指数预测社区居住老年人残疾和死亡率：JAGES队列。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1016/j.archger.2026.106158

Takahiro Hayashi , Taiji Noguchi , Ryota Watanabe , Yuta Kubo , Taishi Tsuji , Masashige Saito , Katsunori Kondo

Background and objectives

We explored the association between a constructed multi-dimensional social frailty index and incidence of disability and all-cause mortality among community-dwelling older adults, examining its prognostic validity.

Research design and methods

We obtained data from the 2016 Japan Gerontological Evaluation Study (JAGES), surveying community-dwelling individuals aged ≥65 years, not certified as requiring long-term care, at baseline. The analytical sample comprised 73,472 participants (mean age, 73.7 years; 53.4% women) from 18 municipalities across 10 prefectures in Japan. The social frailty index comprised seven items across four domains: general resources (subjective financial conditions), social resources (living arrangements; social networks [visiting friends]), social behavior/activities (social participation; decreased frequency of going out), and basic social needs fulfillment (emotional social support; social cohesion [community attachment]). Incident disability and all-cause mortality were recorded over a mean 3.5-year follow-up. Associations were examined using Cox proportional hazards models adjusted for demographics, health status, and physical, cognitive, and depressive symptoms.

Results

Participants were classified as socially non-frail (51.6%), socially pre-frail (39.5%), and socially frail (9.0%). Higher social frailty scores were significantly associated with increased risk of disability and mortality. In the demographics and health status-adjusted model, incident disability hazard ratios were 1.41 for social pre-frailty and 1.77 for social frailty, whereas corresponding mortality hazard ratios were 1.35 and 1.65, respectively (all P < 0.001).

Discussion

The multi-dimensional social frailty index demonstrated robust prognostic validity for adverse health outcomes.

Implications

Integrating social dimensions into frailty assessments may facilitate early interventions, inform policy development, and improve health maintenance in aging populations.

背景和目的：我们探讨了在社区居住的老年人中构建的多维社会脆弱指数与残疾发生率和全因死亡率之间的关系，并检验了其预后有效性。研究设计和方法：我们获得了2016年日本老年学评估研究（JAGES）的数据，调查了≥65岁、未被证明需要长期护理的社区居住个体。分析样本包括来自日本10个县的18个市的73,472名参与者（平均年龄73.7岁，53.4%为女性）。社会脆弱性指数包括四个领域的七个项目：一般资源（主观经济状况）、社会资源（生活安排、社会网络（拜访朋友））、社会行为/活动（社会参与、外出频率下降）和基本社会需求满足（情感社会支持、社会凝聚力（社区依恋））。在平均3.5年的随访中记录了事故致残和全因死亡率。使用Cox比例风险模型对人口统计学、健康状况、身体、认知和抑郁症状进行调整，检验相关性。结果：参与者分为社会非虚弱（51.6%）、社会前期虚弱（39.5%）和社会虚弱（9.0%）。较高的社会脆弱得分与残疾和死亡风险增加显著相关。在人口统计学和健康状态调整模型中，社会脆弱前的事件残疾风险比为1.41，社会脆弱的事件残疾风险比为1.77，而相应的死亡率风险比分别为1.35和1.65（均P < 0.001）。讨论：多维社会脆弱指数对不良健康结果显示了强大的预后有效性。意义：将社会维度纳入脆弱性评估可能有助于早期干预，为政策制定提供信息，并改善老龄人口的健康维护。

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引用次数: 0

The effects of functional exercise on healthy aging in women over 60 years of age: A systematic review and meta-analysis 功能性运动对60岁以上女性健康衰老的影响：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 : 2026-04-01 Epub Date: 2026-01-07 DOI: 10.1016/j.archger.2026.106129

Hugo Rodríguez-Otero , Pablo Hernandez-Lucas , Juan Lopez-Barreiro , Raquel Leirós-Rodríguez

Introduction

Healthy aging is a major public health priority, particularly for women, who have a longer life expectancy and a high prevalence of conditions associated with frailty, sarcopenia, and loss of functional independence. Therefore, the objective of this systematic review and meta-analysis was to evaluate the effects of functional exercise on physical and psychosocial outcomes in women over 60 years of age.

