Archives of gerontology and geriatrics最新文献_第4页

An overview of care coordination elements for older adults with long-term care needs: A narrative review 有长期护理需要的老年人护理协调要素综述：一篇叙述性综述

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-11-03 DOI: 10.1016/j.archger.2025.106077

Natasha Grande de França , Philipe de Souto Barreto , Hyobum Jang , Matteo Cesari , Yves Rolland

Aims

Care coordination is crucial in long-term care (LTC) as it contributes to patient-centered, high-value, and high-quality care. This review presents an overview of how care coordination for older adults with long-term needs is described in the literature.

Methods

This narrative review focused on older adults receiving LTC in institutional settings and the community. A comprehensive and structured search was conducted in PubMed in January 2025 using a combination of key and indexed terms related to care coordination, long-term care, and older adults.

Results

We retained 56 articles published between 1988 and 2024. Most of the information was from North American programs designed for community-dwelling older persons. Description of care coordination is lacking in middle and low-income countries, with limited information on institutional settings. Coordination is commonly performed by a designated health or social worker, responsible for assessing, developing, and monitoring the care plan with the support of a multidisciplinary team (not always including a geriatrician) and electronic health records. Care coordination can be challenging to translate into practice, mainly due to limited time availability and a lack of specific training. Communication across care settings and among the staff is frequently fragmented, partial, and unstandardized.

Conclusions

Care systems for older persons living in the community seem to apply fundamental elements of care coordination. However, their implementation in real life is challenging. The current information on care coordination is not well-documented at the global level, especially in LTC facilities, highlighting the need for more attention to this aspect of care.

AimsCare协调在长期护理（LTC）中至关重要，因为它有助于以患者为中心，高价值和高质量的护理。本文综述了文献中对有长期需要的老年人护理协调的描述。方法本综述主要关注在机构和社区接受LTC治疗的老年人。我们于2025年1月在PubMed上进行了一次全面的结构化搜索，使用了与护理协调、长期护理和老年人相关的关键和索引术语的组合。结果保留了1988 ~ 2024年间发表的56篇文献。大部分信息来自北美为居住在社区的老年人设计的项目。中低收入国家缺乏对护理协调的描述，关于机构设置的信息有限。协调工作通常由指定的卫生工作者或社会工作者进行，负责在多学科团队（不总是包括老年病专家）和电子健康记录的支持下评估、制定和监测护理计划。将护理协调转化为实践可能具有挑战性，主要是由于可用时间有限和缺乏具体培训。护理机构之间和工作人员之间的沟通往往是碎片化的、局部的和不标准化的。结论社区老年人护理系统似乎应用了护理协调的基本要素。然而，它们在现实生活中的实现是具有挑战性的。目前关于护理协调的信息在全球范围内，特别是在LTC设施中，没有得到充分的记录，这突出表明需要更多地关注这方面的护理。

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引用次数: 0

Exercise upregulates Mitsugumin 53 and ameliorates behavioral deficits and mitochondrial biogenesis in a sporadic Alzheimer's disease model in rats 在散发性阿尔茨海默病模型大鼠中，运动上调mitsugumin53并改善行为缺陷和线粒体生物发生

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-11-03 DOI: 10.1016/j.archger.2025.106078

Muaz Belviranlı, Nilsel Okudan, Tuğba Sezer

Chronic physical exercise is a promising non-pharmacological strategy to mitigate the progression of Alzheimer's disease (AD), yet the underlying molecular mechanisms remain incompletely understood. This study investigated the effects of chronic treadmill exercise on behavioral deficits and key molecular pathways in a d-galactose and AlCl₃-induced rat model of sporadic AD. Animals were assigned to control, AD, exercise and AD + exercise (AE) groups for a ten-week intervention. Behavioral assessments included the elevated plus maze and Morris Water Maze, followed by molecular and biochemical analyses (RT-qPCR, ELISA) of the hippocampus, skeletal muscle, and plasma. Our results demonstrate that the AD model induced profound cognitive impairments, diminished locomotor activity, heightened anxiety-like behavior, and elevated plasma tau levels. These pathological changes were accompanied by a significant downregulation of the AMPK/SIRT1/PGC-1α mitochondrial biogenesis pathway and, notably, a marked suppression of the membrane repair protein Mitsugumin 53 (MG53) in both the hippocampus and skeletal muscle. The physical exercise regimen successfully ameliorated these behavioral deficits and normalized plasma tau. Mechanistically, physical exercise potently upregulated the AMPK/PGC-1α/FNDC5/BDNF axis in both central and peripheral tissues. Crucially, this study reveals for the first time that physical exercise also triggers a robust upregulation of MG53 at both the gene and protein levels in the brain, muscle, and circulation. These findings identify the physical exercise-induced mobilization of MG53 as a novel and powerful neuroprotective mechanism, linking systemic cellular repair capacity to the enhancement of cognitive resilience against AD.