Methods

A systematic review and meta-analysis was conducted following PRISMA guidelines. Searches were performed in PubMed, Scopus, Web of Science, and Cochrane Library up to September 2025. Only randomized controlled trials involving women aged 60 years and older who participated in functional exercise interventions were included. Methodological quality was assessed with the PEDro scale, and pooled analyses were conducted using standardized mean differences (SMD) with 95% confidence intervals.

Results

Seventeen randomized controlled trials with a total of 968 participants met the inclusion criteria. Meta-analyses showed that functional exercise significantly improved physical capacities, including functionality (SMD = 0.81; 95% CI = 0.62 to 0.99), strength (SMD = 0.51; 95% CI = 0.11 to 0.91), and power (SMD = 0.28; 95% CI = 0.10 to 0.46). Additional evidence suggested improvements in psychosocial outcomes and reductions in proinflammatory cytokines, although results were more heterogeneous. The overall methodological quality of the included studies was moderate to high.

Conclusions

Functional exercise may be a beneficial strategy to enhance physical and psychosocial capacities in women over 60 years of age. It may also contribute to modulating inflammatory and immunosenescence-related responses; however, the evidence remains limited and should be interpreted with caution. Further high-quality studies are needed to support its integration into healthy aging and preventive care programs.

健康老龄化是一个主要的公共卫生优先事项，特别是对妇女而言，她们的预期寿命较长，并且与身体虚弱、肌肉减少症和丧失功能独立性相关的疾病非常普遍。因此，本系统综述和荟萃分析的目的是评估功能性锻炼对60岁以上女性身体和心理结局的影响。方法按照PRISMA指南进行系统评价和荟萃分析。截至2025年9月，在PubMed、Scopus、Web of Science和Cochrane Library中进行了搜索。只纳入了年龄在60岁及以上的女性参与功能性运动干预的随机对照试验。采用PEDro量表评估方法学质量，并采用95%置信区间的标准化平均差异（SMD）进行合并分析。结果17项随机对照试验共968名受试者符合纳入标准。荟萃分析显示，功能性锻炼显著改善了身体能力，包括功能（SMD = 0.81; 95% CI = 0.62至0.99）、力量（SMD = 0.51; 95% CI = 0.11至0.91）和力量（SMD = 0.28; 95% CI = 0.10至0.46）。其他证据表明，社会心理结果得到改善，促炎细胞因子减少，尽管结果更加不一致。纳入研究的总体方法学质量为中等至高。结论功能锻炼可能是提高60岁以上妇女身体和心理社会能力的有益策略。它也可能有助于调节炎症和免疫衰老相关反应；然而，证据仍然有限，应谨慎解释。需要进一步的高质量研究来支持其纳入健康老龄化和预防保健计划。

{"title":"The effects of functional exercise on healthy aging in women over 60 years of age: A systematic review and meta-analysis","authors":"Hugo Rodríguez-Otero , Pablo Hernandez-Lucas , Juan Lopez-Barreiro , Raquel Leirós-Rodríguez","doi":"10.1016/j.archger.2026.106129","DOIUrl":"10.1016/j.archger.2026.106129","url":null,"abstract":"<div><h3>Introduction</h3><div>Healthy aging is a major public health priority, particularly for women, who have a longer life expectancy and a high prevalence of conditions associated with frailty, sarcopenia, and loss of functional independence. Therefore, the objective of this systematic review and meta-analysis was to evaluate the effects of functional exercise on physical and psychosocial outcomes in women over 60 years of age.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis was conducted following PRISMA guidelines. Searches were performed in PubMed, Scopus, Web of Science, and Cochrane Library up to September 2025. Only randomized controlled trials involving women aged 60 years and older who participated in functional exercise interventions were included. Methodological quality was assessed with the PEDro scale, and pooled analyses were conducted using standardized mean differences (SMD) with 95% confidence intervals.</div></div><div><h3>Results</h3><div>Seventeen randomized controlled trials with a total of 968 participants met the inclusion criteria. Meta-analyses showed that functional exercise significantly improved physical capacities, including functionality (SMD = 0.81; 95% CI = 0.62 to 0.99), strength (SMD = 0.51; 95% CI = 0.11 to 0.91), and power (SMD = 0.28; 95% CI = 0.10 to 0.46). Additional evidence suggested improvements in psychosocial outcomes and reductions in proinflammatory cytokines, although results were more heterogeneous. The overall methodological quality of the included studies was moderate to high.</div></div><div><h3>Conclusions</h3><div>Functional exercise may be a beneficial strategy to enhance physical and psychosocial capacities in women over 60 years of age. It may also contribute to modulating inflammatory and immunosenescence-related responses; however, the evidence remains limited and should be interpreted with caution. Further high-quality studies are needed to support its integration into healthy aging and preventive care programs.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"143 ","pages":"Article 106129"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975411","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

Frailty trajectories and risk of incident advanced CKM syndrome: A national cohort analysis 衰弱轨迹和发生晚期CKM综合征的风险：一项国家队列分析。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1016/j.archger.2026.106159

Haojiang Li , Qingqing Li , Ru Sun , Li Ni , Feng Wang , Jia Cheng , Ling Zhou , Chunxia Zhao

Background

The interplay between frailty dynamics and the newly defined Cardiovascular-Kidney-Metabolic (CKM) syndrome remains poorly understood. We aimed to quantify the association between frailty transitions and the risk of incident advanced CKM syndrome and identify modifiable drivers of frailty progression.

Methods

Using data from the China Health and Retirement Longitudinal Study (CHARLS), we analyzed 8159 participants cross-sectionally and 3506 longitudinally over four years. Frailty was assessed using a deficit-accumulation index. The primary outcome was prevalent and incident advanced CKM syndrome (Stages 3–4). We employed multivariable regression models to evaluate associations and a machine learning pipeline to identify key predictors of frailty progression.

Results

Baseline frailty showed a robust dose-response relationship with prevalent advanced CKM (OR 1.44 per 0.1-unit FI increase; 95% CI 1.38–1.51). Longitudinally, individuals progressing to a frail state had a 40% increased risk of incident advanced CKM compared to stable non-frail peers (OR 1.40; 95% CI 1.01–1.94). Notably, this risk was sex-specific, observing a significant association in men (OR 2.20; 95% CI 1.33–3.64) but not in women. Machine learning identified life satisfaction, smoking status, and sleep duration as the top predictors of frailty progression.

Conclusions

Frailty progression acts as a potent, sex-specific risk amplifier for advanced CKM syndrome. Integrating frailty screening into CKM care and targeting psychosocial well-being—specifically life satisfaction—alongside lifestyle factors may be important strategies to preempt frailty and potentially mitigate cardiovascular-renal-metabolic risks.

背景：虚弱动力学与新定义的心血管-肾-代谢（CKM）综合征之间的相互作用仍然知之甚少。我们的目的是量化虚弱转变与晚期CKM综合征发生风险之间的关系，并确定虚弱进展的可改变驱动因素。方法：利用中国健康与退休纵向研究（CHARLS）的数据，我们对8159名参与者进行了为期四年的横断面分析，并对3506名参与者进行了纵向分析。虚弱是用赤字积累指数来评估的。主要结局是普遍发生的晚期CKM综合征（3-4期）。我们采用多变量回归模型来评估相关性，并采用机器学习管道来识别衰弱进展的关键预测因素。结果：基线虚弱与普遍的晚期CKM呈强烈的剂量-反应关系（每增加0.1单位FI OR 1.44; 95% CI 1.38-1.51）。纵向上，与稳定的非虚弱的同龄人相比，进展到虚弱状态的个体发生晚期CKM的风险增加了40% （OR 1.40; 95% CI 1.01-1.94）。值得注意的是，这种风险是性别特异性的，在男性中观察到显著的相关性（OR 2.20; 95% CI 1.33-3.64），但在女性中没有。机器学习将生活满意度、吸烟状况和睡眠时间确定为虚弱进展的主要预测因素。结论：对于晚期CKM综合征，衰弱进展是一个强有力的、性别特异性的风险放大因素。将衰弱筛查纳入CKM护理，并将心理社会健康（特别是生活满意度）与生活方式因素结合起来，可能是预防衰弱和潜在地减轻心血管-肾脏代谢风险的重要策略。

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引用次数: 0

Clinical impact of cardiac ejection fraction and atrial fibrillation on elderly hemodialysis patients 心脏射血分数与心房颤动对老年血液透析患者的临床影响

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-09 DOI: 10.1016/j.archger.2026.106140

Da Woon Kim , Yu Ah Hong , Sung Joon Shin , Soon Hyo Kwon , Sungjin Chung , Young Youl Hyun , Byung Chul Yu , Jae Won Yang , Won Min Hwang , Jang-Hee Cho , Kyung Don Yoo , In O Sun , Gang-Jee Ko , Hyunsuk Kim , Woo Yeong Park , Eunjin Bae , Sang Heon Song

Background

This study aimed to investigate all-cause mortality in elderly patients starting hemodialysis (HD) according to left ventricular ejection fraction [LVEF] and atrial fibrillation (AF).