慢性体育锻炼是缓解阿尔茨海默病（AD）进展的一种有希望的非药物策略，但其潜在的分子机制仍未完全了解。本研究探讨了慢性跑步机运动对d-半乳糖和alcl3诱导的散发性AD大鼠模型的行为缺陷和关键分子通路的影响。将动物分为对照组、AD、运动组和AD +运动（AE）组，进行为期10周的干预。行为学评估包括升高+迷宫和Morris水迷宫，随后进行海马、骨骼肌和血浆的分子和生化分析（RT-qPCR， ELISA）。我们的研究结果表明，AD模型引起了严重的认知障碍，运动活动减少，焦虑样行为增加，血浆tau水平升高。这些病理变化伴随着AMPK/SIRT1/PGC-1α线粒体生物发生途径的显著下调，值得注意的是，海马和骨骼肌中膜修复蛋白mitsugumin53 （MG53）的显著抑制。体育锻炼方案成功地改善了这些行为缺陷并使血浆tau正常化。在机制上，体育锻炼可以有效上调中枢和外周组织的AMPK/PGC-1α/FNDC5/BDNF轴。至关重要的是，这项研究首次揭示了体育锻炼也会在大脑、肌肉和血液循环中的基因和蛋白质水平上触发MG53的强烈上调。这些发现确定了体育锻炼诱导的MG53动员是一种新的强大的神经保护机制，将全身细胞修复能力与增强对AD的认知恢复力联系起来。

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引用次数: 0

Vitality in older adults: A state-of-the-science review 老年人的活力：一项最新科学综述

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-11-02 DOI: 10.1016/j.archger.2025.106072

Ilana I. Logvinov, Victoria Loerzel

Vitality is increasingly recognized as a multidimensional biophysiological state influenced by physical, emotional, cognitive, social, and subjective factors. However, there is no consensus on its definition, and existing nursing theories and related constructs, such as quality of life and functional status, fail to fully capture its complexity. This state-of-the-science review synthesized findings from 35 research studies to examine how vitality is defined, assessed, and influenced in older adults. The review identified significant variability in measurement tools, with most instruments assessing only one or two domains of vitality. Key findings indicate that low-intensity physical activities, psychological well-being, social engagement, and good physical health enhance vitality, while chronic illness, isolation, and mental health challenges diminish it. Notable gaps include the lack of culturally inclusive research and inadequate integration of older adults’ perspectives. These findings underscore the need for a unified conceptual framework and comprehensive assessment tools that reflect the perceptions and experiences of older adults and support person-centered interventions to promote healthy aging.

活力越来越被认为是一种受身体、情感、认知、社会和主观因素影响的多维生物生理状态。然而，对其定义尚未达成共识，现有的护理理论和相关结构，如生活质量和功能状态，未能充分反映其复杂性。这篇最新的科学综述综合了35项研究的结果，探讨了老年人的活力是如何定义、评估和影响的。该综述确定了测量工具的显著可变性，大多数仪器仅评估一个或两个活力领域。主要研究结果表明，低强度的体育活动、心理健康、社会参与和良好的身体健康可以增强活力，而慢性疾病、孤立和心理健康挑战则会削弱活力。值得注意的差距包括缺乏文化包容性研究和老年人观点的不充分整合。这些发现强调需要一个统一的概念框架和综合评估工具，以反映老年人的看法和经验，并支持以人为本的干预措施，以促进健康老龄化。

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引用次数: 0

Non-pharmacological interventions for preventing delirium in older adults in intensive care units: a systematic review and network meta-analysis 非药物干预预防重症监护病房老年人谵妄：系统回顾和网络荟萃分析

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-11-02 DOI: 10.1016/j.archger.2025.106075

Hu Lizi, Wang Qingyuan, Wang Shuyao, Wang Dan, Hua Kang

Objective

This study compares the effects of non-pharmacological interventions on delirium incidence and other outcomes in elderly patients in ICU.