Methods

We analyzed 1,137 incident HD patients aged ≥70 years from a retrospective multicenter cohort of the Korean Society of Geriatric Nephrology. All-cause mortality was evaluated within the first 6 months and beyond 6 months using a landmark analysis (median follow-up, 3.7 years) according to LVEF and AF status. Sequential Cox proportional hazards models were applied, adjusted for demographic and clinical factors.

Results

Patients were classified into four groups according to LVEF (≥50% vs. <50%) and AF status. After full adjustment, neither reduced LVEF nor AF was independently associated with 6-month mortality. Early mortality was mainly associated with older age, lower serum albumin, and impaired mobility. In the 6-month landmark analysis, compared with patients with preserved LVEF and no AF, those with reduced LVEF without AF (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.01–1.65), preserved LVEF with AF (HR 1.35, 95% CI 1.02–1.80), and reduced LVEF with AF (HR 1.69, 95% CI 1.03–2.79) had progressively higher long-term mortality risks.

Conclusions

In elderly patients initiating HD, reduced LVEF and AF were independently associated with higher long-term mortality, whereas short-term mortality was predominantly driven by frailty and nutritional status rather than cardiac factors. These findings highlight the importance of time-specific risk stratification and integrated cardiovascular and geriatric management in this population.

本研究旨在根据左室射血分数（LVEF）和房颤（AF）调查老年血液透析（HD）患者的全因死亡率。方法：我们分析了1137例年龄≥70岁的HD患者，这些患者来自韩国老年肾病学会的回顾性多中心队列。根据LVEF和AF状态，采用里程碑式分析（中位随访3.7年）评估前6个月和6个月后的全因死亡率。采用顺序Cox比例风险模型，并根据人口学和临床因素进行调整。结果根据LVEF（≥50% vs. <50%）和AF状态将患者分为4组。完全调整后，LVEF和AF的降低与6个月死亡率均无独立相关性。早期死亡主要与年龄较大、血清白蛋白较低和活动能力受损有关。在6个月的里程碑式分析中，与LVEF保留但无房颤的患者相比，LVEF减少而无房颤的患者（风险比[HR] 1.29, 95%可信区间[CI] 1.01-1.65）、LVEF保留并房颤（风险比[HR] 1.35, 95% CI 1.02-1.80）和LVEF减少并房颤（风险比[HR] 1.69, 95% CI 1.03-2.79）的长期死亡风险逐渐升高。结论在老年HD患者中，LVEF和房颤降低与较高的长期死亡率独立相关，而短期死亡率主要由虚弱和营养状况驱动，而不是心脏因素。这些发现强调了在这一人群中进行时间特异性风险分层以及心血管和老年综合管理的重要性。

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引用次数: 0

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 : 2026-04-01 Epub 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

Hospitalisation trends for falls and facial fractures in elderly Australian: A national ecological analysis, from 2013–14 to 2022–23 澳大利亚老年人跌倒和面部骨折的住院趋势：2013-14年至2022-23年的全国生态分析。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-15 DOI: 10.1016/j.archger.2026.106147

Parmis Aminian, Max Eton, Marc Tennant, Estie Kruger

Objective

This study investigated national trends in fall- and facial fracture–related hospitalisations among Australians aged 65 years and over from 2013 to 14 to 2022–23, and examined the association between hospitalisation of specific facial fracture subtypes and fall rates.

Study Design

Ecological study using publicly available national hospitalisation data.

Methods

The dataset included all hospital admissions with a principal diagnosis of fall or facial fracture. Trends in hospitalisation rates were analysed using linear regression, and Pearson correlation was applied to assess associations between fall and facial fracture rates. Indexed trends and scatterplots were used to visualise temporal and population-level relationships.

Results

From 2013–14 to 2022–23, facial fracture hospitalisation rates among Australians aged 65+ increased from 55.7 to 84.4 per 100,000, while fall-related hospitalisations rose from 2891.5 to 3171.8 per 100,000. Although both trends were significant, facial fractures increased disproportionately faster than falls over the decade-long study period overall. Nasal fractures had the highest average rate (40.04 per 100,000) and mandibular fractures the lowest (5.17 per 100,000). Fall-related hospitalisation rates were 9.4 times higher in adults aged 85+ years than in those aged 65–69, while facial fracture rates were 6.6 times higher in the oldest group. Correlation analysis showed a strong positive association between fall-related and overall facial fracture hospitalisation rates across the study period. Reliance on principal diagnosis codes likely underestimated facial fractures.

Conclusions

Facial fracture hospitalisations among older Australians increased disproportionately compared with falls, underscoring the need for integrated prevention strategies in this ageing population.

目的：本研究调查了2013年至2014年至2022-23年期间，澳大利亚65岁及以上人群因跌倒和面部骨折住院的趋势，并研究了特定面部骨折亚型住院与跌倒率之间的关系。研究设计：生态学研究，使用可公开获得的国家住院数据。方法：数据集包括所有主要诊断为跌倒或面部骨折的住院患者。使用线性回归分析住院率的趋势，并应用Pearson相关性来评估跌倒与面部骨折率之间的关联。索引趋势和散点图用于可视化时间和人口水平的关系。结果：从2013-14年到2022-23年，澳大利亚65岁以上老年人面部骨折住院率从55.7 / 10万上升到84.4 / 10万，而与跌倒相关的住院率从2891.5 / 10万上升到3171.8 / 10万。尽管这两种趋势都很显著，但在长达十年的研究期间，面部骨折的增长速度比跌倒的增长速度要快得多。鼻骨折发生率最高（40.04 / 10万），下颌骨骨折发生率最低（5.17 / 10万）。与跌倒相关的住院率在85岁以上的成年人中是65-69岁人群的9.4倍，而面部骨折率在老年人群中是6.6倍。相关分析显示，在整个研究期间，与跌倒相关的面部骨折住院率与整体面部骨折住院率呈正相关。依赖主要诊断代码可能低估了面部骨折。结论：与跌倒相比，澳大利亚老年人面部骨折住院率不成比例地增加，强调了在这一老龄化人口中采取综合预防策略的必要性。

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引用次数: 0

Clinical outcomes and safety of SGLT2 inhibitors in the older population with heart failure: A systematic review and meta-analysis SGLT2抑制剂在老年心力衰竭患者中的临床结局和安全性：一项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 : 2026-04-01 Epub Date: 2026-01-09 DOI: 10.1016/j.archger.2026.106138

Ayan Khalid , Rahul Balach , Anas Rasool , Shaikh Muhammad Daniyal , Muhammad Taha Nizami , Isbah Gul , Ashmat Naqvi , Gregg C. Fonarow , Saad Ahmed Waqas

Background

Heart failure (HF) predominantly affects older adults, yet this group remains underrepresented in sodium–glucose cotransporter-2 inhibitor (SGLT2i) trials. Given their frailty and multimorbidity, clarifying the potential benefit and safety of SGLT2i in older HF patients is essential.

Methods

PubMed, ScienceDirect, and Cochrane Central were searched through August 2025 for randomized controlled trials (RCTs) and observational studies comparing SGLT2i with control in patients aged ≥65 years with HF. Hazard ratios (HRs), risk ratios (RRs), and mean differences (MDs) were pooled using random-effects models.

Results

Ten studies (4 RCTs, 6 cohorts; n = 20,844) were included. SGLT2i was associated with a lower hazard of all-cause mortality (HR 0.81 [95% CI 0.72–0.90]; p < 0.001), cardiovascular (CV) death (HR 0.83 [0.74–0.94]; p = 0.004), first HF hospitalization (HR 0.73 [0.66–0.80]; p < 0.001), composite CV death or HF hospitalization (HR 0.78 [0.70–0.87]; p < 0.001), and rehospitalization (HR 0.60 [0.53–0.69]; p < 0.001). SGLT2i lowered serious adverse events (RR 0.92 [0.89–0.95]; p < 0.001) and slowed renal function decline (MD 1.86 [1.15–2.58] mL/min/1.73 m² per year; p < 0.001). An increase was observed in genital (RR 3.07 [2.03–4.64]; p < 0.001) and urinary tract infections (RR 1.19 [1.03–1.38]; p = 0.02).