Methods

A comprehensive search of eight electronic databases to identify randomized controlled trials (RCTs). The search covered studies from the inception to June 2024. Two reviewers independently screened titles and abstracts according to pre-defined inclusion and exclusion criteria. The analysis was conducted using Stata (version 15.0).

Results

A total of 38 studies involving 7229 critically ill patients and 12 interventions were included. While the network meta-analysis results suggest that nurse-led cluster nursing is the superior intervention for reducing delirium incidence (SUCRA=80.5 %), delirium duration (SUCRA=92.2 %), and mechanical ventilation duration (SUCRA=84.4 %) in elderly patients, it’s important to note that physical exercise (SUCRA=92.9 %) and cluster care (SUCRA=82.4 %) also demonstrated significant effects in decreasing ICU stay duration. However, these findings should be approached with caution.

Conclusion

Our findings indicated that nurse-led cluster nursing showed reliable performance in managing outcome indicators of delirium in the elderly. Our study provides important evidence for clinical medical staff to optimize intensive care programs, but the results should be interpreted with caution.

目的比较非药物干预对ICU老年患者谵妄发生率及其他预后的影响。方法综合检索8个电子数据库，筛选随机对照试验（rct）。搜索涵盖了从开始到2024年6月的研究。两位审稿人根据预先定义的纳入和排除标准独立筛选标题和摘要。使用Stata（15.0版本）进行分析。结果共纳入38项研究，7229例危重患者，12项干预措施。网络荟萃分析结果显示，在降低老年患者谵妄发生率（SUCRA= 80.5%）、谵妄持续时间（SUCRA= 92.2%）和机械通气持续时间（SUCRA= 84.4%）方面，护士主导的集群护理是更优的干预措施，值得注意的是，体育锻炼（SUCRA= 92.9%）和集群护理（SUCRA= 82.4%）在减少ICU住院时间方面也有显著效果。然而，这些发现应该谨慎对待。结论护士主导的集群护理对老年人谵妄结局指标的管理具有可靠的效果。本研究为临床医护人员优化重症监护方案提供了重要依据，但结果应谨慎解读。

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引用次数: 0

Association between obesity and the transitions of frailty based on multi-state Markov model: A prospective study 基于多态马尔可夫模型的肥胖与虚弱转变的关联：一项前瞻性研究。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-11-02 DOI: 10.1016/j.archger.2025.106074

Bosen Lv , Xiaohui Li , Qianning Lu , Xiangjie Kong , Bixuan Liu , Yan Wu , Liying Jing , Jingyi Wang , Wenjing Feng , Yili Wu

Background

New evidence has revealed the dynamic transition characteristics of frailty. However, the potential differences in the effects of different types of obesity on the transition of frailty remain unclear. This prospective study aims to assess the association between obesity-related indicators and frailty transition in older adults.

Methods

This study included 2375 individuals aged ≥60, excluding underweight ones from the English Longitudinal Study of Aging (ELSA) 2008–2016. Frailty was assessed via a 60-item frailty index. Obesity was rated by 4 indicators including body mass index (BMI), waist circumference (WC), conicity index, and body roundness index (BRI). Using multi-state Markov model to evaluate how the obesity affected the probability of frailty state transitions.

Results

During 8 years follow-up, 2517 frailty transitions were observed, with 1484 worsening and 1033 improving. Compared with normal participants, people with obesity were linked to higher risks of deterioration (non-frail to pre-frail: HR_BMI=1.32, 95 % CI=1.07–1.63, HR_WC=1.16, 95 % CI=1.00–1.35; pre-frail to frail: HR_BMI=1.90, CI=1.30–2.78; HR_WC=1.36, 95 % CI=1.03–1.81) and reduced likelihood of recovery (pre-frail to non-frail: HR_BMI=0.52, CI=0.40–0.67, HR_WC=0.66, CI=0.55–0.80). Compared with the low tertiles, the high tertiles of conicity index or BRI similarly accelerated the deterioration (non-frail to pre-frail: HR_{conicity index}=1.29, 95 % CI=1.04–1.59, HR_BRI=1.45, 95 % CI=1.20–1.76; pre-frail to frail: HR_BRI=1.58, 95 % CI=1.13–2.20) and hindered the recovery (pre-frail to non-frail: HR_{conicity index}=0.67, 95 % CI=0.53–0.84, HR_BRI=0.57, 95 % CI=0.46–0.72).

Conclusions

Different types of obesity all show that they accelerate the deterioration of frailty and hinder their ability to recover from frailty among older adults in UK.

背景：新的证据揭示了脆弱性的动态转变特征。然而，不同类型的肥胖对虚弱转变的影响的潜在差异仍不清楚。本前瞻性研究旨在评估老年人肥胖相关指标与虚弱转变之间的关系。方法：本研究纳入2375名年龄≥60岁的个体，不包括2008-2016年英国老龄化纵向研究（ELSA）中体重过轻的个体。虚弱程度通过60项虚弱指数进行评估。采用体重指数（BMI）、腰围指数（WC）、圆度指数（conicity index）、体圆度指数（BRI） 4项指标评价肥胖程度。利用多态马尔可夫模型评价肥胖对脆弱状态转变概率的影响。结果：在8年的随访中，观察到2517例虚弱转变，其中1484例恶化，1033例改善。与正常参与者相比，肥胖的人有更高的恶化风险（非体弱到体弱前期：HRBMI=1.32, 95% CI=1.07-1.63， HRWC=1.16, 95% CI=1.00-1.35；体弱前期到体弱：HRBMI=1.90， CI=1.30-2.78； HRWC=1.36, 95% CI=1.03-1.81）和更低的恢复可能性（体弱前期到体弱：HRBMI=0.52， CI=0.40-0.67， HRWC=0.66， CI=0.55-0.80）。与低三分位相比，高三分位或BRI同样加速了恶化（非虚弱到前期虚弱：HRconicity指数=1.29,95% CI=1.04 ~ 1.59， HRBRI=1.45, 95% CI=1.20 ~ 1.76；前期虚弱到前期虚弱：HRBRI=1.58, 95% CI=1.13 ~ 2.20），阻碍了恢复（前期虚弱到非虚弱：HRconicity指数=0.67,95% CI=0.53 ~ 0.84， HRBRI=0.57, 95% CI=0.46 ~ 0.72）。结论：在英国的老年人中，不同类型的肥胖都表明它们加速了虚弱的恶化，阻碍了他们从虚弱中恢复的能力。

{"title":"Association between obesity and the transitions of frailty based on multi-state Markov model: A prospective study","authors":"Bosen Lv , Xiaohui Li , Qianning Lu , Xiangjie Kong , Bixuan Liu , Yan Wu , Liying Jing , Jingyi Wang , Wenjing Feng , Yili Wu","doi":"10.1016/j.archger.2025.106074","DOIUrl":"10.1016/j.archger.2025.106074","url":null,"abstract":"<div><h3>Background</h3><div>New evidence has revealed the dynamic transition characteristics of frailty. However, the potential differences in the effects of different types of obesity on the transition of frailty remain unclear. This prospective study aims to assess the association between obesity-related indicators and frailty transition in older adults.</div></div><div><h3>Methods</h3><div>This study included 2375 individuals aged ≥60, excluding underweight ones from the English Longitudinal Study of Aging (ELSA) 2008–2016. Frailty was assessed via a 60-item frailty index. Obesity was rated by 4 indicators including body mass index (BMI), waist circumference (WC), conicity index, and body roundness index (BRI). Using multi-state Markov model to evaluate how the obesity affected the probability of frailty state transitions.</div></div><div><h3>Results</h3><div>During 8 years follow-up, 2517 frailty transitions were observed, with 1484 worsening and 1033 improving. Compared with normal participants, people with obesity were linked to higher risks of deterioration (non-frail to pre-frail: <em>HR</em><sub>BMI</sub>=1.32, 95 % <em>CI</em>=1.07–1.63, <em>HR</em><sub>WC</sub>=1.16, 95 % <em>CI</em>=1.00–1.35; pre-frail to frail: <em>HR</em><sub>BMI</sub>=1.90, <em>CI</em>=1.30–2.78; <em>HR</em><sub>WC</sub>=1.36, 95 % <em>CI</em>=1.03–1.81) and reduced likelihood of recovery (pre-frail to non-frail: <em>HR</em><sub>BMI</sub>=0.52, <em>CI</em>=0.40–0.67, <em>HR</em><sub>WC</sub>=0.66, <em>CI</em>=0.55–0.80). Compared with the low tertiles, the high tertiles of conicity index or BRI similarly accelerated the deterioration (non-frail to pre-frail: <em>HR</em><sub>conicity index</sub>=1.29, 95 % <em>CI</em>=1.04–1.59, <em>HR</em><sub>BRI</sub>=1.45, 95 % <em>CI</em>=1.20–1.76; pre-frail to frail: <em>HR</em><sub>BRI</sub>=1.58, 95 % <em>CI</em>=1.13–2.20) and hindered the recovery (pre-frail to non-frail: <em>HR</em><sub>conicity index</sub>=0.67, 95 % <em>CI</em>=0.53–0.84, <em>HR</em><sub>BRI</sub>=0.57, 95 % <em>CI</em>=0.46–0.72).</div></div><div><h3>Conclusions</h3><div>Different types of obesity all show that they accelerate the deterioration of frailty and hinder their ability to recover from frailty among older adults in UK.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106074"},"PeriodicalIF":3.8,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491205","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