Conclusions

In older patients with HF, SGLT2i was associated with lower mortality and HF hospitalizations and with a slower renal decline, while largely maintaining a favorable safety profile. These findings support the consideration of SGLT2i as an important therapeutic option for older adults with HF.

心衰（HF）主要影响老年人，但这一群体在钠-葡萄糖共转运蛋白2抑制剂（SGLT2i）试验中的代表性仍然不足。考虑到老年心衰患者的脆弱性和多发病性，明确SGLT2i治疗老年心衰患者的潜在益处和安全性至关重要。方法检索spubmed、ScienceDirect和Cochrane Central截至2025年8月的随机对照试验（rct）和观察性研究，比较年龄≥65岁HF患者的SGLT2i和对照组。使用随机效应模型汇总风险比（hr）、风险比（rr）和平均差异（MDs）。结果共纳入10项研究（4项随机对照试验，6个队列，n = 20,844）。SGLT2i与全因死亡率（HR 0.81 [95% CI 0.72-0.90]; p < 0.001）、心血管（CV）死亡（HR 0.83 [0.74-0.94]; p = 0.004）、首次HF住院（HR 0.73 [0.66-0.80]; p < 0.001）、复合CV死亡或HF住院（HR 0.78 [0.70-0.87]; p < 0.001）和再住院（HR 0.60 [0.53-0.69]; p < 0.001）的风险较低相关。SGLT2i降低严重不良事件（RR 0.92 [0.89-0.95]; p < 0.001），减缓肾功能下降（MD 1.86 [1.15-2.58] mL/min/1.73 m²/年；p < 0.001）。生殖器感染（RR = 3.07 [2.03-4.64]; p < 0.001）和尿路感染（RR = 1.19 [1.03-1.38]; p = 0.02）增加。结论：在老年HF患者中，SGLT2i与较低的死亡率和HF住院率以及较慢的肾功能下降相关，同时在很大程度上保持了良好的安全性。这些发现支持SGLT2i作为老年心衰患者重要治疗选择的考虑。

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引用次数: 0

The impact of childhood conditions and lifestyles on depression trajectories in older adults: a latent growth model approach 童年条件和生活方式对老年人抑郁轨迹的影响：一种潜在增长模型方法。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-24 DOI: 10.1016/j.archger.2026.106154

Cindy Xinshan Jia , Wenjin Wang , Li Li

Objectives

The current study explored how childhood conditions influence the trajectory of depression in older adults, with a focus on the mediating roles of health-related and social lifestyle factors.

Methods

Longitudinal data were drawn from the 2018, 2020, and 2022 waves of the China Family Panel Studies. It comprised 2, 878 older adults aged 60 or older. Latent growth modeling was used to assess the effects of childhood conditions on baseline levels and changes in depression over time, as well as the mediating roles of lifestyle.

Results

Poor childhood health and lower family status were associated with higher baseline levels of depressive symptoms. Health-promoting and social lifestyle factors, particularly connectedness with children and regular physical activity, were linked to lower initial depression levels, whereas smoking was associated with a faster increase in depressive symptoms over time. In addition, connectedness with children partially mediated the association between childhood health and baseline depression.

Conclusion

The findings address the long-term impact of childhood conditions on depression in later life and highlight the protective role of favorable social and health-promoting lifestyles. Suggestions for targeted policies and interventions to support the mental well-being of aging populations were discussed.

目的：本研究探讨了童年条件如何影响老年人抑郁的发展轨迹，重点关注健康相关和社会生活方式因素的中介作用。方法：从2018年、2020年和2022年的中国家庭面板研究中抽取纵向数据。调查对象包括2878名60岁以上的老年人。潜在生长模型被用来评估儿童时期条件对基线水平的影响，以及随着时间的推移抑郁的变化，以及生活方式的中介作用。结果：儿童期健康状况不佳和家庭地位较低与较高的抑郁症状基线水平相关。促进健康和社会生活方式的因素，特别是与儿童和定期体育活动的联系，与较低的初始抑郁水平有关，而吸烟与抑郁症状随着时间的推移增加得更快有关。此外，与儿童的联系部分介导了儿童健康与基线抑郁之间的关联。结论：研究结果揭示了童年条件对日后抑郁的长期影响，并强调了良好的社会和促进健康的生活方式的保护作用。讨论了支持老龄人口心理健康的针对性政策和干预措施建议。

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引用次数: 0