Nutritional status and frailty in rheumatoid arthritis: A multicenter observational study (T-FLAG) 类风湿性关节炎的营养状况和虚弱：一项多中心观察性研究（T-FLAG）。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-11-02 DOI: 10.1016/j.archger.2025.106073

Mochihito Suzuki , Shuji Asai , Yoshifumi Ohashi , Yasumori Sobue , Kenya Terabe , Shiro Imagama

Objective

Frailty is a relevant clinical issue in rheumatoid arthritis (RA) patients, particularly as the population ages. Malnutrition, decreased physical function, and a loss of social connections are key contributors to frailty. This study aimed to investigate the association of nutritional status with frailty in RA patients, with a focus on physical function and social frailty.

Methods

This cross-sectional study examined RA patients from a multicenter cohort at three hospitals. Nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI). Frailty was defined using the Kihon Checklist, physical function using the Health Assessment Questionnaire Disability Index (HAQ-DI), and social frailty using the Makizako Social Frailty Index. Multivariate logistic regression was performed to identify independent associations with frailty.

Results

A total of 667 patients were included (median age, 72 years; 73 % women). Frailty prevalence increased progressively with worsening nutritional status (GNRI), from 29.6 % in the no risk group to 66.7 % in the major risk group (P < 0.001). In multivariate models, GNRI and social frailty were significantly associated with frailty. This association, however, was no longer significant after adjusting for HAQ-DI, suggesting that physical function may influence this relationship. Stratified analysis confirmed that poor nutritional status was associated with increased frailty prevalence even among patients in HAQ remission (HAQ-DI ≤0.5).

Conclusion

Nutritional status is associated with frailty in RA patients, and this association may be influenced by physical function. A multidimensional approach addressing nutrition, physical function, and social factors is warranted in RA management.

目的：虚弱是类风湿性关节炎（RA）患者的一个相关临床问题，特别是随着人口老龄化。营养不良、身体机能下降和失去社会联系是导致身体虚弱的主要因素。本研究旨在探讨RA患者的营养状况与虚弱的关系，重点关注身体功能和社交虚弱。方法：本横断面研究调查了来自三家医院的多中心队列RA患者。采用老年营养风险指数（GNRI）评估营养状况。虚弱用Kihon检查表定义，身体功能用健康评估问卷残疾指数（HAQ-DI）定义，社会虚弱用Makizako社会虚弱指数定义。进行多变量逻辑回归以确定与虚弱的独立关联。结果：共纳入667例患者（中位年龄72岁，73%为女性）。随着营养状况（GNRI）的恶化，虚弱患病率逐渐增加，从无危险组的29.6%增加到主要危险组的66.7% （P < 0.001）。在多元模型中，GNRI和社会脆弱性与脆弱性显著相关。然而，在调整HAQ-DI后，这种关联不再显著，这表明身体功能可能影响这种关系。分层分析证实，即使在HAQ缓解（HAQ- di≤0.5）的患者中，营养状况不良也与虚弱患病率增加有关。结论：RA患者的营养状况与虚弱相关，这种关联可能受身体功能的影响。在类风湿性关节炎的管理中，需要从营养、身体功能和社会因素三个方面入手。

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引用次数: 0

SGLT2 inhibitors versus DPP-4 inhibitors and dementia risk in type 2 diabetes: A meta-analysis of cohort studies SGLT2抑制剂与DPP-4抑制剂与2型糖尿病痴呆风险：队列研究的荟萃分析

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-10-28 DOI: 10.1016/j.archger.2025.106065

Zhaoshuang Zhong , Shijie Zhao , Wei He , Rongmei Li , Shuyue Xia

Background

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown neuroprotective potential. This meta-analysis aimed to compare the effects of SGLT2 inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors on dementia risk in patients with type 2 diabetes mellitus (T2DM).

Methods

A systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science was conducted from inception through May 2025. Cohort studies comparing dementia incidence in T2DM patients treated with SGLT2 inhibitors versus DPP-4 inhibitors were included. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Data were pooled using a random-effects model in STATA 12.0, with incidence rate ratios (IRRs) and 95 % confidence intervals (CIs) calculated for dementia outcomes.

Results

Eight cohort studies (1275,257 participants) were analyzed. SGLT2 inhibitor use was associated with a 33 % lower risk of all-cause dementia compared to DPP-4 inhibitors (I² = 0.0 %, P = 0.816; IRR = 0.666; 95 % CI: 0.484–0.918; P < 0.05). Subgroup analyses indicated non-significant risk reductions for Alzheimer’s disease (I² = 0.0 %, P = 0.994; IRR = 0.654; 95 % CI: 0.352–1.212; P = 0.177) and vascular dementia (I² = 0.0 %, P = 0.971; IRR = 0.573; 95 % CI: 0.204–1.605; P = 0.289).

Conclusions

SGLT2 inhibitors are associated with a significantly reduced risk of all-cause dementia in T2DM patients compared to DPP-4 inhibitors. While trends favoring SGLT2 inhibitors were observed for dementia subtypes, further long-term studies are needed to confirm these associations.

背景：钠-葡萄糖共转运蛋白2 （SGLT2）抑制剂显示出神经保护潜力。本荟萃分析旨在比较SGLT2抑制剂和二肽基肽酶-4 （DPP-4）抑制剂对2型糖尿病（T2DM）患者痴呆风险的影响。方法：系统检索PubMed、EMBASE、Cochrane Library和Web of Science，检索时间从成立到2025年5月。比较SGLT2抑制剂与DPP-4抑制剂治疗的T2DM患者痴呆发病率的队列研究被纳入。采用纽卡斯尔-渥太华量表（NOS）评估研究质量。使用STATA 12.0中的随机效应模型汇总数据，计算痴呆结局的发病率比（IRRs）和95%置信区间（ci）。结果：对8项队列研究（1275,257名参与者）进行了分析。与DPP-4抑制剂相比，使用SGLT2抑制剂可使全因痴呆的风险降低33% （I²= 0.0%,P = 0.816; IRR = 0.666; 95% CI: 0.484-0.918; P < 0.05）。亚组分析显示，阿尔茨海默病（I²= 0.0%,P = 0.994; IRR = 0.654; 95% CI: 0.352-1.212; P = 0.177）和血管性痴呆（I²= 0.0%,P = 0.971; IRR = 0.573; 95% CI: 0.204-1.605; P = 0.289）的风险无显著降低。结论：与DPP-4抑制剂相比，SGLT2抑制剂与T2DM患者全因痴呆风险显著降低相关。虽然在痴呆亚型中观察到倾向于使用SGLT2抑制剂的趋势，但需要进一步的长期研究来证实这些关联。

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引用次数: 0

Targeting α7nAChR mitigates vascular aging and endothelial cell senescence through inhibiting oxidative stress and inflammation via α7nAChR/Nrf2/HO-1 signaling pathway 以α7nAChR为靶点，通过α7nAChR/Nrf2/HO-1信号通路抑制氧化应激和炎症，减轻血管老化和内皮细胞衰老。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-10-28 DOI: 10.1016/j.archger.2025.106064

Rui Ma , Yawen Zhang , Wencheng Wang , Qian Deng , Chi Cao , Shulin Li , Lei Shi , Chunyang Yu , Yinhua Yu , Jianying Tian

Vascular aging is recognized as critical factor contributing to the onset and progression of cardiovascular diseases, which represent a leading cause of morbidity and mortality worldwide. The α7 nicotinic acetylcholine receptor (α7nAChR) exhibits widespread expressed in the cardiovascular system and is intricately linked to a diverse array of pathologies, in cardiovascular, conditions. Research indicates that oxidative stress plays a crucial role in exacerbating endothelial dysfunction and promoting vascular aging. However, less is known regarding the role of α7nAChR in vascular aging. In this study, we employed a combination of cellular experiments, animal models, and molecular biological techniques, utilizing an agonist (PNU282987) and antagonists (Malondialdehyde, MLA) of α7nAChR as pharmacological tools to investigate the role of α7nAChR in aging-related pathologies. The expression of α7nAChR in vascular tissue decreases with age both in rats and humans. Activation of α7nAChR alleviated vascular aging in aged rats, as evidenced by improving endothelium-dependent vasodilatation and endothelial continuity, decreased senescence-associated β-galactosidase activity, phosphorylation of H2A.X^Ser139, expression of p21 and p16INK4a and inflammation, Notably, effective activation of the α7nAChR mediated Nrf2/HO-1 signaling pathway and antioxidant activity by specific agonist, PNU282987, conversely, which were blocked by the α7nAChR-selective inhibitor MLA. The findings highlight the vital role of α7nAChR receptor in preserving vascular health and endothelial integrity in the development of vascular aging, Consequently, targeting the α7nAChR/Nrf2/HO-1 signaling pathway could serve as a potential therapeutic approach for the development of novel anti-aging strategies.

血管老化被认为是导致心血管疾病发生和发展的关键因素，心血管疾病是世界范围内发病率和死亡率的主要原因。α7烟碱乙酰胆碱受体（α7nAChR）在心血管系统中广泛表达，并与多种心血管疾病有着复杂的联系。研究表明，氧化应激在加剧内皮功能障碍和促进血管老化中起着至关重要的作用。然而，α7nAChR在血管衰老中的作用尚不清楚。在本研究中，我们采用细胞实验、动物模型和分子生物学技术相结合的方法，利用α7nAChR的激动剂（PNU282987）和拮抗剂（Malondialdehyde， MLA）作为药理学工具，研究α7nAChR在衰老相关病理中的作用。大鼠和人血管组织中α7nAChR的表达均随年龄增长而降低。α7nAChR的激活可缓解老年大鼠血管老化，其表现为改善内皮依赖性血管舒张和内皮连续性，降低衰老相关β-半乳糖苷酶活性和H2A磷酸化。值得注意的是，特异性激动剂PNU282987有效激活α7nAChR介导的Nrf2/HO-1信号通路和抗氧化活性，而这被α7nAChR选择性抑制剂MLA阻断。研究结果表明，α7nAChR受体在维持血管健康和血管内皮完整性方面发挥着重要作用，因此，靶向α7nAChR/Nrf2/HO-1信号通路可能是开发新型抗衰老策略的潜在治疗途径。

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引用次数: 0

Effects of branched-chain amino acid-rich nutritional supplements combined with resistance training on body composition and body function in older patients with sarcopenia 富支链氨基酸营养补充剂联合抗阻训练对老年肌少症患者体成分和机体功能的影响

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-10-27 DOI: 10.1016/j.archger.2025.106063

Haoran Li , Runfa Zhang , Yongye Ma , Jiaxin He , Guoxing Li , Jian Sun , DuanyingLi

Background

Sarcopenia impairs self-care ability in older adults. While branched-chain amino acids (BCAAs)/leucine enhance muscle protein synthesis and resistance training promotes muscle growth, the combined effect on sarcopenia remains unclear. This meta-analysis evaluates whether combining resistance training with BCAA-rich supplements synergistically improves body composition and function in sarcopenic elders.

Methods

We systematically searched four databases and analyzed outcomes using Stata 18.0. Standardized mean differences (SMDs) were calculated via random-effects models.

Results

Twelve randomized trials (n = 459) were included. Only skeletal muscle index significantly improved with combined intervention vs. control (SMD = 0.337, 95 % CI [0.035,0.639], p = 0.029). No significant differences were found in: hand grip strength (SMD = 0.289, p = 0.080), 30-s chair stand (SMD = -0.794, p = 0.169), SPPB (SMD = -0.321, p = 0.124), walking speed (SMD = 0.344, p = 0.283), knee extension strength (SMD = 0.332,p = 0.328), total lean mass (SMD = 0.024, p = 0.908), or fat mass (SMD = -0.036, p = 0.866; all p > 0.05).

Conclusion

BCAA supplementation post-resistance training only increased skeletal muscle index in older adults, without improving other functional or body composition outcomes.

背景：骨骼肌减少症损害老年人的自我照顾能力。支链氨基酸(BCAAs)/亮氨酸促进肌肉蛋白质合成，抗阻训练促进肌肉生长，但对肌肉减少症的联合作用尚不清楚。这项荟萃分析评估了将抗阻训练与富含支链氨基酸的补充剂结合是否能协同改善肌肉减少症老年人的身体成分和功能。方法系统检索4个数据库，采用Stata 18.0软件对结果进行分析。标准化平均差异（SMDs）通过随机效应模型计算。结果纳入12项随机试验（n = 459）。联合干预组仅骨骼肌指数较对照组有显著改善（SMD = 0.337, 95% CI [0.035,0.639], p = 0.029）。在握力（SMD = 0.289, p = 0.080）、30-s椅架（SMD = -0.794, p = 0.169）、SPPB （SMD = -0.321, p = 0.124）、步行速度（SMD = 0.344, p = 0.283）、膝关节伸展力（SMD = 0.332,p = 0.328）、总瘦质量（SMD = 0.024, p = 0.908）、脂肪质量（SMD = -0.036, p = 0.866，均p >； 0.05）方面无显著差异。结论：抗阻训练后补充bcaa仅增加老年人骨骼肌指数，未改善其他功能或身体组成结果。

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引用次数: 0

Engagement in cognitive activities and risk of loneliness: A longitudinal study among Japanese older adults 参与认知活动与孤独风险：日本老年人的一项纵向研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-10-25 DOI: 10.1016/j.archger.2025.106061

Fumio Sakimoto , Takehiko Doi , Sho Nakakubo , Soichiro Matsuda , Hiroyuki Shimada

Background

Loneliness is a growing public health concern due to its association with adverse health outcomes in older adults. Research on the relationship between participation in cognitive activities and the alleviation of loneliness remains limited. This study examined longitudinal associations between engagement in cognitive activities and the onset of loneliness among community-dwelling older adults in Japan.

Methods

The prospective cohort initially included 5563 older adults. After excluding participants with baseline loneliness or missing data, 2317 participants (mean age 73.5 ± 5.4 years; 58.1 % women) were analyzed and followed for 36.7 ± 2.3 months. Loneliness was assessed using the UCLA Loneliness Scale. Six cognitive activities were evaluated: reading, keeping a diary, solving crossword puzzles, playing board games, participating in group discussions, and playing musical instruments. Logistic regression, adjusted for demographic, lifestyle, health, and cognitive covariates, examined associations of individual activities and total activity frequency with the onset of loneliness.

Results

During follow-up, 574 participants (24.8 %) developed loneliness. Reading (OR = 0.61, 95 % CI = 0.41–0.91, p = .01) and participating in group discussions (OR = 0.63, 95 % CI = 0.51–0.77, p < .001) were significantly associated with a reduced risk of loneliness. Frequent engagement in other cognitive activities was not associated with lower loneliness.

Conclusions and implications

Engagement in specific cognitive activities was associated with lower odds of loneliness. These findings suggest that it may be important to consider not only the frequency of cognitive activities but also their specific characteristics and qualities.

孤独感与老年人的不良健康结果相关，已成为一个日益严重的公共卫生问题。参与认知活动与减轻孤独感之间的关系研究仍然有限。本研究调查了日本社区居住的老年人参与认知活动和孤独感之间的纵向联系。前瞻性队列研究最初包括5563名老年人。在排除基线孤独或缺失数据的参与者后，对2317名参与者（平均年龄73.5±5.4岁，58.1%为女性）进行了分析，随访36.7±2.3个月。孤独感采用加州大学洛杉矶分校孤独感量表进行评估。研究人员评估了六项认知活动：阅读、写日记、填字游戏、玩棋盘游戏、参加小组讨论和演奏乐器。经人口统计学、生活方式、健康和认知协变量调整后，Logistic回归检验了个体活动和总活动频率与孤独感发生的关系。结果随访期间，574名参与者（24.8%）出现孤独感。阅读（OR = 0.61, 95% CI = 0.41-0.91, p = 0.01）和参与小组讨论（OR = 0.63, 95% CI = 0.51-0.77, p < 0.001）与降低孤独感风险显著相关。频繁参与其他认知活动与孤独感的降低无关。结论和启示参与特定的认知活动与较低的孤独感相关。这些发现表明，不仅要考虑认知活动的频率，还要考虑它们的具体特征和质量，这一点可能很重要。

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引用次数: 0